Low-cost evaluation and real-time feedback of static and dynamic weight bearing asymmetry in patients undergoing in-patient physiotherapy rehabilitation for neurological conditions

Background: weight bearing asymmetry is common in patients with neurological conditions,and recent advances in gaming technology have produced force platforms that are suitable for use in a clinical setting. the aim of this research is to determine whether commercially-available wii balance boards with customized software providing real-time feedback could be used in a clinical setting to evaluate and improve weight-bearing asymmetry in people with various neurological conditions. methods. twenty participants (age = 43.25 ± 19.37 years) receiving physiotherapy as a result of a neurological condition performed three trials each of two tasks (static standing and sit-to-stand) with and without visual feedback. vertical forces were measured using available wii balance boards coupled with customized software that displayed visual feedback in real-time. primary outcome measures included weight-bearing asymmetry as a percentage of body mass,peak force symmetry index,and a visual analogue scale score rating self-perceived level of asymmetry. results: weight-bearing asymmetry during the static balance task was significantly reduced (z = -2.912,p = 0.004,es = 0.65) with visual feedback. there was no significant difference (z = -0.336,p = 0.737) with visual feedback for the dynamic task,however subgroup analysis indicated that those with higher weight-bearing asymmetry responded the most to feedback. correlation analysis revealed little or no relationship between participant perception of weight-bearing asymmetry and the results for the static or dynamic balance task (spearman's rho: ρ = 0.138,p = 0.561 and ρ = 0.018,ρ =0.940 respectively). conclusions: these findings suggest that weight-bearing asymmetry can be reduced during static tasks in patients with neurological conditions using inexpensive commercially-available wii balance boards coupled with customized visual feedback software. further research is needed to determine whether real-time visual feedback is appropriate for reducing dynamic weight-bearing asymmetry,whether improvements result in improved physical function,and how cognitive and physical impairments influence the patient's ability to respond to treatment. © 2013 foo et al.; licensee biomed central ltd.