Effects of Wii Fit on Functional Balance and Elbow Flexion in Children with Unilateral Spastic Cerebral Palsy: A Pilot Study

Background Children with unilateral spastic cerebral palsy often present with impaired dynamic balance, which can negatively affect functional activities and contribute to compensatory upper-limb movement patterns. Although balance-focused interventions have been shown to improve functional balance, their potential influence on upper-limb outcomes has not been well explored. This pilot study explored the effects of balance training using the Wii Fit balance board on functional balance and elbow range of motion (ROM) in children with unilateral spastic cerebral palsy. Methods A single-subject A-B-A (withdrawal) design was implemented across three phases: baseline (4 weeks), intervention (12 weeks), and follow-up (4 weeks). Outcome measures included the Pediatric Balance Scale (PBS), Timed Up and Go (TUG), and elbow ROM. Data were analyzed using visual inspection, Hedges’ g, and the percentage of nonoverlapping data (PND). Results Nine children (mean age = 7.33 ± 2.00 years) participated. Pediatric Balance Scale and Timed Up and Go scores demonstrated notable improvements during the intervention phase (PND ≈ 75%; Hedges’ g > 0.8 for most participants), with gains largely maintained at follow-up. Elbow outcomes also improved, with consistent increases in active elbow range of motion and reductions in passive elbow flexion during the intervention phase (PND = 100% for most participants; Hedges’ g > 0.8), although maintenance of gains varied across participants. Conclusion Balance training with the Wii Fit balance board resulted in improvements in functional balance and elbow range of motion in children with unilateral spastic cerebral palsy. Although balance gains were generally maintained, elbow gains were more variable among subjects at follow-up, suggesting that balance-focused interventions may positively influence upper-limb movement patterns but require additional or sustained intervention to optimize long-term elbow outcomes. Approval code IR.USWR.REC.1399.149.