The effect of the Nintendo Wii Fit on exercise capacity and gait in an elderly woman with CREST syndrome

Background/Purpose: Physical deconditioning and impaired balance and gait are common barriers to exercise in frail older adults. This case report describes the efficacy of Nintendo Wii Fit exercises in improving functional capacity, exercise tolerance, strength and balance in an elderly woman with CREST syndrome and multiple chronic conditions. Case description: A sedentary 77-year-old woman with: scleroderma (CREST syndrome) and secondary Sjögren's syndrome; pulmonary hypertension; coronary artery disease; interstitial lung disease; and tremor. The patient could ambulate with a cane and had a high risk of falling. Methods: The participant completed three 30-minute sessions of Wii Fit exercises per week for 12 weeks. The exercises included step aerobics, marching and interactive games to develop balance, weight transfer and upper and lower body strength. Results: Substantial improvements were seen in the following: 6-minute walk test (6MWT) (100%); Timed Up and Go (TUG) (5.3%); 30-second sit to stand (25%); hand grip strength (right 21%; left 8.6%); ankle plantarflexion (right 16.7%; left 33.3%) and dorsiflexion (right 125%; left 88.9%), Tinetti Balance and Gait Assessment (balance score 35.5%; falls efficacy scale score 21.4%); resting systolic blood pressure (5.1%); and oxygen saturation (3.3%). The average movement of centre of pressure decreased post-intervention, but average velocity increased. Conclusions: Specific Wii Fit games may improve health, exercise capacity, mobility, balance and fall risk in older adults affected with CREST and associated severe cardiopulmonary symptoms.