Does the use of Nintendo Wii Sports™ improve arm function and is it acceptable to patients after stroke? Publication of the Protocol of the Trial of Wii™ in Stroke – TWIST

Abstract

Introduction

Many stroke patients experience loss of arm function requiring rehabilitation, which is expensive, repetitive, and does not always translate into “real life.” Nintendo Wii Sports™ (Wii™) may offer task-specific training that is repetitive and motivating. The Trial of Wii™ in Stroke (TWIST) is designed to investigate feasibility, efficacy, and acceptability using Wii™ to improve affected arm function for patients after stroke.

Method

This is a randomized controlled trial (RCT), incorporating a qualitative study and health economics analysis that compares playing Wii™ versus arm exercises in patients receiving standard rehabilitation in a home setting within 6 months of stroke with a motor deficit of less than 5 on the MRC (Medical Research Council) scale (arm). In this study, we expect to randomize 240 participants.

Outcome measures

Primary outcome is change in affected arm function at 6 weeks follow-up in intervention and control group using the Action Research Arm Test. Secondary outcomes include occupational performance using the Canadian Occupational Performance Measure, quality of life using the Stroke Impact Scale, cost effectiveness analysis, and a qualitative study investigating factors that influence use of Wii™ for patients and carers.

Conclusion

TWIST is the first UK RCT assessing the feasibility, cost effectiveness, and acceptability of Wii™ in stroke rehabilitation. The trial has been registered with ISRCTN 06807619 and UK CRN 11030. Results of the study will be published after completion of study in August 2014.

Keywords:

• virtual reality
• rehabilitation

Acknowledgments

We would like to thank our participants and caregivers and participating centers. We would also like to thank the Research Design Service South West. We thank Jane Vickery, Senior Clinical Trials Manager (Peninsula Clinical Trials Unit) for her comments on drafts of this paper.

Funding

This paper represents independent research funded under the Research for Patient Benefit Programme (PB-PG-0110-20332). The views expressed in this publication are those of the authors and not necessarily those of the NHS, NIHR (National Institute for Health Research), or Department of Health. The trial has been registered with ISRCTN 06807619 and UK CRN 11030.

Disclosure

The authors report no conflicts of interest in this work.