Effect of Nintendo Wii™-based motor and cognitive training on activities of daily living in patients with Parkinson's disease: A randomised clinical trial?

Abstract

Objectives

To investigate the effect of Nintendo Wii™-based motor cognitive training versus balance exercise therapy on activities of daily living in patients with Parkinson's disease.

Design

Parallel, prospective, single-blind, randomised clinical trial.

Setting

Brazilian Parkinson Association.

Participants

Thirty-two patients with Parkinson's disease (Hoehn and Yahr stages 1 and 2).

Interventions

Fourteen training sessions consisting of 30 minutes of stretching, strengthening and axial mobility exercises, plus 30 minutes of balance training. The control group performed balance exercises without feedback or cognitive stimulation, and the experimental group performed 10 Wii Fit™ games.

Main outcome measure

Section II of the Unified Parkinson's Disease Rating Scale (UPDRS-II).

Randomisation

Participants were randomised into a control group (n=16) and an experimental group (n=16) through blinded drawing of names.

Statistical analysis

Repeated-measures analysis of variance (RM-ANOVA).

Results

Both groups showed improvement in the UPDRS-II with assessment effect (RM-ANOVA P<0.001, observed power=0.999). There was no difference between the control group and the experimental group before training {8.9 [standard deviation (SD) 2.9] vs 10.1 (SD 3.8)}, after training [7.6 (SD 2.9) vs 8.1 (SD 3.5)] or 60 days after training [8.1 (SD 3.2) vs 8.3 (SD 3.6)]. The mean difference of the whole group between before training and after training was −0.9 (SD 2.3, 95% confidence interval −1.7 to −0.6).

Conclusion

Patients with Parkinson's disease showed improved performance in activities of daily living after 14 sessions of balance training, with no additional advantages associated with the Wii-based motor and cognitive training.

Registered on http://www.clinicaltrials.gov (identifier: NCT01580787).

Citation

Effect of Nintendo Wii™-based motor and cognitive training on activities of daily living in patients with Parkinson's disease: A randomised clinical trial     José Eduardo Pompeu, Felipe Augusto dos Santos Mendes, Keyte Guedes da Silva, Alexandra Modenesi Lobo, Tatiana de Paula Oliveira, Andrea Peterson Zomignani, Maria Elisa Pimentel Piemonte
Physiotherapy - September 2012 (Vol. 98, Issue 3, Pages 196-204, DOI: 10.1016/j.physio.2012.06.004)