Wii Sports Activities Encourage Speech in Aphasia Group

The versatility of Wii therapy, sometimes called wiihabilitation, becomes more apparent everyday. Although the software programs were not developed for therapy or with disabilities or rehabilitation in mind, so many of Nintendo Wii software applications offer opportunities for every member of the rehab team.
For those recovering from life events that alter their neurological, physical, or social functioning, the rehab team, led by a pysiatrist and most often comprised of an occupational therapist, a speech pathologist, a physical therapist, a clinical psychologist, a clinical social worker, a recreation therapist, a registered dietitian and a nurse create and carry out the plan of care that will propel the client forward toward a restored state of health. A stroke is one medical emergency that can alter a person's ability to live independently. Some who suffer a stroke experience residual language deficits known as aphasia.
The Adler Aphasia Center in Maywood, New Jersey provides ongoing help to clients and families touched by aphasia. In addition to providing direct services, the staff conducts research. Therapists at this center recently conducted a research study and reported the results of observing communicative acts during Wii group activities. The poster is available online. This study of Wii use in therapy contributes to the growing body of evidence-based resources supporting effectiveness of Wii activities in rehabilitation. Readers can examine the results and learn how Wii-hab influences communicative acts among the aphasic population participating in this original research.

New Study Shows Mood Alters reaction to Pain

Results of a recently published study indicate that negative and positive emotions are closely related to pain perception. Lead author, Mathieu Roy, a post=doc student at Columbia, reports that negative emotions are shown to amplify our perception of pain. The subjects reacted more strongly to painful stimuli while looking at unpleasant images than they did when they gazed upon pleasant images.
Wii Bowling seems to have a similar affect on residents of nursing facilities. My personal experiences using Nintendo Wii in therapy suggest that the results of this study ring true. Clients who complain of pain as they stand at a table top doing unilateral or bilateral upper extremity tasks seem relatively pain free as they stand gazing at pleasant Wii scenes, bowling frame after frame. Standing for longer periods while not perceiving pain helps clients boost their confidence while building strength, balance, and endurance for daily activities, functional transfers and functional mobility .

OT Students in North Carolina Research Benefits of Wii

Two professors along with six occupational therapy students from Winston-Salem State University in North Carolina are conducting a study into the effectiveness of Wii activities for Seniors(over 60). More specifically, these researchers will look at the impact of one game in the Wii Sports suite on quality of life, confidence in preventing falls and social skills in a specific population - those over 60 who live in a retirement community. The research team hopes to release the results of the study in January.

Students across the country are planning studies using Wii activities as the independent variable or the tool that is manipulated by the researcher. In the study mentioned above, the researchers have identified three dependent variables, quality of life, confidence in preventing falls and social skills. The researchers hope to find changes in those dependent variables as a result of the "application" of the independent variable which in this case is Wii Bowling. To find the anticipated changes this group of researchers will use a Pre-test, Post-test approach, which means that they will survey each group before the intervention (application of the independent variable) and then again after the intervention. The scores obtained from these 2 surveys will be compared using some statistical test. Usually the results of the statistical test is calculated using a computer program such as SPSS. The Wii intervention will prove to be effective if the difference between the 2 scores(Outcomes)are determined to show statistical significance, in other words, the differences in outcomes are so large that these differences probably are not due to chance.
Research requires perseverance and attention to detail. I look forward to reading the results of this study.

Career TV Features "Wii OT" using Wii in Therapy

Career TV posted a newly created segment featuring the "Wii OT". Watch this video to see how incorporating Wii into therapy helps many clients improve their function.

Fall, Football, and Wii-Hab

Occupational and physical therapists in the Northeast have two upcoming opportunities this Fall to attend Wii-Hab: Using Nintendo Wii in a Therapeutic Setting. Therapists in the Baltimore/Washington area can still sign up for this course being offered at Anne Arundel Community College on Saturday, November 21, 2009. To sign up, contact Continuing Education by phone at 410-777-2325 or email at iscenter@aacc.edu This course runs from 8AM until 4PM. If your favorite football team has any kick off time other than NOON, attendees will be able to enjoy both experiences in one day. Call today to secure a spot in this interactive and engaging continuing education opportunity.
On December 5, 2009, therapists in South Jersey may attend this Workshop at Richard Stockton College of New Jersey.
Sign up today and enjoy this opportunity.
OTs, PTs, COTAs, and PTAs will gain continuing education credit in a fun, active program that will help build confidence in using new technology with clients who have various diagnoses including joint replacement, stroke, cancer related fatigue, COPD, and others.

