Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

Computer games and balance rehabilitation study

19 December 2011

73% of participants aged 18-70 with balance impairment found using a computer games console motivated them more than conventional balance rehabilitation therapies.

Patients with neurological and vestibular diseases could benefit after a HRB-funded study, led by RCSI Researcher Dara Meldrum, opens the possibility of incorporating popular video games consoles into balance rehabilitation programmes.

'Balance problems are common in patients with neurological and vestibular disease, and they can have a serious impact on normal daily life', according to Dara Meldrum, Lecturer in Physiotherapy and Health Research Board (HRB) Research Fellow, in the School of Physiotherapy, at the Royal College of Surgeons in Ireland (RCSI).

'Plus these patients are at a higher risk of fall injuries which can place significant demand on hospital services. While there is strong evidence that exercise programmes can improve balance, in practice it can be hard to get patients to stick to their programmes, simply because these exercises can be repetitive and boring and appear not related to daily life.'

'We wanted to see if a computer games console - the Nintendo Wii Fit Plus - was sufficiently 'usable' to enable physiotherapists to consider using it to come up with new balance rehabilitation programmes. For the patients, it had to be easy to use, safe, provide them with some level of feedback on what they were doing, and hopefully be more enjoyable than conventional exercises. The net effect would be to encourage better compliance with their rehab programmes,' she continued.

Dara Meldrum
Dara Meldrum, School of Physiotherapy, RCSI

Participants were aged between 18 and 70, with a mean age of 43 and took part in a 30-minute session using exercises and games. After sessions, they rated the system usability according to a structured set of metrics called a System Usability Scale (SUS), and answered a questionnaire on their experience and opinions of the Nintendo Wii Fit Plus (NWFP) in relation to their usual rehab.

'The system scored very high on usability, 88% said that they would like to use it in future treatment, 73% reported that the NWFP motivated them more than usual physiotherapy treatment, and 69% reported more enjoyment than usual treatment,' added Ms Meldrum.

'We have established that there is definite potential to improve balance rehabilitation with the NWFP. The next challenge will be to design new balance rehabilitation programmes which incorporate suitable exercises and games for optimum recovery.'

Enda Connolly, Chief Executive of the Health Research Board concluded: 'It is great to see the rapid advances in gaming technology being recognised and assessed for suitability for use in innovative health care programmes. There is a double benefit as this has the potential to improve patient outcomes, and also has an obvious preventative effect. If we can improve people's balance and avoid unnecessary falls in the first instance, we reduce overall pressure and demand on scarce health services.'

The full paper is available at the following link: