"Wii-Hab" in critically ill children: a pilot trial.
OBJECTIVE
To evaluate the safety and feasibility of virtual reality (VR) exercise as a novel acute rehabilitation intervention in a Pediatric Critical Care Unit (PCCU) setting.


METHODS
Children aged 3-18 years with an anticipated PCCU stay > 48 hours, and baseline normal to moderate cognitive and functional disability were eligible. Exclusion criteria included: anticipated death, physical inability, or a contraindication to mobilization. Nintendo Wii™ Boxing was prescribed for a minimum of 10 minutes twice a day for 2 days. Primary outcomes were feasibility and safety.


RESULTS
Of 21 eligible patients, 12 (57.1%) were enrolled and 8 completed the study. 41.7% (5/12) were males, and the median age was 11 (3,16) years. Four of the 8 participants who received the intervention were mechanically ventilated during Wii™ play. Participants used the Wii™ a median of 2 times (1,5) over the 2-day intervention period, for a median total duration of 54.5 (15, 224) minutes. There were no adverse events attributable to the intervention. Upper limb activity during Wii™ was significantly greater than the average daily activity (p=0.049). Grip strength did not change significantly from baseline (p=0.20).


CONCLUSIONS
While the results of this pilot trial suggest that VR exercise may be safely applied in a subset of critically ill children, we observed several threats to its feasibility in this population.
Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON, Canada.
Farah
F
Abdulsatar
Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON, Canada.
Rachel G
RG
Walker
Child Health and Exercise Medicine Program, McMaster University, Hamilton, ON, Canada Department of Pediatrics, McMaster University, Hamilton, ON, Canada.
Brian W
BW
Timmons
Department of Pediatrics, McMaster University, Hamilton, ON, Canada Department of Critical Care, McMaster University, Hamilton, ON, Canada Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
Karen
K
Choong
D000293:Adolescent; D001914:Boxing; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D010865:Pilot Projects; D016896:Treatment Outcome; D018910:Video Games
Pediatrics; acute rehabilitation; critical care; virtual reality gaming