Timed up and go
i D, Ozdincler AR, Tarakci E, Tutuncuoglu F, Ozmen M. Wii-based Balance Therapy to Improve Balance Function of Children with Cerebral Palsy: A Pilot Study. J Phys Ther Sci. 2013;25(9):1123-7.
The purpose of this study was to assess whether a Wii-based balance therapy program will elicit improvements in balance and postural control in individuals with Cerebral Palsy. The timed up and go was one of the outcome measures to evaluate balance. 10 boys and 3 girls ages 5-17 years were recruited from an outpatient neurological clinic. Specifically, 7 individuals had diplegic cerebral palsy, 5 hemiplegic cerebral palsy and 2 dyskinetic cerebral palsy. Exclusion criteria included Gross motor function classification system expanded and Revised (GMFMCS-ER) level of 4 or 5, epilepsy, greater or equal to 3 in lower extremities on modified Ashworth scale for spasticity and incapacity to partake in exercises. Participating individuals must have a diagnoses of CP and normal or mild intellectual disability. The intervention was 40 minutes in duration and performed 2 times a week for 12 weeks. It involved a Wii balance gaming system that took place on a balance board. The four balance games were ski slalom, soccer heading, tilt table and walking a tightrope. Each balance exercise was played 3 times in 1 set. The exercises challenged dynamic balance and trunk control through weight shifting left and right. Participants were supervised by a physiotherapist during sessions. The outcome measures were the timed up and go, one leg standing, the functional reach test and the 6-minute walking test. Each outcome was assessed before and after the intervention. The results consisted of statistically significant improvements in all outcome measures and Wii game scores after the 12-week program. Wii Balance games improved dynamic balance and trunk weight shifting which in return, improved outcome measures. Limitations of the study are small sample size and lack of homogenous sub-groups. In conclusion, a virtual reality gaming system like the Nintendo Wii balance can be beneficial at improving balance in individuals with cerebral palsy. Furthermore, it may be most effective when used in conjunction with other therapy modalities.
3 responses to “Timed up and go”
Leave a Reply
You must be logged in to post a comment.
It is good to know how to incorporate Wii games and technology into balance training to demonstrate functional improvements in the Timed Up and Go Test. This will help when treating patients who enjoy video games and make balance activities more fun for patients instead of jumping or playing sports. Also, this should be helpful in transitioning into a home exercise program since many children have access to Wii at home or even for school PE. It would be interesting to see a study comparing outcomes from a set intervention time and then after a similar period of time as a home exercise program.
Given the research that my group and I did on the TUG in our first year, I typically think of this test being used to estimate fall risk in an older adult population. So it’s really interesting to see this versatile test being used in this pediatric, CP population. With that said, I really liked that the authors used this outcome measure as a way to examine balance. Our research from first year showed that while this test is good for estimating fall risk, it can also provide valuable observational information regarding balance impairments. Therefore, I think the authors of this study chose a valuable tool to examine balance!
Also, it’s really interesting to see how many studies are examining video game based and virtual reality based interventions to target balance impairments. It’s definitely going to be exciting to see what interventions strategies will be available to us going forward!
yes, from the TUG you can potentially infer lots of things related to impairments of body structures and functions including balance, reaction time, strength…
Nice article review Lauren & relevant discussion threads!