Reallocating Rehabilitation Time to Wii Fit or Pilates After Lower-Limb Burn Injury

Overview

This randomized controlled trial will evaluate whether reallocating part of a fixed-duration supervised rehabilitation session to Wii Fit or Pilates will improve functional outcomes in adults with healed lower-extremity burns. Participants will be randomly assigned to Wii Fit, Pilates, or conventional rehabilitation and will receive 60-minute supervised sessions three times weekly for 12 weeks. Walking capacity, postural stability, functional mobility, and quadriceps muscle performance will be assessed at baseline, after the 12-week intervention, and 12 weeks after completion of supervised rehabilitation. The study will compare these time-matched rehabilitation approaches and will assess the persistence of functional changes during the subsequent follow-up period.

Burn injuries involving the lower extremities can result in persistent limitations in walking capacity, balance, functional mobility, and lower-limb muscle performance. Rehabilitation commonly includes gait training, strengthening, balance exercises, and functional activities; however, the optimal allocation of a limited supervised rehabilitation session among different exercise approaches remains uncertain. This randomized controlled trial will evaluate the effects of reallocating part of a fixed-duration supervised rehabilitation session to either Wii Fit-based exercise or Pilates in adults with healed second-degree thermal burns of the lower extremities. Participants will be randomly allocated in a 1:1:1 ratio to three parallel groups: Wii Fit rehabilitation, Pilates rehabilitation, or conventional rehabilitation. All groups will receive supervised rehabilitation three times per week for 12 weeks, with an intended session duration of 60 minutes. In the Wii Fit and Pilates groups, approximately 30 minutes of selected conventional rehabilitation content will be replaced by the corresponding intervention rather than added to the total rehabilitation time. The conventional rehabilitation group will receive the standard 60-minute rehabilitation program. The Wii Fit intervention will incorporate balance, weight-shifting, single-leg balance, step-based, and light aerobic game activities using the Nintendo Wii Fit system and Balance Board. The Pilates intervention will consist of mat-based exercises emphasizing trunk control, postural alignment, breathing, movement precision, and progressive body-weight or elastic-band resistance. Exercise progression will be individualized according to a standardized treatment manual, with progression based on technical performance, tolerance, and absence of clinically relevant symptom or skin/scar exacerbation. Functional outcomes will be assessed at baseline, immediately after the 12-week supervised intervention, and 12 weeks after completion of supervised treatment. Outcomes will include walking capacity measured by the 6-minute walk test, postural stability measured by the Overall Stability Index, functional mobility measured by the Timed Up and Go test, and quadriceps muscle performance measured by isokinetic peak torque. The study will also examine whether functional gains observed following the supervised rehabilitation period will be maintained during the subsequent 12-week observational follow-up period.