control and the influence of a secondary task in people with anterior cruciate
ligament reconstructed knees using a Nintendo Wii balance board
TS, & Webster KE. British Journal of Sports Medicine. Epub ahead of print Dec
25, 2012. DOI:10.1136/bjsports-2012-091525
control may potentially be negatively affected well after anterior cruciate
ligament (ACL) reconstruction surgery. The
loss of mechanoreceptors within the original ACL may contribute to these
deficits, along with many other possible factors (e.g., psychological,
neuromuscular). The question remains
whether postural control would further be affected while performing a secondary
task, which would be more similar to when athletes return to activity post-surgery. Therefore, the purpose of this cross-sectional
study was to evaluate postural control with and without a secondary task among
patients with ACL reconstructions compared to matched controls. The control group was matched by age, gender,
and sport to participants in the ACL reconstruction group (15 women, 30 men per
group). The participants performed two stance tasks on the Nintendo Wii Balance
Board. One task was a single-leg balance
task and the other involved single-leg balance while moving the opposite
shoulder based on cues on a screen. The
participants were tested on both legs and the order of the tasks and legs were
randomly selected. The authors used the Wii Balance Board with a customized
program. Participants with ACL
reconstructions did significantly worse in the single-leg stance task on both
legs (surgical and non-surgical) when compared to their healthy controls. The addition of the secondary task caused
both groups to have poorer postural control.
designing rehabilitation programs, clinicians should realize that the post-ACL
patient is likely to have postural control deficits bilaterally. The group differences were found to be
greatest in the anterior-posterior directions, likely due to the hamstring and
quadriceps involvement. The secondary
task did not affect the post-ACL group any more than the control group, which
may reinforce the concept that the secondary task challenges the central
nervous system’s role in postural deficits rather than the local
mechanoreceptors. It would have been
interesting if the authors looked at bilateral strength measures and correlated
these findings to postural control findings.
This is another study that demonstrates the valid and reliable
utilization of the Nintendo Wii Balance Board for clinical findings. However, it was a custom written program and
the balance board was connected to a laptop.
Where it is exciting that a relatively low cost balance board can give
clinicians valuable information regarding postural control, there is still a need
for more advanced level of programming.
This is something that the average clinician is not likely to be able to
do. Does anyone have any experience with
pairing a Wii balance board to a laptop?
Has anyone encountered or utilized any commercially available games or
applications in the clinical setting?
by: Nicole Cattano
by: Jeffrey B. Driban
Howells BE, Clark RA, Ardern CL, Bryant AL, Feller JA, Whitehead TS, & Webster KE (2012). The assessment of postural control and the influence of a secondary task in people with anterior cruciate ligament reconstructed knees using a Nintendo Wii Balance Board. British Journal of Sports Medicine PMID: 23268373