tag:blogger.com,1999:blog-67425739828760289822024-03-05T07:46:53.462-05:00WiiHab - Rehabilitative Therapy Using the Wii by the "Wii OT""Wiihab" explores the use of the Nintendo Wii as a tool for rehabilitative therapy, including occupational therapy and physical therapy, as well as a way for seniors and elders to stay active and to stay connected.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.comBlogger104125tag:blogger.com,1999:blog-6742573982876028982.post-20211687720057024892016-04-05T11:12:00.001-04:002016-04-05T11:12:18.384-04:00March Madness meets Rehab<span style="font-family: inherit;">In Colorado Springs, a recreational therapist utilized Wii basketball in her therapy sessions. Wii games and activities remain a great tool for therapy because, as the client featured in the article states, <span style="font-size: 14px; line-height: 19px;"><span style="color: #3e3e3e;"> </span>“The Wii does help you forget about all the problems that you have". </span><span style="font-size: 14px; line-height: 19px;">This aspect of Wii contributes to the boost in outcomes often seen in patients using Wii in therapy. Watch the video clip and bring out the Wii again in your clinic. </span></span><br />
<h3 class="" style="clear: both; font-family: 'Open Sans', sans-serif; font-size: 30px; margin: 0px 0px 10px; padding: 0px; text-align: center;">
<a href="http://www.koaa.com/story/31637729/your-healthy-family-wii-basketball-therapy">Wii basketball therapy</a></h3>
<div>
<img src="http://koaa.images.worldnow.com/images/10251046_G.jpg" /></div>
Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com10tag:blogger.com,1999:blog-6742573982876028982.post-3410144994195452202013-09-10T21:37:00.005-04:002013-09-10T21:42:42.271-04:00Adrian Peterson of the Minnesota Vikings Used Wii to Help Get Him Back in the Game<div class="separator" style="clear: both; text-align: center;"><a href="http://helmet2helmet.com/wp-content/uploads/2012/11/adrian-peterson-150x150.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://helmet2helmet.com/wp-content/uploads/2012/11/adrian-peterson-150x150.jpg" /></a></div>Over the summer, Minnesota Vikings running back Adrian Peterson, appeared on <i>Late Night with Jimmy Fallon</i>. At the beginning of the <a href="http://www.cbssports.com/nfl/eye-on-football/22509013/watch-adrian-peterson-crushes-jimmy-fallon-with-handshake">interview </a>he explains to Jimmy how he used Wii games to help rehab his knee following ACL repair surgery. Adrian explains that he started playing the Ski games offered through Fit Fit about one month after surgery. He tells Jimmy that he liked that because it helped him begin to put pressure through the knee. Adrian tells the host that Wii games helped him rebuild his muscles and helped him "get more power and strength into those muscles around the knee." Adrian declares, "It really helped a lot"
The Vikings organization also posted a <a href="http://www.vikings.com/news/blog/article-1/A-Look-Back-Adrian-Peterson-Uses-Wii-To-Rehab/11dfff48-4936-4785-b69f-326826fe3b60">video about Adrian's rehab</a>. If you watch this short segment, you can see Adrian using not only Wii Fit programs in therapy, but also other video games with exercise equipment to achieve his personal rehab goals. This determined player and the trainer explain that the games help reduce the monotony of repetitive exercise, making the process more enjoyable.
Most individuals who need rehab for knee injuries or replacements may not have access to all of the expensive equipment or intense personal attention that Adrian Peterson had at his disposal, but many do have the opportunity to have some therapy. When you watch the video made by the Vikings organization you will hear and see Adrian making some good points; points that would benefit any rehab participant. 1. Adrian points out that he made personal goals that he hoped rehab would help him achieve. As a therapist, an important role is to help your client verbalize their goals. Encouraging your client to verbalize a goal helps that client imagine wellness,an important step that helps the individual push away some of the fear. 2. Adrian demonstrates full engagement in the rehab process. Keeping clients fully engaged in rehab often proves to be a real challenge in some settings. Wii activities help motivate the client and reduce the tedious nature of some rehab processes.
