Thesis (M.S.)--Boston University / OBJECTIVE: The aim of this research study was to see if Nintendo Wii Fit is better able to improve balance in the elderly population when compared to the Matter of Balance program, which is evidence.-based and designed to promote health, balance and wellbeing to decrease the risk of falls. PARTICIPANTS: Residents of an independent living senior housing facility in the Boston area were recruited to participate in this study. A total of 32 residents ages 63 to 90 participated: Wii Fit n=11, Matter of Balance n=11, and Control n=1O. Methods: Participants were separated into three groups. Experimental group 1: The Wii Fit Group performed balance games on the Wii Fit in individual sessions twice a week for three weeks. Experimental group 2: The Matter of Balance Group performed exercises from the Matter of Balance Program in a group setting twice a week for three weeks. The control group received no intervention. Participants in the Wii Fit group had the addition of supplemental home exercises. Two balance and one health and wellness measure were used to determine whether there were any changes following intervention: the Berg Balance Scale, the Tinetti Gait and Balance Assessment, and the Short Form-36 Health Survey (SF-36). RESULTS: Repeated measures ANOV As were used to determine whether there was an effect of the interventions on balance, health and well-being and whether there were any differences between intervention groups. Scores were significantly improved at post-test for both balance assessments: Berg Balance Scale (F1,29= 17.034, p < 0.001); Tinetti Gait and Balance Assessment (F1,29 = 9.715, p < 0.004). The mean increases in balance scores were larger, but not significantly so, for the exercise groups as compared to the control group. Results from the Wii Fit Enjoyment Questionnaire showed that 81% of participants reported high levels of enjoyment while playing the Wii games. DISCUSSION AND CONCLUSION: The Wii Fit is an enjoyable form of exercise as self-reported from an elderly population. Balance improved in the Wii Fit group following intervention, but only a small amount and not significantly more than improvements made by the MOB-exercise and non-exercise control groups. It is likely that the three week duration of the Wii Fit intervention was too short a period to make a large and significant impact on elders' balance.

abstract: Sustaining a fall can be hazardous for those with low bone mass. Interventions exist to reduce fall-risk, but may not retain long-term interest. "Exergaming" has become popular in older adults as a therapy, but no research has been done on its preventative ability in non-clinical populations. The purpose was to determine the impact of 12-weeks of interactive play with the Wii Fit® on balance, muscular fitness, and bone health in peri- menopausal women. METHODS: 24 peri-menopausal-women were randomized into study groups. Balance was assessed using the Berg/FICSIT-4 and a force plate. Muscular strength was measured using the isokinetic dynamometer at 60°/180°/240°/sec and endurance was assessed using 50 repetitions at 240°/sec. Bone health was tracked using dual-energy x-ray absorptiometry (DXA) for the hip/lumbar spine and qualitative ultrasound (QUS) of the heel. Serum osteocalcin was assessed by enzyme immunoassay. Physical activity was quantified using the Women's Health Initiative Physical Activity Questionnaire and dietary patterns were measured using the Nurses' Health Food Frequency Questionnaire. All measures were repeated at weeks 6 and 12, except for the DXA, which was completed pre-post. RESULTS: There were no significant differences in diet and PA between groups. Wii Fit® training did not improve scores on the Berg/FICSIT-4, but improved center of pressure on the force plate for Tandem Step, Eyes Closed (p-values: 0.001-0.051). There were no significant improvements for muscular fitness at any of the angular velocities. DXA BMD of the left femoral neck improved in the intervention group (+1.15%) and decreased in the control (-1.13%), but no other sites had significant changes. Osteocalcin indicated no differences in bone turnover between groups at baseline, but the intervention group showed increased bone turnover between weeks 6 and 12. CONCLUSIONS: Findings indicate that WiiFit® training may improve balance by preserving center of pressure. QUS, DXA and osteocalcin data confirm that those in the intervention group were experiencing more bone turnover and bone formation than the control group. In summary, twelve weeks of strength /balance training with the Wii Fit® shows promise as a preventative intervention to reduce fall and fracture risk in non-clinical middle aged women who are at risk. / Dissertation/Thesis / Ph.D. Exercise and Wellness 2014

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in finding ways to improve balance in seniors, the high incidence of falls continues to plague this demographic. Many of the current treatments to improve balance are too expensive, not accessible, or not motivating for seniors. This research project explored the effect of using a readily available video-game system to address these barriers. The Wii Fit gaming system was used with participants three times each week for 30 minutes and the resulting changes were documented. The Berg Balance Scale and Timed Up and Go test, both frequently used by professionals to assess balance in seniors, were used to document balance change. Every participant showed improvement. The Activities-specific Balance Confidence scale, which is used to measure a person's fear of falling, was also used to assess the participant's confidence in their balance as well as the level of fear associated with falling. The results of this test were positive but not to the extent of the balance tests. Finally, each participant was interviewed to assess how easy to use the participants felt the Wii Fit was as well as the motivational qualities of the Wii Fit as a balance tool. Answers given by the participants in the interview were generally positive. These results indicate that the Wii Fit gaming system may be beneficial for improving balance in seniors.

Seniors are a growing segment of the population of the United States. By 2030 they will make up nearly 20% of the general population. Senior citizens face many health challenges as they age. Injury due to falling is a major concern for many in this age group. Research shows that approximately one third of seniors will fall each year. Injuries that result from falls have been identified as the number one cause of accidental death in this age group each year. While falls have been studied by researchers for a number of years, and some progress has been made in finding ways to improve balance in seniors, the high incidence of falls continues to plague this demographic. Many of the current treatments to improve balance are too expensive, not accessible, or not motivating for seniors. This research project explored the effect of using a readily available video-game system to address these barriers. The Wii Fit gaming system was used with participants three times each week for 30 minutes and the resulting changes were documented. The Berg Balance Scale and Timed Up and Go test, both frequently used by professionals to assess balance in seniors, were used to document balance change. Every participant showed improvement. The Activities-specific Balance Confidence scale, which is used to measure a person's fear of falling, was also used to assess the participant's confidence in their balance as well as the level of fear associated with falling. The results of this test were positive but not to the extent of the balance tests. Finally, each participant was interviewed to assess how easy to use the participants felt the Wii Fit was as well as the motivational qualities of the Wii Fit as a balance tool. Answers given by the participants in the interview were generally positive. These results indicate that the Wii Fit gaming system may be beneficial for improving balance in seniors.

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.

No description available.

The purpose of this study was to assess the performance, ratings of perceived exertion, metabolic responses, and energy expenditure as individuals participated in interactive video game play. There were 14 participants that participated in the study, whose age was 20.1 ± 1.64 years of age. Participants completed a maximal aerobic test to exhaustion (VO2max test), and then 30 minute testing session on both the Kinect Adventures (K) and Wii Fit Plus game. Data were analyzed using a dependent t-test and one-way ANOVA. Significance was accepted at P ≤ 0.05. Energy expenditure and RPE were significant in both exergames interactive game play P=0.044 and P < 0.05, respectively. In addition, heart rate (P=0.001) and performance during exergame play P=0.00015 were of significance in the Xbox Kinect and Wii Fit Plus. In conclusion, we found that individuals participating on the exergame Xbox Kinect expends more calories and work at a higher intensity than the Wii Fit Plus, thus justifying an alternative way to participate in physical activity via exergames. As an alternative way to exercise, individuals can meet the daily requirements of energy expenditure of moderate intensity, which is 150-400 kcals.

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.

No description available.

No description available.