Advertisement

Effectiveness of Exergaming Training in Reducing Risk and Incidence of Falls in Frail Older Adults With a History of Falls

Published:September 07, 2015DOI:https://doi.org/10.1016/j.apmr.2015.08.427

      Abstract

      Objective

      To use Nintendo's Wii Fit balance board to determine the effectiveness of exergaming training in reducing risk and incidence of falls in older adults with a history of falls.

      Design

      Randomized controlled trial.

      Setting

      Nursing home for older adults.

      Participants

      Adults aged 65 years and older (N=60).

      Interventions

      Participants who lived in a nursing home had 6 weeks of balance training with either Wii Fit equipment or conventional exercise.

      Main Outcome Measures

      Physiological Profile Assessment scores and incidence of falls were observed with subsequent intention-to-treat statistical analyses.

      Results

      Physiological Profile Assessment scores and incidence of falls improved significantly in both groups after the intervention (all P<.01), but participants in the Wii Fit training group showed a significantly greater improvement in both outcome measures (P=.004 and P<.001, respectively).

      Conclusions

      In institutionalized older adults with a history of falls, Wii Fit balance training was more effective than conventional balance training in reducing the risk and incidence of falls.

      Keywords

      List of abbreviations:

      FAC (Functional Ambulation Category), PPA (Physical Profile Assessment), RCT (randomized controlled trial)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Hong Kong Census and Statistics Department 2008, Aging Population. Available at: http://www3.news.gov.hk/isd/ebulletin/en/category/administration/070222/html/070222en01005.htm. Accessed April 25, 2012.

      2. World Health Organization 2010, Falls fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs344/en/index.html. Accessed April 25, 2012.

