title: Clinical feasibility of the Nintendo Wii™ for balance training post-stroke: a phase II randomized controlled trial in an inpatient setting.
abstract: OBJECTIVE
  To investigate the feasibility and potential efficacy of the Nintendo Wii™ for balance rehabilitation after stroke.
  
  
  METHODS
  Phase II, single-blind, randomized controlled trial.
  
  
  METHODS
  Inpatient rehabilitation facility.
  
  
  METHODS
  Thirty adults (mean age 63.6 (14.7) years) undergoing inpatient rehabilitation who were less than three months post-stroke and able to stand unsupported.
  
  
  METHODS
  Participants were allocated to a Balance Group, using the 'Wii Fit Plus' in standing, or Upper Limb Group, using the 'Wii Sports/Sports Resort' in sitting. Both groups undertook three 45 minute sessions per week over two to four weeks in addition to standard care.
  
  
  METHODS
  The primary focus was feasibility, addressed by recruitment, retention, adherence, acceptability and safety. Efficacy was evaluated by balance, mobility and upper limb outcomes.
  
  
  RESULTS
  Twenty-one percent of individuals screened were recruited and 86% (n = 30) of eligible people agreed to participate. Study retention and session adherence was 90% and > 99%, respectively, at two weeks; dropping to 70% and 87% at four weeks due to early discharge. All participants reported enjoying the sessions and most felt they were beneficial. No major adverse events occurred. Wii use by the Balance Group was associated with trends for improved balance, with significantly greater improvement in outcomes including the Step Test and Wii Balance Board-derived centre of pressure scores. The Upper Limb Group had larger, non-significant changes in arm function.
  
  
  CONCLUSIONS
  A Wii-based approach appears feasible and promising for post-stroke balance rehabilitation. A larger randomized controlled trial is recommended to further investigate efficacy.
authors.affiliation: Department of Physiotherapy, Melbourne Health, The Royal Melbourne Hospital-Royal Park Campus, Melbourne, Australia Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia kjbower@student.unimelb.edu.au.
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Bower
authors.affiliation: Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia School of Exercise Science, Australian Catholic University, Melbourne, Australia.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Clark
authors.affiliation: Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: McGinley
authors.affiliation: Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia.
authors.forename: Clarissa L
authors.initials: CL
authors.lastname: Martin
authors.affiliation: Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia Department of Physical Therapy, The University of British Columbia, Vancouver, Canada.
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Miller
mesh_terms: D000704:Analysis of Variance; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D012678:Sensation Disorders / Q000209:etiology / Q000534:rehabilitation*; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria; D018910:Video Games
keywords: Nintendo Wii™; Stroke; postural balance; rehabilitation; video games