Impaired visually guided weight-shifting ability in children with cerebral palsy.
A five-minute Wii Fit skiing game shows clear trunk-control gaps in kids with spastic diplegic CP.
01Research in Context
What this study did
Ballaz et al. (2014) asked kids to play a Wii Fit skiing game. The game forces you to shift weight side-to-side to steer.
Ten kids with spastic diplegic CP played. Ten kids with typical development did the same. A force plate under the board tracked how far and how fast each child swayed.
What they found
Kids with CP moved less side-to-side. Their sway was slower and smaller.
They also bent their trunks at odd times. The legs and trunk did not work as one smooth unit.
How this fits with other research
Ju et al. (2010) saw the same clumsy lateral moves. They used a reaching task instead of a game. Both studies show sideways moves are tough for this CP group.
Saether et al. (2014) found high trunk wobble during gait. Laurent shows the wobble starts even when feet are still. The problem is balance, not just walking.
Danitz et al. (2014) warned that Wii games lack solid proof. Laurent does not claim the game fixes balance; it only flags the deficit. No clash—one reviews treatment, the other screens.
Why it matters
You can borrow a Wii Fit board and run a five-minute screen. If sway range is tiny or jerky, you know trunk-hip control is weak. Pair this quick test with your normal gait check. When you plan therapy, add seated trunk games or lateral weight shifts before you ask for smooth walking.
Get CEUs on This Topic — Free
The ABA Clubhouse has 60+ on-demand CEUs including ethics, supervision, and clinical topics like this one. Plus a new live CEU every Wednesday.
Place a Wii Fit board under the client’s feet, run the skiing game for one minute, and note the COP trace—if it’s narrow or choppy, add lateral weight-shift drills to the plan.
02At a glance
03Original abstract
The ability to control voluntary weight shifting is crucial in many functional tasks. To our knowledge, weight shifting ability in response to a visual stimulus has never been evaluated in children with cerebral palsy (CP). The aim of the study was (1) to propose a new method to assess visually guided medio-lateral (M/L) weight shifting ability and (2) to compare weight-shifting ability in children with CP and typically developing (TD) children. Ten children with spastic diplegic CP (Gross Motor Function Classification System level I and II; age 7-12 years) and 10 TD age-matched children were tested. Participants played with the skiing game on the Wii Fit game console. Center of pressure (COP) displacements, trunk and lower-limb movements were recorded during the last virtual slalom. Maximal isometric lower limb strength and postural control during quiet standing were also assessed. Lower-limb muscle strength was reduced in children with CP compared to TD children and postural control during quiet standing was impaired in children with CP. As expected, the skiing game mainly resulted in M/L COP displacements. Children with CP showed lower M/L COP range and velocity as compared to TD children but larger trunk movements. Trunk and lower extremity movements were less in phase in children with CP compared to TD children. Commercially available active video games can be used to assess visually guided weight shifting ability. Children with spastic diplegic CP showed impaired visually guided weight shifting which can be explained by non-optimal coordination of postural movement and reduced muscular strength.
Research in developmental disabilities, 2014 · doi:10.1016/j.ridd.2014.04.019