title: Does the use of Nintendo Wii Sports™ improve arm function and is it acceptable to patients after stroke? Publication of the Protocol of the Trial of Wii™ in Stroke - TWIST.
abstract: BACKGROUND
  Many stroke patients experience loss of arm function requiring rehabilitation, which is expensive, repetitive, and does not always translate into "real life." Nintendo Wii Sports™ (Wii™) may offer task-specific training that is repetitive and motivating. The Trial of Wii™ in Stroke (TWIST) is designed to investigate feasibility, efficacy, and acceptability using Wii™ to improve affected arm function for patients after stroke.
  
  
  METHODS
  This is a randomized controlled trial (RCT), incorporating a qualitative study and health economics analysis that compares playing Wii™ versus arm exercises in patients receiving standard rehabilitation in a home setting within 6 months of stroke with a motor deficit of less than 5 on the MRC (Medical Research Council) scale (arm). In this study, we expect to randomize 240 participants.
  
  
  METHODS
  Primary outcome is change in affected arm function at 6 weeks follow-up in intervention and control group using the Action Research Arm Test. Secondary outcomes include occupational performance using the Canadian Occupational Performance Measure, quality of life using the Stroke Impact Scale, cost effectiveness analysis, and a qualitative study investigating factors that influence use of Wii™ for patients and carers.
  
  
  CONCLUSIONS
  TWIST is the first UK RCT assessing the feasibility, cost effectiveness, and acceptability of Wii™ in stroke rehabilitation. The trial has been registered with ISRCTN 06807619 and UK CRN 11030. Results of the study will be published after completion of study in August 2014.
authors.affiliation: Royal Cornwall Hospital Trust, Cornwall, UK.
authors.forename: Katja
authors.initials: K
authors.lastname: Adie
authors.affiliation: Royal Cornwall Hospital Trust, Cornwall, UK.
authors.forename: Christine
authors.initials: C
authors.lastname: Schofield
authors.affiliation: Peninsula Clinical Trials Unit, Plymouth University Schools of Medicine and Dentistry, Plymouth, Devon, UK.
authors.forename: Margie
authors.initials: M
authors.lastname: Berrow
authors.affiliation: Royal Cornwall Hospital, Truro, Cornwall, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Wingham
authors.affiliation: Royal Cornwall Hospital Trust, Cornwall, UK.
authors.forename: Janet
authors.initials: J
authors.lastname: Freeman
authors.affiliation: Royal Cornwall Hospital Trust, Cornwall, UK.
authors.forename: John
authors.initials: J
authors.lastname: Humfryes
authors.affiliation: Royal Cornwall Hospital, Truro, Cornwall, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Pritchard
keywords: rehabilitation; virtual reality