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Shin S, Wuensche B. What type of exercises should older adults engage in to improve fall efficacy and physical fitness related to falling? J Exerc Rehabil 2023; 19:198-207. [PMID: 37662531 PMCID: PMC10468295 DOI: 10.12965/jer.2346276.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/18/2023] [Indexed: 09/05/2023] Open
Abstract
This study aimed to examine the effects of exercise interventions developed over the past 10 years to prevent falls among older adults. Cochrane, PubMed, and Embase databases were systematically searched on November 3, 2022, using the following keywords: "elderly" or "aged" and "fall prevention exercise" and "randomized controlled trial." A total of 918 articles were retrieved, and finally, 18 studies were included in the meta-analysis. main conclusions were as follows: fall prevention exercises showed moderately positive effects on balance, gait, mobility, physical function, lower limb power, and strength, but low effects on proprioception, vision, and reaction speed. The effect sizes were highest when the intervention period was 1-24 weeks, time was 31-60 min, and frequency was thrice per week. Place of intervention (home, community, laboratory) and age (>75 years, <75 years) showed similarly moderate effect sizes. A combined program that includes balance, co-ordination, and resistance exercises is appropriate to improve fall-related fitness and fall efficacy in community-dwelling older individuals.
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Affiliation(s)
- Sohee Shin
- School of Exercise and Sport Science, University of Ulsan, Ulsan,
Korea
| | - Burkhard Wuensche
- Department of Computer Science, University of Auckland, Auckland,
New Zealand
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Khan MJ, Kannan P, Wong TWL, Fong KNK, Winser SJ. A Systematic Review Exploring the Theories Underlying the Improvement of Balance and Reduction in Falls Following Dual-Task Training among Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16890. [PMID: 36554771 PMCID: PMC9778940 DOI: 10.3390/ijerph192416890] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Balance impairment causes frequent falls in older adults, and preventing falls remains challenging. Dual-task (DT) training reduces falls by improving balance, but the precise theory is not fully understood. This review aims to explore the theories underlying the effectiveness of DT in improving balance and reducing falls in older adults. METHODS Eleven electronic databases were searched from database inception to June 2022. Two reviewers independently performed study screening and data extraction. The risk of bias (RoB) in the included studies was assessed using the Cochrane Collaboration RoB 2 tool. RESULTS The searches yielded 1478 citations, of which 30 studies met the inclusion criteria and were included in the review. Twenty-two of the 30 included studies utilized the motor-cognitive type of DT for training, while six used motor-motor and two utilized cognitive-cognitive DT. The included studies reported 20 different theories to explain the effectiveness of DT for improving balance and reducing falls in older adults. The predominant theory identified in the included studies was attention theory (n = 14). Overall, 26 studies reported improved balance and five studies found a reduction in fall incidence following DT training. Balance and falls improved significantly in 15 motor-cognitive DT intervention studies. CONCLUSION Attention shifting between two tasks is reported to occur following DT training. Motor-cognitive DT training improves balance and reduces fall incidence in older adults by shifting attention based on the difficulty and priority of a task from the motor to the cognitive task.
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Chen Y, Zhang Y, Guo Z, Bao D, Zhou J. Comparison between the effects of exergame intervention and traditional physical training on improving balance and fall prevention in healthy older adults: a systematic review and meta-analysis. J Neuroeng Rehabil 2021; 18:164. [PMID: 34819097 PMCID: PMC8611920 DOI: 10.1186/s12984-021-00917-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/27/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Physical training (PT, e.g., Tai Chi and strength training) has been demonstrated to improve balance control and prevent falls. Recently, exergame intervention (EI) has emerged to prevent falls by enhancing both physical and cognitive functions in older adults. Therefore, we aim to quantitatively assess and compare the effects of PT and EI on the performance of balance control and fall prevention in healthy older adults via meta-analysis. METHODS A search strategy based on the PICOS principle was used to find the publication in the databases of PubMed, EMBASE, Web of Science, Cochrane Library, and MEDLINE. The quality and risk of bias in the studies were independently assessed by two researchers. RESULTS Twenty studies consisting of 845 participants were included. Results suggested that as compared to PT, EI induced greater improvement in postural control (sway path length, SMD = - 0.66, 95% CI - 0.91 to - 0.41, P < 0.001, I2 = 0%; sway speed, SMD = - 0.49, 95% CI - 0.71 to - 0.27, P < 0.001, I2 = 42%) and dynamic balance (SMD = - 0.19, 95% CI - 0.35 to - 0.03, P = 0.02, I2 = 0%) in healthy older adults. The EI with 90-119 min/week for more than 8-week significantly reduced falls. Subgroup analyses revealed that exergames, which were designed by the two principles of repeatedly performing diversified tasks and gradually increase the difficulty of the task, induced significant effects in improving balance control and falls prevention respectively (P = 0.03, P = 0.009). In addition, intervention that combines EI and PT induced significant improvement in postural control (P = 0.003). CONCLUSION The exergame intervention, especially the combination of EI and PT, is a promising strategy to improve balance control and reduce falls in healthy older adults. Future studies with rigorous design, larger sample size, and follow-up assessments are needed to further assess the effectiveness of diverse exergame interventions in fall prevention and to quantify the "dose-effect" relationship, as well as the carry-over effect of such intervention, which will ultimately help optimize the rehabilitative strategies to improve balance control and prevent falls.
