Sunday, December 7, 2014

Yoga on the Wii Fit Used for Encouraging Regular Physical Activity in the Home By Jeffrey Clement









Yoga on the Wii Fit Used for Encouraging Regular Physical Activity in the Home
Yoga: Theory, Culture, and Practice
Jeffrey Clement












INTRODUCTION
The Wii Fit created by Nintendo was released over five years ago as a means for anyone to improve their basic fitness, overall health and well-being right at home. On December 1st, 2012 the Nintendo Wii Fit gaming system celebrated its fifth anniversary. The Wii Fit is perceived as an innovative system because it consists of game software that encourages participants to exercise. The main tool of the Wii console that motivates individual to exercise, strength train and improve posture and balance is the specially developed Wii Fit balance board controller (Goble, 2014). The Wii Fit is widely available commercially because it is relatively inexpensive. It is also user friendly and can be used by virtually anyone in any home. Some even consider the application and use of the Wii Fit by the elderly as an option for improving balance and preventing fatal falls (Franco et al., 2012). The Wii Fit is designed to promote balance and physical activity through interactive exercise games. Wii Fit has over forty exercise options that incorporate strength training, balance training, aerobics and yoga. Some examples of the yoga poses available on the Wii Fit are Deep Breathing, Warrior pose, Tree pose and Triangle pose (Plow, 2011). According to the American College of Sports Medicine, it is recommended that vigorous aerobic training should be performed for about twenty to sixty minutes every day. Currently, “only a few studies have tested actual energy expenditure of children and adults playing the games,” but yoga and other exercises on the Wii Fit may be an effective way to encourage regular physical activity. The general finding of the research is that “the energy requirements of playing the games are comparable to moderate exercise” (Brettler et al., 2011). Many “studies have used Wii Fit yoga games to improve participant balance” for a variety of populations and ailments. Yoga on the Wii Fit by Nintendo improves posture and general health because the yoga poses rely on static balance control. Examples of Wii Fit yoga poses that emphasize posture and balance are the Sun Salutation and Half Moon poses (Goble, 2014). Despite a broad mission of increasing regular physical fitness, the Wii Fit has generated specific interest in rehabilitation as a training device for improving posture, health and balance ability. Growing interest in Wii Fit technology is “likely due to the ubiquitous nature of poor balance and catastrophic falls, which are commonly seen in older adults and various disability conditions” (Goble, 2014). Yoga on the Wii Fit is an impeccable tool to utilize in order to improve personal fitness and balance. Yoga on the Wii Fit may have more implications in society than encouraging basic fitness for everyone, yoga on the Wii Fit may also have the potential to improve the health and well-being of disabled populations such as the elderly.
WII FIT YOGA VS. TRADITIONAL YOGA PRACTICE
               Yoga on the Wii Fit is a very different experience than doing yoga within a yoga studio. When doing yoga on the Wii Fit, participants are led by a virtual trainer on the television screen. When beginning yoga on the Wii Fit, one has the option to choose a male trainer with a male voice to be projected on the screen or a female trainer with a female voice. The selected yoga trainer demonstrates a certain body position that participant must then also achieve. Once the participant is in the posture being displayed on screen, the yoga trainer provides feedback in real-time based on calculation about the participant’s balance on the Wii Fit balance board. The participant’s “goal is to keep their body as still as possible while maintaining the yoga pose” (Goble, 2014). Another unique feature of yoga on the Wii Fit that is not present within a yoga practice at a studio is the opportunity to create an avatar, or a Mii, which looks like the participant and personifies similar motions as the participant. The movements from all the controllers translate to the movement of the Mii in the games. That is, the Wii calculates input from the controls at the participant’s hands and feet. These controllers consist of the Wiimote, Nunchuks, and the Wii Fit balance board (Brettler et al., 2011). Yoga on the Wii Fit is similar to an actual video game in the way one earns points and unlocks new levels based on the amount of time played or once proficiency is achieved (Brettler et al., 2011). 
