Many older adults experience a decrease in physical activity, which often leads to decreases in functioning. Older adults have been shown to have the lowest levels of physical activity for all age groups. This lack of physical activity has been shown to lead to decreases in performance of activities of daily living (ADLs), independence, quality of life, and increases in number of falls, chance of institutionalization, morbidity, and mortality. Physical activity programs in community settings help to restore or maintain physical function and lessen the level of dependence so that individuals will be able to reach the highest level of functioning possible. In recent years, virtual reality (VR) has been incorporated into both programming for older adults and functional improvement through rehabilitation. VR provides three key elements for functional improvement and rehabilitation: repetition, feedback, and motivation. Research has shown that interventions incorporating VR result in improvements in upper extremity and hand function, lower extremity function, balance, fall reduction, and improved ability to perform ADLs. Following the development of the Nintendo WiiTM, many community- based, long term care, and rehabilitation facilities have begun incorporating its use in their programs. Currently there is very limited existing research on the use of the Nintendo WiiTM in rehabilitation, community-based, or other long term care settings. This study examined the effects of an intervention using the Nintendo WiiTM on physical functioning in older adults in a community-based setting.
Results indicate that the Nintendo WiiTM would be beneficial in increasing balance, leisure skills competence, and potentially provide an optimal flow experience for older adults in a community setting. Visual analysis of the data indicated that participants in both groups experienced a mean decrease in Timed Up an Go (TUG) times, mean decrease in balance confidence, and a mean increase in leisure skills competence. While both groups demonstrated a decrease in mean TUG times and Leisure Skills Subscale of the Leisure Competence Measure (LSS LCM) scores, the intervention group experienced a larger decrease than the control group. Although both groups demonstrated a mean decrease in balance confidence, 5 of the intervention group participants and 2 of the control group participants experienced an increase in Activities- Based Balance Confidence (ABC) scores. Split-middle calculation estimates indicated that both groups demonstrated a decelerating trend in mean balance confidence and a mean accelerating trend in leisure skills competence. The intervention group experienced a decelerating trend in TUG times, while the control group experienced an accelerating trend.