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OBJECTIVES The aim of this study was to assess whether a virtual rehabilitation program using Nintendo Wii added to conventional physical therapy improved functionality, balance, and daily activities in chronic stroke survivors, when compared with conventional physical therapy. DESIGN We undertook a randomized controlled clinical trial. The participants of this study were randomized to 2 groups: (1) conventional physical therapy (CPTG), which included exercises related to functionality, balance, and activities of daily living; and (2) virtual reality with Nintendo Wii (VRWiiG), which included balance training with the Wii Balance Board and upper limb exercises with the Wii Sports package, added to conventional physical therapy. SETTING AND PARTICIPANTS This study was conducted in a university rehabilitation clinic and 29 stroke survivors were admitted. METHODS Both interventions lasted 4 weeks, 2 sessions per week. Assessments were performed at baseline and at the end of the study, including functionality (Timed up and go [TUG]), balance (Tinetti Performance-Oriented Mobility Assessment [POMA]), Berg Balance Scale (BBS), and activities of daily living (Fugl-Meyer Upper Limb Motor Assessment, Barthel Index, Frenchay Activity Index [FAI]). RESULTS Regarding TUG, POMA, and BBS, the analysis of variance showed significant differences for time and group∗time interaction. Post hoc analysis showed between-group differences (P = .044, d = -0.78; P = .012, d = 1.00; P = .042, d = 0.79, respectively) and within-group differences only in the VRWiiG (P < .001, d = 0.75; P < .001, d = -0.76; P < .001, d = -0.57, respectively). Regarding activities of daily living, post hoc analysis showed within-group differences only in VRWiiG. CONCLUSIONS AND IMPLICATIONS Our study showed promising results in functionality, balance, and activities of daily living when adding virtual reality with Nintendo Wii to conventional physical therapy in chronic stroke survivors. All procedures were approved by the Human Research Ethics Committee of the University of Valencia (H1518177391901). ClinicalTrials.gov database (NLM identifier NCT04144556).