Thursday, March 7, 2013

Wii Fit Therapy

The military community embraced virtual reality early in its development and provided much of the funding for research that helped advance the field. If you follow the above link you will read about training soldiers using virtual fighting, flying, and driving simulators. The military community has also embraced the use of Wii in rehab for returning injured veterans as well as for older vets who are deconditioned from chronic disease states. One physician at the Central Arkansas Veterans Healthcare System designed a study incorporating Wii activities. Could Wii Fit games be just the thing to improve these Vets balance and coordination? Kalpana P.Padala, MD, MS a staff physician and researcher at the Central Arkansas facility found that Wii Fit Therapy not only improved balance and coordination for these Vets, but provided them with a challenge that they enjoyed and were very willing to engage in regularly.

Wednesday, March 6, 2013

Balance Exercises: Will Wii Activities Help Your Therapy Population?

The LinkedIn Group: Rehabilitation Medicine, posted a discussion about balance and the post stroke population. The discussion leader is promoting her website , particularly a review which she wrote on an article written by Ruth Ann Geiger, Jeffery B Allen, Joanne O’Keefe, and Ramona R Hicks. Their article, Balance and Mobility following Stroke: Effects of Physical Therapy Interventions With and Without Biofeedback/Forceplate Training explains their project which compared outcomes between two groups of participants who had hemiplegia; group A received physical therapy for 50 minutes 2 to 3 times a week which included 15 minutes of treatment using the NeuroCom Balance Master. Group B received physical therapy for 50 minutes 2 to 3 times a week which included approaches designed to improve balance and mobility. This second group did not participate in exercises using the NeuroCom Balance Master. If you read the article, you will see that both groups showed improvement based on the "Timed Get Up and Go" measure as well as the "Berg Balance Scale." You will also read that this study did not show a significant difference between the groups. Balance improved in both groups. This study did not include a quality of life measure or an satisfaction or enjoyment measure to see which approach was more pleasing to the participants. The specific intervention variable used in the above mentioned article is probably expensive and not available to most therapists working with patients with balance issues. On the other hand, a Nintendo Wii balance board is relatively inexpensive and easy to obtain. Games on Wii Fit Plus can be used to provide visual feedback about weight shifting, center of balance and flexibility. Albeit, Wii is far less sophisticated than the Balance Master, using the Wii in therapy requires less space to set it up and less expertise to use. In some cases, the Wii Balance Board (WBB) has been used with modifications and peripherals in studies aimed at assessing improvement in balance. Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury, and Development of an interactive rehabilitation game using the Nintendo® WiiFit™Balance Board for people with neurological injury are two examples. Lean on Wii: Physical Rehabilitation With Virtual Reality and Wii Peripherals outlines more details about add-ons to the WBB. In some studies the Wii Fit Plus is used without changes. Examples include Wii-habilitation as balance therapy for children with acquired brain injury, Benefits of the Wii Fit as an Exercise Program for Older Adults, and Home-Based Balance Training Programme Using Wii Fit with Balance Board for Parkinson's Disease: A Pilot Study. Wii balance board activities can be used to help improve balance in many populations.