Reliability and feasibility of gait initiation centre-of-pressure excursions using a Wii® Balance Board in older adults at risk of falling

James Lee, Graham Webb, Adam Shortland, Rebecca Edwards, Charlotte Wilce, Gareth David Jones

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Background Impairments in dynamic balance have a detrimental effect in older adults at risk of falls (OARF). Gait initia- tion (GI) is a challenging transitional movement. Centre of pressure (COP) excursions using force plates have been used to measure GI performance. The Nintendo Wii Balance Board (WBB) offers an alternative to a standard force plate for the measurement of CoP excursion.
Aims To determine the reliability of COP excursions using the WBB, and its feasibility within a 4-week strength and bal- ance intervention (SBI) treating OARF.
Methods Ten OARF subjects attending SBI and ten young healthy adults, each performed three GI trials after 10 s of quiet stance from a standardised foot position (shoulder width) before walking forward 3 m to pick up an object. Averaged COP mediolateral (ML) and anteroposterior (AP) excursions (distance) and path-length time (GI-onset to first toe-off) were analysed.
Results WBBML(0.866)andAPCOPexcursion(0.895)reliability(ICC3,1)wasexcellent,andCOPpath-lengthreliability was fair (0.517). Compared to OARF, healthy subjects presented with larger COP excursion in both directions and shorter COP path length. OARF subjects meaningfully improved their timed-up-and-go and ML COP excursion between weeks 1–4, while AP COP excursions, path length, and confidence-in-balance remained stable.
Discussion COP path length and excursion directions probably measure different GI postural control attributes. Limitations in WBB accuracy and precision in transition tasks needs to be established before it can be used clinically to measure postural aspects of GI viably.
Conclusions The WBB could provide valuable clinical evaluation of balance function in OARF
Original languageEnglish
Early online date17 Apr 2018
Publication statusE-pub ahead of print - 17 Apr 2018


  • Gait initiation
  • Wii balance board
  • Reliability
  • Falls
  • Rehabilitation
  • Balance function


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