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Concept: Wii Play


BACKGROUND: Video-games have become an integral part of the new multimedia culture. Several studies assessed video-gaming enhancement of spatial attention and eye-hand coordination. Considering the technical difficulty of laparoscopic procedures, legal issues and time limitations, the validation of appropriate training even outside of the operating rooms is ongoing. We investigated the influence of a four-week structured Nintendo® Wii™ training on laparoscopic skills by analyzing performance metrics with a validated simulator (Lap Mentor™, Simbionix™). METHODOLOGYPRINCIPAL FINDINGS: We performed a prospective randomized study on 42 post-graduate I-II year residents in General, Vascular and Endoscopic Surgery. All participants were tested on a validated laparoscopic simulator and then randomized to group 1 (Controls, no training with the Nintendo® Wii™), and group 2 (training with the Nintendo® Wii™) with 21 subjects in each group, according to a computer-generated list. After four weeks, all residents underwent a testing session on the laparoscopic simulator of the same tasks as in the first session. All 42 subjects in both groups improved significantly from session 1 to session 2. Compared to controls, the Wii group showed a significant improvement in performance (p<0.05) for 13 of the 16 considered performance metrics. CONCLUSIONSSIGNIFICANCE: The Nintendo® Wii™ might be helpful, inexpensive and entertaining part of the training of young laparoscopists, in addition to a standard surgical education based on simulators and the operating room.

Concepts: Surgery, Wii, Nintendo, Wii Play, Nintendo GameCube, Virtual Console, Nintendo DS, Wii Remote


OBJECTIVE: The purpose of this study is to assess the effect of exercise training using the Nintendo Wii Fit videogame and balance board system on balance and gait in adults with Parkinson Disease (PD). DESIGN: Prospective Interventional Cohort Study. SETTING: Outpatient group exercise class. PARTICIPANTS: 10 subjects with PD, Hoehn and Yahr Stages 2.5 or 3, with a mean age of 67.1 years; 4 men, 6 women. INTERVENTIONS: Subjects participated in supervised group exercise sessions 3 times per week for 8 weeks, practicing three different Wii balance board games (marble tracking, skiing and bubble rafting) adjusted for their individualized function level. Subjects trained for 10 minutes per game, a total of 30 minutes training per session. MAIN OUTCOME MEASURES: Pre-and post-exercise training, a physical therapist evaluated subjects' function using the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), and Sharpened Romberg with eyes open and closed. Postural Sway was assessed at rest and with tracking tasks using the Wii balance board. Subjects rated their confidence in balance using the Activities-specific Balance Confidence (ABC) scale and depression on the Geriatric Depression Scale (GDS). RESULTS: Balance as measured by the BBS improved significantly, with an increase of 3.3 points (p = .016). The DGI improved as well (mean increase 2.8, p = .004), as did postural sway measured with the balance board (decreased variance in stance with eyes open by 31%, p = .049). Though the Sharpened Romberg with eyes closed increased by 6.85 points and with eyes opened by 3.3 points, improvements neared significance only for eyes closed (p = .07 versus p = .188). There were no significant changes on patient ratings for the ABC (mean decrease -1%, p = .922) or the GDS (mean increase 2.2, p = .188). CONCLUSIONS: An 8-week exercise training class using the Wii Fit balance board improved selective measures of balance and gait in adults with PD. However, no significant changes were seen in mood or confidence regarding balance.

Concepts: Wii, Nintendo, Wii Balance Board, Wii Fit, Wii Menu, Wii Play, History of video game consoles, Wii Remote


BACKGROUND: Children with Developmental Co-ordination Disorder (DCD) experience poor motor and psychosocial outcomes. Interventions are often limited within the healthcare system, and little is known about how technology might be used within schools or homes to promote the motor skills and/or psychosocial development of these children. This study aimed to evaluate whether short, regular school-based sessions of movement experience using a commercially available home video game console (Nintendo’s Wii Fit) would lead to benefits in both motor and psychosocial domains in children with DCD. METHODS: A randomized crossover controlled trial of children with movement difficulties/DCD was conducted. Children were randomly assigned to an intervention (n = 10) or comparison (n = 8) group. The intervention group spent 10 min thrice weekly for 1 month using Wii Fit during the lunch break, while the comparison group took part in their regular Jump Ahead programme. Pre- and post-intervention assessments considered motor proficiency, self-perceived ability and satisfaction and parental assessment of emotional and behavioural problems. RESULTS: Significant gains were seen in motor proficiency, the child’s perception of his/her motor ability and reported emotional well-being for many, but not all children. CONCLUSIONS: This study provides preliminary evidence to support the use of the Wii Fit within therapeutic programmes for children with movement difficulties. This simple, popular intervention represents a plausible method to support children’s motor and psychosocial development. It is not possible from our data to say which children are most likely to benefit from such a programme and particularly what the dose and duration should be. Further research is required to inform across these and other questions regarding the implementation of virtual reality technologies in therapeutic services for children with movement difficulties.

