Balance Rehabilitation in Multiple Sclerosis: A Comparison of Conventional Training with Nintendo® Wii Fit Game Play
Dr. Maureen Dunn, Hope College
Dr. Kirk Brumels, Hope College
Balance and gait disturbances are commonly observed, but poorly managed, in individuals with multiple sclerosis (MS). This pilot study compared the effects of Nintendo® Wii FitTM game play (WII), conventional balance training (TRAD), and control (CON) on balance and mobility outcomes among home-dwelling persons with MS. Nineteen female and 6 male MS patients (mean age: 45.3±8.8 years) with self-reported balance deficits underwent clinical assessment using the Berg Balance Scale (BBS) before (0 weeks, PRE) and after 3 weeks of supervised balance training sessions (MID) and again after 9 weeks of at-home training (POST). Participants further completed questionnaires regarding balance confidence (ABC), walking ability (MSWS-12) and fatigue (MFIS). All training was 3 sessions per week for 30 minutes per session. Compliance varied substantially between individuals for at-home training, but was 100% for supervised training. Effect sizes from PRE to MID and PRE to POST testing were calculated for each group and outcome measure to demonstrate magnitude of change. Following supervised training, both training protocols had greater effects on BBS scores than CON (d’=-0.43), with TRAD (d’=0.84) having a larger effect than WII (d’=0.60). These effects remained following at-home training. PRE to POST effect sizes for BBS scores were as follows: CON, d’= 0.08; TRAD, d’=1.08; WII, d’= 0.75. Questionnaires showed similar trends with effect sizes from PRE to POST for ABC (d’=0.15, 1.02 and 0.34), MSWS-12 (d’=-0.34, 0.35 and 0.27) and MFIS (d’=-0.92, 0.45 and -0.04) for CON, TRAD and WII, respectively. Results suggest that balance rehabilitation training using WII and TRAD may both be effective in improving balance, confidence, perceived walking ability, and fatigue when compared to CON, with TRAD being potentially more effective than WII for this subset of individuals with MS.
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