Wii Benefits Across the Life Span

Students worked together to create a video touting the benefits of Wii-Hab. In this snappy video, viewers get an idea of how Wii is used to encourage improved muscle strength and flexibility in adults.

Children also benefit from using the Wii in therapy. The blog entry posted on October 5, 2009 shares with readers a story about Wii use in a classroom as an addition to traditional therapy. News station KEPR CBS 19 in Pasco, Washington posts a video of Wii being used in a school setting by therapists to improve coordination and balance.

Read Lon Thornburg’s great blog to learn more about creative uses of Wii with children who have developmental disabilities.

Workshops Expand Therapists' Ability to Incorporate Nintendo Wii

Allegany College of Maryland hosted a "Wii-Marathon" for therapists October 2 and October 3. Therapists arrived from many states including West Virginia, Virginia, Pennsylvania and New York to learn more about the therapeutic uses of Wii technology, an affordable, portable and easy to obtain therapeutic tool.
Penn State Abington, located in a suburb of Philadelphia, will host the next workshop. On October 21, 2009 occupational and physical therapists, along with Nurses and Nursing Home Administrators can be a part of this educational, interactive experience . Space is limited, so contact Penn State Abington Continuing Education to grab one of the few remaining spots.

Grant Award Brings Wii Into The Classroom

Since Nintendo brought Wii to the market in 2006, many avid players who also happen to work with individuals with compromised function recognized this tool’s potential for addressing deficits. A special needs teacher in Ohio saw many great ways that Wii activities could improve student outcomes in his classroom.

The teacher, Kevin McDaniels, applied for funds to purchase the needed equipment for his classroom through Mid Ohio Energy Cooperative, INC’s Community Fund because Kevin recognized that using Wii complimented student time spent in occupational and physical therapy. Using Wii activities in the classroom seems to help students improve hand writing and balance by challenging both their fine and gross motor skills.

Although Nintendo has lowered the price of the Wii Console recently, the dollar amount needed to bring the benefits of Wii into classrooms and rehabilitation clinics may be in excess of usual pre-set budgets. Grants and donations have historically filled budgetary gaps in programs focusing on helping address needs in many communities. Most communities have organizations ranging from service groups to corporations willing to help programs reach out and serve those community members with specific needs.

Interested occupational and physical therapists as well as teachers can learn more about skills for grant writing and finding potential donor organizations by attending a grant writing workshop available often through area high school or college adult learning programs, found through internet searches or through companies, such as Grant Writing USA

Exercising With Wii? This Link Suggests Doing Some Research.

A writer working for a Philadelphia online paper, the Examiner.com focuses on Wii Fit. In her article posted on September 8, 2009 she suggests that Wii Fit enthusiasts compile research to build the evidence needed to support the value of Wii Fit. The author, Raina Casare lists 4 steps Wii Fit players should follow to compile needed support of Wii Fit’s value as a true tool for virtual reality fitness.

As therapists, following these same steps can help us gather data supporting Wii Fit’s importance as a therapeutic tool for occupational and physical therapy.

Many students choose to do research aimed at boosting Wii as a tool for therapy. From time to time, students write to me and ask for help on these projects, but many forget to share the outcomes once they finish. If you completed a study involving Wii, why not post information about it under comments. In truth, these early studies and surveys lay the groundwork for more in depth Wii-Hab research in the future.

