Video games could be better for balance rehabilitation than conventional physical therapy

Don’t throw away the Wii Fit Balance Board, it may be more valuable than you think. New research from a Northeastern University team found that active video games, such as Wii Fit and Dance Dance Revolution, are more effective at improving balance than conventional forms of physical therapy.

Led by Amy Lu, associate professor of communication studies at Northeastern, the team of researchers conducted a comprehensive review and meta-analysis of thousands of studies focused on active video gaming. After narrowing their focus to a few hundred, they grouped the studies into different categories based on what they were measuring, from physical fitness to cognitive outcomes. The balance research is just one of a series of articles the team has written based on their work.

“Personally speaking, I don’t think active video gaming itself can replace outdoor physical activities like soccer or basketball,” Lu says. “It’s a good alternative, however, in [this research]We’ve basically found that, compared to conventional treatments, active play works better.”

Dagmar Sternad, a distinguished university professor of biology at Northeastern whom Lu recruited based on her expertise in balance, says that even with a conservative eye, the findings indicate that “this automated and supposedly more motivating and fun way of playing and practicing is at least as good as conventional training.”

The findings are significant, especially in a field that may have life-saving implications. Sternad says that postural balance and falls are, even in healthy people, some of the “major risk factors leading to immobility and ultimately mortality.”

“Even for a 60-year-old woman who falls with weak bones, if there is a fracture, the fracture limits her to being less mobile for three months,” says Sternad. “Reduced mobility has an effect on general health and it’s a downward slope.”

In studies conducted thus far, researchers have found that active video games primarily benefit healthy people with no medical conditions. Lu says it’s indicative of how much more difficult balance work is for people with neurological conditions like multiple sclerosis, Parkinson’s disease, or cerebral palsy.

Analyzing more than 100 studies, Lu and his team also found that active video game treatment had the greatest effect in children, followed by older adults. Lu hopes these findings can send a signal to the gaming industry, which has historically not marketed to or designed for older adults.

“They really liked it and could benefit a lot from it, so just imagine if we’re really going to be able to shift some of the focus from the population to older adults,” Lu says. “We’re probably going to see a lot more public health benefits for this population.”

As for why active video games are so effective, Lu says they are, by design, more engaging and motivating than conventional forms of physical therapy. The Wii Fit Balance Board is not much different from the traditional balance boards used in physical therapy. But the way Nintendo has designed the experience to gamify physical activity—a physical action leads to in-game feedback that helps you achieve a goal both in-game and in real life—may make it more engaging.

“It really gives you this kind of immediate real-time joyful feedback based on your input,” says Lu. “Gaming and gamification companies have done a lot of research on how to make this reward feel very satisfying. Then, on top of that, I also feel that in terms of the design of the devices, over the years, from the Wii to [Microsoft] Kinect to VR, one of the things that I feel companies have been working on is making this interactive process very easy and seamless.”

Sternad says the implications of these findings go beyond the games industry. She says the broader medical field could benefit from using active video games as another tool in the physiotherapy toolkit. In a field that is beginning to explore physically distancing forms of physical therapy, video games could be a boon for patients.

“Yes, you can provide [patients] With assistive devices, you can provide physical therapy to people, but all of that has huge downsides,” says Sternad. “Physiotherapy is expensive. How do people get to the physiotherapy office, if you think of more rural populations? You need a caretaker, a partner to take you there.”

“The opportunity of such active video games [provide] having some kind of fun way to practice at home, self-guided, is huge,” he adds. “It’s a step in a good direction.”

The research is published in the journal Archives of Physical Medicine and Rehabilitation.