The number of Americans experiencing limb loss is expected to increase from 1.7 million to 3.6 million by 2050, due in large part to the increasing incidence of diabetes and vascular disorders. This is of particular concern to older adults, who are at higher risk for such disorders and who are at a higher risk of potentially dangerous falls after losing a limb. A forthcoming article in the Journal of Geriatric Physical Therapy presents two case studies of older adults engaged in physical therapy after limb loss, using the Nintendo Wii’s balance and fitness programs. The article suggests that this easily-available, off-the-shelf technology is useful for falls prevention and other physical interventions for older adults who have lost a limb.
Each of the individuals in the case study were male and reported being in good, overall health. The participants were aged 58 and 62, and had each undergone an above-knee amputation. Each had a fitted prosthesis and concerns about aerobic health and balance. Both participants were able to move independently but reported some limitations in community activities, and were thus motivated to participate in training.
Each participant was provided with six weeks of twice-weekly physical therapy sessions that included 20 minutes of the Wii Fit Balance game, and an additional 20 minutes of a traditional physical rehabilitation strength training. By the end of the six weeks, both participants improved in balance, economy of movement, and balance confidence. Further, one of the participants found a reduced need for additional supportive device, while the other improved his aerobic capacity.
These case studies suggest that the Wii might be a useful component to falls reduction programs for older adults who have lost a limb. Further research would be needed to definitively establish the value of the Wii—for example, how much training would be needed, which games are particularly useful, and would such a program be useful in a broader, more diverse population. Case studies cannot prove that a particular medical intervention would work or definitively show how effective it is, but can be useful in identifying future avenues of research and showing how a treatment may work in a specific context.
These two case studies suggest that the easy-to-obtain Wii system might be a challenging—but entertaining—way to encourage individuals with limb loss to engage in falls reduction programs.
Miller CA, Hayes DM, Dye K, et al. Using the Nintendo Wii Fit and body weight support to improve aerobic capacity, balance, gait ability, and fear of falling: two case reports. J Geriatr Phys Ther. 2011. (e-pub ahead of print.)