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Standing balance therapy through portable and low-cost visual feedback training.

Mohammad Shushtari1,2,3, William Pei1,2, Derrick Lim1,2

  • 1Institute of Biomedical Engineering, University of Toronto, 172 St. George St., Toronto, Ontario, M5R 0A3, Canada.

Biomedical Engineering Online
|January 16, 2026
PubMed
Summary

This study introduces a cost-effective balance training system for individuals with incomplete spinal cord injury (iSCI). Replacing expensive equipment with a Wii Balance Board (WBB) makes functional electrical stimulation (FES) therapy more accessible for rehabilitation.

Keywords:
BalanceRehabilitationVisual feedback training

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Area of Science:

  • Rehabilitation Engineering
  • Neuroscience
  • Biomechanics

Background:

  • Individuals with incomplete spinal cord injury (iSCI) experience impaired sensorimotor integration, leading to balance deficits and falls.
  • Current functional electrical stimulation (FES) therapy combined with visual feedback balance training (VFBT) shows promise for improving standing balance in iSCI.
  • The high cost and bulkiness of traditional force plates (FP) hinder the widespread clinical and home-based application of FES+VFBT.

Purpose of the Study:

  • To evaluate the feasibility of replacing expensive force plates (FP) with an affordable Wii Balance Board (WBB) for FES+VFBT.
  • To assess the accuracy of WBB-estimated center of mass (COM) compared to FP-estimated COM.
  • To determine if a WBB-based system can generate comparable stimulation patterns for balance rehabilitation.

Main Methods:

  • Ten non-injured participants performed balance tasks.
  • Center of mass (COM) data was collected simultaneously using a ground force plate (FP) and a Wii Balance Board (WBB).
  • Prediction error and correlation between WBB- and FP-estimated COM were analyzed.
  • Stimulation patterns were compared between WBB- and FP-based approaches.

Main Results:

  • The WBB demonstrated low prediction error for COM estimation in both anteroposterior (RMSE: 4.13 ± 0.69 mm) and mediolateral (RMSE: 6.25 ± 1.80 mm) directions.
  • High correlation was found between WBB- and FP-estimated COM (r: 0.94 ± 0.02 AP; r: 0.92 ± 0.04 ML).
  • Similar stimulation patterns were achieved using the WBB-based system compared to the FP-based system.

Conclusions:

  • A Wii Balance Board (WBB) can accurately estimate center of mass (COM) in balance tasks, comparable to traditional force plates (FP).
  • The WBB-based functional electrical stimulation (FES) therapy combined with visual feedback balance training (VFBT) system offers a more accessible and cost-effective therapeutic strategy.
  • This approach has the potential to significantly improve balance rehabilitation accessibility for individuals with incomplete spinal cord injury (iSCI) in various settings.