               The chief goal of yoga on the Wii Fit is modeling the ideal movement of the virtual yoga trainer on screen. Scoring is based on a star rating system and is typically rewarded for stability. There are many exercises present on the Wii Fit that use the Wiimote and the Fit balance board. The yoga poses are supposed to improve one’s flexibility, stability, strength and breathing. In addition to yoga poses, there is the option to do other exercises such as balance games (Brettler et al., 2011). One of the most challenging yoga poses that takes many Wii Fit Credits to unlock is the Bridge pose. In the Bridge pose, the player lays on their back. Following the instructions of the yoga trainer on screen, the player then executes and maintains bridge position (Brettler et al., 2011). The first and simplest yoga pose available on the Wii Fit is the Deep Breathing exercise. While standing will flat and parallel feet on the Wii Fit board, the participant performs deep breathing with the palms on the abdomen below the belly button and while maintaining stability. The participant can monitor their stability by maintaining a red dot on screen within the yellow circle provided.  The red dot mirrors the player's real time position (Brettler et al., 2011). The Downward Facing Dog position begins on with both hands on the Wii Fit board. Then the player brings their hips up, extends their knees and arms and looks towards the floor. Similar to Deep Breathing, the player must try to maintain the red bar within the blue target area (Brettler et al., 2011). Half Moon pose is another pose where the player must standing on the Wii Fit balance board. Then they must bend from side to side with arms overhead and palms together while also maintaining stable. Again, the main goal is to maintain the red dot in yellow circle. The Sun Salutation pose, with arms extended overhead and palms together, is supposed to be performed while maintaining the red dot in the yellow circle (Brettler et al., 2011). Triangle pose, performed by standing on the Wii Fit balance board, asks the participant to rotate at the hip with the feet spread apart and parallel. Next, the participant is supposed to flex at the hips, placing and maintaining weight on front leg, bringing back arm and reaching towards the ceiling. Finally, the participant must hold this position while keeping the red bar in the blue target area. Then the triangle pose is repeated on the opposite side. Warrior is the final yoga pose that emphasizes posture and balance. The player must lean forward, placing and maintaining weight on their front leg so the red bar stays within the blue target area. This pose is also repeated on opposite side (Brettler et al., 2011). Although all of the poses available for practice on the Wii Fit are also popular in yoga classes in a yoga studio, the emphasis on balancing one’s center of pressure in a blue target area projected on a television is a vastly different experience not found in any yoga studio. 
One of the most alarming differences between yoga on the Wii Fit and traditional yoga within a studio is the direction and attention of one’s gaze. In a traditional, yoga practice, participants typically soften the gaze or focus on one steady point to find stability and center within. When practicing yoga on the Wii Fit, however, it is necessary to look at the television screen and monitor the stability of a red dot. In some poses, the body position does not allow “the players to actually see the visual information displayed on the screen. Typically, this occurs because the movement requires that they lose sight of the screen for at least part of the time” such as forward bending during Sun Salutation pose (Brettler et al., 2011). It’s also important to note the sensitivity and calibration of the Wii controls. If the Wii Fit balance board, for example, is not calibrated correctly, then the participant’s balance, focus, and proper execution of the pose may be effected. The Wiimote is more sensitive to “acceleration over movement direction or amplitude… [this] suggests that the upper extremity trajectories would prompt individuals to make rapid and potentially inaccurate movements and still be rewarded by the system” (Brettler et al., 2011). This type of error does not exist in traditional yoga practices within a studio due to the presence of an actual yoga instructor.
FITNESS
According to Nintendo, “the purpose for developing the Wii Fit was to combine fun and fitness for all ages, including such aspects of physical well-being as joint flexibility, muscle strength, and upright standing posture” (Goble, 2014). In addition, the Wii Fit system is easy to access because it is relatively inexpensive and it is highly engaging (Goble, 2014). Some of the interactive features of the Wii Fit include encouragement for participants to set health-related goals, rewards for regular use of the machine, and promotion of maintaining physical activity (Plow, 2011). The main fitness feature of yoga on the Wii Fit is the body test program. The body test program evaluates the player’s weight and balance in order to set a weight-loss or weight-gain goal (Plow, 2011). During the body test on the Wii Fit, participants stand still on the Wii Fit balance board for seven seconds while data is collected. From this data, the participant’s average center of balance “from body midline is calculated, indicating a measure of weight bearing asymmetry. Overall, this assessment is thought to provide information about body posture” (Goble, 2014). The body test on the Wii Fit helps individuals monitor their weight at home, which may be an effective strategy for promoting weight loss or weight gain. Once completed, the participant is given a score, called their Wii Fit age, which represents what age the Wii perceives they are based on their performance. This Wii Fit ages ranges from two years old to ninety nine years old. A score of forty six, for example, indicates the balance ability equal to that of the average forty six year old (Goble, 2014). Yoga on the Wii Fit includes elements of strength training, balance improvement, and aerobic endurance which are all “have been found to reduce fatigue, increase fitness levels, and improve quality of life in people” (Plow, 2011).
