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| Does Nintendo Wii Balance Board improve standing balance? A randomised controlled trial in children with cerebral palsy [with consumer summary] |
| Gatica-Rojas V, Mendez-Rebolledo G, Guzman-Munoz E, Soto-Poblete A, Cartes-Velasquez R, Elgueta-Cancino E, Cofre Lizama E |
| European Journal of Physical and Rehabilitation Medicine 2017 Aug;53(4):535-544 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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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. AIM: 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. DESIGN: Two-arm, matched-pairs, parallel-groups, randomized, controlled clinical trial. SETTING: Outpatient Rehabilitation Centre in the city of Talca. POPULATION: 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 centre-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 to 4 weeks. Post hoc analysis revealed that only SHE children benefited from Wii-therapy. CONCLUSION: 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 to 4 weeks after the end the intervention.
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