Videogaming as a Diagnostic Tool for Fall Risk

The Nintendo Wii, a videogame console that detects the user’s motion in gameplay, has been used in community centers and residences as a way to encourage physical activity. A group of researchers hypothesized that the Wii and its sensors might serve as a diagnostic tool as well. In a study, the Wii Fit Balance Board, which has sensors that detect shifts in movement by the user atop it, measured the movement of two groups of older adults: a group of subjects who reported a fall in the previous year and a group who hadn’t.

Because the Wii Fit program requires the user to tend to both their own movement and the game system itself, the researchers conjecture that it’s a useful proxy for the context of most falls: dual tasking, when individuals are performing two tasks at the same time. The researchers hypothesized that individuals who hadn’t suffered a fall would perform better on the Wii balance board than those who had. Ideally, a cutoff point of balance board performance could be established, and individuals below the cutoff could be targeted for balance and other physical activity interventions.

Forty-five subjects participated in the study, 16 who reported a fall in the previous year and 28 who hadn’t. There were no statistically significant differences between the fall and non-fall groups in age, weight, height, body mass index (BMI) or Rapid Dementia Screening Test (RDST) scores. Subjects played two Wii Fit games: a basic stepping game and a ski slalom balance game, both of which were performed in a sitting position. Five physical performance tests were administered using the two games, which included a count of steps taken in a 10-meter walk and what is called the timed up-and-go (TUG) test, which is often used to assess balance and gait for falls risk assessment.

The researchers found a significant difference between the fall and non-fall groups in the number of steps taken. The researchers were able to identify a cutoff point on this task as well that indicated a risk for falling. The availability of a user-friendly, entertaining system creates the potential for an effective program for both diagnosis and targeted exercise.

Source:

Yamada M, Aoyama T, Nakamura M, Tanaka B, Nagai K, Tatematsu N, Uemura K, Nakamura T, Tsuboyama T, Ichihashi N (2011). “The Reliability and Preliminary Validity of Game-Based Fall Risk Assessment in Community-Dwelling Older Adults.” Geriatric Nursing, in press.

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