Efficacy of Wii Balance Board-Based Exergame Training Among Individuals with Cerebellar Ataxia: A Feasibility Study

Abstract
Background: Conventional rehabilitation methods have shown limited and transient improvements, necessitating personalized
approaches in the diverse population of cerebellar ataxia (CA). Wii balance board exergame training, integrating physical exercise with
interactive video games, presents a novel and engaging neuro-rehabilitation strategy.
Objectives: The primary objective of this study was to assess the clinical feasibility of implementing Wii Balance Board-based exergame
training among individuals with various forms of CA. The secondary objective was to investigate the preliminary efficacy and assess the
enjoyment of the intervention.
Methods: The study incorporates a pilot randomized control trial and feasibility study design. We recruited 10 patients using a block
randomization method. The Wii balance board training was administered for 18 sessions, 3 sessions per week, over 6 weeks. The primary
outcomes of feasibility testing were evaluated through clinical research log documentation, while secondary outcomes of balance,
ataxia severity rate, functional independence, and enjoyment were assessed with the mini-BESTest, Scale for Assessment and Rating of
Ataxia (SARA), Functional Independence Measure Scale (FIMs), and Exergame Enjoyment Questionnaire (EEQ). Data were analyzed using
descriptive statistics and non-parametric tests to evaluate changes in outcomes.
Results: The study enrollment rate was 77% (n = 10). The Wii intervention group showed a 100% (n = 5) retention rate compared to 80% (n =
4) in the control group (CG). The Wii intervention group demonstrated a tendency towards better outcomes at follow-up in SARA (P = 0.063,
effect size/RM = 0.84) and Mini-BESTest (P = 0.071, effect size/RM = 0.79) but not in the case of FIM (P = 0.794, effect size/RM = 0.14), along with
reporting a moderate level of enjoyment.
Conclusions: Wii Balance Board-based exergame training is considered feasible for implementation in clinical settings among individuals
with various forms of CA, suggesting the conduction of a larger definitive study to further explore the intervention’s efficacy.
Keywords: Balance; Cerebellar Ataxia; Exergames; Virtual Reality Rehabilitation; Wii Balance Board