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Unilateral lower limb strength assessed using the Nintendo Wii Balance Board: a simple and reliable method

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Abstract

Background

Lower limb weakness is an important risk factor for fall accidents and a predictor for all-cause mortality among older adults. Unilateral whole-lower limb strength may be a better measure of fall risk than the bilateral measure. In addition, a number of clinical conditions affect only one leg, and thus this type of assessment is relevant in clinical settings.

Aim

To explore the intra-rater reproducibility of the Nintendo Wii Balance Board (WBB) to measure unilateral whole-lower limb strength and to compare the method with stationary isometric muscle apparatus (SID).

Method

Intra-rater test–retest design with 1 week between sessions. Thirty community-dwelling older adults (69 ± 4.2 years) were enrolled and examined for maximum lower limb strength in their dominant and non-dominant leg. Intraclass correlation coefficient (ICC) was calculated to describe relative reproducibility, while standard error of measurement (SEM), limits of agreement (LOA) and smallest real difference (SRD) were calculated to describe absolute reproducibility between test sessions. Concurrent validity with the SID was explored using the Pearson product-moment correlation coefficient (PCC).

Results

No systematic difference was observed between test sessions. ICC was 0.919–0.950 and SEM, LOA and SRD was 2.9–4.1 kg, 24.1–28.3 kg and 7.6–11.3 kg, respectively. Further, the PCC was 0.755 and 0.730 for the dominant limb and the non-dominant limb, respectively.

Conclusion

A high relative and an acceptable absolute reproducibility was seen when using the Nintendo Wii Balance Board for testing unilateral lower limb strength in community-dwelling older adults. The WBB correlated strongly with the SID.

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Author contributions

AWB, principal investigator of this study, analysed the data and drafted the first version of the manuscript. MGJ designed the study and collected the data. All authors substantially contributed to the design and the interpretations of data, revising the first manuscript, gave final approval of the version to be published and agreed to being accountable for all aspects of the work.

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Authors and Affiliations

  1. Department of Geriatric and Internal Medicine, Aalborg University Hospital, Aalborg, Denmark

    A. W. Blomkvist, S. Andersen & M. G. Jorgensen

  2. Department of Clinical Medicine, Aalborg University, Aalborg, Denmark

    S. Andersen

  3. Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland

    E. de Bruin

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  1. A. W. Blomkvist
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  2. S. Andersen
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  3. E. de Bruin
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  4. M. G. Jorgensen
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Correspondence to A. W. Blomkvist.

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Conflict of interest

AWB, SA and EDB declare that they have no competing interests. MGJ developed and holds a patent on the software used in the study.

Ethical approval

The study was approved by the regional ethics committee, The North Denmark Region Committee on Health Research Ethics.

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All participants gave written informed consent.

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Blomkvist, A.W., Andersen, S., de Bruin, E. et al. Unilateral lower limb strength assessed using the Nintendo Wii Balance Board: a simple and reliable method. Aging Clin Exp Res 29, 1013–1020 (2017). https://doi.org/10.1007/s40520-016-0692-5

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