Does an exercise programme integrating the Nintendo Wii-Fit Balance Board improve balance in ambulatory children with cerebral palsy?

Abstract

Background: Cerebral palsy is a common childhood movement disorder with balance impairment a common complaint. Active video games such as the Nintendo Wii-Fit have been found to be a valuable therapeutic tool, enjoyed by a variety of populations including children with CP, but a synthesis of the research investigating its specific use for balance in children with CP has yet to be conducted. Objectives: To determine the effectiveness of a Nintendo Wii-Fit Balance board programme in improving balance in ambulatory children with CP. Methods: A systematic search of the literature was conducted. A total of six studies matching inclusion and exclusion criteria were found and critically appraised by a modified version of Downs and Black's Checklist. Results: All studies used the Nintendo Wii-Fit software, with variable programme length and frequency of sessions. All but one study demonstrated a significant improvement in at least one balance outcome post-intervention, with dynamic balance appearing to be greater influenced. Discussion: The impact of age on the results was inconclusive. Children with cognitive, visual or vestibular impairments may show less of an improvement. A 6-week programme appears sufficient, provided training frequency remains high. Overall, there is moderate evidence to suggest that a Nintendo Wii-Fit Balance Board programme can improve balance in children with CP. Conclusions: Balance training with a Nintendo Wii-Fit Balance Board can enhance balance in individuals with ambulatory CP. Due to limited evidence investigating ataxic or dyskinetic CP, results from this study should be generalised with caution to these subtypes. Future research should aim to investigate the long-term effects of the intervention.