title: Does Nintendo Wii Balance Board improve standing balance? A randomized controlled trial in children with cerebral palsy.
abstract: BACKGROUND
  Evidence on the effect of systemic exercise programs to improve the standing balance with the Nintendo Wii system is very limited and its post-treatment effectiveness is unknown in cerebral palsy (CP) patients.
  
  
  OBJECTIVE
  Primary aim was to compare the effect of Nintendo Wii balance board (Wii-therapy) and standard physiotherapy (SPT), on the performance of standing balance in children and adolescents with CP. Secondary aim was to determine the post-treatment effectiveness of Wii-therapy and SPT.
  
  
  METHODS
  Two-arm, matched-pairs, parallel-groups, randomized, controlled clinical trial.
  
  
  METHODS
  Outpatient Rehabilitation Centre in the city of Talca.
  
  
  METHODS
  Patients with CP type spastic hemiplegia (SHE) and spastic diplegia (SDI), aged 7 to 14 years, and level I or II of GMFCS or GMFCS-ER. Were excluded patients with FSIQ<80, epilepsy, previous surgeries and application of Botulinum Toxin-A in the lower limb, uncorrected vision and hearing disorders.
  
  
  METHODS
  Thirty-two CP patients (10.7±3.2 years old) were randomly assigned to either Wii-therapy (SDI=7; SHE=9) or SPT intervention (SDI=7; SHE=9). In each group, patients received three sessions per week over a period of 6 weeks. Standing balance was assessed at baseline and every 2 weeks. Additionally, two follow-up assessments (4 additional weeks) were performed to determine post-treatment effectiveness. Standing balance was quantified on force platform obtaining the outcomes area of center-of-pressure (CoP) sway (CoPSway), standard deviation in the medial-lateral (SDML) and the anterior-posterior (SDAP) directions, and velocity in both directions (VML and VAP).
  
  
  RESULTS
  Compared to SPT, Wii-therapy significantly reduced the CoPSway (P=0.02) and SDAP in the eyes-open condition (P=0.01). However, the effects wane after 2-4 weeks. Post-hoc analysis revealed that only SHE children benefited from Wii-therapy.
  
  
  CONCLUSIONS
  Wii-therapy was better than SPT in improving standing balance in patients with CP, but improves the balance only in SHE patients. Also, Wii-therapy effectiveness waned 2-4 weeks after the end the intervention.
  
  
  CONCLUSIONS
  A systematic exercise program like Wii-therapy using the Nintendo Wii Balance Board device can be considered to improves the standing balance in patients with CP, specifically in the SHE type. This program is easy to transfer to physiotherapists and rehabilitation centers.
authors.affiliation: Human Motor Control Laboratory, Faculty of Health Sciences, University of Talca, Talca, Chile - vgatica@utalca.cl.
authors.forename: Valeska
authors.initials: V
authors.lastname: Gatica-Rojas
authors.affiliation: Human Motor Control Laboratory, Department of Human Movement Sciences, Faculty of Health Sciences, University of Talca, Talca, Chile.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Méndez-Rebolledo
authors.affiliation: School of Kinesiology, Faculty of Health, University of Santo Tomás, Talca, Chile.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Guzman-Muñoz
authors.affiliation: Institute of Mathematics and Physics, University of Talca, Talca, Chile.
authors.forename: Alex
authors.initials: A
authors.lastname: Soto-Poblete
authors.affiliation: School of Dentistry, University of Concepción, Concepción, Chile.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cartes-Velásquez
authors.affiliation: Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
authors.forename: Edith
authors.initials: E
authors.lastname: Elgueta-Cancino
authors.affiliation: Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia.
authors.forename: L Eduardo
authors.initials: LE
authors.lastname: Cofré Lizama
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001315:Australia; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000534:rehabilitation*; D002648:Child; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018910:Video Games