Effect of Wii Fit© Exercise on Balance of Older Adults with Neurocognitive Disorders: A Meta-Analysis

Acceptability of Physical Therapy Combined with Nintendo Ring Fit Adventure Exergame for Geriatric Hospitalized Patients

Geriatric hospitalized patients often experience complications associated with frailty and impaired functioning in activities of daily living. To enhance their functional independence, repetitive and continuous high-frequency exercises are necessary. However, conventional physical therapy (PT) can be monotonous and lead to reduced adherence. The introduction of Nintendo Ring Fit Adventure exergame (EG) as a complement to PT for geriatric inpatients has the potential to improve exercise enjoyment and acceptability. This study aimed to evaluate the acceptability of combining EG with PT for geriatric inpatients. A total of 30 geriatric inpatients were included in the study, receiving EG+PT on day 1 and PT only on day 2. The rate of perceived exertion (RPE) was assessed using the Borg scale, whereas enjoyment, motivation to continue, and perceived effectiveness were evaluated through a questionnaire after each exercise session and subsequently compared. The RPE for the lower extremities and the sense of enjoyment (P = 0.06) were found to be higher after the EG+PT session. The results suggest that combining PT with EG can enhance the enjoyment of exercise sessions and facilitate an increase in the intensity and frequency of exercise therapy. Incorporating EGs into geriatric PT holds promise as an effective strategy to improve patient engagement and adherence to exercise regimens. Further research is warranted to explore the long-term benefits and potential applications of EGs in geriatric rehabilitation settings.

Does physical exercise improve the capacity for independent living in people with dementia or mild cognitive impairment: an overview of systematic reviews and meta-analyses

OBJECTIVE

To summarise existing systematic reviews which assessed the effects of physical exercise on activities of daily living, walking, balance and visual processing in people with dementia or mild cognitive impairment.

METHODS

In this overview of systematic reviews and meta-analyses, seven electronic databases were searched to identify eligible reviews published between January 2015 and April 2021.

RESULTS

A total of 30 systematic reviews were identified and included in the overview. The most frequent type of exercise for the intervention group was multimodal exercises. Mind-body exercises, exergames, dance intervention and aerobic exercise were other exercise types. Most of the reviews reported that exercise is significantly effective for improving activities of daily living (SMD 95%CI, from 0.27 to 1.44), walking (SMD 95%CI, from 0.08 to 2.23), balance (SMD 95%CI, from 0.37 to 2.24) and visuospatial function (SMD 95%CI, from 0.16 to 0.51), which are among the most leading determinants of independent living in individuals with dementia or mild cognitive impairment.

CONCLUSION

Evidence has shown that exercise (especially multicomponent exercise programmes including cognitive, physical and multitasking exercises) with sufficient intensity improves the activities of daily living skills. Exercise also improves walking, balance and visual processing, which can provide a more independent life for people with dementia and mild cognitive impairment. Cognitively impaired people should therefore be encouraged to exercise regularly in order to be more independent.

Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2019192.

Benefits of Virtual Reality Program and Motor Imagery Training on Balance and Fall Efficacy in Isolated Older Adults: A Randomized Controlled Trial

Background and Objectives: for isolated older adults, alternative training indoors to maintain balance is essential; however, related studies are lacking. To improve the balance of isolated older adults and reduce their fear of falling, we aimed to examine the balance−keeping effect of a virtual reality (VR) program and motor imagery training (MIT) and propose training that could improve physical activity among older adults. Methods: a total of 34 older adults admitted to a convalescent hospital were assessed. VR (n = 12) and MIT (n = 10) groups completed their assigned intervention in six weeks, whereas the control group (CG) (n = 12) did not. The follow−up was performed after two weeks. Results: in group × time interactions, body center movement area, open and closed eyes balance scores, and fall efficacy were significantly different (p < 0.05). In contrast with the VR group, the MIT group did not show a significant difference in the open or closed eyes balance scores depending on the period. However, there was a significant difference between the MIT group and CG in the open eyes balance score post-test (d = 1.13, 95% confidence interval, 0.40−12.33). Conclusions: we propose VR and MIT as training methods to prevent physical weakness in isolated older adults.

Effectiveness of Nintendo Wii on Balance in People with Parkinson's Disease: A Systematic Review

The use of exergaming exercises is increasingly becoming accepted as an alternative to surgical and medical therapies for Parkinson's disease (PD). Although the area has attracted some results, there is still no conclusive evidence on the benefit of exergaming exercises in improving PD patients' body balance. The current study is a systematic review aiming at examining the effectiveness of the Nintendo Wii Fit ("Wii Fit") game on improving the balance in people with Parkinson's disease. A total of 200 articles were selected online after conducting an extensive search on PubMed, Cochrane, PEDro, CAPES Periodic, ResearchGate, Web of Science, and ProQuest. Upon reviewing the identified sources, ten articles were included, of which four were randomized control trials. The results show that at least five weeks of Wii Fit exercises effectively enhance PD patients' body balance and life outcomes. However, better results occur when patients combine Wii Fit with other conventional exercises.

