Participant and caregiver experience of the Nintendo Wii Sports™ after stroke: qualitative study of the trial of Wii™ in stroke (TWIST)

Objective: To understand stroke survivors and their caregivers' experience and acceptability of using the Nintendo Wii Sports (TM) games (Wii (TM)) as a home-based arm rehabilitation tool. Design: A qualitative study within a randomized controlled trial investigating the effectiveness of using the Wii (TM) for arm rehabilitation. Data were analysed using thematic analysis. Settings: Participants and carers were interviewed in their homes. Subjects: Eleven male and seven female participants and 10 caregivers who were taking part in the randomized controlled trial within six months of stroke. Median age 65. Intervention: All participants were using the Wii (TM) for arm rehabilitation. Main Measures: Semi-structured interviews. Results: Five themes were identified: diligence of play, perceived effectiveness, acceptability, caregiver and social support, and the set-up and administration of the Wii (TM). Participants appreciated the ability to maintain a social role and manage other comorbidities around the use of the Wii (TM). A small number of participants found the Mii characters too childlike for adult rehabilitation. The most popular game to start the rehabilitation programme was bowling. As confidence grew, tennis was the most popular, with baseball and boxing being the least popular games. Caregivers provided some practical support and encouragement to play the Wii (TM). Conclusions: The Wii (TM) may provide an engaging and flexible form of rehabilitation with relatively high reported usage rates in a home setting. The Wii (TM) was acceptable to this sample of patients and their caregivers in home-based rehabilitation of the arm following stroke.