Balance exercise for persons with multiple sclerosis using Wii games: a randomised, controlled multi-centre study

Background: The use of interactive video games is expanding within rehabilitation. The evidence base is, however, limited. Objective: Our aim was to evaluate the effects of a Nintendo Wii Fit (R) balance exercise programme on balance function and walking ability in people with multiple sclerosis (MS). Methods: A multi-centre, randomised, controlled single-blinded trial with random allocation to exercise or no exercise. The exercise group participated in a programme of 12 supervised 30-min sessions of balance exercises using Wii games, twice a week for 6-7 weeks. Primary outcome was the Timed Up and Go test (TUG). In total, 84 participants were enrolled; four were lost to follow-up. Results: After the intervention, there were no statistically significant differences between groups but effect sizes for the TUG, TUGcognitive and, the Dynamic Gait Index (DGI) were moderate and small for all other measures. Statistically significant improvements within the exercise group were present for all measures (large to moderate effect sizes) except in walking speed and balance confidence. The non-exercise group showed statistically significant improvements for the Four Square Step Test and the DGI. Conclusion: In comparison with no intervention, a programme of supervised balance exercise using Nintendo Wii Fit (R) did not render statistically significant differences, but presented moderate effect sizes for several measures of balance performance.