Bakgrund: Fall hos äldre är vanligt förekommande. Regelbunden balansträning krävs för att bibehålla och förbättra balansförmågan. En persons self-efficacy och utfallsförväntningar spelar roll för om träningen blir av eller inte då många äldre inte tränar på grund av att de inte tror sig få ut något av det. Nintendo Wii Fit är ett modernt sätt att träna balansförmågan på. Syfte: Syftet var att undersöka om Nintendo Wii Fit har effekt på balansförmågan, self-efficacy till balansförmågan i hemmet, utfallsförväntningar på balansförmågan av balansträningen samt fallrelaterad self-efficacy hos tre hemmaboende personer över 70 år under och efter tre veckor interventionsperiod. Metod: Experimentell single-case design A-B-A2 användes. Interventionen bestod av balansträning med Nintendo Wii Fit tre gånger i veckan under tre veckor. Kontinuerliga skattningar av personernas self-efficacy till balansförmågan och utfallsförväntningar för balansträning pågick genom A-B-A2. Andra variabler som utvärderades var balansförmåga (Bergs balansskala) och fallrelaterad self-efficacy (FES(S)). Resultat: Resultatet visade tendenser på att balansträning med Nintendo Wii Fit hade en positiv påverkan balansförmågan, fallrelaterad self-efficacy, self-efficacy för balansförmågan i hemmet samt utfallsförväntningar på balansförmågan av balansträningen. Slutsats: Mer forskning inom området behövs innan några säkra slutsatser om effekten på balansförmågan av Nintendo Wii Fit på individnivå kan göras. / Background: Elderly people relatively often fall. Regular balance training is required to maintain and improve balance ability. A person's self-efficacy and outcome expectations may affect whether he or she perform the exercises or not. Many older persons do not exercise because of lack of confidence. Nintendo Wii Fit can be a modern way to increase confidence and balance ability. Objective: The objective was to investigate whether the Nintendo Wii Fit has an effect on the balance ability, the person's self-efficacy in their balance ability in a home environment, a person's outcome expectations of balance ability from balance training with the Nintendo Wii Fit and fall-related self-efficacy of three individuals ages over 70 years at their homes. The study was conducted during and after a three-week long intervention period. Method: An experimental single-case design A-B-A2 was used. The intervention included balance training with Nintendo Wii Fit three times a week over a three-week long period. Continuous monitoring of the participants self-efficacy in balance ability and outcome expectations of the balance training was performed at all phases. Other evaluated variables were balance (Berg balance scale) and fall-related self-efficacy (FES (S)). Results: The results shows tendencies that balance training with Nintendo Wii Fit has a positive effect for the three participants regarding balance ability, fall-related self-efficacy, self-efficacy for balance ability in the home and outcome expectations of balance ability by balance training. Conclusion: More research is needed in this area before any firm conclusions about the effect on individual level regarding balance ability by balance training with the Nintendo Wii Fit can be made.

Purpose: To assess if a balance retraining program using the NintendoTM Wii Fit: 1) can improve balance, gait, and quality of life in ambulatory individuals with incomplete spinal cord injury (iSCI), 2) can improve standing tolerance in individuals with iSCI, 3) requires individuals to work outside of their limits of stability, 4) can determine if there is a relationship between changes in standing balance measures and the RAND Short Form 36 (RAND SF-36) health measure, 5) can determine if there is a change in postural stability, control, and adaptation to the virtual reality (VR) environment. Problem Statement: There are no studies to date on the effects of an intensive virtual reality balance training program on gait, balance, or quality of life in the iSCI population. Relevance: There is a need for continued research to support effective treatment techniques in individuals with iSCI to maximize each individual's potential. Subjects: Five males with a mean age of 58.6 years who had an iSCI greater than one year post injury. Inclusion: 1) iSCI, 2) ambulate with or without assistive devices, AFOs, and no greater than minimal assistance for a minimum of 10 meters, 3) tolerate static standing for at least 5 minutes at a time with no greater than minimal assistance. Exclusion: 4 Significant orthopedic impairments, pain or a spinal stabilization device that may limit standing or ambulation. Methods: A repeated measures design with three pretests over three weeks, a post-test within one week of the intervention, and a four week follow up. Outcome measures: 10 meter walk test (10MWT), Timed Up and Go (TUG), Forward Functional Reach Test (FFRT) and Lateral Functional Reach Test (LFRT), RAND SF-36. Intervention consisted of one hour sessions with varied games using the Nintendo Wii Fit twice per week for seven weeks. Subjects' subjective reports were collected during the intervention phase. Survey data was also collected at post-test. Results: There were statistically significant changes found in FFRT that were clinically meaningful (Z = -1.84, p = 0.07; average change scores 8.00 centimeters). The changes were also maintained at the four week follow up post-test. Subject reports suggested improvements in balance, endurance, and mobility with daily tasks at home. There was a high correlation between the change scores of the TUG and the RAND SF-36 (r=0.90). Discussion: The training using the NintendoTM Wii Fit improved balance in all five individuals with iSCI. There was an increase in standing during the intervention with decrease in rests. VR training practices task specific training of standing balance. Further research is needed to assess different gaming options to focus on task specific training of gait and mobility.

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