Wii-Hab Meets Medical Illustration

An artist, who received her MFA (Master of Fine Arts) in Advertising Design from Savannah College of Art and Design, which is located in my hometown of Savannah, GA, created wonderful visuals depicting the crucial aspects of Wii-Hab. Angela Moramarco infuses the very human components - the brain, the muscles, the bones and the soft tissue - into the very technical components - the remote and the console - of Nintendo Wii. These great illustrations tell a concise story. Nintendo Wii, when used correctly in a therapeutic setting, helps patients build new connections within the brain and between the brain and the muscles. For some patients therapy can be difficult and repetitious. Wii offers occupational and physical therapists a versatile tool to use as a part of the therapy plan not only for improving strength, endurance, and flexibility but also for improving sequencing and problem solving in a variety of patient settings including pediatrics (autism, cerebral palsey, PDD) and geriatrics (stroke, joint replacement, fall prevention).

WiiHab - Using the Nintendo Wii in a Therapeutic Setting

Therapists throughout Maryland, Pennsylvania and New Jersey will have the opportunity to learn more about using Wii in therapy during the Fall months. On both Friday, October 2 and Saturday, October 3, Allegany College of Maryland located in Cumberland, Maryland will host the Wii-Hab workshop. On Wednesday October 21, 2009 the Wii-hab Workshop will be held at Penn State Abington. This location is in easy driving distance from Philadelphia and any of the suburbs. The Penn State workshop has been approved for 6 CEUs for Registered Nurses, expanding the appeal for this interactive seminar. The Wii-Hab workshop will be offered at Anne Arundel Community College on November 21. Therapists from the Baltimore/Washington area will like this location. For therapists living in New Jersy, the December 5 date at Stockton College will be great for them. Sign up early! Tell a friend.

WiiHab in the News Throughout The Summer (Part 1)

Frequently, during the summer months articles appeared in newspapers, on television, and in blogs explaining the benefits people gain when Wii activities are incorporated into their rehabilitation programs. In June, the El Paso Times printed an article about Del Sol rehabilitation center’s use of the Wii in their Physical and Occupational therapy programs. The accompanying picture tells the whole story! Also in June, Hulig News ( an independent public news organization) placed a great story on line about a patient at University of Wisconsin, Madison’s American Family Children’s Hospital. This story offers some insight into the versatility of Wii as a therapeutic activity. More positive reviews of Wiihab can be found when you read an article from June 15, 2009 in the Vail Daily. Therapists in Silverstone, Colorado include many different Wii programs into the plan of care for their patients. They report improved outcomes, particularly with knee replacement patients. A study which will contribute to the evidence-base for using Wii in therapy for knee replacement patients is taking place in Toronto. Researchers hope to complete this study by the end of the year.

Reports of Injuries from Wii Sports and Wii Fit

Whenever a certain colleague of mine mentions the Wii, talk of fear of injuries to players creeps into the conversation. An article appeared recently in the New York Times entitled, More Wii Warriors are Playing Hurt. Readers find references to strains and sprains as well as rotator cuff tears and knee injuries. This article suggests that Wii related injuries are increasing along with the popularity of the Wii gaming system, itself. In the therapeutic setting, I have not had any experience with patients adding to their injuries or pain using the Wii, because we are very careful to follow the"Play It Safe" (for Wii Sports) suggestions while working with patients. Earlier this summer though, I met someone who had broken his toe playing the Wii. Aaron Martin, a delightful and inspiring speaker, known best as the face of BASSEDGE, related the story of how he broke his toe playing a Wii game with friends. He hit his foot on a chair as he lunged to make the play. A reminder ofPoint # 4 from the "Play it Safe" sheet may have helped Aaron avoid that injury.

Although reports fill the internet of Wii related injuries to players and equipment, many more reports tout the benefits of using the Wii. Any activity can result in injury if the participant over-indulges or disregards safe practices. Using Wii Fit in therapy requires additional safety measures to insure against potential falls, especially when using this tool to improve balance and encourage weight-shifting in an elderly population. Safe use of therapeutic tools is common sense and usual practice for therapists. I always remind my colleague that stories of Wii injuries relate to public use of the gaming system, not to the supervised use of Wii as a therapeutic tool for Wii-hab.

