Nintendo Wii as a Training Tool on Quality of Life in Elderly

Josimara Cristina Alves, Gustavo Augusto Alves Rodrigues, Eric Fernandes Dias, Elisangela Silva,

Wagner Zeferino Freitas, Fabiano Fernandes da Silva and Renato Aparecido de Souza

Grupo de Estudos e Pesquisa em Ciência da Saúde, Instituto Federal de Educação, Ciência e Tecnologia do Sul de Minas

Gerais, Câmpus Muzambinho, Rua Dinah,75, Canaã, Muzambinho, Minas Gerais, Brazil

1 OBJECTIVES

The aim of this study was to assess the quality of life

data of non-institutionalized and functionally

independent elderly submitted to an exercise training

protocol using virtual interactive games generated

by Nintendo Wii.

2 METHODS

This is an interventional and self-controlled study.

Participated in the study, 10 elderly (58 ± 6.4 years,

63.8±13.6 kg, 152 ± 6 cm and BMI 27.4± 4.7),

members of the Family Health Program (PSF) of the

Muzambinho city, Minas Gerais, Brazil.

Experimental Routine. The experimental procedures

were performed at the Laboratory of Physical

Activity in Virtual Environment (LAFAV,

IFSULDEMINAS, Campus Muzambinho, Minas

Gerais, Brazil). This laboratory has six Nintendo Wii

consoles with their accessories and let the training

was conducted in a group. Each volunteer had a

physical area to carry out the training of

approximately 25 m

and was 1.5 meters in front of

to the television set that reproduced the virtual

environment. The experimental routine consisted of:

(a) a preliminary assessment of the parameters of

quality of life, (b) training protocol with virtual

reality (VR) promoted by interaction with the

Nintendo Wii console (Nintendo, Kyoto, Japan) and

evaluated. In addition, all training was monitored

individually by a researcher.

Assessment of Quality of Life. The quality of life was

assessed with the questionnaire SF-36 (Medical

Outcomes Study 36 - Item Short Form Health

Survey). The SF-36 consists of 36 items grouped

into eight domains: 1 - Functional Capacity (FC) 2 -

Physical Aspects (PA), 3 - Emotional Aspects (EA)

4 - Pain (P), 5 - General Health Status (GHS) 6 -

Vitality (V) 7 - Social Aspects (SA) and 8 - Mental

Health (MH). Each of these domains has received

scores from 0 to 100, where zero corresponds to the

worst score and 100, the best score. Moreover, it

was evaluated the dimensions related to general

mental health (SA + EA + MH; maximum 300

points) and physical health (FC + PA + P + V +

GHS; maximum 500 points). The SF-36 was

administered through individual interviews (Ware et

al., 1993).

Environment and Virtual Training. The virtual

environment was simulated by the console Nintendo

Wii. The input devices that allowed the interaction

process Wii-elderly were: (a) Wii Remote, which is

equipped with an accelerometer capable of detecting

motion in three dimensions and communicates via

wireless (Bluetooth) with the Sensor Bar, which is

responsible for detecting and transmitting to the

console infrared signals generated by the Wii

Remote, (b) Wii Motion Plus adapted to Wii

Remote. Thus, the movements are reproduced more

accurately, in real time (1:1) and faithful

reproduction of the player's movements on the

projection screen virtual environment (Wii, 2011),

instrument and high reliability when compared with

the force platform (Clark and Kraemer, 2009), (d)

software Wii Fit Plus, which has about 50 different

exercises grouped into five categories: yoga, balance

exercises, aerobic exercises, muscle strength

exercises and training plus. The VR training

consisted of 8 sessions lasting 60 minutes each and

frequency of 2 times per week. All exercise training

had 4 weeks. Each session was structured with the

application of 16 virtual games in three stages: warm

up, training and cool down, necessarily in that order.

The training was performed in groups of five

volunteers each.

Statistical Analysis. Statistical analysis was

performed using paired T-Student test. Data were

expressed as mean± standard deviation and were

considered statistically significant those with a value

Alves J., Alves Rodrigues G., Fernandes Dias E., Silva E., Freitas W., Fernandes da Silva F. and de Souza R..

Nintendo Wii as a Training Tool on Quality of Life in Elderly.

 2013 SCITEPRESS (Science and Technology Publications, Lda.)

of p <0.05.

3 RESULTS

Table 1 shows the results of assessment of quality of

life prior and post the VR training. Post After

training with VR, it was observed a significant

improvement in the pain (77.8%) and general health

(16.7%) domains (p <0.05). Although the remaining

domains showed improvements, it were with no

statistical significance (p>0.05). By analyzing the

dimensions of SF-36 questionnaire, it was identified

significant improvement in physical health

dimension (16.19%) (p <0.05).

Table 1: Assessment of life of quality.

Variables Experimental Time

Domains Prior Post

Functional Capacity 75 ± 21,0 81,6 ± 13,0

Physical Aspects 88,8 ± 13,2 86,1 ± 33,3

Pain 45,6 ± 24,2 81,1 ± 20,0*

General health

status

59,7 ± 15 69,7 ± 16,6*

Vitality 66,6 ± 20,9 71,6 ± 17,7

Social Aspects 93,1 ± 16,7 88,8 ± 19,2

Emotional Aspects 74,1 ± 43,4 74,1 ± 36,4

Mental health 71,5 ± 20,0 71,1 ± 20,3

Dimensions Prior Post

Physical Health 335,9 ± 58,1 390,3 ± 99,1*

General Mental

Health

238,7 ± 68,4 234,1 ± 63,4

* Indicates p<0.05 (Post vs. Prior)

4 DISCUSSION

The aging favours the onset of functional limitations

and reduces the availability and motivation for

physical activity (Elward and Larson, 1992). Several

studies attribute to regular physical activity, as a

positive factor that favours longevity, reduction of

prescription drugs, prevention of cognitive decline,

maintain functional status, reducing the frequency of

falls and the incidence of fractures, in addition to the

psychological benefits such as improved self-esteem

(Elward and Larson, 1992).Moreover, it is justified

the inclusion of tools that seek to promote physical

activity by the elderly. Thus, the purpose of this

study was to investigate the effects of a exercise

training protocol in a virtual environment with the

Nintendo Wii games, on quality of life in elderly

healthy and not institutionalized.

The main findings of the present study are

associated with a better perception of the elderly as

their quality of life after use of the Nintendo Wii. It

was observed after the protocol with the Wii, a

significant improvement in the pain (ie, the elderly

reported less pain after study) and general health

domains and physical health dimension. Similarly,

Sposito et al., (2013) observed favourable results in

the quality of life of elderly women undergoing

training with the Nintendo Wii. Moreover, it has

been reported the possible benefit of Nintendo Wii

on physical and vitality (Cindy, 2008); (Graves et

al., 2008).

In summary, the results of this study support the

hypothesis that training with Nintendo Wii is

beneficial to improve the quality of life of elderly

healthy and functionally independent.

ACKNOWLEDGEMENTS

The authors thank the Fundação de Amparo à

Pesquisa do Estado de Minas Gerais (FAPEMIG -

APQ-02744-11) and the Instituto Federal de

Educação, Ciência e Tecnologia do Sul de Minas

Gerais (IFSULDEMINAS) for financial support.

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