Structured Wii protocol for rehabilitation of shoulder impingement syndrome: A pilot study.

Only 8 Wii and 3 control patients remained, so the results are too small to guide treatment choices. Patients were assigned by alternating placement rather than a true random draw, and the groups were not equivalent at baseline: the Wii group had greater horizontal-plane ROM and the control group had weaker external rotators. The paper reports 50% attrition in the control group, and the dropout account is inconsistent, so the remaining groups may not represent the original participants. Both groups received the same home exercise program, so the contribution of the Wii sessions alone cannot be separated. Strength was measured with a nonvalidated digital scale, and shoulder movement was assessed only with 2-D video. The authors pooled sub-measures across outcomes to increase power, but they state this violates independence. The Wii protocol was limited by the commercially available games, which may not target every needed shoulder movement.

Do not read this as proof that Wii games work better than usual therapy or that they improve strength. The Wii group also received the same home exercise program, and the study had 8 Wii and 3 control patients, alternating allocation, baseline differences, and no significant strength gains in individual muscle groups.