Virtual reality rehabilitation of balance: Assessment of the usability of the Nintendo Wii ^® Fit Plus

Purpose: The aim of this study was to investigate the usability of the Nintendo Wii Fit Plus ^® (NWFP) in the treatment of balance impairment in vestibular and other neurological disease. Methods: This was a cross-sectional, quasi-experimental study. Participants (n=26; mean age 43±14, M13:F13) with quantified balance impairment took part in a 30-minute session on the NWFP using exercises and games that challenge balance. Outcomes included the System Usability Scale (SUS), a numerical rating scale of enjoyment and a post treatment questionnaire. Results: The mean SUS score was high (mean 82±18%) with only two participants rating below 50%. There was a negative correlation of age with SUS scores (r=-0.54; p=0.004). Mean numerical rating scale score (/10) for enjoyment of the NWFP session was 8.4±3. Of the participants, 88.5% said that they would like to use the NWFP in future treatment. Seventy-three percent reported more enjoyment and motivation than usual physiotherapy. No falls occurred during testing. Conclusions: This study has quantified the usability of the NWFP as a treatment for balance impairment showing high levels of usability and enjoyment with no serious adverse effects. The results of this study may assist physiotherapists in devising novel balance rehabilitation programmes. Implications for Rehabilitation The Nintendo Wii Fit Plus ^® virtual reality system has the potential to improve balance rehabilitation, but usability of this system requires investigation. In this study, patients with balance impairment as a result of neurological disease reported very high levels of usability and enjoyment when performing selected Nintendo Wii Fit Plus ^® balance exercises and games. The majority of patients preferred the Nintendo Wii Fit Plus to conventional treatment which may have implications for patient compliance with exercise.