BALANCE
The most successful application of yoga on the Wii Fit is the improvement of balance. “No study has reported a negative impact of Wii Fit training for any measure of balance ability, and most have indicated at least some quantitative or anecdotal evidence of improvement” (Goble, 2014). The Wii Fit’s effectiveness in improving balance is due to the balance board. While using the balance board during yoga, the location of one’s center of pressure is displayed relative to the target area. Poses such as Tree pose or Warrior include this function (Franco et al., 2012). Not only do yoga poses train one’s balance, but the balance games offered on the Wii Fit project one’s center of pressure as well. Some of the fun balance games that can be accessed on the Wii Fit are Ski Jump, Tightrope, and Penguin Slide. The Wii Fit by Nintendo as claims to train coordination and endurance. This ability is attributed to the games that require combinations of accurate movements and speed in order to achieve. This patterning of the body and limbs has an effect on the cardiovascular and overall endurance. There are other games that require the body to sustain long repetitious movements for longer than there minutes of continuous exercise such as Long Run or Hula Hoop (Brettler et al., 2011). Finally, there are additional exercises available on the Wii Fit which emphasizes strength. The exercises that “require generating a group of muscles to overcome a force against gravity or resistance under a specific set additional outside resistance of circumstances" to improve muscle mass and strength.
Coinciding with an emphasis of balance is a focus on postural control. Postural control can be defined as the ability to maintain, achieve, or restore a state of balance during any posture or activity (van Diest et al., 2013). Balance is the ability to maintain an upright posture against the changing effects of gravity on the body segments, so “postural control mechanisms help a person maintain balance by ensuring that the center of gravity is maintained within the base of support” (Franco et al., 2012). On the Wii Fit by Nintendo, the most “frequently played exercises were the balance games, followed by yoga, aerobics, and strength exercises” (Plow, 2011). The Wii Fit balance board is a type of force platform (Goble, 2014). A force platform device provides accurate measures of the body’s center of pressure, which is an approximation of the body’s center of mass and balancing point. projected vertically onto the floor below. The center of pressure, or balancing point, is frequently assessed throughout the yoga poses in order approximate body sway (Goble, 2014). When standing on the Wii Fit balance board, it measures your body sway in the side to side as well as front to back “based on downward force sensor data generated at each corner of the Wii” balance board (Goble, 2014). The data provided by the balance board measuring one’s center of pressure is reliable, “evidenced by strong interclass correlations between trials of similar balance conditions” (Goble, 2014). The innovative balance board transforms one’s posture and balance because one can monitor their performance, reduce asymmetry with the visual feedback, and improve stability in yoga postures.
MOTIVATION FOR FITNESS
One appeal of yoga on the Wii Fit is that its accessibility and simplicity may motivate individuals to engage in regular physical fitness. “Interactive gaming can promote intensive task-based therapy in a manner that is motivating for the user. Widespread enthusiasm for consoles and their games prompted us to analyze the games for their rehabilitation elements related to improving balance and mobility for individuals” (Brettler et al., 2011). An encouraging attribute of yoga on the Wii Fit is that there is positive feedback linked to performance which enhances participation, motivation and engagement. For example, during all the sports games, there is cheering in the stands. Another form of positive feedback linked to success is the playing of pleasing music when a game is won. “This type of feedback may explain some of the appeal of the games. Players are also given stars or scores for their performance” (Brettler et al., 2011). Feedback is also provided in many mediums such as visual feedback as well as auditory feedback. The “abundance and redundancy [of feedback] will allow clinicians to direct patients' attention to select particular sensory information to augment their performance” (Brettler et al, 2011). The star system, another form of feedback provided by the game, is not always a completely positive response. It is possible to score one two, three or four stars as feedback. It requires substantial improvement between yoga poses to change a two star rating to a three star rating, for example (Brettler et al., 2011). All in all, Wii Fit yoga poses, as well as other exercises, are fun to play. Not only does a fun activity provide a distraction and relief from the stresses of daily life, but it also creates intrinsic motivation for individuals to engage in regular physical activity (Plow, 2011). Yoga on the Wii Fit by Nintendo was released with an intention to promote fitness for anyone at home. This specific focus on fitness, including an emphasis on balance and postural strength, makes yoga on the Wii Fit also applicable and beneficial for disabled populations without an accessible outlet for regular physical activity. It’s important to consider the Wii Fit as “beneficial in initially motivating people to engage in some type of physical activity and whether introducing variety into an existing exercise program helps promote physical activity” (Plow, 2011). Yoga on the Wii Fit is appropriate for anyome who wished to be encouraged about regular physical activity. The elderly is one population that may benefit from the encouraging promotion of regular physical activity due to long-term use of  the Wii Fit (Plow, 2011).
