Wii-fit for improving gait and balance in an assisted living facility: a pilot study

Kalpana P Padala, Prasad R Padala, Timothy R Malloy, Jenenne A Geske, Patricia M Dubbert, Richard A Dennis, Kimberly K Garner, Melinda M Bopp, William J Burke, Dennis H Sullivan, Kalpana P Padala, Prasad R Padala, Timothy R Malloy, Jenenne A Geske, Patricia M Dubbert, Richard A Dennis, Kimberly K Garner, Melinda M Bopp, William J Burke, Dennis H Sullivan

Abstract

Objectives. To determine the effects on balance and gait of a Wii-Fit program compared to a walking program in subjects with mild Alzheimer's dementia (AD). Methods. A prospective randomized (1 : 1) pilot study with two intervention arms was conducted in an assisted living facility with twenty-two mild AD subjects. In both groups the intervention occurred under supervision for 30 minutes daily, five times a week for eight weeks. Repeated measures ANOVA and paired t-tests were used to analyze changes. Results. Both groups showed improvement in Berg Balance Scale (BBS), Tinetti Test (TT) and Timed Up and Go (TUG) over 8 weeks. However, there was no statistically significant difference between the groups over time. Intragroup analysis in the Wii-Fit group showed significant improvement on BBS (P = 0.003), and TT (P = 0.013). The walking group showed a trend towards improvement on BBS (P = 0.06) and TUG (P = 0.07) and significant improvement in TT (P = 0.06). Conclusion. This pilot study demonstrates the safety and efficacy of Wii-Fit in an assisted living facility in subjects with mild AD. Use of Wii-Fit resulted in significant improvements in balance and gait comparable to those in the robust monitored walking program. These results need to be confirmed in a larger, methodologically sound study.

Figures

Figure 1
Figure 1
Subject recruitment and participation.
Figure 2
Figure 2
Comparison of mean change in BBS* between the Wii-Fit and walking groups. *BBS: Berg Balance Scale; Data points represent means and error bars represent ±2 SEM.

References

    1. Weller I, Schatzker J. Hip fractures and Alzheimer’s disease in elderly institutionalized Canadians. Annals of Epidemiology. 2004;14(5):319–324.
    1. Wittwer JE, Andrews PT, Webster KE, Menz HB. Timing variability during gait initiation is increased in people with Alzheimer’s disease compared to controls. Dementia and Geriatric Cognitive Disorders. 2008;26(3):277–283.
    1. Allan LM, Ballard CG, Burn DJ, Kenny RA. Prevalence and severity of gait disorders in Alzheimer’s and non-Alzheimer’s dementias. Journal of the American Geriatrics Society. 2005;53(10):1681–1687.
    1. Webster KE, Merory JR, Wittwer JE. Gait variability in community dwelling adults with Alzheimer disease. Alzheimer Disease and Associated Disorders. 2006;20(1):37–40.
    1. Howe TE, Rochester L, Jackson A, Banks PM, Blair VA. Exercise for improving balance in older people. Cochrane Database of Systematic Reviews. 2007;17(4):p. CD004963.
    1. Hiroyuki S, Uchiyama Y, Kakurai S. Specific effects of balance and gait exercises on physical function among the frail elderly. Clinical Rehabilitation. 2003;17(5):472–479.
    1. DeVito CA, Morgan RO, Duque M, Abdel-Moty E, Virnig BA. Physical performance effects of low-intensity exercise among clinically defined high-risk elders. Gerontology. 2003;49(3):146–154.
    1. Belza B, Walwick J, Shiu-Thornton S, Schwartz S, Taylor MLJ. Older adult perspectives on physical activity and exercise: voices from multiple cultures. Preventing Chronic Disease. 2004;1(4) .
    1. Dubbert PM, Morey MC, Kirchner KA, Meydrech EF, Grothe K. Counseling for home-based walking and strength exercise in older primary care patients. Archives of Internal Medicine. 2008;168(9):979–986.
    1. Nintendo. Nintendo’s New Wii-Fit Makes Fitness Fun. 2008, .
    1. Muir SW, Berg K, Chesworth B, Speechley M. Use of the Berg Balance Scale for predicting multiple falls in community-dwelling elderly people: a prospective study. Physical Therapy. 2008;88(4):449–459.
    1. Tinetti ME, Franklin Williams T, Mayewski R. Fall risk index for elderly patients based on number of chronic disabilities. American Journal of Medicine. 1986;80(3):429–434.
    1. Podsiadlo D, Richardson S. The timed “Up and Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142–148.
    1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. The Journal of the American Medical Association. 1963;185:914–919.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186.
    1. Logsdon RG, Gibbons LE, McCurry SM, Teri L. Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine. 2002;64(3):510–519.
    1. Folstein MF, Folstein SE, P. R. McHugh. Mini-Mental State: a practical method for grading the state of patients for the clinician. Journal of Psychiatric Research. 1975;12:189–198.
    1. Agmon M, Perry CK, Phelan E, Demiris G, Nguyen HQ. A pilot study of wii-Fit exergames to improve balance in older adultz. Journal of Geriatric Physical Therapy. 2011;34(4):161–167.
    1. Dougherty J, Kancel A, Ramar C, Meacham C, Derrington S. The effects of a multi-axis balance board intervention program in an elderly population. Missouri medicine. 2011;108(2):128–132.
    1. Williams MA, Soiza RL, Jenkinson AM, Stewart A. EXercising with C-omputers in L-ater L-ife (EXCELL)—pilot and feasibility study of the acceptability of the Nintendo® Wii-Fit in community-dwelling fallers. BMC Research Notes. 2010;3, article 238
    1. Brandt K, Paniagua MA. The use of Nintendo Wii with long-term care residents. Journal of the American Geriatrics Society. 2011;59(12):2393–2395.
    1. Yamaguchi H, Maki Y, Takahashi K. Rehabilitation for dementia using enjoyable video-sports games. International Psychogeriatrics. 2010;23(4):674–667.
    1. Nintendo Wii-Fit Plus, 2011,
    1. Thorbahn LDB, Newton RA. Use of the Berg balance test to predict falls in elderly persons. Physical Therapy. 1996;76(6):576–585.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi