Feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit PlusTM for frail older adults: A randomized feasibility clinical trial

Gisele Cristine Vieira Gomes; Maria do Socorro Simões; Sumika Mori Lin; Jéssica Maria Ribeiro Bacha; Larissa Alamino Pereira Viveiro; Eliana Maria Varise; Nelson Carvas Junior; Belinda Lange; Wilson Jacob Filho; José Eduardo Pompeu

doi:10.1016/j.maturitas.2018.10.002

Feasibility, safety, acceptability, and functional outcomes of playing Nintendo Wii Fit Plus^TM for frail older adults: A randomized feasibility clinical trial

Maturitas. 2018 Dec:118:20-28. doi: 10.1016/j.maturitas.2018.10.002. Epub 2018 Oct 4.

Affiliations

¹ Faculty de Medicina FMUSP, Universidade de Sao Paulo, 51 Cipotânea Street, University City, Sao Paulo, SP, Zip Code: 05360-160, Brazil. Electronic address: giselecvgomes@usp.br.
² Faculty de Medicina FMUSP, Universidade de Sao Paulo, 51 Cipotânea Street, University City, Sao Paulo, SP, Zip Code: 05360-160, Brazil. Electronic address: msmpereira@usp.br.
³ Division of Geriatrics, Department of Internal Medicine, University of São Paulo Medical School, 255, Doctor OlívioPires Campos Street, Sao Paulo, SP, Zip Code: 05403-000, Brazil. Electronic address: sumikamorilin@usp.br.
⁴ School of Medicine FMUSP, University of Sao Paulo, 51 Cipotânea Street, University City, Zip Code: 05360-160, Sao Paulo, Brazil. Electronic address: jessicarbacha@usp.br.
⁵ School of Medicine FMUSP, University of Sao Paulo, 51 Cipotânea Street, University City, Zip Code: 05360-160, Sao Paulo, Brazil. Electronic address: larissaviveiro@usp.br.
⁶ Institute of Psychology, University of Sao Paulo - Department of Neuroscience and Behavior, 1721 Professor Mello de Morais Avenue, University City, Sao Paulo, SP, Zip Code: 05508-030, Brazil. Electronic address: elianavarise@usp.br.
⁷ Institute of Medical Assistance, Hospital Servidor Público, 981 Ibirapuera Avenue, Sao Paulo, SP, Zip Code: 04038-034, Brazil. Electronic address: nelson.carvas96@gmail.com.
⁸ Flinders University, Health Sciences Building RGH (Health Sciences Bldg, level 2), GPO Box 2100, Adelaide, 5001, South Australia, Australia. Electronic address: belinda.lange@flinders.edu.au.
⁹ School of Medicine, University of Sao Paulo - Department of Geriatric - University of São Paulo, 255 Doctor Olívio Pires Campos Street, Cerqueira Cesar, Sao Paulo, SP, Zip Code: 05403-000, Brazil. Electronic address: wiljac@usp.br.
¹⁰ School of Medicine, University of Sao Paulo - Department of Physical Therapy, Speech Therapy and Occupational Therapy, 51 Cipotânea Street, University City, Sao Paulo, SP, Zip Code: 05360-160, Brazil. Electronic address: j.e.pompeu@usp.br.

PMID: 30415751
DOI: 10.1016/j.maturitas.2018.10.002

Abstract

Background: Recently, interactive video games (IVGs) have been used as a health-care intervention that provides both exercise and cognitive stimulation. Several studies have shown that IVGs can improve postural control, gait, cognition, and functional independence in elderly people and patients with neurological disease. However, there is a lack of evidence about the effects of IVGs on frail and pre-frail elderly people. The aim of this study was to evaluate the feasibility, safety, and acceptability of playing Nintendo Wii Fit Plus^™ (NWFP) interactive video games, and the functional outcomes (postural control, gait, cognition, mood, and fear of falling) in frail and pre-frail older adults.

Methods: This study is a randomized controlled, parallel-group, feasibility trial. Participants were frail and pre-frail older adults randomly assigned to the experimental group (EG, n = 15) or control group (CG, n = 15). Participants in the EG performed 14 training sessions, lasting 50 min each, twice a week. In each training session, participants played five of 10 selected games, with two attempts at each game. Participants in the CG received general advice regarding the importance of physical activity. All participants were assessed on three occasions by a blinded physical therapist: before and after intervention, and 30 days after the end of the intervention (follow-up). We assessed the feasibility (score of participants in the games), acceptability (game satisfaction questionnaire), safety (adverse events during training sessions), and functional outcomes: (1) postural control (Mini-BESTest); (2) gait (Functional Gait Assessment); (3) cognition (Montreal Cognitive Assessment); (4) mood (GDS-15); and (5) fear of falling (FES-I).

Results: Participants in the EG improved their scores in all 10 games, reported that they understood and enjoyed the tasks of the games, and presented few adverse events during the practice. There was a significant improvement in the Mini-BESTest and Functional Gait Assessment in the EG when compared with the CG (p < 0.05).

Conclusion: The use of NWFP was feasible, acceptable, and safe for frail older adults and improved their postural control and gait. There were no effects on cognition, mood, or fear of falling. This trial was registered in the Brazilian Registry of Clinical Trials (RBR-823rst) on 11 June 2016.

Keywords: Aged; Exercise; Frail elderly; Postural balance; Virtual reality.

Publication types

Randomized Controlled Trial

MeSH terms

Accidental Falls
Affect
Aged
Aged, 80 and over
Cognition
Exercise* / physiology
Exercise* / psychology
Fear
Feasibility Studies
Female
Frail Elderly* / psychology
Frailty / physiopathology*
Frailty / psychology*
Gait
Humans
Male
Patient Satisfaction
Physical Therapy Modalities* / psychology
Postural Balance
Single-Blind Method
Surveys and Questionnaires
Video Games* / adverse effects
Video Games* / psychology