3) Adrian explains (in the Jimmy Fallon interview) that the Wii Ski games helped him adjust to putting weight through his repaired knee. As a therapist, I understand that this activity early in the rehab process helped him gain confidence in the joint. As the stability in the joint increased so did his confidence in his ability to use it. Wii Fit activities provide a great way for therapists to help clients gain confidence in a replaced or repaired joint, because many activities like the Ski Jump and the Tilt Table require weight bearing and or weight shifting in a relaxed, fun setting. Pull out that Wii Console and put it to use! The Wii offers many programs that enhance our tried and true exercises and add exciting activities, making therapy more enjoyable and beneficial.
Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com12tag:blogger.com,1999:blog-6742573982876028982.post-68975795658352250992013-03-07T15:56:00.002-05:002013-03-07T16:00:39.728-05:00Wii Fit Therapy <a href="http://profile.ak.fbcdn.net/hprofile-ak-prn1/c28.0.75.75/16940_243325980059_6071369_s.jpg" imageanchor="1" ><img border="0" src="http://profile.ak.fbcdn.net/hprofile-ak-prn1/c28.0.75.75/16940_243325980059_6071369_s.jpg" /></a>
The <a href="http://science.howstuffworks.com/virtual-military.htm">military community embraced virtual reality</a> 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 <a href="http://science.dodlive.mil/2013/02/17/wii-fit-therapy/">Wii Fit Therapy</a> 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. Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com5tag:blogger.com,1999:blog-6742573982876028982.post-78485586046435969422013-03-06T15:36:00.000-05:002013-03-06T15:38:00.965-05:00Balance Exercises: Will Wii Activities Help Your Therapy Population?The LinkedIn Group:<i> Rehabilitation Medicine</i>, posted a discussion about balance and the post stroke population. The discussion leader is promoting her <a href="http://www.exerciseforbalance.com">website </a>, 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, <a href="http://physther.net/content/81/4/995.full">Balance and Mobility following Stroke: Effects of Physical Therapy Interventions With and Without Biofeedback/Forceplate Training</a> 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 <a href="http://resourcesonbalance.com/neurocom/products/SMARTBalanceMaster.aspx">NeuroCom Balance Master</a>. 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. <a href="http://resourcesonbalance.com/neurocom/products/images/smart_balance_master.jpg" imageanchor="1" ><img border="0" src="http://resourcesonbalance.com/neurocom/products/images/smart_balance_master.jpg" /></a>
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. <a href="http://www.jneuroengrehab.com/content/8/1/30/">Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury</a>, and <a href="http://www.icdvrat.rdg.ac.uk/2010/papers/ICDVRAT2010_S08_N05_Lange_etal.pdf">Development of an interactive rehabilitation game using the Nintendo® WiiFit™Balance Board for people with neurological injury</a> are two examples.
<a href="http://webdocs.cs.ualberta.ca/~wfb/ammi/publications/C-2010-Anderson.pdf">Lean on Wii: Physical Rehabilitation With Virtual Reality and Wii Peripherals</a> outlines more details about add-ons to the WBB. In some studies the Wii Fit Plus is used without changes. Examples include <a href="http://informahealthcare.com/doi/abs/10.3109/17518423.2012.740508">Wii-habilitation as balance therapy for children with acquired brain injury</a>, <a href="http://soar.wichita.edu/bitstream/handle/10057/3201/GRASP_2010_119-120.pdf">Benefits of the Wii Fit as an Exercise Program for Older Adults</a>, and <a href="http://www.ingentaconnect.com/content/mjl/sreh/2012/00000044/00000002/art00008">Home-Based Balance Training Programme Using Wii Fit with Balance Board for Parkinson's Disease: A Pilot Study</a>. Wii balance board activities can be used to help improve balance in many populations.
Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com4tag:blogger.com,1999:blog-6742573982876028982.post-56319725557704395052012-10-17T08:57:00.000-04:002012-10-17T08:57:01.222-04:00Why WiiHab May Be Helpful Therapy In Preventing FallsThe Lancet published results of what researchers, observing falls in long term care residents, found through videos of the incidents. Take a minute to read the summary of this study (primary source: Robinovitch S, et al "Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study" Lancet 2012; DOI: 10.1016/S0140-6736(12)61263-X.) as published on<a href="http://www.medpagetoday.com/Geriatrics/GeneralGeriatrics/35354"> MEDPAGE. </a>
Interestingly, the study found falls in this long term care population occurred at higher rates during standing and transferring and at lower rates during walking, with a larger proportion of falls attributed to center-of-mass disturbances as compared to base-of-support disturbances (trips, slips, and stumbles). Therapy that includes Wii Fit activities like Ski Jump can be used to increase awareness of center-of-mass and improve control and voluntary engagement of muscles required in weight shifting. Through my experience, the elders seem to enjoy Wii activities. The video game format and the Miis that they can create, encourage them to invest a bit more in their therapy than traditional, repetitive therapeutic activities. Based on knowledge gained through this study on causes of falls, elders would benefit from targeted programs that promote more control of center-of-mass.
Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com4tag:blogger.com,1999:blog-6742573982876028982.post-87513364963370110652012-10-09T10:56:00.000-04:002012-10-09T10:56:09.544-04:00Research Supports Wii in TherapyFalls in community dwelling elders concern not only those who might be at risk, but also the physicians and therapists who see the sometimes life changing effects of these incidents. Research on prevention strategies abounds. Many approaches show results in reducing risk.
Many students choose Nintendo® Wii Fit™ as an intervention in their research. <a href="http://www.jsptr.org/attachments/JSPTR_Volume_2_Number_1_Article_2.pdf">A physical therapist published his study</a> showing improvements in all of the chosen outcome measures. He used Nintendo® Wii Fit™ activities combined with traditional activities in his therapeutic approach.
A <a href="http://thescholarship.ecu.edu/bitstream/handle/10342/3660/Gardner_ecu_0600M_10489.pdf?sequence=1">second study conducted by a graduate occupational therapy student </a> focuses on the benefits of Nintendo® Wii Fit™ activities for a older adult with Myasthenia Gravis. Her research also shows improvements in outcome measures. A third <a href="http://library3.sage.edu/archive/thesis/PT/2012bucci_lomonaco_wasiczko.PDF">study presented in May 2012</a> further supports using Nintendo® Wii Fit™ activities as a key component of fall prevention programs for reducing fall risk in older adults. Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-91947605552299143272012-09-09T17:07:00.000-04:002012-09-09T17:07:48.367-04:00Wii-Hab Therapy Article Appears in New York TimesOnce I worked with a fantastic Occupational Therapist who always motivated his staff and kept morale high even during periods when the case load was tough. He would always say, "Everything that is old, is new again." He said this because his years of experience taught him that the treatment approach that was most talked about just the other day, would be overshadowed by a different treatment approach for a while, only to resurface again as the hot "new" topic once more. Rehabilitation approaches, like life, appear to be cyclical and using Wii in rehab appears to run in and out of the spotlight regularly. The New York Times shines that spotlight on Wii once more by publishing an article Saturday highlighting the value of Wii Golf in therapy. Wii activities bring FUN into treatment. FUN helps patients stay motivated. <a href="http://www.nytimes.com/2012/09/09/health/physical-therapists-use-wii-golf-to-treat-patients.html?_r=1">This article</a> suggests that some in rehab even forget that they are exercising. They just think they are having fun as their strength, balance and cognition improves. A patient once said to me, "Every part of therapy doesn't need to be so hard." She loved Wii because the games let her feel successful and refreshed. She enjoyed laughing. Her standing tolerance was much higher during Wii Bowling than during the therapeutic ball tap activity. Bring those Wii games back out this week. If you wish you knew more about using Wii in therapy, keep a lookout for a workshop in your area. Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-7215202702103450412012-07-27T12:35:00.000-04:002012-07-27T12:37:45.627-04:00Post-stroke Balance Improved With YogaWii Fit Plus activities can be used in therapy in many creative ways. Wii therapy with yoga poses (found in the Wii Fit program) may be very beneficial. For individuals recovering from stroke, yoga helps improve balance, function, and quality of life.
