title: Efficacy of Nintendo Wii training on mechanical leg muscle function and postural balance in community-dwelling older adults: a randomized controlled trial.
abstract: BACKGROUND
  Older adults show increased risk of falling and major risk factors include impaired lower extremity muscle strength and postural balance. However, the potential positive effect of biofeedback-based Nintendo Wii training on muscle strength and postural balance in older adults is unknown.
  
  
  METHODS
  This randomized controlled trial examined postural balance and muscle strength in community-dwelling older adults (75±6 years) pre- and post-10 weeks of biofeedback-based Nintendo Wii training (WII, n = 28) or daily use of ethylene vinyl acetate copolymer insoles (controls [CON], n = 30). Primary end points were maximal muscle strength (maximal voluntary contraction) and center of pressure velocity moment during bilateral static stance.
  
  
  RESULTS
  Intention-to-treat analysis with adjustment for age, sex, and baseline level showed that the WII group had higher maximal voluntary contraction strength (18%) than the control group at follow up (between-group difference = 269 N, 95% CI = 122; 416, and p = .001). In contrast, the center of pressure velocity moment did not differ (1%) between WII and CON at follow-up (between-group difference = 0.23 mm(2)/s, 95% CI = -4.1; 4.6, and p = .92). For secondary end points, pre-to-post changes favoring the WII group were evident in the rate of force development (p = .03), Timed Up and Go test (p = .01), short Falls Efficacy Scale-International (p = .03), and 30-second repeated Chair Stand Test (p = .01). Finally, participants rated the Wii training highly motivating at 5 and 10 weeks into the intervention.
  
  
  CONCLUSIONS
  Biofeedback-based Wii training led to marked improvements in maximal leg muscle strength (maximal voluntary contraction; rate of force development) and overall functional performance in community-dwelling older adults. Unexpectedly, static bilateral postural balance remained unaltered with Wii training. The high level of participant motivation suggests that biofeedback-based Wii exercise may ensure a high degree of compliance to home- and/or community-based training in community-dwelling older adults.
authors.affiliation: Department of Geriatrics, Aalborg University Hospital, Hobrovej 18-22, DK-9000 Aalborg, Denmark. Martin.joergensen@rn.dk
authors.forename: Martin G
authors.initials: MG
authors.lastname: Jorgensen
authors.forename: Uffe
authors.initials: U
authors.lastname: Laessoe
authors.forename: Carsten
authors.initials: C
authors.lastname: Hendriksen
authors.forename: Ole Bruno Faurholt
authors.initials: OB
authors.lastname: Nielsen
authors.forename: Per
authors.initials: P
authors.lastname: Aagaard
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D001676:Biofeedback, Psychology; D004311:Double-Blind Method; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D061826:Foot Orthoses; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D007866:Leg; D008297:Male; D053580:Muscle Strength; D011145:Polyvinyls; D004856:Postural Balance; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D011145:Polyvinyls; C016438:ethylenevinylacetate copolymer