title: A randomized controlled trial to evaluate the feasibility of the Wii Fit for improving walking in older adults with lower limb amputation.
abstract: OBJECTIVE
  To assess the feasibility of Wii.n.Walk for improving walking capacity in older adults with lower limb amputation.
  
  
  METHODS
  A parallel, evaluator-blind randomized controlled feasibility trial.
  
  
  METHODS
  Community-living.
  
  
  METHODS
  Individuals who were ⩾50 years old with a unilateral lower limb amputation.
  
  
  METHODS
  Wii.n.Walk consisted of Wii Fit training, 3x/week (40 minute sessions), for 4 weeks. Training started in the clinic in groups of 3 and graduated to unsupervised home training. Control group were trained using cognitive games.
  
  
  METHODS
  Feasibility indicators: trial process (recruitment, retention, participants' perceived benefit from the Wii.n.Walk intervention measured by exit questionnaire), resources (adherence), management (participant processing, blinding), and treatment (adverse event, and Cohen's d effect size and variance). Primary clinical outcome: walking capacity measured using the 2 Minute Walk Test at baseline, end of treatment, and 3-week retention.
  
  
  RESULTS
  Of 28 randomized participants, 24 completed the trial (12/arm). Median (range) age was 62.0 (50-78) years. Mean (SD) score for perceived benefit from the Wii.n.Walk intervention was 38.9/45 (6.8). Adherence was 83.4%. The effect sizes for the 2 Minute Walk Test were 0.5 (end of treatment) and 0.6 (3-week retention) based on intention to treat with imputed data; and 0.9 (end of treatment) and 1.2 (3-week retention) based on per protocol analysis. The required sample size for a future larger RCT was deemed to be 72 (36 per arm).
  
  
  CONCLUSIONS
  The results suggested the feasibility of the Wii.n.Walk with a medium effect size for improving walking capacity. Future larger randomized controlled trials investigating efficacy are warranted.
authors.affiliation: 1 Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
authors.forename: Bita
authors.initials: B
authors.lastname: Imam
authors.affiliation: 1 Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.|2 Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
authors.affiliation: 3 Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Finlayson
authors.affiliation: 1 Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.|4 Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
authors.forename: Janice J
authors.initials: JJ
authors.lastname: Eng
authors.affiliation: 1 Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.|2 Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada.
authors.forename: Tal
authors.initials: T
authors.lastname: Jarus
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation*; D001186:Artificial Limbs; D005081:Exercise Therapy / Q000295:instrumentation*; D017079:Exercise Tolerance; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology; D016896:Treatment Outcome; D018910:Video Games; D016138:Walking / Q000502:physiology*
keywords: Aging; amputation; randomized controlled trial; video games; walking