Aaron Martin, BASSEDGE, meets the "Wii" OT

Using Nintendo Wii in Therapy: Benefits Seen Over Time

WiiHab - Rehabilitative Therapy Using the Wii by the "Wii OT” has been up and running for over a year now. Thank you for all of your visits and emails. So many people have responded to my blog. Not only have other occupational and physical therapists and students sent emails and responses but also family members whose loved ones are recovering from TBI, stroke or joint replacement and are benefiting from using Nintendo Wii have contacted me from time to time. And these responses have come from many states like Pennsylvania and Georgia and from countries far and near to the USA like England, Sweden and Canada. The use of Nintendo Wii as a therapeutic tool continues to spread, while therapists, researchers, and patients alike continue to recognize the advantages of including this tool in plans of care.

Just the other day, another article appeared in print and online about the benefits of using Nintendo Wii to help people recover from injury, illness and surgery. This article highlights 2 important points. First, mention is made that Wii offers an opportunity for socialization, helping reduce feelings of isolation. Second, this overview states that using the Wii is fun. Bringing fun into therapy helps patients who are dealing with a changing health status to reduce feelings of anxiety. Learning to use adaptive devices or learning to do familiar things in new ways is easier when feelings of isolation and anxiety are reduced. Reducing feelings of isolation and anxiety is such an important part of therapy.

So again, thank you for your support. Post your experiences in the comments section for all to see.

MCG's DR. HERZ PRESENTS RESULTS OF STUDY OF WII THERAPY AND PARKINSON'S

Completeing the research and publishing the studies that form the basis for evidence-based medicine takes time, money, and expertise. Lead researcher, Dr. Ben Herz, from Medical College of Georgia, is among the first researchers to publish a study which demonstrates the benefits of using Nintendo Wii in a therapeutic setting. On June 12, 2009 he presented the results of his study that examined the benefits of an occupational therapy intervention for patients with Parkinson's disease using actvities available through Nintendo Wii .

Those attending the fifth anual Games for Health in Boston heard Dr. Herz's report that the study participants demonstrated a decrease in depression as well as an increase in agility. These improvements would be very beneficial to someone with Parkinson's since those with Parkinson's disease experience both depression and bradykinesia (slowing of movement).

High School and Middle School Special Needs Students in Oregon To Benefit from Wii-Hab Pilot Program

As planned, Lon Thornberg, along with the occupational and physical therapists who he works with in Oregon, spent two days observing ways that activities and exercises available through Nintendo Wii might benefit children with special needs. The article posted on No Limits to Learning describes the program designed to help these three dedicated individuals develop a program for their students that will incoroparte the most effective Wii programs for their student population.

Activities offered through Nintendo Wii Sports provide opportunities to improve :

1. motor skills, especially gross and fine coordination,
2. cognitive skills, especially sequencing, memory and recognition

as well as many other areas.

If you have used activities offered through Nintendo Wii in a school based setting, please let Lon and me know about your experience.

FIFTH ANNUAL GAMES FOR HEALTH CONFERENCE

The Fifth Annual GAMES FOR HEALTH conference, made possible in part by the Robert Wood Johnson Foundation, takes place June 11-12 in Boston, MA.  "The Healthcare Guy" posts what Ben Sawyer, co-founder of Games for Health, has to say about the upcoming conference.  This article provides both a good background on the history of gaming for health as well as a glimpse into the newest games available for the therapy toolkit.  

One game that Mr. Sawyer mentions is Electronic Arts' EA Sports Active.  This game features a personal trainer who leads the participant through a workout that really makes the player break a sweat.  This game encourages the participant to strengthen the upper body, build endurance, improve balance and strengthen the lower extremities. 

During a recent "Wii-Hab - Using Nintendo Wii in a Therapeutic Setting" Seminar, a student was very interested in using Wii activities for high level patients in an outpatient occupational therapy and physical therapy rehabilitation setting.  EA Sports Active  provides high level activities that may be well suited for that population.  

SENIOR HEALTH & FITNESS DAY 2009

May 27, 2009 was National Senior Health and Fitness Day. As you may know, seniors who stay active and physically fit help themselves avoid some of the declines associated with aging; in particular, the increased risk for falls.

