When friends would come round to play, I would tell them that the Wii Fit board was broken because I didn’t want them to see what it said.”

Hanneton S: Coaching the Wii: Evaluation of a physical training experiment assisted by a video game. Haptic, Audio, Visual Environments and Games; Lecco, Italy 2009, 54-57. Gray P, Hildebrand K: Fall risk factors in Parkinson's disease. J Neurosci Nurs 2000, 32: 222-228. 10.1097/01376517-200008000-00006This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. Use and acceptance of the Wii Fit as a balance assessment and neurorehabilitation tool is growing rapidly. With respect to assessment, initial attempts to use the WBB as a low cost proxy for a scientific force platform via customized software applications appear to be an extremely promising area of exploration. Research relying on measurement of balance ability using Wii Fit software-based metrics, however, has been far less convincing to date. With respect to balance neurorehabilitation, there is reason for optimism regarding the use of Wii Fit-based interventions to foster meaningful balance improvements across a variety of clinical populations. Multiple studies now show improvement in balance control following reasonable periods of training with the Wii Fit games and custom designed applications. This frustrated Osu, because the Wii Fit avatars weren’t very accurate. “Body types are so different,” she said, noting that “just because you got a certain score doesn’t mean you look a certain way, yanno?” Wii Fit took none of these nuances into account. It might be easy to just write Wii Fit off as a well-intentioned game that used a common index for its time, but even then, the game was inconsistent with what it considered to be a good and bad BMI. Polygon reviewed one play through where the player had a “healthy” BMI of 22.97 by the game’s and medical standards, but the game still suggested that the person try to lower it. Miller CA, Hayes DM, Dye K, Johnson C, Meyers J: Using the Nintendo Wii Fit and body weight support to improve aerobic capacity, balance, gait ability, and fear of falling: two case reports. J Geriatr Phys Ther 2012, 35: 95-104. 10.1519/JPT.0b013e318224aa38

Nilsagard YE, Forsberg AS, von Koch L: Balance exercise for persons with multiple sclerosis using Wii games: a randomised, controlled multi-centre study. Mult Scler 2013, 19: 209-216. 10.1177/1352458512450088 Deutsch JE, Brettler A, Smith C, Welsh J, John R, Guarrera-Bowlby P, Kafri M: Nintendo wii sports and wii fit game analysis, validation, and application to stroke rehabilitation. Top Stroke Rehabil 2011, 18: 701-719. 10.1310/tsr1806-701 Not all Wii fit balance interventions have been game-based. Shih[ 42], for example, used a unique approach that encouraged individuals with Cerebral Palsy to become more aware of their COP location. In this experiment, a customized WBB setup was used to activate participants’ favorite television programs when standing on the board with their COP centered between the feet. Deviation from this ideal resulted in the television program being turned off. Even though the participants had reduced cognitive abilities, they were able to implicitly learn COP control over multiple trials and keep the television on for longer periods of time than normal. An increased percentage of trials with the desired COP location were also found in retention trials with the television stimulus constantly on. Efficacy of Wii Fit-based interventionsKwok BC, Mamun K, Chandran M, Wong CH: Evaluation of the Frails’ Fall Efficacy by Comparing Treatments (EFFECT) on reducing fall and fear of fall in moderately frail older adults: study protocol for a randomised control trial. Trials 2011, 12: 155. 10.1186/1745-6215-12-155 Deutsch JE, Robbins D, Morrison J, Guarrera Bowlby P: Wii-Based Compared to Standard of Care Balance and Mobility Rehabilitation for Two Individuals Post-Stroke. Virtual Rehabilitation International Conference; Haifa 2009, 117-120. Of the studies gathered for this review, only three were identified as having some form of randomized control design. The best insight into the overall effectiveness of Wii Fit interventions might be gained from this work by calculating effect sizes for the mean outcome measure differences. First, in a study by Franco et al.[ 28], it was shown that six, 15-minute sessions of Wii Fit exer-gaming had a strong effect (Cohen’s d = 0.7) on Berg Balance score in a group of community dwelling older adults compared those that did not use the Wii Fit. Toulotte et al.[ 14] also found moderate to strong effects across all balance outcome variables in a study of older adults who played Wii Fit games one hour per week for 20 weeks. Balance measures in this study included unilateral stance tests with eyes open (Cohen’s d = 0.5) and eyes closed (Cohen’s d = 1.3), Tinetti’s static (Cohen’s d = 3.8) and dynamic (Cohen’s d = 1.0) tests, as well as the Wii Fit test of center of balance (Cohen’s d = 1.9). We know from research that weight is one of the most prevalent reasons that kids are teased or bullied.” Zettergren K, Franca J, Antunes M, Lavallee C: The effects of Nintendo Wii Fit training on gait speed, balance, functional modility and depression in one person with Parkinson's disease. Med Health Sci J 2011, 9: 18-24.