Grant: Operating Grant

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. Prosthetic rehabilitation programs are designed to enhance mobility primarily through gait retraining. An ideal rehabilitation program optimizes balance and lower limb strength which in turn enhance functional mobility. This potentially equates to a reduced risk of prosthesis abandonment, falling and fear of falling, and an increase in participation in physical and social activities. Providing a rehabilitation program that is motivating and engaging is challenging because improvement requires highly repetitious task performance. 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. In 1994-97, the cost of surgery, rehabilitation and one year follow up post LLAs varied between $86,000 to $110,000 (US) depending on the level of amputation. Thus, novel methods which are practical, cost-effective, and well-received by clients are needed to deliver sufficient amounts of therapy. Commercially available virtual reality (VR) gaming software such as the WiiFitTM by Nintendo has the potential to be a valuable intervention for older adults with LLA. Based on pilot and feasibility studies our team has developed a customized version of the WiiFit™ for individuals with LLA called WiiNWALK. WiiNWALK is a 4-week supervised, home-oriented intervention targeted to improve walking capacity in individuals with LLA. The purpose of our randomized controlled trial is to evaluate the effect of the WiiNWALK program in older (50+ years) community living adults who have a unilateral above or below knee amputation.