Nintendo Wii Balance Board for Rehabilitation in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis

Background: Cerebral palsy (CP), the leading cause of childhood motor disability, is commonly associated with impaired balance, postural control, and functional mobility. Virtual reality–based interventions, including the Nintendo Wii Balance Board, have been increasingly integrated into pediatric neurorehabilitation. However, the overall effectiveness of Wii-based rehabilitation in children with CP remains uncertain. Objective: This systematic review and meta-analysis evaluated the effects of Nintendo Wii Balance Board–based therapy on balance, motor, and mobility outcomes in children with CP. Methods: Randomized controlled trials were identified through a systematic search of major electronic databases, including PubMed, Scopus, Google Scholar, and Web of Science, without publication timeframe restrictions. Eligible studies included pediatric patients with cerebral palsy undergoing Nintendo Wii Balance Board–based rehabilitation, rehabilitation games, or neurological therapy. Outcomes included balance, gross motor function, coordination, motor control, and therapy engagement, measured pre- and post-intervention using standardized clinical scales. Effect sizes were calculated as standardized mean differences (SMDs) with 95% confidence intervals (CIs), and heterogeneity was assessed using the I² statistic. Results: Ten trials involving 257 participants were included. Intervention durations ranged from 8 to 12 weeks and were compared with traditional therapy or no intervention. A meta-analysis of ten studies showed significant improvements in balance favoring Wii-based rehabilitation (SMD = 0.84, 95% CI 0.54–1.15; p = 0.0015), with low heterogeneity (I² = 26%). No significant effects were observed for functional mobility outcomes, including the 1-Minute Walk Test and Timed Up and Go. Individual studies also reported improvements in gross motor function and coordination, as well as increased motivation and engagement. Conclusion: Nintendo Wii Balance Board–based therapy may improve balance outcomes in ambulatory children with cerebral palsy; however, further high-quality randomized trials with standardized protocols are required.