Assessing and training standing balance in older adults: A novel approach using the 'Nintendo Wii' Balance Board

Older adults, deemed to be at a high risk of falling, are often unable to participate in dynamic exercises due to physical constraints and/or a fear of falling. Using the Nintendo 'Wii Balance Board' (WBB) (Nintendo, Kyoto, Japan), we have developed an interface that allows a user to accurately calculate a participant's centre of pressure (COP) and incorporate it into a virtual environment to create bespoke diagnostic or training programmes that exploit real-time visual feedback of current COP position. This platform allows researchers to design, control and validate tasks that both train and test balance function. This technology provides a safe, adaptable and low-cost balance training/testing solution for older adults, particularly those at high-risk of falling.

A Wii Bit of Fun: A Novel Platform to Deliver Effective Balance Training to Older Adults

BACKGROUND: Falls and fall-related injuries are symptomatic of an aging population. This study aimed to design, develop, and deliver a novel method of balance training, using an interactive game-based system to promote engagement, with the inclusion of older adults at both high and low risk of experiencing a fall.

STUDY DESIGN: Eighty-two older adults (65 years of age and older) were recruited from sheltered accommodation and local activity groups. Forty volunteers were randomly selected and received 5 weeks of balance game training (5 males, 35 females; mean, 77.18 ± 6.59 years), whereas the remaining control participants recorded levels of physical activity (20 males, 22 females; mean, 76.62 ± 7.28 years). The effect of balance game training was measured on levels of functional balance and balance confidence in individuals with and without quantifiable balance impairments.

RESULTS: Balance game training had a significant effect on levels of functional balance and balance confidence (P < 0.05). This was further demonstrated in participants who were deemed at high risk of falls. The overall pattern of results suggests the training program is effective and suitable for individuals at all levels of ability and may therefore play a role in reducing the risk of falls.

CONCLUSIONS: Commercial hardware can be modified to deliver engaging methods of effective balance assessment and training for the older population.

Successful balance training is associated with improved multisensory function in fall-prone older adults

Balance maintenance relies on a complex interplay between many different sensory modalities. Although optimal multisensory processing is thought to decline with ageing, inefficient integration is particularly associated with falls in older adults. We investigated whether improved balance control, following a novel balance training intervention, was associated with more efficient multisensory integration in older adults, particularly those who have fallen in the past. Specifically, 76 healthy and fall-prone older adults were allocated to either a balance training programme conducted over 5 weeks or to a passive control condition. Balance training involved a VR display in which the on-screen position of a target object was controlled by shifts in postural balance on a Wii balance board. Susceptibility to the sound-induced flash illusion, before and after the intervention (or control condition), was used as a measure of multisensory function. Whilst balance and postural control improved for all participants assigned to the Intervention group, improved functional balance was correlated with more efficient multisensory processing in the fall-prone older adults only. Our findings add to growing evidence suggesting important links between balance control and multisensory interactions in the ageing brain and have implications for the development of interventions designed to reduce the risk of falls.