The effects of Wii Fit rhythmic stepping exercise on stepping ability and gait performance in community-dwelling older adults

Abstract

Background and purposes: Balance and gait deterioration are the most common risk factors of falling in the elderly population Falls often occur in complex dividing attention task situation Therefore the ability to modulate attention may play an important role in overcoming real-life situation Besides stepping ability is one of the balance strategies to against fall which is affected by aging and balance impairment A next-generation exergame “Nintendo Wii Fit” is popular in many families Previous studies have shown that Wii Fit has several benefits and it may be an effective way to improve stepping ability and dual task capability while walking Nevertheless none of the previous studies has investigated the effects of Wii Fit rhythmic stepping exercise on stepping ability and dual task ability during walking The purposes of this study were to investigate whether the Wii Fit rhythmic stepping exercise program would improve stepping ability gait performance and dual task performance of walking in community-dwelling older adults Additionally we would like to examine the training effects of Wii Fit on physical test concern of falling and executive function Methods: Older adults were recruited from local community in Tainan Participants received clinical evaluation stepping task on 2 force platforms and 3-D gait analysis with a dual task paradigm Stroop test and manual task were chosen as the secondary tasks during walking After baseline measure individuals were randomly divided into Wii Fit (WF) group or control group and the WF group received a 4-week period intervention Three-way ANOVA with repeated measures on time and task factors were used to analyze the gait spatiotemporal parameters and secondary task performance between 2 groups Two-way ANOVA with repeated measure were used to analyze step ability Results: After 4 weeks of training durations of anticipatory postural adjustments (APAs) phase decreased for stepping forward (p<0125) For both stepping forward and backward variability of peak COPAP displacement during APAs phase reduced after the WF training (all p<0125) Although change in gait speed of the WF group during performing manual task was larger than single and cognitive tasks it did not reach the significant level WF group had significant improvement in overall balance performance (p<025) executive function and muscle strength of right hip flexors and extensors after training (p<0125) Conclusion: The WF training showed benefits on stepping ability of older adults with shortened their preparation time and more stable APA amplitudes The WF training also had positive impacts on balance performance muscle strength of lower limbs and executive function However the effect of WF training on dual task capability of walking was not obvious after 4 weeks training Therefore Wii Fit rhythmic stepping exercise has shown effects on balance control and health promotion It might be an appropriate training program for fall prevention in community-dwelling older adults For further study the training period could be extended and the training effect on dual task capability of walking might become apparent

Date of Award	2014 Jan 21
Original language	English
Supervisor	Chiung-Yu Cho (Supervisor)