Wednesday, July 30, 2008
'Wiihabilitation' helps patients recover quicker
Dayton Daily News (July 29, 2008)
Senior center adds Wii system
Marshfield Mariner (July 29, 2008)
Nintendo Wii Used For Rehab
KSAT.com, TX (July 28, 2008)
New Orleans CityBusiness, LA (July 28, 2008)
Foundation Grant Funds "Wii-habilitation" Therapy
Southern Pines Pilot (July 26, 2008)
Bayfront uses Wii for rehab
Tampa Bay's 10, FL (July 25, 2008)
Tuesday, July 29, 2008
The Wii gaming system could be utilized in therapy for Alzheimer's patients with reduced ability to perform activities of daily living. Wii Bowling, Wii Baseball, Wii Tennis and Wii Golf provide a therapeutic opportunity to improve both flexibility and balance. The therapist may also place weights on the patients’ wrists as a means of incorporating strength training into the activity.
Furthermore, Wii encourages reminiscing. Individuals with Alzheimer’s disease experience short term memory loss and often retreat to the past. These past memories often become their reality. Even though hand over hand cueing may be required for successful use of the game with this population, therapeutically playing Wii Bowling, Wii Baseball, Wii Tennis or Wii Golf, may stir memories of pleasant past experiences for these individuals. The therapeutic use of Wii may help reduce anxiety in this population.
Monday, July 28, 2008
For maximum enjoyment, suggestions for the safe use of the Wii Gaming System should be posted in an obvious spot near where the game is set up for casual use. Below is a Safety Tip Sheet from The Wii OT, Mershon W. Hinkel, MSPH, OTR/L, that may be copied and placed either in a free-standing frame on the table top, or on the wall where the Wii is being used.
Wii PLAY IT SAFE
Wii is a great activity for all ages. By using a wireless remote, Wii has taken "playing" video games off the couch. Wii games are a physical activity, a social activity, and a wonderful way to interact with younger generations.
For an enjoyable, safe, and healthy time playing the Wii, follow the guidelines below:
1. Always use the included Wii wrist strap and the Wii remote safety jacket. The wrist strap prevents accidentally dropping or throwing the remote, and the jacket gives the remote a softer and less slippery surface.
2. Don't overdo it, especially when you're first starting out. Like with playing any new game or sport, you may find yourself using muscles you don't usually use, and these muscles may become strained or sore. Stretching before playing and using ice to relieve any soreness after playing can protect muscles and tendons from injury.
3. If you are concerned about your ability to balance, many of the Wii games can be played sitting down. You may also wish to use a form of support for extra safety to avoid falling.
4. Be sure the playing area is clear of potential obstacles that may get in the way of your arms or legs when playing. Be sure you are not too close to other players or observers.
5. If you have a condition such as epilepsy, are prone to motion sickness, or have a pacemaker, you may want to discuss using Wii and other video games with your health care provider prior to playing.
6. To avoid the spread of germs, wipe the remote's surface with a sanitizing wipe. Players may also want to use hand sanitizing gels between turns.
Monday, July 21, 2008
Fall Prevention and Wii
Many Wii games can be played from a seated position. However, sometimes the goals of therapy include getting a patient to stand and balance. For a patient whose balance may be in question, the therapist may wish to use a gait belt. Another option would be to use parallel bars for support or for safety, or using a walker with therapist at the side. For example, while the Wii balance board is very sensitive to shifts in weight, it can still be effectively used to train balance while the user relies partly on upper-body strength to support the lower body.
When using the balance board, be sure it is not on a slippery surface and that other people will not trip over it. The balance board is white and may be difficult to see on a white or light colored floor, especially for patients with low vision. This potential risk can be mitigated by placing the balance board on top of a non-stick mat, such as a yoga mat, in a darker color. For patients at risk for falls, Wii use that involves standing should always be supervised.
Infection control and Wii
If the Wii equipment is shared in a clinic setting, it must be appropriately cleaned between uses to prevent potential transfer of any pathogens (germs).
To fully clean the remote, the protective safety jacket should be removed from the remote. The jacket can be immersed for cleaning, but the remote can NOT be immersed. The remote itself should be wiped with disinfectant solution readily available in the clinic (use the same wiping method as for similar plastic items). The Wii remote strap can be removed and washed as well. (See the photo below of a Wii remote with safety jacket and with jacket removed.)
Photo by frostova on Flickr
Also, users can wear latex gloves while handling the remote for extra precaution.
Injury Prevention and Wii
Therapists incorporating Wii into a therapeutic plan should use the same strategies that they would use if a person had started a new sport. For example, if the patient has been bothered by a wrist or elbow in the past, the therapist may consider using ice and monitoring a patient to prevent overuse. Because of the "fun" element involved in Wii, overuse may be of particular concern. Also, therapists should make sure all movements are being done correctly and that patients do not compensate for a weak muscle with a stronger muscle group.