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Affiliation(s)
- Yan Chen
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Yuan Zhang
- Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Zhenxiang Guo
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Junhong Zhou
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, USA
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Wang YH, Liu YH, Yang YR, Wang RY. Effects of square-stepping exercise on motor and cognitive function in older adults - A systematic review and meta-analysis. Geriatr Nurs 2021; 42:1583-1593. [PMID: 34773911 DOI: 10.1016/j.gerinurse.2021.10.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To document the effects of square-stepping exercise (SSE) on motor and cognitive function in older adults. METHODS Five online databases were searched in May 2021. Controlled studies published from 2006 to May 2021 were included. The experimental group received SSE alone or SSE combined with other exercise(s), whereas the control group received no training or other exercise(s). Motor and cognitive outcomes included balance, fall risk, agility, endurance, gait speed, flexibility, muscle strength, reaction time, global cognitive function, memory, and executive function. RESULTS Ten articles with a total of 920 participants were included. Static balance (p=0.0009), dynamic balance (p=0.0008), fall risk (p<0.00001), and agility (p=0.02) improved more in the intervention group than in the control group. However, SSE did not seem to exert beneficial effects on cognitive function. CONCLUSION In older adults, SSE provided beneficial effects on motor function, including static and dynamic balance, risk of falls, and agility. However, positive effects on cognitive function were not observed and require further investigation.
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Affiliation(s)
- Yin-Hsiang Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yun-Hsien Liu
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
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Peric I, Spasic M, Novak D, Ostojic S, Sekulic D. Pre-Planned and Non-Planned Agility in Patients Ongoing Rehabilitation after Knee Surgery: Design, Reliability and Validity of the Newly Developed Testing Protocols. Diagnostics (Basel) 2021; 11:diagnostics11010146. [PMID: 33478145 PMCID: PMC7835766 DOI: 10.3390/diagnostics11010146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Due to its association with the risk of falling and consequent injury, the importance of agility is widely recognized, but no study so far has examined the different facets of agility in an untrained/clinical population. The aim of this study was to evaluate the reliability, validity, and correlates of newly developed tests of non-planned agility (NPA) and pre-planned agility (PPA) in an untrained/clinical sample. Methods: The sample comprised 38 participants older than 40 years (22 females, age: 56.1 ± 17.3 years, height: 170.4 ± 10.8 cm, mass: 82.54 ± 14.79 kg) who were involved in a rehabilitation program following total knee arthroplasty and knee arthroscopy. Variables included age, gender, type of surgery, history of fall, anthropometrics/body composition, and newly developed tests of NPA and PPA. Results: The results showed the high inter-testing- (ICC > 0.95, CV < 9%), and intra-testing-reliability (ICC > 0.96, CV < 9) of the newly developed tests. PPA and NPA were found to be valid in differentiation between age groups (>50 yrs. vs. <50 yrs.), and genders, with better performance in younger participants and males. Only NPA differentiated participants according to type of surgery, with better performance in those who had arthroscopic surgery, than those who had total knee arthroplasty. No differences in NPA and PPA were established between groups based on fall-history. In females, the body mass (Pearson’s r = 0.58 and 0.59, p < 0.001) and body fatness (Pearson’s r = 0.64 and 0.66, p < 0.001) were negatively correlated, while the lean body mass (Pearson’s r = 0.70 and 0.68, p < 0.001) was positively correlated with PPA and NPA. The NPA and PPA were highly correlated (Pearson’s r = 0.98, p < 0.001). Conclusions: We found that the proposed tests are reliable when evaluating agility characteristics in an untrained/clinical population after knee arthroplasty/arthroscopy. Further evaluation of the specific validity of the proposed tests in other specific subsamples is warranted.
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Affiliation(s)
- Ivan Peric
- Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia;
| | - Miodrag Spasic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (M.S.); (D.N.)
| | - Dario Novak
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (M.S.); (D.N.)
- Institute for Anthropological Research, 10000 Zagreb, Croatia
| | - Sergej Ostojic
- Faculty of Sport and Physical Education, University of Novi Sad, 21000 Novi Sad, Serbia;
| | - Damir Sekulic
- Faculty of Kinesiology, University of Split, 21000 Split, Croatia; (M.S.); (D.N.)