An occupational therapist led <a href="http://stroke.ahajournals.org/content/early/2012/07/24/STROKEAHA.112.658211.abstract">a study looking at the effects of a yoga</a> program on participants who had strokes. The outcome measures included balance as measured by the 14-item Berg Balance Scale, balance efficacy as measured by the Balance Confidence scale and quality of life indicators as measured by the 49-item Stroke-Specific QoL scale. The <a href="http://www.medpagetoday.com/Cardiology/Strokes/33934">researcher reports</a> using seated, standing and floor postures. Wii Fit Plus offers 18 different Yoga poses as outlined in the <a href="http://www.dummies.com/how-to/content/yoga-exercises-for-wii-fit-plus.html">Yoga Exercises for Wii Fit Plus cheat sheet</a>. Each pose benefits the participant in ways ranging from improved postural alignment, to increased strength, to improved flexibility. Using yoga activities with Wii for therapy has the advantage of providing the therapist and patient with immediate feed back, a score that can be used to indicate improvement, and an easy way to boost carry through by including the Wii activities in a home program.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com3tag:blogger.com,1999:blog-6742573982876028982.post-40223189890817519162012-07-20T07:47:00.000-04:002012-07-20T07:47:49.368-04:00Wii based Movement TherapyWhat is that quote from Shakespeare's Romeo and Juliet? Remember? Juliet says, "What's in a name? That which we call a rose by any other name would smell as sweet;" ******* WiiHab**** Wiihabilitation*****Wii Therapy*****Wii based Movement Therapy********* Different names; same results. Patient's have fun and have more motivation to stick with the rehab plan of care when Wii games are added as a complement to their traditional therapy program. P. McNultey, a neurophysiologist at Neuroscience Research Australia, presents data from her research in Brisbane today (July 20) demonstrating that patients who participated in an intensive 2 week program based on Wii showed significant improvement in their ability to use their limbs. This improvement occurred in participants even if
they had experienced the stroke many years ago. <a href="http://www.baysidebulletin.com.au/news/local/news/general/video-games-can-be-good-for-your-health/2628917.aspx">Dr McNulty said</a>, “The Wii is inexpensive, easy to use and, very importantly, fun. This type of rehabilitation motivates participants to actually complete their therapy, which is essential for maximum recovery.” Incorporating Wii into your treatment day makes therapy more fun for everyone. If set-up and space are concerns, try to pick a time slot or a day and use Wii activities as a therapeutic approach for the scheduled patients during that time. Are you wanting to increase your knowledge and understanding of which activities work best for which goals? Contact me about bringing The WiiHab Workshop to your area. What a fun way to earn those CEUs!Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com19tag:blogger.com,1999:blog-6742573982876028982.post-60995572444529097712012-07-17T09:08:00.000-04:002012-07-17T09:08:36.700-04:00Wii Fit as Therapy for Cancer Related FatigueActivities available through Wii Fit are showing value as a user-acceptable therapy to help combat cancer related fatigue in patients with non small cell lung cancer (NSCLC).