        • Nevitt M.C.
        • Cummings S.R.
        • Kidd S.
        • Black D.
        Risk factors for recurrent nonsyncopal falls: a prospective study.
        JAMA. 1989; 261: 2663-2668
        • Tinetti M.E.
        • Williams C.S.
        The effect of falls and fall injuries on functioning in community-dwelling older persons.
        J Gerontol A Biol Sci Med Sci. 1998; 53: M112-M119
        • Vellas B.
        • Cayla F.
        • Bocquet H.
        • de Pemille F.
        • Albarede J.L.
        Prospective study of restriction of activity in old people after falls.
        Age Ageing. 1987; 16: 189-193
        • Tinetti M.E.
        • Williams C.S.
        Falls, injuries due to falls, and the risk of admission to a nursing home.
        N Engl J Med. 1997; 337: 1279-1284
        • Luukinen H.
        • Koski K.
        • Hiltunen L.
        • Kivelä S.-L.
        Incidence rate of falls in an aged population in Northern Finland.
        J Clin Epidemiol. 1994; 47: 843-850
        • Rubenstein L.Z.
        • Josephson K.R.
        • Robbins A.S.
        Falls in the nursing home.
        Ann Intern Med. 1994; 121: 442-451
        • Ibrahim J.E.
        • Murphy B.J.
        • Bugeja L.
        • Ranson D.
        Nature and extent of external-cause deaths of nursing home residents in Victoria, Australia.
        J Am Geriatr Soc. 2015; 63: 954-962
        • Gillespie L.D.
        • Robertson M.C.
        • Gillespie W.J.
        • et al.
        Interventions for preventing falls in older people living in the community.
        Cochrane Database Syst Rev. 2012; 9: CD007146
        • Cameron I.D.
        • Murray G.R.
        • Gillespie L.D.
        • et al.
        Interventions for preventing falls in older people in nursing care facilities and hospitals.
        Cochrane Database Syst Rev. 2010; : CD005465
        • Riva G.
        • Rizzo A.
        • Alpini D.
        • et al.
        Virtual environments in the diagnosis, prevention, and intervention of age-related diseases: a review of VR scenarios proposed in the EC VETERAN Project.
        Cyberpsychol Behav. 1999; 2: 577-591
        • Schultheis M.T.
        • Rizzo A.A.
        The application of virtual reality technology for rehabilitation.
        Rehabil Psychol. 2001; 46: 296-311
        • Betker A.L.
        • Szturm T.
        • Moussavi Z.K.
        • Nett C.
        Video game-based exercises for balance rehabilitation: a single-subject design.
        Am J Phys Med Rehabil. 2006; 87: 1141-1149
        • Flynn S.
        • Palam P.
        • Bender A.
        Feasibility of using the Sony PlayStation 2 gaming platform for an individual poststroke: a case report.
        J Neurol Phys Ther. 2007; 31: 180-189
        • Merians A.S.
        • Jack D.
        • Boian R.
        • et al.
        Virtual reality-augmented rehabilitation for patients following stroke.
        Phys Ther. 2002; 82: 898-915
        • Laufer Y.
        • Dar G.
        • Kodesh E.
        Does a Wii-based exercise program enhance balance control of independently functioning older adults? A systematic review.
        Clin Interv Aging. 2014; 9: 1803-1813
        • Van Diest M.
        • Lamoth C.J.C.
        • Stegenga J.
        • Verkerke G.J.
        • Postema K.
        Exergaming for balance training of elderly: state of the art and future developments.
        J Neuroeng Rehabil. 2013; 10: 101
        • Hung J.W.
        • Hung J.W.
        • Chou C.X.
        • et al.
        Randomized comparison trial of balance training by using exergaming and conventional weight-shift therapy in patients with chronic stroke.
        Arch Phys Med Rehabil. 2014; 95: 1629-1637
        • Kramer A.
        • Dettmers C.
        • Gruber M.
        Exergaming with additional postural demands improves balance and gait in patients with multiple sclerosis as much as conventional balance training and leads to high adherence to home-based balance training.
        Arch Phys Med Rehabil. 2014; 95: 1803-1809
        • Carter N.D.
        • Khan K.M.
        • McKay H.A.
        • et al.
        Community-based exercise program reduces risk factors for falls in 65- to 75-year-old women with osteoporosis: randomized controlled trial.
        CMAJ. 2002; 167: 997-1004
        • Campbell A.J.
        • Robertson M.C.
        • Gardner M.M.
        • Norton R.N.
        • Tilyard M.W.
        • Buchner D.M.
        Randomised controlled trial of a general practice programme of home based exercise to prevent falls in elderly women.
        BMJ. 1997; 315: 1065-1069
        • Lord S.R.
        • Menz H.B.
        • Tiedemann A.
        A physiological profile approach to fall risk assessment and prevention.
        Phys Ther. 2003; 83: 237-252
        • Verbaken J.
        Population norms for edge contrast sensitivity.
        Am J Optom Physiol Opt. 1986; 63: 724-732
        • Clark R.
        • Kraemer T.
        Clinical use of Nintendo Wii™ bowling simulation to decrease fall risk in an elderly resident of a nursing home: a case report.
        J Geriatr Phys Ther. 2009; 32: 174-180
        • Hakim R.M.
        • Salvo C.J.
        • Balent A.
        • Keyasko M.
        • McGlynn D.
        Case report: a balance training program using the Nintendo Wii Fit to reduce fall risk in an older adult with bilateral peripheral neuropathy.
        Physiother Theory Pract. 2015; 31: 130-139
        • Rendon A.A.
        • Lohman E.B.
        • Thorpe D.
        • Johnson E.G.
        • Medina E.
        • Bradley B.
        The effect of virtual reality gaming on dynamic balance in older adults.
        Age Ageing. 2012; 41: 549-552
        • Jorgensen M.G.
        • Laessoe U.
        • Hendriksen C.
        • Nielsen O.B.
        • Aagaard P.
        Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial.
        J Gerontol A Biol Sci Med Sci. 2013; 68: 845-852
        • Cone B.L.
        • Levy S.S.
        • Goble D.J.
        Wii Fit exer-game training improves sensory weighting and dynamic balance in healthy young adults.
        Gait Posture. 2015; 41: 711-715
        • Sohlberg M.M.
        • Mateer C.A.
        Cognitive rehabilitation: an integrative neuropsychological approach.
        Guilford, New York2001
        • Rizzo A.A.
        • Bowerly T.
        • Buckwalter J.G.
        • et al.
        Virtual environments for the assessment of attention and memory processes: the virtual classroom and office.
        in: Sharkey P. Lanyi C.S. Standen P. Proceedings of the 4th International Conference on Disability, Virtual Reality and Associated Technology; 2002; Vresprem, Hungary. University of Reading, Reading2002: 3-12