Effect of Nintendo Wii™-based motor and cognitive training on activities of daily living in patients with Parkinson's disease: a randomised clinical trial.
OBJECTIVE
To investigate the effect of Nintendo Wii™-based motor cognitive training versus balance exercise therapy on activities of daily living in patients with Parkinson's disease.


METHODS
Parallel, prospective, single-blind, randomised clinical trial.


METHODS
Brazilian Parkinson Association.


METHODS
Thirty-two patients with Parkinson's disease (Hoehn and Yahr stages 1 and 2).


METHODS
Fourteen training sessions consisting of 30 minutes of stretching, strengthening and axial mobility exercises, plus 30 minutes of balance training. The control group performed balance exercises without feedback or cognitive stimulation, and the experimental group performed 10 Wii Fit™ games.


METHODS
Section II of the Unified Parkinson's Disease Rating Scale (UPDRS-II).


METHODS
Participants were randomised into a control group (n=16) and an experimental group (n=16) through blinded drawing of names.


METHODS
Repeated-measures analysis of variance (RM-ANOVA).


RESULTS
Both groups showed improvement in the UPDRS-II with assessment effect (RM-ANOVA P<0.001, observed power=0.999). There was no difference between the control group and the experimental group before training {8.9 [standard deviation (SD) 2.9] vs 10.1 (SD 3.8)}, after training [7.6 (SD 2.9) vs 8.1 (SD 3.5)] or 60 days after training [8.1 (SD 3.2) vs 8.3 (SD 3.6)]. The mean difference of the whole group between before training and after training was -0.9 (SD 2.3, 95% confidence interval -1.7 to -0.6).


CONCLUSIONS
Patients with Parkinson's disease showed improved performance in activities of daily living after 14 sessions of balance training, with no additional advantages associated with the Wii-based motor and cognitive training. Registered on http://www.clinicaltrials.gov (identifier: NCT01580787).
São Paulo University, São Paulo, Brazil. j.e.pompeu@usp.br
José Eduardo
JE
Pompeu
Felipe Augusto Dos Santos
FA
Mendes
Keyte Guedes da
KG
Silva
Alexandra Modenesi
AM
Lobo
Tatiana de Paula
Tde P
Oliveira
Andrea Peterson
AP
Zomignani
Maria Elisa Pimentel
ME
Piemonte
D000203:Activities of Daily Living; D000368:Aged; D003071:Cognition; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D010300:Parkinson Disease / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities; D004856:Postural Balance; D011446:Prospective Studies; D016037:Single-Blind Method; D016896:Treatment Outcome; D014584:User-Computer Interface; D018910:Video Games