- Correspondence:
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Pano-Rodriguez A, Beltran-Garrido JV, Hernandez-Gonzalez V, Reverter-Masia J. Effects of Whole Body Electromyostimulation on Physical Fitness and Health in Postmenopausal Women: A Study Protocol for a Randomized Controlled Trial. Front Public Health 2020; 8:313. [PMID: 32793536 PMCID: PMC7391420 DOI: 10.3389/fpubh.2020.00313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Age-related problems such as chronic diseases, functional limitation and dependence, reduce the quality of life in the elderly, and increase public spending in health. It has been established that physical activity plays a fundamental role in the health of the elderly. The whole body electromyostimulation (WB-EMS) could be a successful methodology as high-intensity training to improve the physical fitness of older people. Methods: A minimum of 13 women between 55 and 70 years old will be randomized in two groups. The exercise with WB-EMS group (EX + WB-EMS) will conduct a resistance strength training program with superimposed WB-EMS while the exercise group (EX) will perform only resistance strength and aerobic training. Balance, strength, flexibility, agility, speed, and aerobic performance (EXERNET battery and progressive resistance test), as well as body composition, blood parameters and physical activity reporting (IPAQ-E) will be assessed to analyze the effects of whole body electromyostimulation in the physical fitness and the health in postmenopausal women. Discussion: Innovative and scientifically well-designed protocols are needed to enhance the knowledge of the body's responses within this training methodology which is being used by a big quantity of population. This trial will provide evidence on the effectiveness of whole-body electromyostimulation in physical fitness and health in elderly women. Trial Registration: ISRCTN15558857 registration data: 27/11/2019 (retrospectively registered).
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Sun Y, Cullen HM, Zehr EP. Harnessing the Power of a Novel Program for Dynamic Balance Perturbation with Supported Body Weight. J Mot Behav 2019; 52:643-655. [PMID: 31608808 DOI: 10.1080/00222895.2019.1670129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Self-initiated postural adjustments commonly occur in daily life. To accessibly measure this type of dynamic balance, we developed a simple computer program to induce virtual perturbations and combined it with a commercially available balance board and portable EMG system to measure resulting self-initiated postural adjustments. When performing perturbed balance tests, safety harness with body weight support (BWS) is often used. However, influences of these harnesses on postural reactions are not well known. This study investigated the sensitivity of our assessment tool under different BWS conditions and muscle responses during postural adjustments following perturbation at different directions. Fifteen neurologically intact participants performed self-initiated postural adjustments under conditions with: (1) no harness; (2) harness with no BWS; and (3) harness with 10% BWS. Postural adjustment time and muscle activities of the lower leg were measured. We observed significant increases in postural adjustment time in the harness with no BWS condition and differneces in lower leg muscles response to virtual perturbation. Our findings suggest that the combination of our customized program with EMG is a sensitive and convenient tool to measure postural adjustments that approximate real-world scenarios. This method can be used with light body weight support to ensure safety without influencing muscle synergies.
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Affiliation(s)
- Yao Sun
- Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discovery (ICORD), Vancouver, BC, Canada
| | - Hilary M Cullen
- Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discovery (ICORD), Vancouver, BC, Canada
| | - E Paul Zehr
- Rehabilitation Neuroscience Laboratory, University of Victoria, Victoria, BC, Canada.,Human Discovery Science, International Collaboration on Repair Discovery (ICORD), Vancouver, BC, Canada.,Division of Medical Science, University of Victoria, Victoria, BC, Canada
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Martínez-Carbonell Guillamón E, Burgess L, Immins T, Martínez-Almagro Andreo A, Wainwright TW. Does aquatic exercise improve commonly reported predisposing risk factors to falls within the elderly? A systematic review. BMC Geriatr 2019; 19:52. [PMID: 30795740 PMCID: PMC6387499 DOI: 10.1186/s12877-019-1065-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 02/13/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND According to the World Health Organization, the elderly are at the highest risk of injury or death from a fall. Age-related changes in strength, balance and flexibility are degenerative factors that may increase the risk of falling, and an aquatic training may offer a favourable environment to improve these modifiable risk factors. METHODS A systematic review was conducted to assess the potential preventative role of aquatic exercise for reducing the risk of falls in the elderly by improving predisposing risk factors. Electronic databases and reference lists of pertinent articles published between 2005 and 2018 were searched. Randomized controlled trials (RCTs) that directly or indirectly addressed the effect of aquatic exercise for the prevention of falls in healthy participants were included within the synthesis. Studies were included if they were reported between January 2005 and May 2018 within a population aged between 60 and 90 years old that were without exercise-effecting comorbidities. Data related to participant demographics, study design, methodology, interventions and outcomes was extracted by one reviewer. Methodological quality assessment was independently performed by two reviewers using the PEDro (Physiotherapy Evidence Database) scale. RESULTS Fourteen trials met the inclusion criteria. Exercise intervention duration and frequency varied from 2 to 24 weeks, from 2 to 3 times per week, from 40 to 90 min per session. Fall rate was not reported in any of the studies analysed. However, aquatic exercise improved key predisposing physical fitness components that are modifiable and internal risk factors for falling. CONCLUSIONS There is limited, low-quality evidence to support the use of aquatic exercise for improving physiological components that are risk factors for falling. Although the evidence is limited, and many interventions are not well described, these results should be considered by health and exercise professionals when making evidence-based, clinical decisions regarding training programmes to reduce the risk of falling.
