Wii Fit^TM balance games produce beneficial training effects in older adults

The Nintendo Wii Fit gaming system has become increasingly popular for use in balance training and potentially fall prevention in older adults. However, it is unclear how games designed primarily for younger adults transfer to this population, both in terms of acceptability and efficacy.

Purpose: The goal of this investigation was to examine balance, physical function, and perceptions about video games after short-term exposure to Wii Fit games requiring different levels of physical and cognitive challenge.

Methods: Fifteen healthy older adults (8 women, 7 men: age = 75.9 6 5.3 yrs, BMI = 27.2 6 6.2 kg/m2 [mean 6 SD]) with neither balance disorders nor video game familiarity visited the laboratory on four separate occasions within a twoweek period. Subjects were guided through creating a Wii Fit character and learned how to use the system on the first visit, playing the Penguin Slide and Table Tilt games briefly. During the remaining three visits subjects played Balance Bubble, Soccer Heading, Obstacle Course, and Tilt City in randomized 10 min. blocks separated by a rest period. The games had been selected from a menu of games based on a task analysis and required the ankle and hip strategy, foot movement, and dual task performance (upper and lower extremities), respectively. Prior to being exposed to the system and at the end of the 4th visit subjects were tested for balance, physical function, and perceptions about video games.

Results: At the end of the study, subjects significantly improved their 3 m Timed Up and Go (10.6 6 1.6 vs 9.8 6 1.4 s, p = 0.005) and 4-Square Step Test performances (8.1 6 2.3 vs 6.9 6 1.2 s, p = 0.006). From the questionnaires about video games, initial Comfort and Interest were low compared to Efficacy. However, all categories showed significant improvement (p , 0.05) with medium to large effect sizes (Cohen’s d = 0.70–1.04). Correlations between physical function and perceptions about video games were not significant during the initial visit, at the end, or in terms of the differences in scores pre-to-post (p . 0.05).

Conclusions: Although any major conclusions from this pilot study are limited due to the small sample size, limited duration of the exposure, and the high level of functioning of the subjects, there are some preliminary conclusions that may be drawn. First, the use of Wii Fit balance games may be suitable to improve balance and physical function and, hence, may have potential as a modality for delivering fall prevention training for older adults. Second, while some older adults may have reservations about video games, the experiences with the Wii Fit were generally positive. Third, improvements in physical function appear to be independent of perceptions about video games, suggesting additional potential for adoption as an intervention modality.

Practical Applications: Even short duration exposure to Wii Fit balance games may have beneficial training effects for older adults and could therefore be included as a component of an overall frailty prevention program.

Acknowledgments: Funded by the Colorado State University Center on Aging.