Grant: Doctoral: Anne Martin-Matthews Prize of Excellence on Aging

Many older Canadians are living with lower limb amputation (LLA). The prevalence of LLA is projected to double by 2050 primarily due to chronic systemic dysvascular diseases that are common with aging. This will impose an economic burden on the Canadian healthcare system due to the substantial costs associated with post-amputation care. Functional independence following a LLA requires individuals to undertake structured prosthetic ambulation programs. An ideal rehabilitation program improves balance and lower limb strength, and ultimately enhances walking capacity which has been reported as one of the strongest determinants of health-related quality of life in individuals with LLA. Functionally, improvement in walking capacity potentially equates to a reduced risk of prosthesis abandonment, falling and fear of falling and an increase in physical and social activity. Shrinking health care resources often make it difficult to deliver sufficient amount of therapy to achieve standard of care, and impossible to deliver more therapy. It is clear that there is a need for innovative, cost-effective rehabilitation programs. One potential solution may be a monitored home program that integrates fun and challenging activities such as the use of commercially available Nintendo WiiFit gaming program. In this study we will assess the effectiveness of a supervised home-based Nintendo WiiFit program for improving walking capacity in older adults with LLA. If the home-based Wii program is useful in improving subjects' functional outcomes, it could become an integral part of the LLA rehabilitation. Patients would be able to use the program at home, or after discharge to maintain or improve their skills. The benefits go beyond improved walking capacity and include increased physical activity tolerance, health and participation in important life activities which may ultimately ameliorate social and financial costs.