Effectiveness of Nintendo Wii and Physical Therapy in Functionality, Balance, and Daily Activities in Chronic Stroke Patients

Elena Marques-Sule; Anna Arnal-Gómez; Gloria Buitrago-Jiménez; Luis Suso-Martí; Ferran Cuenca-Martínez; Gemma Victoria Espí-López

doi:10.1016/j.jamda.2021.01.076

Effectiveness of Nintendo Wii and Physical Therapy in Functionality, Balance, and Daily Activities in Chronic Stroke Patients

J Am Med Dir Assoc. 2021 May;22(5):1073-1080. doi: 10.1016/j.jamda.2021.01.076. Epub 2021 Feb 24.

Authors

Elena Marques-Sule¹, Anna Arnal-Gómez², Gloria Buitrago-Jiménez², Luis Suso-Martí³, Ferran Cuenca-Martínez³, Gemma Victoria Espí-López⁴

Affiliations

¹ Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain; Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, Valencia, Spain.
² Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain.
³ Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios (CSEU) La Salle, Universidad Autónoma de Madrid, Madrid, Spain.
⁴ Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, Valencia, Spain. Electronic address: gemma.espi@uv.es.

PMID: 33639116
DOI: 10.1016/j.jamda.2021.01.076

Abstract

Objectives: The aim of this study was to assess whether a virtual rehabilitation program using Nintendo Wii added to conventional physical therapy improved functionality, balance, and daily activities in chronic stroke survivors, when compared with conventional physical therapy.

Design: We undertook a randomized controlled clinical trial. The participants of this study were randomized to 2 groups: (1) conventional physical therapy (CPTG), which included exercises related to functionality, balance, and activities of daily living; and (2) virtual reality with Nintendo Wii (VRWiiG), which included balance training with the Wii Balance Board and upper limb exercises with the Wii Sports package, added to conventional physical therapy.

Setting and participants: This study was conducted in a university rehabilitation clinic and 29 stroke survivors were admitted.

Methods: Both interventions lasted 4 weeks, 2 sessions per week. Assessments were performed at baseline and at the end of the study, including functionality [Timed up and go (TUG)], balance [Tinetti Performance-Oriented Mobility Assessment (POMA)], Berg Balance Scale (BBS), and activities of daily living [Fugl-Meyer Upper Limb Motor Assessment, Barthel Index, Frenchay Activity Index (FAI)].

Results: Regarding TUG, POMA, and BBS, the analysis of variance showed significant differences for time and group∗time interaction. Post hoc analysis showed between-group differences (P = .044, d = -0.78; P = .012, d = 1.00; P = .042, d = 0.79, respectively) and within-group differences only in the VRWiiG (P < .001, d = 0.75; P < .001, d = -0.76; P < .001, d = -0.57, respectively). Regarding activities of daily living, post hoc analysis showed within-group differences only in VRWiiG.

Conclusions and implications: Our study showed promising results in functionality, balance, and activities of daily living when adding virtual reality with Nintendo Wii to conventional physical therapy in chronic stroke survivors. All procedures were approved by the Human Research Ethics Committee of the University of Valencia (H1518177391901). ClinicalTrials.gov database (NLM identifier NCT04144556).

Keywords: Physical therapy; activities daily living; balance; functionality; stroke; virtual reality.

Publication types

Randomized Controlled Trial

MeSH terms

Activities of Daily Living
Exercise Therapy
Humans
Physical Therapy Modalities
Postural Balance
Stroke Rehabilitation*
Stroke*
Video Games*

Associated data

ClinicalTrials.gov/NCT04144556