title: Home-based balance training using the Wii balance board: a randomized, crossover pilot study in multiple sclerosis.
abstract: OBJECTIVE
  To evaluate the effectiveness of a home-based rehabilitation of balance using the Nintendo Wii Balance Board System (WBBS) in patients affected by multiple sclerosis (MS).
  
  
  METHODS
  In this 24-week, randomized, 2-period crossover pilot study, 36 patients having an objective balance disorder were randomly assigned in a 1:1 ratio to 2 counterbalanced arms. Group A started a 12-week period of home-based WBBS training followed by a 12-week period without any intervention; group B received the treatment in reverse order. As endpoints, we considered the mean difference (compared with baseline) in force platform measures (i.e., the displacement of body center of pressure in 30 seconds), 4-step square test (FSST), 25-foot timed walking test (25-FWT), and 29-item MS Impact Scale (MSIS-29), as evaluated after 12 weeks and at the end of the 24-week study period.
  
  
  RESULTS
  The 2 groups did not differ in baseline characteristics. Repeated-measures analyses of variance showed significant time × treatment effects, indicating that WBBS was effective in ameliorating force platform measures (F = 4.608, P = .016), FSST (F = 3.745, P = .034), 25-FWT (F = 3.339, P = .048), and MSIS-29 (F = 4.282, P = .023). Five adverse events attributable to the WBSS training (knee or low back pain) were recorded, but only 1 patient had to retire from the study.
  
  
  CONCLUSIONS
  A home-based WBBS training might potentially provide an effective, engaging, balance rehabilitation solution for people with MS. However, the risk of WBBS training-related injuries should be carefully balanced with benefits. Further studies, including cost-effectiveness analyses, are warranted to establish whether WBBS may be useful in the home setting.
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University, Rome, Italy. luca.prosperini@uniroma1.it
authors.forename: Luca
authors.initials: L
authors.lastname: Prosperini
authors.forename: Deborah
authors.initials: D
authors.lastname: Fortuna
authors.forename: Costanza
authors.initials: C
authors.lastname: Giannì
authors.forename: Laura
authors.initials: L
authors.lastname: Leonardi
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Marchetti
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzilli
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D004185:Disability Evaluation; D004311:Double-Blind Method; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000534:rehabilitation; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D057566:Self Report; D012678:Sensation Disorders / Q000209:etiology* / Q000534:rehabilitation*; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome; D018910:Video Games; D055815:Young Adult
keywords: Wii Balance Board; balance; crossover trial; multiple sclerosis; neurorehabilitation; static posturography; visual feedback