EFFECT OF NINTENDO WII FIT<SUP>TM</SUP>ON POSTURAL CONTROL OF FRAIL ELDERLY: RANDOMIZED CLINICAL TRIAL

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Belasco Junior D.1, Gomes G.C.V.2, Mori S.3, Simões M.D.S.2, Jacob-Filho W.4, Pompeu J.E.2
1Universidade Paulista, Physical Therapy, São Paulo, Brazil, 2Universidade de São Paulo, Physical Therapy, São Paulo, Brazil, 3Universidade de São Paulo, Medical School, São Paulo, Brazil, 4Universidade de São Paulo, Geriatrics, São Paulo, Brazil

Background: Frailty is characterized by increased vulnerability to stressors that puts older subjects at risk of developing adverse outcomes, including hospitalization, disability, and mortality. Several evidences suggest that exercise interventions can be used to restore and/or maintain functional independence in older adults and prevent, delay or reverse the frailty process. Virtual Reality (VR) is a computer generated technology that promotes interaction between users and virtual environments, where tasks are performed at a high-intensity stimulation provided by augmented visual, sensory and auditory feedback. Some studies suggest that VR exercises in elderly patients promote improvements in mobility, muscular strength, cognition, balance control, reaction time and falls prevention.

Purpose: To analize the effect of Nintendo Wii FitTM training on postural control of frail elderly.

Methods: 24 elderly people (mean age 84,5 years [SD 5,9]) were recruited in this Randomized Clinical Trial. The inclusion criteria were: (1) diagnose of Frail Syndrome according to the criteria of Fried and (2) capacity to maintain standing position and walk. Elderly were randomized between control group (CG) and experimental group (EG), 12 in each one.Patients were assessed by a blind examiner pre and post 14 training sessions and 30 days after the end of the training (follow-up). Each session lasted 60-minutes and was performed twice a week. Elderly of the EG practiced 10 games, five games per session. CG received orientations about the frailty and the importance of the exercises in the treatment of the syndrome, beside the conventional medical treatment. The main outcome was the postural control assessed by the Mini Balance Evaluation Systems Test (Mini BESTest). Secondary outcomes were:safety (number of adverse events during the training) and feasibility (performance of patients in the games). Statistical analyses was performed by ANOVA of repeated measures and the post doc of Tukey and ANOVA ofFriedman. It was adopted alfa of 0.05.

Results: EG showed improvement in Mini BESTest (P=0.004) and maintenance of results after 30 days of follow up. There was no change in the Mini BESTest of the CG. No adverse events were registered during the EG training. Patients of EG improved their scores on all practiced games (p 0,05).

Conclusion(s): Motor training using Nintendo Wii FitTM was safe, feasible and improved postural control of frail elderly people.

Implications: Nintendo Wii Fit can be used in the clinical practice to improve postural control of frail elderly.

Funding acknowledgements: None

Topic: Older people

Ethics approval: Ethics Committee of the Clinics Hospital of the Medical School at the University of São Paulo (CAAE: 46658315.5.000.0068).


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