Study of WiiFit to Enhance Walking in Older Adult Amputees
Condition: Lower Limb Amputation; Older Adults
Study type: Interventional

Summary: 
      WiiNWALK is a 4 week physical activity, with the intervention of a WiiFit, targeted to
      improve walking capacity in individuals with either a unilateral below-knee or above-knee
      amputation. This is a randomized control trial to evaluate the effectiveness of the WiiNWALK
      program in older (50+ years) community living adults with lower limb amputations (LLA).

      Hypothesis: We expect the WiiNWALK intervention will have a treatment effect with improvement
      in functional walking capacity, compared to the control group who will only be playing
      cognitive games. Secondarily, a functional walking capacity will also include an improvement
      in lower extremity strength and balance, inter-limb gait symmetry, balance confidence along
      with participation in daily and social activities, locomotor capabilities and an increase in
      physical activities.
    

Detailed description: 
      Lower limb amputation (LLA) is prevalent among older Canadians. Estimates from 2003 suggest
      that > 2 million individuals were living with LLA in North America with an annual estimated
      150,000 incident cases. Over 50% of these procedures are considered major, with 28% of
      individuals having a transtibial (TT) or below knee amputation and 26% having a transfemoral
      (TF) or above knee amputation. The WiiNWalk is designed to evaluate whether this intervention
      does improve the walking capacity of older adults through a series of balancing and other
      physical activities using the Wii balance board.

      An improved walking capacity (ie: being able to walk a longer distance) may effect balance,
      strength, and fitness components that are critical to improve prosthetic walking. The ability
      to walk a longer distance may effect a person's lifestyle as it allows the individual to move
      around his/her environment independently which in turn impacts ones choice of daily and
      social activities and participation, and therefore providing them with more mobility, freedom
      and choice.

      This study focuses on older adults because, according to Canadian Institute of Health
      Information data, 50-74 year old were 17 times more likely to have a LLA and individuals aged
      ≥ 75 were 36 times more likely to have a LLA.The primary reason for this exponential
      age-related increased incidence is the late stage effects of chronic diseases such as
      diabetes and vascular disease that are common in older adults.

      If as anticipated, the WiiFit proves to increase walking capacity, it will provide a low cost
      method for those with LLA to have an accessible system that, due to the weight-shifting,
      balance and aerobic training nature of the Wii games, will serve as a therapeutic agent for
      rehabilitation.
    

Intervention name(s): Nintendo Wii; Wii Big Brain Academy Degree program
Intervention type(s): Device; Device
Intervention description(s): Subjects will receive the intervention for 40-minute sessions, 3x/week for 4 weeks. The interventions will be administered in combination of onsite group training and individualized home-based training.; Subjects will receive the intervention for 40-minute sessions, 3x/week for 4 weeks. The interventions will be administered in combination of onsite group training and individualized home-based training.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Rehabilitation; Lower Limb Amputation; Prosthetic; Walking; unilateral transtibial amputation; unilateral transfemoral amputation; older adults; cognitive computer games; home-based training; Nintendo Wii; virtual reality