Comparing the Energy Expenditure of Wii Fit?-Based Therapy Versus Traditional Physiotherapy

Objective: Activity-promoting computer gaming systems, which encourage the use of the body to control game play, are commonly used in rehabilitation. However, the mechanisms by which improvements in clinical outcomes occur after using activity-promoting gaming systems are unknown. Therefore the aims of this study were to compare the physiological cost and enjoyment of Nintendo� (Kyoto, Japan) Wii Fit?-based therapy compared with traditional-based physiotherapy training. Subjects and Methods: Young adults (n=35), 20.7�1.6 years old, carried out a traditional physiotherapy training program and a Wii Fit-based training program. Energy expenditure was assessed using indirect calorimetry while at rest and during training modes, and enjoyment was measured using a modified Physical Activity Enjoyment Scale. Results: For the traditional physiotherapy-based program, all physiological measures (oxygen consumption [VO2], energy expenditure, and metabolic equivalents [METs]) were significantly greater (VO2, 0.64 versus 0.51 L/minute; energy expenditure, 186.0 versus 146.5?J/kg/minute; METs, 2.6 versus 2.1) than for the Wii Fit-based program. Enjoyment was rated statistically significantly higher for the Wii Fit-based program (76.0�13.7 percent) compared with the traditional program (67.5�14.8 percent). Conclusions: The lower physiological cost associated with the Wii Fit suggests that it is less demanding than the traditional therapy, even though this modality of training has been shown to elicit improvements in rehabilitative outcomes. This suggests that frailer individuals, whose energy levels are impaired, may benefit from using the Wii Fit as a rehabilitative tool because of the lower demand on energy.