title: Feasibility and Efficacy of the Nintendo Wii Gaming System to Improve Balance Performance Post-Stroke: Protocol of a Phase II Randomized Controlled Trial in an Inpatient Rehabilitation Setting.
abstract: OBJECTIVE
  Balance deficits following stroke are common and debilitating. Commercially available gaming systems, such as the Nintendo(®) (Kyoto, Japan) Wii™, have been widely adopted clinically; however, there is limited evidence supporting their feasibility and efficacy for improving balance performance following stroke. The aim of this trial is to investigate the clinical feasibility and efficacy of using the Nintendo Wii gaming system as an adjunct to standard care to improve balance performance following stroke in an inpatient rehabilitation setting.
  
  
  METHODS
  Thirty participants undergoing inpatient stroke rehabilitation will be recruited into this Phase II, single-blind, randomized controlled trial. Participants will be allocated into a Balance or Upper Limb Group, and both groups will perform activities using the Nintendo Wii in addition to their standard care. Participants will attend three 45-minute sessions per week, for a minimum of 2 and a maximum of 4 weeks.
  
  
  RESULTS
  The main focus of the study is to investigate the feasibility of the intervention protocol. This will be evaluated through recruitment, retention, adherence, acceptability, and safety. The Step Test and Functional Reach Test will be the primary efficacy outcomes. Secondary outcomes will include force platform, mobility, and upper limb measures. Assessments will occur at baseline, 2 weeks, and 4 weeks after study entry.
  
  
  CONCLUSIONS
  To the authors' knowledge, this will be the largest randomized clinical trial to investigate the feasibility and efficacy of the Nintendo Wii gaming system for improving balance performance in a stroke population. The results will inform the design of a Phase III multicenter trial.
authors.affiliation: 1 Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne , Carlton, Victoria, Australia .|4 Department of Physiotherapy, Melbourne Health, The Royal Melbourne Hospital-Royal Park Campus, Parkville, Victoria, Australia .
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Bower
authors.affiliation: 1 Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne , Carlton, Victoria, Australia .
authors.forename: Ross A
authors.initials: RA
authors.lastname: Clark
authors.affiliation: 1 Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne , Carlton, Victoria, Australia .
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: McGinley
authors.affiliation: 2 Institute for Safety, Compensation and Recovery Research, Monash University , Melbourne, Victoria, Australia .
authors.forename: Clarissa L
authors.initials: CL
authors.lastname: Martin
authors.affiliation: 1 Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne , Carlton, Victoria, Australia .|3 Department of Physical Therapy, University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Miller