Using the Wii Fit as a tool for balance assessment and neurorehabilitation: the first half decade of "Wii-search"

Daniel J Goble, Brian L Cone, Brett W Fling, Daniel J Goble, Brian L Cone, Brett W Fling

Abstract

The Nintendo Wii Fit was released just over five years ago as a means of improving basic fitness and overall well-being. Despite this broad mission, the Wii Fit has generated specific interest in the domain of neurorehabilitation as a biobehavioral measurement and training device for balance ability. Growing interest in Wii Fit technology is likely due to the ubiquitous nature of poor balance and catastrophic falls, which are commonly seen in older adults and various disability conditions. The present review provides the first comprehensive summary of Wii Fit balance research, giving specific insight into the system's use for the assessment and training of balance. Overall, at the time of the fifth anniversary, work in the field showed that custom applications using the Wii Balance Board as a proxy for a force platform have great promise as a low cost and portable way to assess balance. On the other hand, use of Wii Fit software-based balance metrics has been far less effective in determining balance status. As an intervention tool, positive balance outcomes have typically been obtained using Wii Fit balance games, advocating their use for neurorehabilitative training. Despite this, limited sample sizes and few randomized control designs indicate that research regarding use of the Wii Fit system for balance intervention remains subject to improvement. Future work aimed at conducting studies with larger scale randomized control designs and a greater mechanistic focus is recommended to further advance the efficacy of this impactful neurorehabilitation tool.

Figures

Figure 1
Figure 1
Growth in Wii Fit Research. From 2011 till the fifth anniversary the number of Wii Fit-balance related papers has shown an exponential increase [1,2,4-42].
Figure 2
Figure 2
Representative COPx (A) and COPy (B) data for the force plate and WBB over the course of an example 20 s static balance trial. Pearson Correlation between the two signals is r = 0.99.
Figure 3
Figure 3
Group sizes for Wii Fit Interventions. A majority of Wii Fit intervention studies have utilized group sizes of 10 participants or less. [1,2,4,7,10,14,15,17-19,21,22,27-31,34,36].
Figure 4
Figure 4
Wii Fit Intervention Dosing Parameters. Box and whisker plots representing the 95th percentile (whiskers), interquartile range (box), mean (black circle) and median (black line) data for the various dosing parameters of Wii Fit interventions [1,2,4,7,10,15,17-19,21,22,27-31,34,36].

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