title: Feasibility of the Nintendo WiiFit™ for improving walking in individuals with a lower limb amputation.
abstract: OBJECTIVE
  To evaluate the feasibility of the Nintendo WiiFit™ as an adjunct to usual therapy in individuals with a lower limb amputation.
  
  
  METHODS
  The study was a Multiple Baseline (AB) Single Subject Research Design. Subjects were ≥19 years old, had their first unilateral transtibial or transfemoral amputation  ≤12 months ago, and were participating in prosthetic training. WiiFit training was provided for 30 min, 5 times a week, for a minimum of 2 and a maximum of 6 weeks in addition to usual therapy. Feasibility indicators were safety, post-intervention fatigue and pain levels, adherence, and subject's acceptability of the program as measured by the Short Feedback Questionnaire-modified (SFQ-M). The primary clinical outcome was walking capacity assessed by the 2 Minute Walk Test (2MWT). The secondary clinical outcomes were the Short Physical Performance Battery, L-test, and Activities-Specific Balance Confidence.
  
  
  RESULTS
  Subjects (4 transtibial; 2 transfemoral) had a median age of 48.5 years (range = 45-59 years). No adverse events associated with the intervention occurred. Median pain and fatigue levels were 1.3 (range = 0.5-3.5) and 3.1 (range = 1.4-4.1), respectively. Median adherence was 80%. Subjects found the WiiFit enjoyable and acceptable (median SFQ-M = 35). Five subjects showed statistical improvement on the 2MWT and four on the secondary outcomes (p < 0.05).
  
  
  CONCLUSIONS
  The WiiFit intervention was found to be feasible in individuals with unilateral lower limb amputation. This research provides the foundation for future clinical research investigating the use of the WiiFit as a viable adjunctive therapy to improve outcomes in individuals with unilateral lower limb amputation who are participating in prosthetic training.
authors.affiliation: Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada.
authors.forename: Bita
authors.initials: B
authors.lastname: Imam
authors.affiliation: Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada; GF Strong Rehabilitation Centre, Vancouver, BC, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
authors.affiliation: GF Strong Rehabilitation Centre, Vancouver, BC, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: McLaren
authors.affiliation: Victoria General Hospital, Victoria, BC, Canada.
authors.forename: Paul
authors.initials: P
authors.lastname: Chapman
authors.affiliation: Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: Finlayson
keywords: Nintendo WiiFit™; lower limb amputation; single subject research design; virtual reality therapy; walking capacity