A nursing researcher from Michigan State University College of Nursing <a href="http://news.msu.edu/story/researcher-uses-nintendo-wii-to-address-cancer-related-fatigue/">reported on her study </a>that utilized Wii Fit Plus walking and balance activities with post surgical patients as they recover and transition to home. The participants in the pilot study funded by the National Cancer Institute and the Nintendo Wii game system utilized the virtual exercises to help them build activity tolerance while focusing on the fun of exercise.**********************************
OTs often work with cancer patients post surgically to help them meet the goals highlighted in this study including <b>reduction in levels of cancer related fatigue </b>(for increased independence in self care), <b>reduction in sedentary lifestyle</b> (for reduced likelihood of post surgical complications such as pneumonia),
<b>increase in activity tolerance</b> (for higher levels of independence in home management tasks) and <b>increase in engagement in leisure time activities </b>(for improved feelings of self worth, reduced feelings of depression - resulting in more willingness to engage in self care and other occupational roles). WiiHab activities offered in Wii Fit Plus, evidence-based approaches, should be used to help patients meet these goals. This study demonstrated that patients like this type of self paced, light intensity activity when recovering from cancer surgery even during chemo and/or radiation.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com1tag:blogger.com,1999:blog-6742573982876028982.post-46537298275185318242012-07-01T22:59:00.000-04:002012-07-01T22:59:07.669-04:00Wondering about Wii and Therapy?A concern that often pops up during discussions about Wii and therapy is that the Wii is a passing trend for therapy. That idea may have been a possible concern initially, but after four to five years of use, research, and development Wii and newer video platforms have secured a place in treatment with many patient populations.
Take a moment to read <a href="http://www.webpt.com/blog/post/do-you-wii-hab-using-motion-gaming-your-therapy-clinic">Do You Wii-Hab? Using Motion Gaming in Your Therapy Clinic </a>. This great post by CHARLOTTE BOHNETT on WebPT.com highlights many uses for Wii in the clinic while also providing a brief comparison of Wii with Kinect for Xbox 360.
Conversation among some researchers and developers of rehab software for both Wii and Kinect for Xbox 360 often gravitate to which system is best. My experience suggests that both systems offer benefits and a skilled therapist can use either system to achieve goals in their setting. An ongoing discussion among members of the WiiHab group on LinkedIn discuss some of the positive and negative aspects of each system. One frequently criticized aspect of Wii is the need for a hand held device or controller. Kinect for Xbox 360 does not require the player to hold a device. But critics of the Kinect system point out the need for a larger playing field. This aspect of the Kinect system sometimes makes using it difficult in certain clinic settings.
Melissa from Chicago points out in this LinkedIn discussion that unlike the Wii system, the Kinect system is difficult to modify for some disabilities and furthermore, if a patient requires assistance to stand, the Kinect system will sometimes confuse the therapist holding the gate belt with the actual player.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-58279653792103009092012-04-12T20:38:00.004-04:002012-04-12T21:20:21.284-04:00Wii Fit for Therapy - A Fun Way to Improve Many DeficitsI have recently returned from Anchorage, Alaska where I taught "WiiHab- Using Nintendo Wii in a Therapeutic Setting." The attendees were a great audience. The workshop began at 7:30 AM and ran til after 5 PM and everyone learned so many new ways to use Wii activities and exercises to meet therapeutic goals. Like at other WiiHab workshops, the Alaska participants brought a variety of expertise to the group. The therapists worked in all sorts of settings and enjoyed learning how Wii could strengthen their practice and improve their ability to achieve the goals set for different patient populations. <br />One patient population that Wii seems a natural fit for therapy is pediatrics. Kids are quick to master the use of the remote. And when compared to the geriatric population, the kids respond readily to the video game platform. <br />The Wii Fit and Wii Fit Plus offer so many great activities to improve weight shifting, dynamic balance and standing tolerance. Those who need to improve these areas the most often require much effort from the staff to guard and support them as they work on these goals. A group of therapists in Utah came up with a great modification to use with the balance board to help a student work on all of the above mentioned areas. <a href="http://www.youtube.com/watch?v=YIzvbKM6N3U&feature=endscreen&NR=1">Watch the student using Wii Fit</a> with the modification as the therapists also provide hand over hand cueing for accuracy and verbal cueing for encouragement. <br />Use Wii more often in your therapy setting. If your rehab team wants to learn more, contact me and we will work together to bring the WiiHab workshop to your area of the country. The Wii brings FUN to Therapy. Don't be left out!Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com4tag:blogger.com,1999:blog-6742573982876028982.post-43211284632721699572012-02-17T08:08:00.004-05:002012-02-17T09:55:13.668-05:00WiiHab in the Forefront - Preview of Premier Issue of G4H - GAMES FOR HEALTH -Journal Now Available<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjI1XG3bBL_8p21oAhL9mFbyJdpoYDmofwpecNm6qGJwAqp2_t8PHSf6nK6PQ7afX6QeIGhTTYxZ0OHDiKWdJI_N_l-QXggvR-Vzv5QUhRXmu-Rftykyb0AwGLn79Ytt2mZZGAAMZxNPY_z/s1600/DSCN2299.JPG"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjI1XG3bBL_8p21oAhL9mFbyJdpoYDmofwpecNm6qGJwAqp2_t8PHSf6nK6PQ7afX6QeIGhTTYxZ0OHDiKWdJI_N_l-QXggvR-Vzv5QUhRXmu-Rftykyb0AwGLn79Ytt2mZZGAAMZxNPY_z/s320/DSCN2299.JPG" border="0" alt=""id="BLOGGER_PHOTO_ID_5710118084590311442" /></a><br />One frequently heard criticism of video games in therapy has been the lack of evidence that using gaming actually impacts specific outcomes. Now a group of dedicated professionals has created a forum which will share the results of studies that use gaming as a variable in health care research. This peer review journal,<span style="font-style:italic;"> Games for Health Journal: Research, Development, and Clinical Applications</span>, will be published bimonthly by Mary Ann Liebert, Inc., publishers. Therapists interested in using Wii or other gaming systems in their therapeutic setting may want to check this source out. A <a href="http://www.liebertpub.com/mcontent/files/G4H250989.pdf">preview</a> is available as well as an opportunity to sign up for a <a href="http://www.liebertpub.com/g4h">biweekly eNewsletter</a>. <br />Just yesterday I was reminded of the importance of fun in therapy as I spoke with a student struggling in her fieldwork experience. Seasoned OTs forget from time to time to encourage our proteges to seek therapeutic activities that allow our clients to succeed while they experience a sense of enjoyment. Gaming is the perfect tool for bringing laughter, enjoyment and success into therapy. Follow the articles published in <span style="font-style:italic;"> Games for Health Journal: Research, Development, and Clinical Applications</span> to boost your own confidence for using Wii and other gaming systems during therapy sessions.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com3tag:blogger.com,1999:blog-6742573982876028982.post-67115804337637054762011-10-27T06:10:00.000-04:002014-06-28T09:15:19.051-04:00For Therapy: Is Nintendo Wii Fit Always a Good Choice?Nintendo first introduced the Wii gaming console into the US market in 2007. A few savvy therapists recognized the potential of Wii games for therapy rather quickly. Research into the effectiveness of Wii activities began soon after the Wii was introduced and one of the <a href="http://ptjournal.apta.org/content/88/10/1196.short">first published projects</a> demonstrated the effectiveness of Wii activities in improving balance and other measures in a adolescent with cerebral palsy. Over the next few years, many other pilot studies, along with research conducted on a larger scale produced outcomes indicating that Wii activities can improve outcomes in several patient populations.<br />In the most recent issue of BMC Geriatrics, Kate Laver, Julie Ratcliffe, Stacey George, Leonie Burgess, and Maria Crotty present the findings of their research.<br /><span style="font-style:italic;">Is the Nintendo Wii Fit really acceptable to older people?: A discrete choice experiment</span> found in<br /><a href="http://www.biomedcentral.com/1471-2318/11/64/abstract">BMC Geriatrics 2011, 11:64 (20 October 2011)</a> finds that for hospitalized older people Wii Fit activities may not be the best choice. This study indicates that some hospitalized older adults prefer traditional therapy to Nintendo Wii Fit activities for rehab. <br />The researchers hypothesized that the older adults would have a more positive view of the use of Wii Fit in therapy following exposure to use. The research outcome did not support that hypothesis, finding instead that this particular study group(n=18) indicated a preference for traditional therapy approaches to Wii Fit activities. The participants often cited as a reason that they thought more traditional approaches were more effective. The participants engaged in Wii fit activities for 25 minutes a day, 5 days a week, averaging 6 sessions.