Effect of Balance Exercises for Person with Multiple Sclerosis using Wii® Game: A Systematic Review of Randomized and Non-Randomized Control Trials.

Background: The recent engagement of Game base console is emerging in rehabilitation practice and its overall effectiveness has not been yetsubstantially manifested. Objective: To evaluate the effectiveness of Wii based balance interventions among Multiple Sclerosis people. Data Sources: A systemic search was conducted in the PubMed and Scopus data bases electronically up to February 2014. Study Selection: Randomized and non-randomized control trials with Wii intervention on balance as an outcome measure among people with Multiple Sclerosis were included in this review. Data Synthesis: After screening 57 studies, 7 were selected for full-text screening and 5 were included in this review. Three out of five were RCTs and rest were quasi experimental and 2-point crossover pilot studies. Total of 205 medically diagnosed mild to moderate MS people were in the selected studies with less than 6 expanded disability status scale (EDSS). Total of 13 different outcome measures were used on assessment of balance in Multiple sclerosis individuals and the most common outcomes were Berg balance scale (BBS), Center of Pressured (COP), Four Square step test (FSST), Time up and Go test (TUG). Three out of five studies report statistical significant improvement in the Four Square step test (FSST), Berg Balance Scale (BBS) and center of Pressure (COP) between intervention and control groups of MS. Conclusion: Review of the selected studies indicates that the inclusion of Wii game in balance exercise on Multiple sclerosis people improve static balance more effectivelyas compare to dynamic balance in mild to moderate level of disability. However evidence on the mode selection in Wii, treatment setting and frequency lacking. Further studies with large sample size and more homogenize outcome measure and control setting is recommended for future.

Avaliação da performance muscular de idosas não sedentárias antes e após aplicação de um programa de exercícios de equilíbrio / Evaluation of muscular performance in not sedentary elderly before and after the application of an exercise program for balance

INTRODUÇÃO: Uma das alterações do processo natural de senescência é a diminuição da massa e força muscular, denominada de sarcopenia. Caracterizada por um processo lento e progressivo no idoso, afetará a funcionalidade e a qualidade de vida, aumentando a morbidade, dependência, hospitalizações recorrentes, riscos de quedas e fraturas. OBJETIVO: Avaliar os efeitos dos exercícios de equilíbrio na força e na flexibilidade de idosos. MÉTODOS: 13 idosas com idade de 60 a 83 anos (73 anos ± DP 5,15), voluntárias e praticantes de atividade física, foram avaliadas antes e após aplicação de um programa de equilíbrio, realizado por 12 semanas consecutivas, uma vez na semana, em relação à força e flexibilidade de membros inferiores. A força foi avaliada por meio do teste de sentar e levantar, e a flexibilidade do teste de sentar e alcançar. Os resultados foram analisados por meio do teste paramétrico ANOVA (p>0,05) RESULTADOS: Não ocorreram ganhos significativos (p>0,05) em relação à força e à flexibilidade, porém ocorreu manutenção dos seus valores. CONCLUSÃO: 12 semanas de aplicação de exercícios de equilíbrio, realizados uma vez na semana, são suficientes para manutenção da força e flexibilidade de idosas não sedentárias.

INTRODUCTION: One of the natural processes of senescence is the decrease in muscle strength and mass, called sarcopenia, a slow and progressive process that in the elderly will affect the functionality and quality of life by increasing morbity, dependence, recurrent hospitalizations, risk of falls and fractures. OBJECTIVE: To evaluate the effects of balance exercises on the strength and flexibility in elderly. METHODS: 13 volunteered elderly women aged 60 to 83 years (73 years ± 5.15), engaged in physical activity were evaluated for strength and flexibility of the lower limbs before and after the application of a balance program, for 12 consecutive weeks, once a week. Strength was evaluated using the test sitting and standing and the flexibility through the sit and reach test. The results were analyzed by ANOVA (p>0.05). RESULTS: There was no significant gains (p>0,05) in the strength and flexibility, but there was a maintaining in the values. CONCLUSION: 12 weeks of application of balance exercises, performed once a week are enough to maintain strength and flexibility of non-sedentary elderly.

Effects of Physical Exercise on Fall Risk Factors in Elderly at Home in Intervention Trial

Objective: In this study, we used an intervention approach to examine the effects of physical exercise on elderly people living at home in a rural area. Methods: Two regions in a village were randomly assigned as the control and intervention regions. The subjects were 60 years of age or older and were able to carry out their activities of daily living independently. The numbers of subjects were 56 and 81 for the control and intervention regions, respectively. In the control region, lectures on health were provided twice. In the intervention region, instructions on ten types of physical exercise were provided six times during this three-month study. In addition, the subjects in the intervention region were instructed to do exercises by themselves at home three days per week. The effects were compared by evaluating motor functions in maximum step length, 10-m full-power walking parameters, right knee extension torque, right hip flexion torque, and stepping time on a 40-cm staircase; data were obtained before and after the intervention. Results: Analysis of covariance (ANCOVA) showed significant improvements in right maximum step length, the mean of the right and left maximum step lengths, and right hip flexion torque in the intervention region. Conclusion: The three-month physical exercise program improves the motor functions of the elderly.

Effects of physical exercise on fall risk factors in elderly at home in intervention trial

<p><b>OBJECTIVE</b>In this study, we used an intervention approach to examine the effects of physical exercise on elderly people living at home in a rural area.</p><p><b>METHODS</b>Two regions in a village were randomly assigned as the control and intervention regions. The subjects were 60 years of age or older and were able to carry out their activities of daily living independently. The numbers of subjects were 56 and 81 for the control and intervention regions, respectively. In the control region, lectures on health were provided twice. In the intervention region, instructions on ten types of physical exercise were provided six times during this three-month study. In addition, the subjects in the intervention region were instructed to do, exercises by themselves at home three days per week. The effects were compared by evaluating motor functions in maximum step length, 10-m full-power walking parameters, right knee extension torque, right hip flexion torque, and stepping time on a 40-cm staircase; data were obtained before and after the intervention.</p><p><b>RESULTS</b>Analysis of covariance (ANCOVA) showed significant improvements in right maximum step length, the mean of the right and left maximum step lengths, and right hip flexion torque in the intervention region.</p><p><b>CONCLUSION</b>The three-month physical exercise program improves the motor functions of the elderly.</p>