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Clinical Use of Nintendo Wii™ Bowling Simulation to Decrease Fall Risk in an Elderly Resident of a Nursing Home: A Case Report

Clark, Robert PT, DPT1; Kraemer, Theresa PT, PhD, ATC2

Journal of Geriatric Physical Therapy: 2009 - Volume 32 - Issue 4 - p 174–180
Case Report

Purpose: Of the estimated 1.7 million residents of nursing homes in the United States, approximately half fall annually; and 11% of these sustain injury. This is twice the rate for persons dwelling in the community. By addressing fall risk, physical therapists have an opportunity to reduce falls which are the leading cause of injury deaths, as well as the most common cause of nonfatal injuries for older adults in the United States. This case report examines the effect of a novel interactive video game intervention to address balance dysfunction in an elderly resident of a nursing home who was at risk for falls.

Case Description: The patient is an 89-year-old resident diagnosed with an unspecified balance disorder and a history of multiple falls. Self reports of gait abnormalities, scores on several clinical measures, and her fall history classified her as having substantial risk for future falls.

Intervention: A nontraditional approach to balance training, employing the Nintendo Wii bowling simulation, was used as intervention for this patient's balance disorder.

Outcomes: After 6 one-hour treatment sessions, the patient's Berg Balance Score improved from 48 to 53. On the Dynamic Gait Index, the patient improved her score from 19 to 21. The patient's Timed Up and Go Test improved from 14.9 to 10.5 seconds, all suggesting a reduced risk of falling. The patient's ABC Score improved from 88 to 90%.

Conclusion: Physical therapy intervention, using the Nintendo Wii bowling simulation, may have decreased fall risk for this individual.

1Senior Director of Rehabilitation Operations, HealthBridge Management, Connecticut

2Associate Professor, Touro University Nevada's School of Physical Therapy, Henderson, NV

Address correspondence to: Robert Clark, Long Ridge of Stamford, 710 Long Ridge Road, Stamford, CT 06902 Ph: 203–905–3562, Fax: 908–378–7942 (

Copyright © 2009 the Section on Geriatrics of the American Physical Therapy Association
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