Nintendo Wii training on postural balance and mobility rehabilitation of adults with Parkinson's disease: a systematic review

Abstract Introduction: Postural instability affects balance control in Parkinson disease (PD) patients and increases the particular risk of falling compared with healthy older adults. Video games with not immersive virtual reality have been used in neurological disorders rehabilitation process. Objective: To evaluate the effectiveness of the video game console Nintendo Wii (NW) on postural balance and mobility treatment of adults with PD in Hoehn and Yahr stages I to III. Methods: The following databases were searched electronically on MEDLINE, Cochrane Library, PEDro, CAPES Periodic, BIREME, and LILACS databases. The search period for this review was January 2010 to June 2016. The assessment of methodological quality was performed using the PEDro Scale as reference. Results: 12 original studies were selected, but only 3 were randomized controlled trials (RCTs). Conclusion: Some of the studies analysed suggest that NW can provide improvement in balance and mobility of adults with PD. These benefits should be interpreted with caution because of the low methodological quality of the included trials, and the lack of common assessment of treatment effects. There is little evidence to ensure the effectiveness and support the inclusion of the treatment with NW of patients with PD.

摘要 引言：姿势不稳会损害帕金森病（Parkinson Disease, PD）患者的平衡控制能力，且相较于健康老年人，该类患者的跌倒风险显著升高。非沉浸式虚拟现实电子游戏已被应用于神经系统疾病的康复治疗流程。研究目的：评估任天堂Wii（Nintendo Wii, NW）游戏主机对Hoehn-Yahr分期I至III期帕金森病成人患者的姿势平衡与运动功能的治疗效果。研究方法：本研究于MEDLINE、Cochrane图书馆、PEDro、CAPES期刊数据库、BIREME及LILACS数据库中开展电子检索，本次系统评价的检索时限为2010年1月至2016年6月。采用PEDro量表作为评价标准，对纳入研究的方法学质量进行评估。研究结果：共纳入12项原始研究，但其中仅3项为随机对照试验（Randomized Controlled Trial, RCTs）。研究结论：部分纳入分析的研究表明，任天堂Wii游戏主机可改善帕金森病成人患者的平衡与运动功能。但由于纳入研究的方法学质量偏低，且缺乏统一的治疗效果评估体系，对上述获益的解读需持谨慎态度。目前尚无充分证据证实任天堂Wii游戏治疗用于帕金森病患者的有效性，亦无法支持将其纳入帕金森病患者的治疗方案。