A Step in the Right Direction: Evaluating the Effectiveness of Customized Stepping Game Software and Balance Boards for Balance Rehabilitation Therapy and Measurement

The incidence of falls significantly increases with age in older populations. Traditionally, exercise interventions have been effective in improving balance and strength, thereby reducing the number and risk of falls. To minimize costs, to make exercise more engaging, and to reduce the burden on therapists, the use of serious gaming using virtual reality technologies has become more common. These gaming systems allow the evaluation of compensatory strategies to reduce falls. One of the easiest compensatory strategies to reduce falls is to step forward. To evaluate stepping, the time it takes to step, response times, and reaction times, a stepping game was developed using two Nintendo Wii Balance Boards™.The objective of this study was to investigate the stepping game system for its efficacy as a supplemental balance therapy by evaluating functional outcomes and participant satisfaction. The game was able to identify changes in performance measures (response time, reaction time and step time) for some participants over the span of the exercise program; however, a larger sample size and a stricter protocol is necessary to evaluate the clinical significance.Clinical Relevance— The stepping game appears to be more sensitive to detecting change in balance related measures including step time, reaction time, response time, than the Berg Balance Scale.