Recalibrating disparities in perceived and actual balance abilities in older adults: a mixed-methods evaluation of a novel exergaming intervention.
Toby J Ellmers, Ioannis Th Paraskevopoulos, A Mark Williams and 1 others
PMID 29566720WHAT IT FOUND
Older adults who played a supervised balance game for eight short sessions showed a closer match between perceived and actual balance.
Some gained confidence; others recognised limits and reduced risky movements. Falls were not measured.
Key findings
01After the intervention, balance confidence was related to measured postural control in both directions, while before the intervention it was not.
02The average balance confidence score did not change, but the change in confidence was related to the starting confidence score.
03Focus groups described awareness of balance strengths and limits, with some participants reporting more confidence in daily tasks and others reporting less risky reaching.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
No passive or active control group, so learning, attention, novelty, or usual changes cannot be ruled out. Small analysed sample: 20 completed all sessions, and three were excluded from balance-confidence analyses. The design was within-participant and all participants received the same intervention, so there was no random allocation or comparison group. The sample came from sheltered accommodation and had to stand unaided for 10 minutes; five used a walking aid for daily walking. People with neurological or cognitive diagnoses, or medication for dizziness, vertigo, or vestibular function, were excluded. No retention or longer follow-up, so it is unknown whether changes persisted. The paper reports no participant fell during gameplay, but it does not report whether falls occurred outside gameplay. The intervention combined a bespoke game, Wii Balance Board, visual and score feedback, difficulty adjustment, and supervision, so the effect of any one part cannot be separated.
Declared interests
The supplied text names The Richard Benjamin Trust as funder. It does not include a conflict-of-interest declaration.
The easy way to misread this
Do not read this as evidence that a home Wii game prevents falls. The study had no control group, included only 20 completers from sheltered accommodation, measured balance confidence and postural control rather than falls, and the game, balance board, feedback, and supervision were given together. The forward-backward improvement did not extend to sideways control.