July 28, 2010

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By Julia Ferrante

LEWISBURG, Pa. — Helen Spotts Kirsch stepped onto the balance board and prepared for the onslaught of soccer balls, shoes and pandas that soon would come flying at her head.

The 81-year-old retiree tilted her body from side to side, trying to make "contact" with the soccer balls while narrowly avoiding the shoes and pandas. Soccer balls were worth a point each - or more if she hit them in succession. Getting struck by a shoe took away a point, and clashing with a panda depleted her score by three points.

"Ooh, it got me," Kirsch said as a shoe bonked into the head of her Wii Fit Plus persona, a little blonde cartoon image on the television screen in front of her. "I don't remember three of them coming at me at once."

"Twenty-nine points!" said Neil Dold, a rising junior biomedical engineering major at Bucknell University who has served as Kirsch's balance coach this summer. "That was one of your best scores."

Kirsch is among 11 residents at Buffalo Valley Lutheran Village in Lewisburg, Pa., participating in a balance study this summer with Dold and Assistant Professor of Biomedical Engineering Katie Bieryla. Five residents of the over-55 community trained three times a week for three weeks using the Wii Fit Plus, an interactive, computer-controlled program that measures movements and gives participants verbal feedback as they practice yoga, "ski jumping," and other exercises that increase strength and flexibility. Six others who exercise regularly served as a control group.

Seeking better balance
Bieryla, who studies falls and fall prevention in older adults, organized the study to determine if training with the Wii Fit Plus would provide older adults with better balance and therefore make them less susceptible to injuries from falls, which can range from bruises to hip fractures and even death. She became interested in fall prevention while conducting research as an undergraduate at the University of Pittsburgh and as a graduate student at Virginia Tech and decided to explore the question of whether older adults can improve their balance through training and exercise.

The Centers for Disease Control recommends regular exercise to increase strength, improve balance and prevent injuries from falls, but results from exercise programs vary, Bieryla noted. Many nursing homes have Nintendo Wiis, interactive game consoles that offer virtual "bowling" and "tennis" games. The Wii Fit Plus is an advanced program that incorporates a balance board that can sense weight and movement in conjunction with balance-enhancing games.

The Buffalo Valley residents completed the same sequence of exercises during each of the nine sessions at the Village Common, including a series of yoga poses and several rounds of the soccer game followed by "ski jumping," which involves bending and leaning as if about to sit in a chair then quickly extending one's legs. They also participate in a low-impact exercise group at their community center.

A change in plans
Bieryla and Dold designed the program to include exercises they thought would be appropriate for older adults. They modified the program after the first session when some participants, who range in ages from 70 to 92, had difficulty with a hula-hoop game. They swapped that exercise with an extra round of the soccer game.

The participants showed short-term improvement in the games, but Bieryla hopes the improvement correlates with better balance in the long run.

Bieryla and Dold measured the progress of the participants after the training and will follow up at the end of July to compare the results with the control group. The researchers will use several clinical balance measures that involve sitting and standing, reaching, balancing on one leg with eyes shut and stepping over things.

"When people stand, they do move and sway, and some studies show the more they move and sway the greater risk they are at for a fall," Bieryla said. "This is an inexpensive and fun way of improving balance. All you need it a television and a Wii Balance Board."

Showing improvement
Kirsch, who had knee replacement in early July, did well before the surgery with torso twists but had difficulty with ski jumping. She bent her knees slightly then straightened her legs, but the movement did not register, and her Wii persona went tumbling down the trail. Still, she said the training has made her stronger.

"I feel good," she said. "I usually sit down and get a glass of juice after the training."

Another study participant, Angie Stackhouse, 82, said she enjoyed working with the Wii Fit.

"I think my balance has improved, too," she said.

Barbara Ott, 85, said the training brought out her competitive spirit.

"I'm very competitive, and that's why I get frustrated," she said. "But I feel that I have accomplished something."

Dold said he was impressed with the Buffalo Valley residents' improvement, and the study gave him the opportunity to take a leading role in research as an undergraduate.

"It's been pretty rewarding, and I had a fair degree of freedom to figure out how we could do this," he said. "I was surprised by how much energy they had. One of the participants is 92, and she probably had more energy than anyone."

Contact: Division of Communications