Avoiding injury to others or damage to equipment with the Wii
In the early days of the Wii, anecdotes of Wii bowlers accidentally throwing the Wii remote through a television screen abounded. The Wii remote's safety strap and safety instructions given at the start of each Wii session and game, as well as the new safety jacket, should help prevent this type of damage (or injury that could result if the remote hit another person).
Always clear the area of potential hazards or obstructions before using the Wii, make sure he safety strap is secured to the player's wrist, and use the padded secure-grip safety jacket on the remote (see the photo above of the remote with and without the safety jacket). Also, follow all safety precautions given by the Wii software.
Friday, July 18, 2008
This research funding is a wonderful step towards developing an evidence-base that supports use of video games as therapeutic activities. Many of the movements involved in playing the Wii or other interactive video games are already based on evidence and research that certain tasks improve balance, strength, coordination, and self-care abilities. Continuing to conduct research in this area will yield even more information about how providers can implement the use of video games in their practices and bring this technology to a wide variety of patients.
Thursday, July 17, 2008
Guitar Hero uses a wireless guitar-shaped controller. The player "strums" a bar-shaped button on the body of the "guitar" and presses buttons on the neck of the "guitar" to select notes while following along with songs on the monitor. The game requires finger dexterity, and it has different modes and levels so that people can progress to more difficult movements. Playing games such as Guitar Hero that require movement of the fingers can help patients regain fine motor skills in the hands and also improve coordination. For patients with skin grafts on the hands or arms, the game can help them practice moving and stretching the skin as it heals.
Wednesday, July 16, 2008
Tuesday, July 15, 2008
Photo by SMercury98 on Flickr
Bilateral coordination is the coordinated use of both sides of the body at the same time, either in similar movements or in alternating movements. An example of a similar movement is using both hands to pick up an object or using both hands to throw a beach ball; an example of alternating movement is walking up the stairs or pedaling with the feet or the hands.
In Mario Kart Wii, players insert the regular Wii remote, which is rectangular in shape, into a wheel-shaped adapter. Because the wheel Wii controller is held and controlled with both hands, bilateral coordination is involved in playing the game.
Also, effective playing of the game can involve alternating movements, such as holding down the "2" button to speed up the kart while using the "b" button on the reverse of the controller to "drift" while in manual mode. (Manual mode is optional, and less advanced patients can play in automatic mode.)
"The Wii system has been an asset to our rehab unit...The system encourages patients to perform the actual movements of the sport. Driving games help patients with visual tracking and scanning. Bowling, tennis, and baseball improve hand/eye coordination."(As a note, the driving game mentioned is likely Mario Kart -- if you're not familiar with the game, it is a driving game that allows the player to attach the regular Wii remote to a driving wheel-shaped remote.)
Photo by Michael T. Gilbert on Flickr
The article also mentions that using the Wii can help improve memory skills, as the patient has to remember the motions and steps involved in using each particular game. The social aspects of playing Wii with others can also help aid in patients' feelings of loneliness or isolation.
Monday, July 14, 2008
This story from Texas reports on how therapists are using Wii games to help children not only gain strength and flexibility, but also improve coordination. As in many cases, the games chosen are tailored to patients' needs, such as Bowling and Boxing for arm strength and coordination.
Wiihab might be particularly useful for children because it removes the boredom factor from therapy. Using the Wii is also a distraction technique, reduces anxiety, and incorporates play into therapy.
For OTs, using the Wii with pediatric patients can be an especially important component of a well-rounded therapy program because playing is part of a child's "occupation." Additionally, because the Wii is a popular toy for younger age groups, learning how to use the Wii may help a child with social interaction and playing with peers. Playing Wii also is an opportunity for children to interact with parents and adults in a way that has therapeutic value.
Friday, July 11, 2008
The principal researcher, Professor Janet Eyre, has noted improvements in the children's use of the less frequently used limb as well as improvements in coordination and social interaction:
"What has been striking to us, and the parents and children, is that by playing the games the children are using their [disabled] arm more in everyday life. We're trying to give them an incentive so that they will use it a lot."
She also notes the social value of using games, which are an integral part of childhood, to de-stigmatize therapy for children and families:
"Children sometimes feel stigmatised by therapy but everyone plays games, and they can play them with their parents or their brothers and sisters."Therapy may hold a stigma even for adults; using the Wii and other video game / interactive tools may be of use even with older patients who resist therapy or who are unlikely to adhere to recommended courses of therapeutic treatment.