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Affiliation(s)
- Eduardo Martínez-Carbonell Guillamón
- Faculty of Health Science, Catholic University of Murcia, UCAM, Av. de los Jerónimos, 135, Guadalupe, 30107 Murcia, Spain
- Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB UK
| | - Louise Burgess
- Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB UK
| | - Tikki Immins
- Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB UK
| | - Andrés Martínez-Almagro Andreo
- Faculty of Health Science, Catholic University of Murcia, UCAM, Av. de los Jerónimos, 135, Guadalupe, 30107 Murcia, Spain
| | - Thomas W. Wainwright
- Orthopaedic Research Institute, Bournemouth University, 6th Floor, Executive Business Centre, 89 Holdenhurst Road, Bournemouth, BH8 8EB UK
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Thompson CJ, Holskey TH, Wallenrod S, Simunovich S, Corn R. Effectiveness of a Fall Prevention Exercise Program on Falls Risk in Community-Dwelling Older Adults. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2019. [DOI: 10.1249/tjx.0000000000000078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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10
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Bohrer RCD, Pereira G, Beck JK, Lodovico A, Rodacki ALF. Multicomponent Training Program with High-Speed Movement Execution of Ankle Muscles Reduces Risk of Falls in Older Adults. Rejuvenation Res 2018; 22:43-50. [PMID: 29911496 DOI: 10.1089/rej.2018.2063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The purpose of this study was to investigate the effects of multicomponent training program, designed to improve the torque around the ankle joint performing high-speed movement execution, on healthy older adults. Participants were balanced by torque around the ankle joint and randomly allocated to either exercise (n = 12, 69.7 ± 4.8 years, 74.6 ± 16.8 kg, 1.63 ± 0.10 m) or control group (CG) (n = 14, 70.86 ± 6.48 years; 73.5 ± 13.4 kg, 1.56 ± 0.05 m). The exercise group (EG) performed a multicomponent training of resistance, agility, and coordination exercises, focusing on the plantar flexor muscles during 12 weeks (3 days per week). Outcome measures were torque (plantar flexion and extension), reactive capacity (Step test), and functional mobility (gait and timed up and go [TUG] test). The training program was induced to increase peak torque of extensor muscles around the ankle joint to EG (Δ = 50%; d = 1.59) compared to the CG. Such improvement was converted to reactive capacity improvements considering the decrease in the execution time of the Swing phase and in the Total time of the Step test (Δ = 19%; d = 0.93, Δ = 14%; d = 1.02, respectively). Gains in functional mobility were verified by the increase of the walking speed (Δ = 15%; d = 1.37) and by the smaller time of execution of TUG test (Δ = 17%; d = 1.73) in the EG. Therefore, the multicomponent training was effective to reduce or to reverse muscular age-related declines, which are associated with functional capacity and reduction of fall risk in older adults.
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Affiliation(s)
- Roberta Castilhos Detanico Bohrer
- 1 Department of Physical Education, Federal University of Paraná, Curitiba, Brazil.,2 Physical Education, Universidade Positivo, Curitiba, Brazil
| | - Gleber Pereira
- 1 Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Joice Katiane Beck
- 1 Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
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Can Driving-Simulator Training Enhance Visual Attention, Cognition, and Physical Functioning in Older Adults? J Aging Res 2018; 2018:7547631. [PMID: 29593908 PMCID: PMC5821998 DOI: 10.1155/2018/7547631] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 11/30/2017] [Accepted: 01/10/2018] [Indexed: 11/18/2022] Open
Abstract
Virtual reality offers a good possibility for the implementation of real-life tasks in a laboratory-based training or testing scenario. Thus, a computerized training in a driving simulator offers an ecological valid training approach. Visual attention had an influence on driving performance, so we used the reverse approach to test the influence of a driving training on visual attention and executive functions. Thirty-seven healthy older participants (mean age: 71.46 ± 4.09; gender: 17 men and 20 women) took part in our controlled experimental study. We examined transfer effects from a four-week driving training (three times per week) on visual attention, executive function, and motor skill. Effects were analyzed using an analysis of variance with repeated measurements. Therefore, main factors were group and time to show training-related benefits of our intervention. Results revealed improvements for the intervention group in divided visual attention; however, there were benefits neither in the other cognitive domains nor in the additional motor task. Thus, there are no broad training-induced transfer effects from such an ecologically valid training regime. This lack of findings could be addressed to insufficient training intensities or a participant-induced bias following the cancelled randomization process.
