Randomized comparison trial of balance training by using exergaming and conventional weight-shift therapy in patients with chronic stroke

Abstract

Objective: To compare the effects of exergaming with conventional weight-shift training on balance function in patients with chronic stroke.

Design: Single-blind randomized controlled trial.

Setting: Medical center.

Participants: Patients (N=30) with chronic stroke and balance deficits.

Interventions: Twelve weeks of Wii Fit training or conventional weight-shift training.

Main outcome measures: Static balance was assessed using posturography. We recorded the stability index and percentage of weight bearing on the affected leg in 8 positions. We also used the timed Up and Go and forward reach tests for dynamic balance evaluation, Falls Efficacy Scale-International for fear of falling assessment, and Physical Activity Enjoyment Scale for estimating the enjoyment of training.

Results: The exergaming group showed more improvement in stability index than the control group in head straight with eyes open while standing on a foam surface, eyes closed while standing on a solid surface with head turned 30° to the left, and eyes closed while standing on a solid surface with head turned up positions (time-group interaction P=.02, .04, and .03, respectively); however, the effects were not maintained. At 3-month follow-up, the control group showed more improvement in weight-bearing symmetry in the head straight with eyes open while standing on a solid surface position than the exergaming group (time-group interaction P=.03). Both groups showed improvement in the timed Up and Go test, forward reach test, and fear of falling. The improvement in fear of falling was not maintained. The exergaming group enjoyed training more than the control group (P=.03).

Conclusions: Exergaming is enjoyable and effective for patients with chronic stroke.

Keywords: Feedback, sensory; Postural balance; Rehabilitation; Stroke; Video games.