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- Title
Group-based telerehabilitation intervention using Wii Fit to improve walking in older adults with lower limb amputation (WiiNWalk): A randomized control trial.
- Authors
Tao, Gordon; Miller, William C.; Eng, Janice J.; Esfandiari, Elham; Imam, Bita; Lindstrom, Heather; Payne, Michael W.
- Abstract
Objective: Determine efficacy of the novel WiiNWalk intervention on walking-related outcomes in older adults with lower limb amputation. Design: Multi-site, parallel, evaluator-masked randomized controlled trial. Setting: Home-setting in three Canadian cities. Participants: Community-dwelling lower limb prosthesis users over 50 years of age. Interventions: The WiiNWalk group (n = 38) used modified Wii Fit activities for prosthetic rehabilitation. The attention control group (n = 33) used Big Brain Academy: Wii Degree, comprising of cognitive activities. Both groups completed a 4-week supervised phase with three 1-h sessions/week in groups of three overseen by a clinician via videoconferencing and a 4-week unstructured and unsupervised phase. Main Measures: Primary outcome was walking capacity (2 min walk test); secondary outcomes were balance confidence (activities-specific balance confidence scale), dynamic balance (four-step square test), and lower limb functioning (short physical performance battery). Outcomes were compared across time points with repeated measures analysis of covariance, adjusting for baseline and age. Results: Mean age was 65.0 (8.4) years, with 179.5 (223.5) months post-amputation and 80% transtibial amputation. No group difference in a 2 min walk test with an effect size: 1.53 95% CI [−3.17, 6.23] m. Activities balance confidence was greater in the WiiNWalk group by 5.53 [2.53, 8.52]%. No group difference in the four-step square test −0.16 [−1.25, 0.92] s, nor short physical performance battery 0.48 [−0.65, 1.61]. A post-hoc analysis showed the greatest difference in balance confidence immediately after an unsupervised phase. Conclusions: The WiiNWalk intervention improved balance confidence, but not walking-related physical function in older adult lower limb prosthesis users. Future rehabilitation games should be specific to the amputation context. Clinical Trial Registration number, NCT 01942798.
- Subjects
CANADA; LEG physiology; TELEREHABILITATION; RESEARCH; ARTIFICIAL limbs; STATISTICS; HOME rehabilitation; POSTURAL balance; MEDICAL cooperation; AMPUTEES; TREATMENT effectiveness; RANDOMIZED controlled trials; WALKING; REPEATED measures design; ANALYSIS of covariance; DESCRIPTIVE statistics; INDEPENDENT living; RESEARCH funding; LEG amputation; STATISTICAL sampling; DATA analysis software; DATA analysis
- Publication
Clinical Rehabilitation, 2022, Vol 36, Issue 3, p331
- ISSN
0269-2155
- Publication type
Article
- DOI
10.1177/02692155211061222