Videogaming as a Diagnostic Tool for Fall Risk

The Nintendo Wii, a videogame console that detects the user’s motion in gameplay, has been used in community centers and residences as a way to encourage physical activity. A group of researchers hypothesized that the Wii and its sensors might serve as a diagnostic tool as well. In a study, the Wii Fit Balance Board, which has sensors that detect shifts in movement by the user atop it, measured the movement of two groups of older adults: a group of subjects who reported a fall in the previous year and a group who hadn’t.

Because the Wii Fit program requires the user to tend to both their own movement and the game system itself, the researchers conjecture that it’s a useful proxy for the context of most falls: dual tasking, when individuals are performing two tasks at the same time. The researchers hypothesized that individuals who hadn’t suffered a fall would perform better on the Wii balance board than those who had. Ideally, a cutoff point of balance board performance could be established, and individuals below the cutoff could be targeted for balance and other physical activity interventions.

Forty-five subjects participated in the study, 16 who reported a fall in the previous year and 28 who hadn’t. There were no statistically significant differences between the fall and non-fall groups in age, weight, height, body mass index (BMI) or Rapid Dementia Screening Test (RDST) scores. Subjects played two Wii Fit games: a basic stepping game and a ski slalom balance game, both of which were performed in a sitting position. Five physical performance tests were administered using the two games, which included a count of steps taken in a 10-meter walk and what is called the timed up-and-go (TUG) test, which is often used to assess balance and gait for falls risk assessment.

The researchers found a significant difference between the fall and non-fall groups in the number of steps taken. The researchers were able to identify a cutoff point on this task as well that indicated a risk for falling. The availability of a user-friendly, entertaining system creates the potential for an effective program for both diagnosis and targeted exercise.


Yamada M, Aoyama T, Nakamura M, Tanaka B, Nagai K, Tatematsu N, Uemura K, Nakamura T, Tsuboyama T, Ichihashi N (2011). “The Reliability and Preliminary Validity of Game-Based Fall Risk Assessment in Community-Dwelling Older Adults.” Geriatric Nursing, in press.


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