Nintendo wii virtual reality game improves short term balance capabilities in multiple sclerosis patients: A pilot quasi-experimental study

Objective: Balance abnormalities are common complaints among multiple sclerosis (MS) patients. The new generation of wireless based computer games creates an innovative opportunity as a rehabilitation tool to improve balance and stability in the MS patient. The aim of this study was to determine the effect of practicing with these new generation computer games on balance parameters of MS patients. Design and participants: Thirty-two MS patients, 19 females and 13 males, mean age 43.6 (S.E.=1.9) years, mean EDSS 3.1 (S.E.=0.2) followed at the Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel were assessed during a single session of Nintendo Wii. Intervention: Each participant, while in a standing position, completed the thirty minute training mode for tennis (Nintendo Wii gaming console). Main outcome measures: Balance was evaluated using the Functional Reach Test (FRT) and the Four Square Step Test (FSST) prior and following the game session. Results: Compared to baseline, significant improvements were observed for both balance tests, subsequent to the training session. FRT (cm) increased from 30.3 (SD=4.6) to 32.9 (SD=5.03), P=0.03, indicative of a 9.1% improvement. FSST (sec) decreased from 10.3 (SD=3.6) to 8.7 (SD=2.6), P=0.04, representing a 17.5% improvement. Conclusions: Active virtual reality games had immediate beneficial effects on balance following a single session. This improvement could be related to simultaneous auditory and visual feedback and reinforcing multi-sensory integration, thus leading to better motor stabilization of balance. Utilization of new generation computer games as rehabilitation tools for patients with MS are recommended.