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Caña-Pino A, Apolo-Arenas MD, Moral-Blanco J, De la Cruz-Sánchez E, Espejo-Antúnez L. A novel determination of energy expenditure efficiency during a balance task using accelerometers. A pilot study. Assist Technol 2017; 31:61-67. [DOI: 10.1080/10400435.2017.1358775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Alejandro Caña-Pino
- Medical Surgical-Therapy Department, Universidad de Extremadura Facultad de Medicina, Badajoz, Spain
| | | | - Javier Moral-Blanco
- Departamento de Teoría de la Señal e Ingeniería Telemática, Valladolid University, Valladolid, Spain
| | | | - Luis Espejo-Antúnez
- Medical Surgical-Therapy Department, Universidad de Extremadura Facultad de Medicina, Badajoz, Spain
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Blaylock SE, Vogtle LK. Falls prevention interventions for older adults with low vision: A scoping review: Étude de portée sur les interventions visant à prévenir les chutes chez les aînés ayant une basse vision. The Canadian Journal of Occupational Therapy 2017; 84:139-147. [PMID: 28730900 DOI: 10.1177/0008417417711460] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Older adults with low vision are especially vulnerable to falls. There are no comprehensive reviews of fall prevention interventions for older adults with vision loss who live in the community. PURPOSE The aim of this study was to review the evidence regarding community-based falls prevention interventions that appear inclusive of and/or accessible to individuals with low vision. METHOD A scoping review was completed using the framework developed by Arksey and O'Malley, and the charted data were analyzed using sums and percentages and qualitative content analysis. FINDINGS Seventeen publications were selected for this review. The analysis allowed for a thorough description of the types of falls prevention interventions (multiple components, home safety/modification, tai chi, the Alexander Technique, improvement of vision through vision assessment and referral, vision/agility training, and yoga), how each intervention addresses vision impairment, and the relation of results to falls risk. IMPLICATIONS Falls prevention research targeting individuals with visual impairment is limited, and the intervention approaches available may not be effective for older adults with permanent vision loss.
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Paquette MR, Schilling BK, Bravo JD, Peel SA, Li Y, Townsend RJ. Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2017; 88:44-51. [PMID: 27902891 DOI: 10.1080/02701367.2016.1252031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. PURPOSE This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. METHOD Thirty recreationally active young adults (Mage = 22.8 ± 3.1 years; Mheight = 1.71 ± 0.7 m; Mbodymass = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes. Participants had no previous barefoot or minimal-footwear training experience. Dependent variables included change-of-direction test time to completion, Star Excursion Balance Test, and single-leg stability evaluation. Testing was performed at the start of the training program, after 2 weeks, after 4 weeks, and at the end of the training program. RESULTS No group or time interactions were found for any of the dependent variables. Time main effects were observed for the performance measures of change of direction, Star Excursion, and single-leg-with-eyes-open stability evaluation. Participants improved in all 3 tests as early as 2 weeks into the intervention, with improvements continuing through the entire 6-week intervention. CONCLUSIONS The lack of interaction and footwear effects suggests that agility and balance improvements during foot agility training are independent of footwear in a recreationally active young-adult population. Computerized agility training improves change-of-direction and balance performance within 2 weeks of training implementation. Future studies should consider footwear training effects in different populations, including frail older adults and athletes.
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Reed-Jones R, Carvalho L, Sanderson C, Montelpare W, Murray N, Powell D. Examining Changes to Center of Pressure During the First Trials of Wii Gameplay. Games Health J 2016; 6:61-64. [PMID: 28026984 DOI: 10.1089/g4h.2016.0054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Use of the Nintendo Wii™ as a balance assessment and rehabilitation tool continues to grow. One advantage of the Wii is that games can serve as a virtual reality training tool; however, a disadvantage of the Wii is the human-machine interface and the learning effect over multiple trials. The purpose of this study was to assess changes in postural control during Wii gameplay over a series of trials in novice players. MATERIALS AND METHODS Thirty-one university athletes (aged 18-25 years) completed four trials of the Nintendo Wii Fit™ soccer heading (SH) balance game. Center of pressure (COP) was calculated in the anterior-posterior (AP) and medial-lateral (ML) directions for each 70-second time trial at 1000 Hz. COP was assessed using six linear and two nonlinear measures. Repeated measures analysis of variances compared COP measures over the four trials. RESULTS Significant differences in COP magnitude and velocity were found between trials 1 and 2 in the ML direction. No significant effects of trial were found in the AP direction. In contrast, a measure of the overall area of COP using an ellipse method revealed a significant reduction to COP area between trials 3 and 4. No significant differences between trials were observed in nonlinear measures. CONCLUSIONS These results demonstrate how magnitude and velocity measures of COP control stabilize after the first trial of Wii SH game play in novice young adults. As Wii rehabilitation focuses on individuals with balance difficulties, an important consideration when using the game as an assessment tool is that more than four trials may be required to capture learning in these populations. In addition, contrasting results from ellipse measurement methods point to the use of multiple measures for robust description of COP behavior. This work provides understanding of normative postural control responses with further research in clinical populations needed.
