1. Group-based telerehabilitation intervention using Wii Fit to improve walking in older adults with lower limb amputation (WiiNWalk): A randomized control trial.
- Author
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Tao, Gordon, Miller, William C., Eng, Janice J., Esfandiari, Elham, Imam, Bita, Lindstrom, Heather, and Payne, Michael W.
- Subjects
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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 - 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. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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