title: Effectiveness and Limitations of Unsupervised Home-Based Balance Rehabilitation with Nintendo Wii in People with Multiple Sclerosis.
abstract: Balance training represents a critical part of the rehabilitation process of individuals living with multiple sclerosis (MS) since impaired postural control is a distinctive symptom of the disease. In recent years, the use of the Nintendo Wii system has become widespread among rehabilitation specialists for this purpose, but few studies have verified the effectiveness of such an approach using quantitative measures of balance. In this study, we analyzed the postural sway features of a cohort of twenty-seven individuals with MS before and after 5 weeks of unsupervised home-based balance training with the Wii system. Center of pressure (COP) time-series were recorded using a pressure platform and processed to calculate sway area, COP path length, displacements, and velocities in mediolateral (ML) and anteroposterior (AP) directions. Although the results show a significant reduction in sway area, COP displacements, and velocity, such improvements are essentially restricted to the ML direction, as the Wii platform appears to properly stimulate the postural control system in the frontal plane but not in the sagittal one. Available Wii games, although somewhat beneficial, appear not fully suitable for rehabilitation in MS owing to scarce flexibility and adaptability to MS needs and thus specific software should be developed.
authors.affiliation: Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Pau
authors.affiliation: Multiple Sclerosis Centre, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09126 Cagliari, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Coghe
authors.affiliation: Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy ; Multiple Sclerosis Centre, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09126 Cagliari, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Corona
authors.affiliation: Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Leban
authors.affiliation: Multiple Sclerosis Centre, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09126 Cagliari, Italy.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Marrosu
authors.affiliation: Multiple Sclerosis Centre, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09126 Cagliari, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Cocco
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy*; D004856:Postural Balance / Q000502:physiology; D012984:Software; D018910:Video Games