Elsevier

Gait & Posture

Volume 33, Issue 2, February 2011, Pages 303-305
Gait & Posture

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Assessing and training standing balance in older adults: A novel approach using the ‘Nintendo Wii’ Balance Board

https://doi.org/10.1016/j.gaitpost.2010.10.089Get rights and content

Abstract

Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo ‘Wii Balance Board’ (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.

Introduction

Each year 30–60% of older adults fall, and 10–20% of these falls result in either significant injury or mortality [1]. Although considerable efforts have been made to develop means of identifying and rehabilitating factors that predispose individuals to an increased risk of falling, there is still a need to develop new safe ways of engaging older adults in balance based training on a regular basis. The current article proposes a new solution that exploits WBB technology, to provide a safe, low-cost, engaging, balance training solution for older adults, particularly those at risk of falling.

The WBB is predominantly used in combination with its associated gaming console. A recent study, however, has shown that older adults have difficulty playing existing games, often finding the level too advanced [3]. Although these existing balance based games were not designed to train balance in older adults, the benefits of WBB technology can still be exploited. A recent study reported how changes in COP derived from the WBB signals post hoc were very similar to those obtained from a typical force plate [2]. These results, along with good test–retest reliability provide a general validation of the WBB as a means of monitoring COP. By designing an interface that retrieves information from the WBB and displays the resulting COP as real-time visual feedback, we wanted to see if functional balance training games can be developed specifically for an older adult population.

Section snippets

Materials: description of interface

The WBB contains four transducers that provide information relating to force distribution. The wireless communication protocol normally used to exchange commands and data between the WBB and the games console is well known and thus any computer with appropriate software can be configured to use the data from WBB sensors. Virtools 4.0 (Dassault Systems) provided the monitoring and data processing environment, in addition to rendering the virtual environment and presenting graphical feedback to

Applications

Clark et al. [2] suggested that the WBB might provide clinicians with a low-cost tool to assess standing balance. Our interface provides the next step; a novel method to design and deliver balance training tasks that require the use of visual feedback to control COP. Our interface also provides the potential to easily reproduce many of the validated tasks used in diagnosing balance impairments, such as testing limits of stability and functional reach tests [5], [6], movement in COP both with

Acknowledgements

This work was supported by a Seed Grant (Changing Ageing Partnership) and a European Research Council grant (TEMPUS_G; 21007).
Conflict of interest statement

All authors confirm there are no known conflicts of interest.

References (7)

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