Exercising With Computers in Later Life (EXCELL)

• Improvement in formal balance score [ Time Frame: 4 weeks and 12 weeks following the exercise intervention ] [ Designated as safety issue: No ]
  Berg and Tinetti balance scores
  
  

• Acceptability of the Nintendo WiiFit in community-dwelling older fallers [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  Individual interview and completion of the Attitudes to Falls-Related Interventions Scale (AFRIS)
  
  
• Participants degree of concern about falling in certain situations following the intervention [ Time Frame: 4 weeks and 12 weeks ] [ Designated as safety issue: No ]
  Falls Efficacy Scale - International (FES-I)
  
  

The population is ageing and as a result medical staff and allied health professionals are likely to see an increase in the number of patients with falls. Community dwelling individuals over 65 fall at a rate of 30% per year. This risk increases with advancing age. Falls have significant consequences for both the individual and the population as a whole. Falls risk increases with age due to increased body sway, a reduction in reaction times, deterioration in the efficiency of the walking pattern and diminished balance.

People who fall should be referred for multidisciplinary falls assessment. Locally, patients are assessed by the multidisciplinary team and, if appropriate, attend falls group. This group consists of a 12 week exercise program to improve balance and muscle strength (patients attend the group up to 3 times weekly). Previously trials have shown variable compliance with exercise programs but locally compliance is felt to be good. Falls groups aim to reduce falls through the benefits of exercise; improvement in muscle strength,balance, general fitness and well being. It has been shown that exercise has statistically significant beneficial effects on balance.

Due to advances in technology, equipment has been produced to improve balance on both the medical and commercial market. There is a large variability in cost between this equipment with commercial prices being much lower. The Wii has been very successful in encouraging sedentary youths to partake in exercise (all be it in a limited form). WiiFit is a specifically designed "game" for the Wii to improve balance with an element of entertainment value.

This project is important due the large number of falls that occur in the community and the significant impact this has on an under resourced NHS. It is timely because the WiiFit has only just been introduced into the market. Through the use of a Wii, balance training may be more enjoyable and as a result elderly community dwellers may be more likely to participate in exercise programmes. The Wii is considerably cheaper than the medical alternatives and if an improvement can be shown in post−intervention balance assessments, then we have to consider whether the use of similar equipment should be instituted in falls groups.