Feasibility of Wii Fit Training to Improve Clinical Measures of Balance in Older Adults

Background and purpose: Numerous interventions have been proposed to improve balance in older adults with varying degrees of success. A novel approach may be to use an off-the-shelf video game system utilizing real-time force feedback to train older adults. The purpose of this study is to investigate the feasibility of using Nintendo's Wii Fit for training to improve clinical measures of balance in older adults and to retain the improvements after a period of time. Methods: Twelve healthy older adults (aged >70 years) were randomly divided into two groups. The experimental group completed training using Nintendo's Wii Fit game three times a week for 3 weeks while the control group continued with normal activities. Four clinical measures of balance were assessed before training, 1 week after training, and 1 month after training: Berg Balance Scale (BBS), Fullerton Advanced Balance (FAB) scale, Functional Reach (FR), and Timed Up and Go (TUG). Friedman two-way analysis of variance by ranks was conducted on the control and experimental group to determine if training using the Wii Balance Board with Wii Fit had an influence on clinical measures of balance. Results: Nine older adults completed the study (experimental group n = 4, control group n = 5). The experimental group significantly increased their BBS after training while the control group did not. There was no significant change for either group with FAB, FR, and TUG. Conclusion: Balance training with Nintendo's Wii Fit may be a novel way for older adults to improve balance as measured by the BBS.

The Modified Direct Analysis Method: an Extension of the Direct Analysis Method

The purpose of this research project is to study an innovative method for the stability assessment of structural steel systems, namely the Modified Direct Analysis Method (MDM). This method is intended to simplify an existing design method, the Direct Analysis Method (DM), by assuming a sophisticated second-order elastic structural analysis will be employed that can account for member and system instability, and thereby allow the design process to be reduced to confirming the capacity of member cross-sections. This last check can be easily completed by substituting an effective length of KL = 0 into existing member design equations. This simplification will be particularly useful for structural systems in which it is not clear how to define the member slenderness L/r when the laterally unbraced length L is not apparent, such as arches and the compression chord of an unbraced truss. To study the feasibility and accuracy of this new method, a set of 12 benchmark steel structural systems previously designed and analyzed by former Bucknell graduate student Jose Martinez-Garcia and a single column were modeled and analyzed using the nonlinear structural analysis software MASTAN2. A series of Matlab-based programs were prepared by the author to provide the code checking requirements for investigating the MDM. By comparing MDM and DM results against the more advanced distributed plasticity analysis results, it is concluded that the stability of structural systems can be adequately assessed in most cases using MDM, and that MDM often appears to be a more accurate but less conservative method in assessing stability.