Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial.
OBJECTIVE
To determine whether Nintendo Wii Fit™ is an acceptable adjunct to physiotherapy treatment in the rehabilitation of balance, lower extremity movement, strength and function in outpatients following total knee replacement.


METHODS
Preliminary randomised controlled trial.


METHODS
Outpatient department of a rehabilitation hospital.


METHODS
Adult outpatients following total knee replacement.


METHODS
The study group received a physiotherapy session followed by 15minutes of Wii Fit gaming activities. The games encouraged lateral and multidirectional weight shifting, and provided visual feedback regarding postural balance. The control group received a physiotherapy session followed by 15minutes of lower extremity strengthening and balance training exercises.


METHODS
Length of outpatient rehabilitation, 2-minute walk test, knee range of motion, timed standing, Activity-specific Balance Confidence Scale, Lower Extremity Functional Scale and Numeric Pain Rating Scale, all measured on admission and every 2 weeks until discharge. A patient satisfaction survey was completed at discharge.


RESULTS
Seventeen males (34%) and 33 females (66%) with a mean age of 68 (standard deviation 11) years participated in the study. No significant differences in age, gender, days since surgery or length of outpatient rehabilitation were found between the groups. In addition, there were no significant differences in pain (P=0.220), knee flexion (P=0.951), knee extension (P=0.492), walking speed (P=0.855), timed standing tasks (P=0.289), Lower Extremity Functional Scale (P=0.079), Activity-specific Balance Confidence Scale (P=0.523) or patient satisfaction with therapy services (P=0.201) between the groups.


CONCLUSIONS
Wii Fit is potentially acceptable as an adjunct to physiotherapy intervention for outpatients following total knee replacement, provided the games chosen challenge balance and postural control, and use the lower extremities. Further research is needed to establish whether video games as a therapy adjunct increase patient motivation and compliance with rehabilitation goals. ClinicalTrials.gov ID: NCT01548664.
St. John's Rehab Hospital, Toronto, Ontario, Canada.
Vera
V
Fung
Aileen
A
Ho
Jennifer
J
Shaffer
Esther
E
Chung
Manuel
M
Gomez
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D017060:Patient Satisfaction; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D004856:Postural Balance; D055070:Resistance Training / Q000379:methods; D016896:Treatment Outcome; D014584:User-Computer Interface; D018910:Video Games; D016138:Walking