Bower Kelly J, Clark Ross A, McGinley Jennifer L, Martin Clarissa L, Miller Kimberly J
Department of Physiotherapy, Melbourne Health, The Royal Melbourne Hospital-Royal Park Campus, Melbourne, Australia Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia School of Exercise Science, Australian Catholic University, Melbourne, Australia.
Clin Rehabil. 2014 Sep;28(9):912-23. doi: 10.1177/0269215514527597. Epub 2014 Mar 25.
To investigate the feasibility and potential efficacy of the Nintendo Wii™ for balance rehabilitation after stroke.
Phase II, single-blind, randomized controlled trial.
Inpatient rehabilitation facility.
Thirty adults (mean age 63.6 (14.7) years) undergoing inpatient rehabilitation who were less than three months post-stroke and able to stand unsupported.
Participants were allocated to a Balance Group, using the 'Wii Fit Plus' in standing, or Upper Limb Group, using the 'Wii Sports/Sports Resort' in sitting. Both groups undertook three 45 minute sessions per week over two to four weeks in addition to standard care.
The primary focus was feasibility, addressed by recruitment, retention, adherence, acceptability and safety. Efficacy was evaluated by balance, mobility and upper limb outcomes.
Twenty-one percent of individuals screened were recruited and 86% (n = 30) of eligible people agreed to participate. Study retention and session adherence was 90% and > 99%, respectively, at two weeks; dropping to 70% and 87% at four weeks due to early discharge. All participants reported enjoying the sessions and most felt they were beneficial. No major adverse events occurred. Wii use by the Balance Group was associated with trends for improved balance, with significantly greater improvement in outcomes including the Step Test and Wii Balance Board-derived centre of pressure scores. The Upper Limb Group had larger, non-significant changes in arm function.
A Wii-based approach appears feasible and promising for post-stroke balance rehabilitation. A larger randomized controlled trial is recommended to further investigate efficacy.
探讨任天堂Wii™用于中风后平衡功能康复的可行性和潜在疗效。
II期单盲随机对照试验。
住院康复机构。
30名中风后不到三个月且能够独立站立的成年住院康复患者（平均年龄63.6（14.7）岁）。
参与者被分配到平衡组，站立使用“Wii Fit Plus”，或上肢组，坐着使用“Wii Sports/Sports Resort”。除标准护理外，两组均在两到四周内每周进行三次45分钟的训练。
主要关注可行性，通过招募、留存率、依从性、可接受性和安全性来衡量。通过平衡功能、活动能力和上肢功能结果评估疗效。
筛选的个体中有21%被招募，符合条件的人中有86%（n = 30）同意参与。两周时的研究留存率和训练依从率分别为90%和> 99%；四周时由于提前出院降至70%和87%。所有参与者都表示喜欢这些训练课程，大多数人认为这些课程有益。未发生重大不良事件。平衡组使用Wii与平衡功能改善趋势相关，包括台阶试验和Wii平衡板得出的压力中心得分等结果有显著更大改善。上肢组手臂功能有较大但不显著的变化。
基于Wii的方法对中风后平衡功能康复似乎可行且有前景。建议进行更大规模的随机对照试验以进一步研究疗效。