Concepts: Wii, Nintendo, Wii Balance Board, Wii Menu, Shigeru Miyamoto, Wii Play, Nintendo GameCube, Video game console


The aim of this study was to examine differences in the performance of children with probable Developmental Coordination Disorder (p-DCD) and balance problems (BP) and typical developing children (TD) on a Wii Fit task and to measure the effect on balance skills after a Wii Fit intervention. Twenty-eight children with BP and 20 TD-children participated in the study. Motor performance was assessed with the Movement Assessment Battery for Children (MABC2), three subtests of the Bruininks Oseretsky Test (BOT2): Bilateral Coordination, Balance and Running Speed & Agility, and a Wii Fit ski slalom test. The TD children and half of the children in the BP group were tested before and after a 6weeks non-intervention period. All children with BP received 6weeks of Wii Fit intervention (with games other than the ski game) and were tested before and afterwards. Children with BP were less proficient than TD children in playing the Wii Fit ski slalom game. Training with the Wii Fit improved their motor performance. The improvement was significantly larger after intervention than after a period of non-intervention. Therefore the change cannot solely be attributed to spontaneous development or test-retest effect. Nearly all children enjoyed participation during the 6weeks of intervention. Our study shows that Wii Fit intervention is effective and is potentially a method to support treatment of (dynamic) balance control problems in children.

Concepts: Assessment, Wii, Wii Balance Board, Wii Fit, Wii Menu, Shigeru Miyamoto, Wii Play, Slalom skiing


To determine the effectiveness of vestibular rehabilitation using the Wii Fit balance platform, in adults with dizziness.

Concepts: Wii, Wii Balance Board, Wii Fit, Wii Menu, Shigeru Miyamoto, Wii Play, Game controller, Super Mario Bros.


Active video game (AVG) playing, also known as “exergaming,” is increasingly employed to promote physical activity across all age groups. The Wii Fit Balance Board is a popular gaming controller for AVGs and is used in a variety of settings. However, the commercial off-the-shelf (OTS) design poses several limitations. It is inaccessible to wheelchair users, does not support the use of stabilization assistive devices, and requires the ability to shift the center of balance (COB) in all directions to fully engage in game play.

Concepts: Play, Video game, Wii, Wii Balance Board, Wii Fit, Wii Play, Game controller, Wii Remote


The use of exergame for balance competencies was recently explored in women affected by balance ability reduction with non-conclusive results. The aim of the study was to evaluate the efficacy of a supervised exergame performed with the Wii Fit(®) compared to conventional exercises on balance function, quality of life, fear of fall and well-being in women with bone loss. Thirty-eight female participants aged over 65 years, with a bone loss condition, were enrolled and random allocated in the Wii group or control group. Subject enrolled in Wii group performed a balance training with a Wii Fit supervised by a physiotherapist (1 h, 2 days per week, during 8 weeks) while in control subjects performed the same amount of conventional balance exercises. Subject enrolled in experimental group showed significantly higher scores in terms of Berg Balance Scale (p = 0.027). In SF-36 scores, a significant difference was reported for physical activity score after treatment (p = 0.031). Fear of falling and the psychological scales were not significantly different between the two groups. In women with bone loss condition, a supervised Wii Fit training has shown better efficacy in improving balance performance with respect to conventional balance exercises.

Concepts: Randomized controlled trial, Efficacy, Wii, Balance, Wii Balance Board, Wii Menu, Shigeru Miyamoto, Wii Play


Despite numerous health benefits, less than half of American adults engage in regular physical activity. Exercise videogames (EVG) may be a practical and attractive alternative to traditional forms of exercise. However there is insufficient research to determine whether EVG play alone is sufficient to produce prolonged engagement in physical activity or improvements in cardiovascular fitness and overall health risk. The goal of the present study is to test the efficacy of exercise videogames to increase time spent in moderate to vigorous physical activity (MVPA) and to improve cardiovascular risk indices among adults.

Concepts: Present, Time, Cardiovascular disease, Physical exercise, Exercise, Health club, Wii, Wii Play



Purpose To assess the effects of virtual reality using the NintendoTM Wii Fit on balance, gait, and quality of life in ambulatory individuals with incomplete spinal cord injury (iSCI). Relevance There is a need for continued research to support effective treatment techniques in individuals with iSCI to maximize each individual’s potential functional performance. Subjects Five males with a mean age of 58.6 years who had an iSCI and were greater than one-year post injury. Methods An interrupted time series design with three pretests over three weeks, a post-test within one week of the intervention, and a four-week follow up. Outcome measures: gait speed, timed up and go (TUG), forward functional reach test (FFRT) and lateral functional reach test (LFRT), RAND SF-36. Intervention consisted of one-hour sessions with varied games using the Nintendo Wii Fit twice per week for seven weeks. Survey data was also collected at post-test. Results There were statistically significant changes found in gait speed and functional reach. The changes were also maintained at the four-week follow up post-test. Survey reports suggested improvements in balance, endurance, and mobility with daily tasks at home. Conclusion All subjects who participated in training with the NintendoTM Wii Fit demonstrated statistically significant improvements in gait speed and functional reach after seven weeks of training. Given the potential positive impact that the NintendoTM Wii Fit has on functional reach and gait speed in patients with iSCI, physical therapists may want to incorporate these activities as part of a rehabilitation program.

Concepts: Statistics, Wii, Nintendo, Wii Balance Board, Wii Fit, Wii Menu, Shigeru Miyamoto, Wii Play