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Affiliation(s)
- Rebecca Reed-Jones
- 1 Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island , Charlottetown, Canada
| | - Laura Carvalho
- 1 Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island , Charlottetown, Canada
| | - Chelsey Sanderson
- 1 Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island , Charlottetown, Canada
| | - William Montelpare
- 1 Department of Applied Human Sciences, Faculty of Science, University of Prince Edward Island , Charlottetown, Canada
| | - Nicholas Murray
- 2 School of Health Science & Kinesiology, Georgia Southern University , Statesboro, Georgia
| | - Douglas Powell
- 3 Department of Exercise Science, University of Memphis , Memphis, Tennessee
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Tanaka EH, Santos PFD, Silva MF, Botelho PFFB, Silva P, Rodrigues NC, Gomes MM, Moraes R, Abreu DCCD. The effect of supervised and home based exercises on balance in elderly subjects: a randomized controlled trial to prevent falls. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2016. [DOI: 10.1590/1809-98232016019.150027] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: The aim of the present study was to evaluate the influence of a balance training program on the semi-static balance of elderly persons by comparing a supervised group with individual home-based application. Method: A blinded randomized controlled multi-arm trial was conducted. The elderly individuals were randomized into: Supervised Group (SG; n=18); Domiciliary Group (DG; n=20) and Control Group (CG; n=18). The SG and DG participated in twice weekly training sessions for 10 weeks. A posturography evaluation was performed based on velocity, anterior-posterior (AP) and medial-lateral (ML) medial amplitude variables in firm surface with eyes open (FSEO) and closed (FSEC), tandem stance with eyes open (Tandem EO) and closed (Tandem EC), and single-leg stance (SL) situations. Two-way ANOVA and Tukey's post-hoc were used for parametric data, the Friedman and Wilcoxon post-hoc tests were used for intragroup analysis and the Kruskal-Wallis and Mann-Whitney post-hoc tests were used for intergroup analysis. Results: In intergroup analysis, the DG group showed improvement in body sway in the Tandem EC (velocity and medial amplitude AP) and single-leg stance (medial amplitude ML) situations. The SG showed a decline in the Tandem EO situation in all the variables. In intergroup analysis, the DG showed improvement in the FSEO position (medial amplitude ML), in the Tandem EC position (medial velocity ML), and the single-leg stance position (medial amplitude AP and ML). The SG showed improvement in the FSEO position (medial amplitude ML) and the single-leg stance position (medial amplitude AP), but showed a decline in the FSEO (variable medial velocity AP) and Tandem EO position (medial amplitude AP). Conclusion: The exercises were beneficial for the balance of the elderly individuals, with the DG presenting the best results. REBEC: RBR-3S9M65.
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Morris JN, Howard EP, Steel K, Berg K, Tchalla A, Munankarmi A, David D. Strategies to reduce the risk of falling: Cohort study analysis with 1-year follow-up in community dwelling older adults. BMC Geriatr 2016; 16:92. [PMID: 27129303 PMCID: PMC4851816 DOI: 10.1186/s12877-016-0267-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 04/25/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND According to the CDC, falls rank among the leading causes of accidental death in the United States, resulting in significant health care costs annually. In this paper we present information about everyday lifestyle decisions of the older adult that may help reduce the risk of falling. We pursued two lines of inquiry: first, we identify and then test known mutable fall risk factors and ask how the resolution of such problems correlates with changes in fall rates. Second, we identify a series of everyday lifestyle options that persons may follow and then ask, does such engagement (e.g., engagement in exercise programs) lessen the older adult's risk of falling and if it does, will the relationship hold as the count of risk factors increases? METHODS Using a secondary analysis of lifestyle choices and risk changes that may explain fall rates over one year, we drew on a data set of 13,623 community residing elders in independent housing sites from 24 US states. All older adults were assessed at baseline, and a subset assessed one year later (n = 4,563) using two interRAI tools: the interRAI Community Health Assessment and interRAI Wellness Assessment. RESULTS For the vast majority of risk measures, problem resolution is followed by lower rate of falls. This is true for physical measures such as doing housework, meal preparation, unsteady gait, transferring, and dressing the lower body. Similarly, this pattern is observed for clinical measures such as depression, memory, vision, dizziness, and fatigue. Among the older adults who had a falls risk at the baseline assessment, about 20 % improve, that is, they had a decreased falls rate when the problem risk improved. This outcome suggests that improvement of physical or clinical states potentially may result in a decreased falls rate. Additionally, physical exercise and cognitive activities are associated with a lower rate of falls. CONCLUSIONS The resolution of risk problems and physical and cognitive lifestyle choices are related to lower fall rates in elders in the community. The results presented here point to specific areas, that when targeted, may reduce the risk of falls. In addition, when there is problem resolution for specific clinical conditions, a decreased risk for falls also may occur.
