Liu Haoyan, Xing Yu, Wu Ying
Department of Physical Education and Training, Shanghai University of Sport, Shanghai, China.
Front Med (Lausanne). 2022 May 6;9:812570. doi: 10.3389/fmed.2022.812570. eCollection 2022.
Falls and fall-related injuries are not uncommon among older adults and may lead to serious health deterioration and decreased quality of life. Numerous types of physical activity have been proposed to improve balance and strength in older adults with varying degrees of success. Nintendo's Wii Fit video exergame uses body movement as a game controller and provides real-time feedback for games designed to enhance balance and muscle strength. However, whether Wii Fit exercise improves the balance and lower limb muscle strength of older adults remains uncertain.
To evaluate the current literature by using meta-analyses to assess whether Wii Fit exercise is associated with improved balance and lower limb muscle strength in older adults.
We searched PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, and Wanfang Data from inception to February 16, 2022, for relevant studies and conducted a manual search of the literature. Data extraction of the included studies were independently performed by two authors. The methodologic quality of each included study was assessed using the Physical Therapy Evidence Database (PEDro) scale. Meta-analyses were conducted using Review Manager 5.3.
Of 991 articles initially identified, 10 articles (379 participants; aged ≥65 years, range 65-92 years; 188 participants in Wii Fit exercise groups, and 191 participants in control groups), including 8 randomized controlled trials, were assessed in this meta-analysis. The methodologic quality of the included studies evaluated with the PEDro average score was 6.4 and ranged from 5 to 8 points, indicating moderate quality. Compared with no exercise, Wii Fit exercise was associated with significant improved scores on the Berg Balance Scale, which evaluates functional balance (mean difference, 1.38; 95% CI, 0.61-2.16; = 31%; = 0.0005) and on the Timed Up and Go test, which evaluates static and dynamic balance (standardized mean difference, -0.51; 95% CI,-0.88 to -0.14; = 52%; = 0.007). However, for the three studies assessed, Wii Fit exercise did not significantly improve scores on the 30-s chair stand test, which evaluates the functional strength and endurance of the lower limb muscles (mean difference, 0.82; 95% CI, -0.14 to 1.77; = 1.68; = 0.09).
Our findings indicated that Wii Fit exercise is an effective approach to improve functional, static, and dynamic balance among older adults. Additional meta-analyzes with higher numbers of randomized controlled trials are suggested to confirm the benefits of Wii Fit exercise on balance in older adults, to establish whether functional strength and endurance of lower limb muscles are improved, and to explore the relationship between improved balance and fall prevention in this population.
跌倒及与跌倒相关的损伤在老年人中并不罕见，可能导致严重的健康恶化和生活质量下降。人们提出了多种体育活动来改善老年人的平衡能力和力量，取得了不同程度的成功。任天堂的Wii Fit视频健身游戏将身体运动用作游戏控制器，并为旨在增强平衡能力和肌肉力量的游戏提供实时反馈。然而，Wii Fit锻炼是否能改善老年人的平衡能力和下肢肌肉力量仍不确定。
通过荟萃分析评估当前文献，以确定Wii Fit锻炼是否与老年人平衡能力和下肢肌肉力量的改善相关。
我们检索了PubMed、EMBASE、Web of Science、中国知网和万方数据，检索时间从建库至2022年2月16日，以查找相关研究，并对文献进行了手工检索。两名作者独立对纳入研究进行数据提取。使用物理治疗证据数据库（PEDro）量表评估每项纳入研究的方法学质量。使用Review Manager 5.3进行荟萃分析。
在最初识别的991篇文章中，本荟萃分析评估了10篇文章（379名参与者；年龄≥65岁，范围65 - 92岁；Wii Fit锻炼组188名参与者，对照组191名参与者），包括8项随机对照试验。纳入研究的PEDro平均评分为6.4分，范围为5至8分，表明质量中等。与不锻炼相比，Wii Fit锻炼与评估功能平衡的伯格平衡量表得分显著提高相关（平均差值，1.38；95%置信区间，0.61 - 2.16；P = 31%；P = 0.0005），以及与评估静态和动态平衡的定时起立行走测试得分相关（标准化平均差值，-0.51；95%置信区间，-0.88至-0.14；P = 52%；P = 0.007）。然而，对于所评估的三项研究，Wii Fit锻炼并未显著提高评估下肢肌肉功能力量和耐力的30秒坐立试验得分（平均差值，0.82；95%置信区间，-0.14至1.77；P = 1.68；P = 0.09）。
我们的研究结果表明，Wii Fit锻炼是改善老年人功能、静态和动态平衡的有效方法。建议进行更多随机对照试验的荟萃分析，以确认Wii Fit锻炼对老年人平衡能力的益处，确定下肢肌肉的功能力量和耐力是否得到改善，并探索改善平衡与该人群预防跌倒之间的关系。