According to the website, www.fitnessday.com/ the common goal for this day is to help keep older Americans healthy and fit. Many health related facilities held special events to help raise fitness awareness in those who they serve. The life care community where I work scheduled many different events to encourage all of the residents at all fitness levels, to either stay or become active.

Occupational Therapy's interactive Wii Fit presentation proved to be a very popular. Thirty-five participants, many of which had never seen a Wii, a Wii Fit balance board, or a Mii before, enjoyed learning all about using the Nintendo Wii and playing the fun games. Wii Fit offers an exciting alternative to the more traditional machine-based exercises, encouraging participants to improve their balance, endurance, and strength while having fun and experiencing new technology that they know their grandchildren also enjoy.

Occupational Therapist to Pilot Wii Program for School Based Treatment

Using Wii as a therpeutic tool for the geriatric population recieves a great deal of press but the use of Wii based activities for children in school based programs is discussed only occasionally in the news.  In Oregon, an occupational therapist, with the help of the assistive technology specialist and trainer has planned an assessment day during which students will try out several Wii applications.  The OT will gather useful information about which applications are best for various motor levels and abilities.  This fact finding day, described in the May 7,2009 post on No Limit 2 Learning will provide a wealth of information.  Take a minute to read about this well thought out venture by clicking here.

  

New Wii Remote Accessory May Increase Therapeutic Value for High Level Clients

Nintendo plans to release a new accessory for the Wiimote.  The Wii MotionPlus can be easily attached to the remote. Once attatched, this device enhances the remote's ability to detect and reflect arm and wrist motions.  This increased sensitivity and accuracy may improve Wii's value as a therpeutic tool for rehabing higher functioning clients.  By enhancing the remote's ability to detect even the slightest movement of the wrist and arm, Nintendo might be making it easier to target specific muscles and to encourage increases in strength, coordination and endurance .  The release date for this attachment is June 8, 2009 for the USA markets.   

Students Enjoy "Wii-Hab - Using the Nintendo Wii in a Therapeutic Setting"

Allegany College of Maryland

hosted the most recent Wii-Hab workshops. Students learned how the games in Wii Sports and Wii Fit can be used as therapeutic activities (97530) and/or therapeutic exercises (97110) and/or Neuro-muscular re-education (97112) to achieve specific patient goals. The participants also had fun as they pacticed using Wii Sports and Wii Fit in innovative ways. Students also enjoyed applying what they learned by designing treatment plans for case study patients described as having poor endurance, weakness and lack of coordination.

Additional Wii-Hab workshops at Allegany College of Maryland are planned for October 2 or 3, 2009. Penn State Abington will host Wii-Hab: Using Nintendo Wii in a Therapeutic Setting on October 21, 2009. On Saturday, November 21, 2009, Wii-Hab: Using Nintendo Wii in a Therapeutic Setting, will take place in the Baltimore/Washington, D.C. area at Anne Arundel Community College's Arundel Mills campus.

Gathering Evidence of the Effectiveness of Wii-Hab

Therapists are always encouraged to think in terms of evidence-based approaches when designing treatment plans for their patients.  Local newspapers and blogs , including WiiHab - Rehabilitative Therapy Using the Wii, often publish stories about Wii and the use of Wii Sports and Wii Fit in therapy.  The March 2, 2009 addition of Advance for Occupational Therapy Practitioners published an article by Elizabeth Karan that included treatment success stories for 2 patients who had suffered strokes.  She told about improvements in balance and endurance as well as improved function in ADL performance and ambulation.

Gathering actual evidence-based outcomes take time because researchers must design a study, gain approval from an Institutional Review Board (IRB), and in many cases, find research subjects to study before finally conducting the experiment and collecting the data.  But researchers are busy doing all of those things to find out just how effective the Wii is for therapy.  Medical College of Georgia is conducting a study to determine if occupational therapy enhances the treatment for Parkinson's Disease.  

Playing Wii is part of that treatment.  

