Wii Fit: the new generation tool for improving balance, health and well-being for women?

By the year 2031 women (and men) who are currently 40 years of age and over will comprise the 25% of the Australian population aged over 65. The projected fall related health costs will have escalated to over $1000 million annually (Moller 2003) and the current rate of falls (1 in 3 older persons falling annually) will continue for those over 65 (Morris et al 2004) unless new initiatives are implemented. Moller (2003) identified a need for more effective prevention of falls and we believe this intervention must start before decline in balance and bone density become established. Current initiatives that aim to reduce falls and fall related injury and are available in the community presently target adults 65 years and over. Over the last eight years our research team has undertaken a number of projects that helped to inform the evidence base regarding the decline in the sensory-motor contribution to balance and the efficacy of specific balance strategy training in counteracting this decline. Our research team has demonstrated that postural stability and functional balance capacity are significantly reduced in women across the menopause transition period (40 to 60 years) and further reduced in the older person (Isles et al 2004, Low Choy et al 2003, Nitz et al 2003). We have found reduced strength and flexibility, reduced sensory acuity, and increased joint position error and higher thresholds of vibration sensitivity negatively contributing to this early change period in balance ability (Low Choy et al 2008; Low Choy et al 2007; Nitz & Low Choy 2004). Similar findings were reported by Lord & Ward (1994) although there was less data for women under 65 with only 20 to 30 subjects in the 40s and 50s decade groups compared to 118 and 116 for our study. A contributing factor associated with reduced strength and flexibility and reduced ability to balance in women, (Nitz & Low Choy 2007) is a lower self-reported activity level where habitual patterns of activity range from sedentary through to walking several times a week at a comfortable pace. Another most important aspect revealed by our studies of women aged 40 to 80 years has been the identification of the prevalence of falls across these decades and the major physiological factors that might have contributed to the falls in these women. Of particular interest are the findings over the 5 year longitudinal assessment study of balance and postural stability in women aged 40-80. Falls were recorded in 8.5% of women in their 40s in the year 1 audit and this rose to 15% in year 5. For those in their 50s, 13.5% had fallen at year 1 audit. This prevalence remained stable over 5 years. 24.5% of women in their 60s had fallen at year 1 audit but this prevalence dropped slightly to 21% by year 5 and 43% in their 70s had fallen at year 1 audit and this prevalence dropped to 31% by year 5. Of interest is the rise in multiple fall episodes in some women in their 40s through to 70s in the 5 year data collection period (Nitz et al, in review). This provides compelling evidence for the need to target women prior to age 64 for pre-emptive balance preserving intervention. Of particular interest for these younger women is what type of exercise might be adopted to address these declines and potential to fall. We propose to investigate three different exercise approaches that theoretically might reduce or delay the decline in balance and sensorimotor function in younger women. The effect of three approaches to slowing the balance, sensorimotor and fitness decline problem through three different exercise programs will be compared. Previously, balance strategy training has been shown and to improve balance (Hourigan et al 2008) as has aerobic exercises (Lui-Ambrose et al 2007). The effect achieve through exercise using a Wii.Fit™ will be evaluated. Then the three exercise approaches will be compared for effect. Primary aims are to: 1. demonstrate the effect of a training program using the Wii.Fit trademarkon balance, sensorimotor function and fitness in women aged 20-70years. 2. compare the effect in women aged 20-70year of Wii.Fit trademark training with balance strategy training (BST) and aerobic training (AT). Secondary aims are to identify whether one training method is better than another in this cohort of women