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Affiliation(s)
- John N Morris
- Hebrew SeniorLife, Institute for Aging Research, 1200 Centre Street, Boston, MA, 02131, USA
| | - Elizabeth P Howard
- School of Nursing, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.
| | - Knight Steel
- Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ, 07601, USA
| | - Katherine Berg
- Department of Physical Therapy and Rehabilitation Sciences Institute, University of Toronto, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada
| | - Achille Tchalla
- Geriatric Medicine Department, Limoges University, IFR 145 Geist; EA 6310 HAVAE, CHU Limoges, Limoges, F-87025, France
| | - Amy Munankarmi
- Northeastern University, 360 Huntington Ave, Boston, MA, 02115, USA
| | - Daniel David
- VA Quality Scholar, Geriatrics, Palliative and Extended Care Service, San Francisco Veterans Affairs Medical Center, San Francisco, CA, 94121, USA
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Serchi V, Peruzzi A, Cereatti A, Della Croce U. Use of a Remote Eye-Tracker for the Analysis of Gaze during Treadmill Walking and Visual Stimuli Exposition. BIOMED RESEARCH INTERNATIONAL 2016; 2016:2696723. [PMID: 26904671 PMCID: PMC4745929 DOI: 10.1155/2016/2696723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/14/2015] [Indexed: 11/17/2022]
Abstract
The knowledge of the visual strategies adopted while walking in cognitively engaging environments is extremely valuable. Analyzing gaze when a treadmill and a virtual reality environment are used as motor rehabilitation tools is therefore critical. Being completely unobtrusive, remote eye-trackers are the most appropriate way to measure the point of gaze. Still, the point of gaze measurements are affected by experimental conditions such as head range of motion and visual stimuli. This study assesses the usability limits and measurement reliability of a remote eye-tracker during treadmill walking while visual stimuli are projected. During treadmill walking, the head remained within the remote eye-tracker workspace. Generally, the quality of the point of gaze measurements declined as the distance from the remote eye-tracker increased and data loss occurred for large gaze angles. The stimulus location (a dot-target) did not influence the point of gaze accuracy, precision, and trackability during both standing and walking. Similar results were obtained when the dot-target was replaced by a static or moving 2D target and "region of interest" analysis was applied. These findings foster the feasibility of the use of a remote eye-tracker for the analysis of gaze during treadmill walking in virtual reality environments.
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Affiliation(s)
- V. Serchi
- Information Engineer Unit, POLCOMING Department, University of Sassari, Viale Mancini 5, 07100 Sassari, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy
| | - A. Peruzzi
- Information Engineer Unit, POLCOMING Department, University of Sassari, Viale Mancini 5, 07100 Sassari, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy
| | - A. Cereatti
- Information Engineer Unit, POLCOMING Department, University of Sassari, Viale Mancini 5, 07100 Sassari, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy
| | - U. Della Croce
- Information Engineer Unit, POLCOMING Department, University of Sassari, Viale Mancini 5, 07100 Sassari, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy
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Skjæret N, Nawaz A, Morat T, Schoene D, Helbostad JL, Vereijken B. Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy. Int J Med Inform 2015; 85:1-16. [PMID: 26559887 DOI: 10.1016/j.ijmedinf.2015.10.008] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 10/22/2015] [Accepted: 10/23/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description and discussion of different game technologies, physical functions targeted, and safety issues related to older adults playing exergames. OBJECTIVES This integrative review provides an overview of the technologies and games used, progression, safety measurements and associated adverse events, adherence to exergaming, outcome measures used, and their effect on physical function. METHODS We undertook systematic searches of SCOPUS and PubMed databases. Key search terms included "game", "exercise", and "aged", and were adapted to each database. To be included, studies had to involve older adults aged 65 years or above, have a pre-post training or intervention design, include ICT-implemented games with weight-bearing exercises, and have outcome measures that included physical activity variables and/or clinical tests of physical function. RESULTS Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and intervention designs and mostly focused on community-dwelling healthy older adults. The majority of the studies used commercially available gaming technologies that targeted a number of different physical functions. Most studies reported that they had used some form of safety measure during intervention. None of the studies reported serious adverse events. However, only 21 studies (35%) reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical measures of balance were the most frequently used outcome measures. PEDro scores indicated that most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out of 10. Several studies found positive effects of exergaming on balance and gait, while none reported negative effects. CONCLUSION Exergames show promise as an intervention to improve physical function in older adults, with few reported adverse events. As there is large variability between studies in terms of intervention protocols and outcome measures, as well as several methodological limitations, recommendations for both practice and further research are provided in order to successfully establish exergames as an exercise and rehabilitation tool for older adults.
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Affiliation(s)
- Nina Skjæret
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway.
| | - Ather Nawaz
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway.
| | - Tobias Morat
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933 Cologne, Germany.
| | - Daniel Schoene
- Institute for Biomedicine of Aging, Friedrich-Alexander-University Erlangen-Nuremberg, Koberger Str. 60, 90408 Nuremberg, Germany.
| | - Jorunn Lægdheim Helbostad
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway; Department of Clinical Services, St. Olav University Hospital, PO Box 3250 Sluppen, 7006 Trondheim, Norway.
| | - Beatrix Vereijken
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology PO Box 8905, 7491 Trondheim, Norway.
