Use of Nintendo Wii Fit™ in the rehabilitation of outpatients following total knee replacement: a preliminary randomised controlled trial

Objectives To determine whether Nintendo Wii Fit (TM) is an acceptable adjunct to physiotherapy treatment in the rehabilitation of balance, lower extremity movement, strength and function in outpatients following total knee replacement. Design Preliminary randomised controlled trial. Setting Outpatient department of a rehabilitation hospital. Participants Adult outpatients following total knee replacement. Interventions The study group received a physiotherapy session followed by 15 minutes of Wii Fit gaming activities. The games encouraged lateral and multidirectional weight shifting, and provided visual feedback regarding postural balance. The control group received a physiotherapy session followed by 15 minutes of lower extremity strengthening and balance training exercises. Main outcome measures Length of outpatient rehabilitation, 2-minute walk test, knee range of motion, timed standing, Activity-specific Balance Confidence Scale, Lower Extremity Functional Scale and Numeric Pain Rating Scale, all measured on admission and every 2 weeks until discharge. A patient satisfaction survey was completed at discharge. Results Seventeen males (34%) and 33 females (66%) with a mean age of 68 (standard deviation 11) years participated in the study. No significant differences in age, gender, days since surgery or length of outpatient rehabilitation were found between the groups. In addition, there were no significant differences in pain (P = 0.220), knee flexion (P = 0.951), knee extension (P = 0.492), walking speed (P = 0.855), timed standing tasks (P = 0.289), Lower Extremity Functional Scale (P = 0.079), Activity-specific Balance Confidence Scale (P = 0.523) or patient satisfaction with therapy services (P = 0.201) between the groups. Conclusions Wii Fit is potentially acceptable as an adjunct to physiotherapy intervention for outpatients following total knee replacement, provided the games chosen challenge balance and postural control, and use the lower extremities. Further research is needed to establish whether video games as a therapy adjunct increase patient motivation and compliance with rehabilitation goals. ClinicalTrials.govID: NCT01548664. Crown Copyright (C) 2012 Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy. All rights reserved.