ELDERLY
Yoga on the Wii Fit may have extremely positive applications for the health and preventative care of elderly citizens. The elderly is “defined to include those with a chronological age of sixty five years and older. The elderly population is rapidly increasing and currently makes up twelve percent of the population” (Franco et al., 2012). It’s also important to note that “more than one third of the community-dwelling individuals aged sixty five and older falls at least once per year” (van Diest et al., 2013). For this reason, it’s imperative for seniors age sixty five or older to regularly exercise in order to maintain proper strength and balance. Some key components of fall prevention training programs for the elderly include balance, muscle strength, flexibility and endurance. The greatest effects on fall rate are seen in fall programs that “included a combination of a high dose of exercise and challenging balance exercises” (van Diest et al., 2013). The Wii Fit may be effective similar to other fall programs that highlight balance and strengthening. Older adults “enjoyed participating in Wii Fit over traditional treadmill walking and jogging” (Franco et al., 2012). Yoga on the Wii Fit is important to consider in addition to other fall programs for the elderly because the Wii Fit is fun. Because yoga and other exercises on the Wii Fit are fun and encouraging, the elderly may continue to participate in exercise or yoga training routinely (Franco et al., 2012). Yoga on the Wii Fit is similar to other “interventions that bring together several components such as strength training, resistance, balance exercises, cognitive elements and education that stimulate the older person on a broader level and prevent disability” (Molina, 2014). Some of the major risk factors for the elderly falling down are impaired or decreased mental status, side effects of medication, visual impairments, poor balance, gait impairments, and lower limb weakness. The addition of yoga and other forms of balance training could help address the risk factors of falling such as balance and gait impairments and lower limb weakness (Franco et al., 2012). The risk factors related to age that increase chances of falling down are due to changes in the musculoskeletal and neuromuscular systems of the body that impact overall balance. Some of the major changes that occur in the aging neuromuscular and musculoskeletal systems include a “loss of elasticity in the tissues, decreased bone density, and a decrease in muscle mass and strength” (Franco et al., 2012). Routine physical activity is important to combat these effects of the aging body. Therefore, Yoga on the Wii Fit may be applicable to the lifestyles of the elderly.
It is important to note that about forty to fifty percent of elderly people who fall down and are admitted to a hospital will next be admitted to a nursing home (Franco et al., 2012). According to the World Health Organization, a routine and regular physical practice is essential for older adults in order to prevent against diseases and disability. Some of the physical activities recommended by WHO include walking, cycling, household chores, games, sports or planned exercise. The use of “interactive games through virtual reality can be, therefore, considered as a form of physical activity and this way should obey recommendations related to period and length of practice, to bring the desired benefits to the health of the older person” (Molina, 2014). According to the directives of the Global Recommendations on Physical Activity for Health, it is recommend that older people practice at least one hundred and fifty minutes of moderate physical activity or at least seventy five minutes of vigorous physical activity over the course of one week (Molina, 2014). Yoga on the Wii Fit may be successful in engaging the elderly to integrate physical activity because it “involves tasks that combine physical and cognitive demands in an attractive and challenging way, interactive games may represent an option that is both viable and well-accepted by older people, thereby expanding the therapeutic strategies” (Molina, 2014). Difficulties with balance that create a high risk of falling amongst older people are a main reason why elders cannot safely remain living independently in    their homes (Franco et al., 2012). Poor postural control is one of the major risk factors for falling so this is typically the focus of training in fall prevention programs. These types of programs, however, suffer from low therapy adherence since prevention is the goal. To provide a fun and motivating training environment for the elderly, exercise programs at home such as yoga or balance games on the Wii Fit may be essential training tools (van Diest et al., 2013). However, it is important to note that the Wii Fit game was not created for the sixty and older population (Franco et al., 2012).
CONCLUSION
Yoga on the Wii Fit by Nintendo was intended to make fitness possible for anyone in any home. The applications of this technology have stretched further than the makers of the Wii Fit ever imagined. The tools that improve one’s balance and postural control have beneficial uses in the elderly population In order for older people over the age of sixty five to prevent a fatal fall, they must adopt a greater on regular exercise, balance, flexibility and strength training. Yoga on the Wii Fit is an easily accessible, very encouraging, and fun tool for achieving this type of training. Although yoga on the Wii Fit is a very different experience than doing yoga within a yoga studio, yoga on the Wii Fit is an impeccable tool to utilize in order to improve personal fitness and balance. Yoga on the Wii Fit may have more implications in society than encouraging basic fitness for everyone, yoga on the Wii Fit may also have the potential to improve the health and well-being of disabled populations such as the elderly.





References
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