Effect of Wii Fit Exercise With Balance and Lower Limb Muscle Strength in Older Adults: A Meta-Analysis

Background

Falls and fall-related injuries are not uncommon among older adults and may lead to serious health deterioration and decreased quality of life. Numerous types of physical activity have been proposed to improve balance and strength in older adults with varying degrees of success. Nintendo's Wii Fit video exergame uses body movement as a game controller and provides real-time feedback for games designed to enhance balance and muscle strength. However, whether Wii Fit exercise improves the balance and lower limb muscle strength of older adults remains uncertain.

Objective

To evaluate the current literature by using meta-analyses to assess whether Wii Fit exercise is associated with improved balance and lower limb muscle strength in older adults.

Methods

We searched PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data from inception to February 16, 2022, for relevant studies and conducted a manual search of the literature. Data extraction of the included studies were independently performed by two authors. The methodologic quality of each included study was assessed using the Physical Therapy Evidence Database (PEDro) scale. Meta-analyses were conducted using Review Manager 5.3.

Results

Of 991 articles initially identified, 10 articles (379 participants; aged ≥65 years, range 65–92 years; 188 participants in Wii Fit exercise groups, and 191 participants in control groups), including 8 randomized controlled trials, were assessed in this meta-analysis. The methodologic quality of the included studies evaluated with the PEDro average score was 6.4 and ranged from 5 to 8 points, indicating moderate quality. Compared with no exercise, Wii Fit exercise was associated with significant improved scores on the Berg Balance Scale, which evaluates functional balance (mean difference, 1.38; 95% CI, 0.61–2.16; I² = 31%; P = 0.0005) and on the Timed Up and Go test, which evaluates static and dynamic balance (standardized mean difference, −0.51; 95% CI,−0.88 to −0.14; I² = 52%; P = 0.007). However, for the three studies assessed, Wii Fit exercise did not significantly improve scores on the 30-s chair stand test, which evaluates the functional strength and endurance of the lower limb muscles (mean difference, 0.82; 95% CI, −0.14 to 1.77; z = 1.68; P = 0.09).

Conclusions

Our findings indicated that Wii Fit exercise is an effective approach to improve functional, static, and dynamic balance among older adults. Additional meta-analyzes with higher numbers of randomized controlled trials are suggested to confirm the benefits of Wii Fit exercise on balance in older adults, to establish whether functional strength and endurance of lower limb muscles are improved, and to explore the relationship between improved balance and fall prevention in this population.

[Exergames to promote physical activity and mobility in inpatient long-term nursing-An overview]

Maintaining and promoting mobility is a key objective and central goal of nursing care. Active video games or so-called exergames can also be used for this purpose. In the group of older people some studies showed indications of positive effects with respect to mobility. In this article the focus is on studies that examined the use of exergames for the purpose of maintaining or promoting physical activity and mobility in the setting of long-term inpatient nursing. In summary, a literature search in databases indicated that individual studies on this topic found indications of positive effects: however, the informative value of the results is limited due to their heterogeneity and small samples.

The effect of video game-based training on postural control during gait initiation in community-dwelling older adults: a randomized controlled trial

PURPOSE

The aim was to investigate the effect of video game training as compared to dual-task training on gait initiation (GI) which is a sensitive indicator of balance deficiency in older adults.

METHOD

Sixty-six older adults were allocated to the video game-based training (intervention group) or the motor-cognitive dual-task training (active control group). The outcome measures were the mediolateral (ML)/anteroposterior (AP) displacement and velocity of COP during the phases of GI (anticipatory, weight transition, and locomotor).

RESULTS

The results indicated in the anticipatory phase, the ML & AP COP displacement were significantly increased at post-training relative to pre-training across both groups (p < 0.041). In the weight transition phase, the AP COP displacement & ML COP velocity were significantly increased at post-training than pre-training (p < 0.032). However, in the locomotor phase, within the intervention group, the ML COP displacement & ML COP velocity were significantly increased at follow-up as compared to pre-training (p < 0.05), while no such differences were observed within the control group.

CONCLUSION

Both treatments were effective in improving COP trajectory during the phases of anticipatory and weight transition, while the intervention group was more effective during the phase of locomotor. So, these treatments can be recommended for clinical settings.Implications for rehabilitationThe video game and dual task training were effective in improving COP trajectory during the phases of anticipatory and weight transition.The video game-based training was more effective during the phase of locomotor.The study findings could have useful implications to further introduce cognition-based rehabilitation programs such as video games for older adults.Rehabilitation professionals could use the video game to improve the postural control of older adults.