title: Novel use of the Nintendo Wii board as a measure of reaction time: a study of reproducibility in older and younger adults.
abstract: BACKGROUND
  Reaction time (RT) has been associated with falls in older adults, but is not routinely tested in clinical practice. A simple, portable, inexpensive and reliable method for measuring RT is desirable for clinical settings. We therefore developed a custom software, which utilizes the portable and low-cost standard Nintendo Wii board (NWB) to record RT. The aims in the study were to (1) explore if the test could differentiate old and young adults, and (2) to study learning effects between test-sessions, and (3) to examine reproducibility.
  
  
  METHODS
  A young (n = 25, age 20-35 years, mean BMI of 22.6) and an old (n = 25, age ≥65 years, mean BMI of 26.3) study-population were enrolled in this within- and between-day reproducibility study. A standard NWB was used along with the custom software to obtain RT from participants in milliseconds. A mixed effect model was initially used to explore systematic differences associated with age, and test-session. Reproducibility was then expressed by Intraclass Correlation Coefficients (ICC), Coefficient of Variance (CV), and Typical Error (TE).
  
  
  RESULTS
  The RT tests was able to differentiate the old group from the young group in both the upper extremity test (p < 0.001; -170.7 ms (95%CI -209.4; -132.0)) and the lower extremity test (p < 0.001; -224.3 ms (95%CI -274.6; -173.9)). Moreover, the mixed effect model showed no significant learning effect between sessions with exception of the lower extremity test between session one and three for the young group (-35,5 ms; 4.6%; p = 0.02). A good within- and between-day reproducibility (ICC: 0.76-0.87; CV: 8.5-12.9; TE: 45.7-95.1 ms) was achieved for both the upper and lower extremity test with the fastest of three trials in both groups.
  
  
  CONCLUSIONS
  A low-cost and portable reaction test utilizing a standard Nintendo wii board showed good reproducibility, no or little systematic learning effects across test-sessions, and could differentiate between young and older adults in both upper and lower extremity tests.
authors.affiliation: Department of Geriatrics, Aalborg University Hospital, Hobrovej 18-22, DK-9000, Aalborg, Denmark. mgj@rn.dk.
authors.forename: Martin Gronbech
authors.initials: MG
authors.lastname: Jorgensen
authors.affiliation: Department of Geriatrics, Aalborg University Hospital, Hobrovej 18-22, DK-9000, Aalborg, Denmark. sparam10@student.aau.dk.
authors.forename: Sentha
authors.initials: S
authors.lastname: Paramanathan
authors.affiliation: Department of Geriatrics, Odense University Hospital, Odense, Denmark. Jesper.Ryg@rsyd.dk.|Institute of Clinical Research, University of Southern Denmark, Odense, Denmark. Jesper.Ryg@rsyd.dk.
authors.forename: Jesper
authors.initials: J
authors.lastname: Ryg
authors.affiliation: Health care for Older People, Nottingham University Hospital NHS Trust, Nottingham, Notts, UK. Tahir.Masud@nuh.nhs.uk.
authors.forename: Tahir
authors.initials: T
authors.lastname: Masud
authors.affiliation: Department of Geriatrics, Aalborg University Hospital, Hobrovej 18-22, DK-9000, Aalborg, Denmark. stiga@dadlnet.dk.|Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. stiga@dadlnet.dk.
authors.forename: Stig
authors.initials: S
authors.lastname: Andersen
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D005121:Extremities / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D018794:Problem-Based Learning / Q000379:methods; D011930:Reaction Time / Q000502:physiology*; D015203:Reproducibility of Results; D018910:Video Games