Judith E Deutsch, Megan Borbely, Jenny Filler, 

Karen Huhn and Phyllis Guarrera-Bowlby published

a case report in October of 2008 in which they explained 

the benefits playing Wii had for an Adolescent With Cerebral Palsy . 

Now, a researcher in Canada is looking for subjects

 to participate in her study as she works to 

measure the

therapeutic value of active video games,

 including Nintendo Wii.

The Benefits of Wii from a Patient's Perspective

Occupational therapists like to utilize a patient-center approach in all aspects of treatment.  According to this article, Nintendo Wii as Therapy and Fun For Multiple Sclerosis, Wii, from a patient's perspective, is both enjoyable and therapeutic when coping with Multiple Sclerosis.  

 Problems for those with multiple sclerosis include fatigue, balance, flexibility and motor control.  Wii provides an array of activities which encourage a person to use and improve balance, flexibility and motor control.  These activities are fun and engaging, helping the participant focus on what they can do.  These self-paced activities allow for frequent rests while providing excellent feedback on improvements in a fun format.  Wii sports games, such as Bowling, baseball and Tennis help with motor control and flexibility.  The training moduals for each sport records your progress while the fitness modual calculates your Wii Age and posts it for encouragement.  Wii fit has great activities for improving balance and flexibility.  All of these games can be played for short periods with rests as needed.  Wii therapy brings a smile to all who try it.  Have you tried wiihab in your clinical setting yet?

Continuing Education Workshop featuring the "Wii OT"

Allegany College in Cumberland, Maryland  is now offering a second one-day continuing education workshop featuring the "Wii OT''.   The May 1st educational workshop is filled to capacity. So, on Saturday, May 2, 2009 another opportunity for occupational and physical therapists (and other rehabilitation professionals) to be introduced to the Nintendo Wii as a therapuetic tool will be offered. The WiiHab Therapy  Workshop offers a full day of exciting activities to help therapists and others involved in health care learn not only the great benefits of using the Wii in their clinical setting, but also the best methods to ensure that using the Wii is truly therapuetic.  

Course Description:

Rehabilitation therapists have a long history of using innovative and entertaining activities to help patients reach therapeutic goals. In this one-day course, therapists will be introduced to the Nintendo Wii as a therapeutic tool which can help patients increase strength, balance, endurance, flexibility and hand-eye coordination. Additionally, participants will learn appropriate adaptations and modification for Wii play in various patient populations, particularly older adults. Course will include case studies and practical considerations for patient safety.

Continuing Education Information:

Approved by the Maryland Board of Occupational Therapy Practice for 7 contact hours. Approved by the Maryland Board of Physical Therapy Examiners for .7 CEU’s. All other professionals will receive 7 contact hours from Allegany College of Maryland.

For more information, call:

Linda Atkinson, Director,

Institute for Health

and Human Services

(301) 784-5526

I look forward to seeing many of you there!

The Wii can fight Childhood Obesity

Earlier, I wrote about the Wii and Health Promotion (October 8, 2008).   Using the Wii is a great tool to combat the sedentary lifestyle.  Now, researchers in England are looking into the use of Wii to combat obesity in children.    How are you using the Wii in your practice?   Do you find that it motivates those you are working with?  I see it every day.  Helping people move more in an enjoyable and motivating way promotes a positive attitude.  

Following Stroke, The Wii Encourages Bilateral Upper Extremity Use

Using  Wiihab encourages many responses.  Often occupational and physical therapists are challenged to  find therapeutic activities to elicit one desired response,  bilateral upper extremity use.   Those recovering from stroke may find using the involved extremity uncomfortable and challenging because of muscle weakness, increased or decreased muscle tone, poor sensation, or loss of position sense (proprioception).   Boxing in Wii Sports, especially, offers an opportunity to use both upper extremities reciprocally and spontaneously.   Boxing in virtual reality creates a need to make alternating movements with the arms to protect yourself from punches or to knock out your opponent.  If the participant's bilateral cordination is sluggish, their opponent will punch them.  Many will work hard to avoid that!  All of the Wii games promote therapeutic movement and many news reports explain the value patients find in using games as therapy.  

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