Public health

Wii-Fit U an alternative to physio for older people with chronic back pain?

Home-based video-game exercises have potential to manage chronic low back pain in older people and substitute for programs supervised by a physiotherapist, Australian research suggests.

In a first-of-its-kind study, 54 patients aged over 55 with chronic low back pain were randomised to either take part in a self-managed home-based video game exercise program using a Nintendo Wii-Fit-U, or usual activities, for eight weeks.

The Wii-Fit U group (n=26) practised flexibility, body weight resistance and aerobic exercises for 60 minutes, three times per week after receiving an initial session with a physical therapist.

The participants demonstrated “significantly greater improvements” in pain and function at eight weeks compared to controls, and were also more likely to engage in flexibility exercises at six months.

However, these effects were small and were of questionable clinical significance, acknowledged study author Dr Joshua Zadro (PhD), a physiotherapy researcher at the University of Sydney.

The Wii Fit U group participants had significantly higher pain self-efficacy (PSEQ scores) at six months, but not immediately post-intervention or at three months, and there was no difference between the groups in terms of care they sought for their pain.

The Wii Fit U demonstrated a 71% adherence to the recommended exercise time, which was a high rate when compared to adherence of to exercise without supervision in similar cohorts, the authors write.

Despite the modest improvements, the study investigators said the findings showed the potential cost-effectiveness of video games in self management of low back pain in older people.

“Given the enormous global cost of chronic low back pain, increasing an individual’s capacity to self-manage their pain, while reducing the need for therapist supervision, should be a priority,” said Dr Zadro, writing in Physical Therapy.

“Home-based video-game exercises could be a solution to this problem as they reduce reliance on a healthcare system with scare resources. Units are low cost at around $200 and patients wouldn’t need to travel to treatment clinics.

“These programs could be implemented under the current Medical Benefit Scheme (MBS) chronic pain care pathway in Australia, with only one session needed to set up the program and teach patients how to use it. Traditional exercise programs require many more sessions than are funded by MBS,” he added.

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