title: Evaluation of the Wii Balance Board for walking aids prediction: proof-of-concept study in total knee arthroplasty.
abstract: OBJECTIVE
  To provide proof-of-concept for the validity of the Wii Balance Board (WBB) measures to predict the type of walking aids required by inpatients with a recent (≤4 days) total knee arthroplasty (TKA).
  
  
  METHODS
  A cross-sectional sample of 89 inpatients (mean age, 67.0±8 years) with TKA was analyzed. A multivariable proportional odds prediction model was constructed using 8 pre-specified predictors – namely, age, sex, body mass index, knee pain, knee range-of-motion, active knee lag, and WBB-derived standing balance. The type of walking aids prescribed on day 4 post-surgery was the outcome of interest – an ordinal variable with 4 categories (walking stick, narrow- and broad-base quadstick, and walking frame).
  
  
  RESULTS
  Women, increasing body mass index, and poorer standing balance were independently associated with greater odds for requiring walking aids with a larger base-of-support. The concordance-index of the prediction model was 0.74. The model comprising only WBB-derived standing balance had nearly half (44%) the explanatory power of the full model. Adding WBB-derived standing balance to conventional demographic and knee variables resulted in a continuous net reclassification index of 0.60 (95%CI,0.19-1.01), predominantly due to better identification of patients who required walking aids with a large base-of-support (sensitivity gain).
  
  
  CONCLUSIONS
  The WBB was able to provide quantitative measures of standing balance which could assist healthcare professionals in prescribing the appropriate type of walking aids for patients. Further investigation is needed to assess whether using the WBB could lead to meaningful changes in clinical outcomes such as falls.
authors.affiliation: Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
authors.forename: Yong-Hao
authors.initials: YH
authors.lastname: Pua
authors.affiliation: School of Exercise Science, Australian Catholic University, Melbourne, Australia.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Clark
authors.affiliation: Department of Physiotherapy, Singapore General Hospital, Singapore, Singapore.
authors.forename: Peck-Hoon
authors.initials: PH
authors.lastname: Ong
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D015915:Motion Therapy, Continuous Passive / Q000295:instrumentation*; D004856:Postural Balance; D018910:Video Games; D016138:Walking / Q000502:physiology*