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British Orthopaedic Research Society (BORS)


Medical and allied health staff are beginning to incorporate the Nintendo Wii-Fit into musculoskeletal rehabilitation protocols. One potential application is the assessment of standing balance following Orthopaedic lower limb surgery. The Wii Balance Board (WBB) has been shown to be a valid equivalent to a laboratory grade force platform for the assessment of standing balance. Our objective was to investigate the validity and reliability of the balance tests included with the Wii-Fit software.

Initially, a single subject performed multiple repeats of a standing balance test. The data was collected simultaneously from a commercial force platform using its integrated software that measured centre of pressure and from the WBB using the Wii-Fit software that generated a percentage score. The data from each was compared and analyzed, applying the equations of known, validated standing balance measurements.

Then, thirty subjects free of lower limb pathology performed a series of standing balance tests combining single leg and double leg stance with their eyes open and then closed. Data was collected from one set of trials on the WBB using the Wii-Fit software and another using bespoke centre of pressure software on a laptop computer. The tests were then repeated on a second occasion within 2 weeks.

The algorithm used by the Wii-Fit software to generate the ‘Stillness’ standing balance score was calculated with a predictive value (R squared) of 0.94. This correlated well to a known, valid measure of standing balance.

Test-retest reliability was examined for the data from both pieces of software. Both demonstrated good-to-excellent test-retest reliability within ‘software’. The laptop data was transformed using the algorithm and the between ‘software’ reliability was calculated as good-to-excellent.

The Wii-Fit software collects standing balance data from the WBB at a fraction of the cost of laboratory grade systems. The score generated by the Wii-Fit software is reliable and valid as an overall assessment of standing balance. Although its application would be limited for detailed assessment of balance disorders, it could still provide surgeons with an affordable, clinic based balance-screening tool. This could form part of an assessment protocol following lower limb surgery.