Video Games for Balance

Using video games for exercise took off with the Nintendo Wii Fit and scientists researching the trend coined a new term to describe it: exergaming. They also discovered something rather surprising: it helps those with disabilities, and it’s fun.


Using video games to help with exercise has been around since essentially Pong was developed. You miss the pong, you jump up and shake your fist at the TV, bingo: exercise. Well, technically exergaming started in the 1980s, but it wasn’t until 1998 that it really kicked into high gear with Dance, Dance Revolution. Hardcore gamers went so far as to purchase commercial pads to play the game on their home gaming systems. Then they got so good, that when they invited friends over to play it wasn’t much fun because ANDY would win every dang time. You know, the kind of guy who wouldn’t let it go and would even bring such a system to his own wedding to prove, once-and-for-all, who was the DDR master. Thanks, ANDY.


Well, researchers picked up on the trend and started testing such gaming systems with people with neurological challenges, in particular multiple sclerosis. Multiple studies have been done on MS and the benefit of exergaming—which uses technology to tracks body movements and reactions—and we’ve documented them all here in our forum. Wikipedia even has a full entry devoted to exergaming. And despite the Nintendo Wii Fit getting retired in 2012, research is ongoing with that system. Indeed, a 2020 study “confirmed that balance rehabilitation training performed using the Nintendo Wii with balance board significantly reduced some postural sway parameters in multiple sclerosis patients. It could be a good support to standard rehabilitation program in multiple sclerosis patients.”

“I now walk faster, straighter and feel more confident in my balance,” says Tricia.

One MSer who took part in earlier clinical trials is Tricia Pell, a member of ActiveMSers. At the age of 28, after a year of confusion, fear and test after test, Tricia was diagnosed with multiple sclerosis. It wasn’t long before she had more assistive devices than her grandma. One cane turned to two (one for each vehicle), the handicapped license plate soon followed (her neurologist didn’t blink before he said, “okay”), then the freebie walker came out from her closet (where she had hidden it so she wouldn’t have to look at it), and now she needs a wheelchair for distances. But there was one new “aid” that’s made a surprising difference in her quality of life: using video games to exercise and balance better.


Throughout her pre-MS life, she loved many different sports—dancing, roller skating, bowling, and long walks just for the sake of walking. But her new MS life brought on balance problems that were thwarting her active passions.


“I desperately wanted to do anything resembling the old me,” said Tricia. “The old me didn’t walk into walls, fall over in the dark or need to hold railings tightly to get up stairs. I could run, jump, skip, dance, skate and bowl without a worry. Then I started playing the Nintendo Wii, a video game system. I loved that it involved light physical activity and reminded me (a little) of the fun I used to have playing sports. And many of the games could be adapted to sitting if need be.”

In 2011 she was asked to be a participant in a balance study for people with MS being run by primary investigator Maureen Dunn out of Hope College in Holland, Michigan. The portion of the study she was in used the Wii Fit—the balance games specifically—to see if the gaming system would help with everyday balance in multiple sclerosis.


“It was frustrating at first—I kept falling off the balance board!” remembers Tricia. The balance board is a small platform that comes with the Wii Fit that you stand on while gaming. It senses the motion of your body and makes corresponding motions on the screen with your character. “Because of my poor balance I couldn’t complete many of the games, had very low scores, and I wondered if I would ever be able play the games well.”


At the beginning of each session of play, the system records your center of balance and then shows you where that center of balance was. The system helps you to recognize where the balance needs to be (indicated by a blue dot in the center of the screen) and how it feels when your body is in the correct position.


“My body has lessened sensations on the right side. Until I played the game, I had no idea that I was leaning quite far to my right because that’s the only way my body felt like I was putting the same amount of weight on both feet. After many sessions, I learned the way my body felt when it was properly aligned and though it felt like I was putting more weight on the left side, I now know that’s how I was supposed to feel and I became much more balanced in all my daily activities.”


With practice learning how to balance, the games turned from frustrating to fun. Her favorites: Table Tilt and Table Tilt Plus. She also used Ski Slalom, Penguin Slide and the Balance Bubble games in the study.


“I now walk faster, straighter and feel more confident in my balance,” said Tricia. “Other than the benefit of improved balance, there’s the benefit of moderate exercise without even having to leave the house and fun while you’re at it. The game can be adapted to your needs and can be played with a chair in front of you for stability.”


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Make room. Exercising to a video game takes space. “You don’t need much space but, to be realistic and safe, I’d estimate having about 6 feet of free space in either direction (in case you fall) is a good idea,” said Tricia. “It is recommended that you have your board about 5 feet from the sensor bar (bar that goes up by your TV to ‘see’ you while you’re playing). I actually have mine about 4 feet away and about a 2-3 foot clearance on either side of me. I have never fallen while playing, though. If you are prone to falling, making sure that there is nothing you can fall onto or into is important.”


Challenge yourself. You can do it, says Tricia! “The Wii Fit also has yoga and more aerobic games as well for those with fewer restrictions so you can definitely challenge yourself with more difficult games if you are able. I have continued to use the Wii Fit since the end of the study and I have continued to see improvements in balance and coordination. I plan to keep using the Wii as long as I am capable of doing so. Not only is it a fun way to spend time, the games helped my balance significantly.”


Purchase. The now-retired Nintendo Wii can be found used and refurbished on Amazon, that will help challenge you to get and stay active. Other exergaming systems now exist, the Nintendo Switch is one.

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