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

ABSTRACT

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.