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No transfer between conditions in balance training regimes relying on tasks with different postural demands: Specificity effects of two different serious games. Gait Posture 2015; 41:774-9. [PMID: 25791870 DOI: 10.1016/j.gaitpost.2015.02.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 12/04/2014] [Accepted: 02/15/2015] [Indexed: 02/02/2023]
Abstract
Despite the increasing use of video games involving whole body movements to enhance postural control in health prevention and rehabilitation, there is no consistent proof that training effects actually transfer to other balance tasks. The present study aimed to determine whether training effects on two different video-game-based training devices were task-specific or could be transferred to either postural control in quiet stance or to performance on the other device. 37 young healthy adults were split into three groups: two intervention groups that trained for 30min on either the Nintendo(®) Wii Fit Balance Board or the MFT Challenge Disc(®) three times per week for 4 weeks and a control group that received no training. All games require participants to control virtual avatars by shifting the center of mass in different directions. Both devices differ in their physical properties. The Balance Board provides a stable surface, whereas the Challenge Disc can be tilted in all directions. Dependent variables were the game scores on both devices and the center of pressure (COP) displacements measured via force plate. At posttest, both intervention groups showed significant increases in performance on the trained games compared to controls. However, there were no relevant transfer effects to performance on the untrained device and no changes in COP path length in quiet stance. These results suggest that training effects on both devices are highly specific and do not transfer to tasks with different postural demands.
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Serchi V, Peruzzi A, Cereatti A, Della Croce U. Tracking gaze while walking on a treadmill: spatial accuracy and limits of use of a stationary remote eye-tracker. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2014:3727-30. [PMID: 25570801 DOI: 10.1109/embc.2014.6944433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inaccurate visual sampling and foot placement may lead to unsafe walking. Virtual environments, challenging obstacle negotiation, may be used to investigate the relationship between the point of gaze and stepping accuracy. A measurement of the point of gaze during walking can be obtained using a remote eye-tracker. The assessment of its performance and limits of applicability is essential to define the areas of interest in a virtual environment and to collect information for the analysis of the visual strategy. The current study aims at characterizing a gaze eye-tracker in static and dynamic conditions. Three different conditions were analyzed: a) looking at a single stimulus during selected head movements b) looking at multiple stimuli distributed on the screen from different distances, c) looking at multiple stimuli distributed on the screen while walking. The eye-tracker was able to measure the point of gaze during the head motion along medio-lateral and vertical directions consistently with the device specifications, while the tracking during the head motion along the anterior-posterior direction resulted to be lower than the device specifications. During head rotation around the vertical direction, the error of the point of gaze was lower than 23 mm. The best accuracy (10 mm) was achieved, consistently to the device specifications, in the static condition performed at 650 mm from the eye-tracker, while point of gaze data were lost while getting closer to the eye-tracker. In general, the accuracy and precision of the point of gaze did not show to be related to the stimulus position. During fast walking (1.1 m/s), the eye-tracker did not lose any data, since the head range of motion was always within the ranges of trackability. The values of accuracy and precision during walking were similar to those resulting from static conditions. These values will be considered in the definition of the size and shape of the areas of interest in the virtual environment.
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Vision and falls: A multidisciplinary review of the contributions of visual impairment to falls among older adults. Maturitas 2013; 75:22-8. [DOI: 10.1016/j.maturitas.2013.01.019] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 01/21/2013] [Indexed: 11/20/2022]
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WiiFit™ Plus balance test scores for the assessment of balance and mobility in older adults. Gait Posture 2012; 36:430-3. [PMID: 22534562 PMCID: PMC3407275 DOI: 10.1016/j.gaitpost.2012.03.027] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 01/30/2012] [Accepted: 03/30/2012] [Indexed: 02/02/2023]
Abstract
The Nintendo Wii™ is becoming an increasingly popular technology for the training and assessment of balance in older adults. Recent studies have shown promising results for its use in fall prevention. However, it is not clear how scores on the WiiFit™ balance games relate to current standardized tests of balance and mobility. The purpose of this study was to evaluate the relationship between WiiFit™ Plus balance tests, and standardized tests of older adult fitness, balance, mobility, self-reported balance confidence, and visual attention and processing. Results from 34 older adult participants indicate that WiiFit™ balance tests do not correlate well with standardized functional balance, mobility and fitness tests. However, the Wii balance score, as measured by the Basic Balance Test of the WiiFit™, does correlate with visual processing speed as measured by the Useful Field of View (UFOV(®)) test. These results indicate that WiiFit™ balance tests may provide advantageous information supplementary to information obtained through standard functional mobility and balance tests; however, caution should be used when using the WiiFit™ balance tests in isolation. Further research is necessary as these technologies become widely used in clinical and home settings for balance training and assessment.
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