Improving Lower Limb Weight Distribution Asymmetry During the Squat Using Nintendo Wii Balance Boards and Real-Time Feedback

Abstract

Weight-bearing asymmetry (WBA) may be detrimental to performance and could increase the risk of injury; however, detecting and reducing it is difficult in a field setting. This study assessed whether a portable and simple-to-use system designed with multiple Nintendo Wii Balance Boards (NWBBs) and customized software can be used to evaluate and improve WBA. Fifteen elite Australian Rules Footballers and 32 age-matched, untrained participants were tested for measures of WBA while squatting. The NWBB and customized software provided real-time visual feedback of WBA during half of the trials. Outcome measures included the mean mass difference (MMD) between limbs, interlimb symmetry index (SI), and percentage of time spent favoring a single limb (TFSL). Significant reductions in MMD (p = 0.028) and SI (p = 0.007) with visual feedback were observed for the entire group data. Subgroup analysis revealed significant reductions in MMD (p = 0.047) and SI (p = 0.026) with visual feedback in the untrained sample; however, the reductions in the trained sample were nonsignificant. The trained group showed significantly less WBA for TFSL under both visual conditions (no feedback: p = 0.015, feedback: p = 0.017). Correlation analysis revealed that participants with high levels of WBA had the greatest response to feedback (p < 0.001, ρ = 0.557). In conclusion, WBA exists in healthy untrained adults, and these asymmetries can be reduced using real-time visual feedback provided by an NWBB-based system. Healthy, well-trained professional athletes do not possess the same magnitude of WBA. Inexpensive, portable, and widely available gaming technology may be used to evaluate and improve WBA in clinical and sporting settings.