<br />The authors of this study present a thorough review of their work, including areas of potential future research brought to mind by this study. <br />This study produced findings that were not in sync with the popular presentation of Wii and Wii fit activities in therapy. In my own practice, I choose to use Nintendo Wii activities in conjunction with traditional approaches. I find with older adults, especially if they have cognitive impairments or signs of depression, Wii activities are less readily accepted. In the above mentioned study, each participant took the Mini Mental State Examination(MMSE) and scored greater than or equal to 21/30, ruling out cognitive impairment. In future studies aimed at determining acceptability of Nintendo Wii activities in therapy, including a depression scale measurement may provide additional insight into willingness to accept new approaches over more traditional therapeutic methodologies in this population.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com4tag:blogger.com,1999:blog-6742573982876028982.post-75238802944336149402011-10-15T08:46:00.009-04:002011-10-15T22:46:18.879-04:00Nintendo Wii Boxing Tournament Highlights Benefits of TherapyOctober is National Physical Therapy Month. The staff at Shriners Hospitals for Children in Greenville devised an activity to illustrate several therapeutic attributes of Nintendo Wii based treatments. The <a href="http://www.shrinershospitalsforchildren.org/en/Hospitals/Locations/Greenville/Press/Physicaltherapymonth.aspx">PT department</a> at this nationally recognized hospital started a boxing tournament designed to illustrate how the Wii gaming system can be used to help young patients develop strength, improve motion and boost quality of life in an engaging way. The PTs are also providing insight to the participants as to how therapists can grade an activity to foster success for those with less function or challenge those with increasing ability. <br /><br />The benefits of using Wii in occupational, physical and speech therapy seem limited only by the knowledge and creativity of the therapist designing the plan of care. Would you like to improve your level of expertise in using Nintendo Wii in your therapeutic setting? Contact <a href="http://www.blogger.com/profile/16569790584358353811">Mershon W. Hinkel </a> at the email address on this blog's profile page to find out about an opportunity to gain experience using the Wii in therapy by attending the workshop,entitled <span style="font-style:italic;">WiiHab: Using Nintendo wii in a Therapeutic Setting. </span>Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com1tag:blogger.com,1999:blog-6742573982876028982.post-89001468658835665972011-08-15T08:11:00.003-04:002011-08-15T08:39:00.561-04:00Notre Dame researchers create program for Wii use in therapyOne of the first aspects of Wii Fit that attracted therapists to its unique design was the balance test. The balance test indicates how equally - or not- the participant distributes their weight through their lower extremities when the individual stands on the board. Occupational and physical therapists found this feature helpful for many patient populations, helping bring an innovative change into therapy using Wii. This blog mentioned the center of gravity aspect and one of the therapeutic indications in a post dated <a href="http://wiihabtherapy.blogspot.com/2008/09/using-wii-to-detect-changes-in-center.html">September 5, 2008</a>.
<br />Now a team of students have created software to expand this therapeutic feature -WiiHab feature - into a more user friendly format. Individuals recovering from a stroke utilize the center of balance indication to improve dynamic balance and gait. These students hope to market this program to rehab centers for both clinic and eventual home use. <a href="http://www.inquisitr.com/134083/the-wii-continues-to-expand-its-footprint-in-the-medical-field-now-with-homework-for-stroke-victims/">Watch the interview </a>with the design team to understand more fully what their product hopes to address. Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-65680148631530141062011-06-12T09:17:00.000-04:002011-06-12T09:41:54.387-04:00Nintendo Wii offers Opportunities for Occupational and Physical TherapyNintendo Wii offers limitless opportunities for treatment in both occupational and physical therapy. No matter where along the age spectrum your patient population falls, something offered with the Nintendo Wii system can benefit your case load. Two articles in the news today highlight Wii-Hab or ways Wii might be used as a part of occupational and physical therapy.<br />In the first news article out of Leeds, England, one reads about a new <a href="http://www.yorkshirepost.co.uk/news/around-yorkshire/local-stories/bedside_electronics_provide_game_thrills_for_sick_children_1_3467706">bedside entertainment system</a> for hospitalized Children. This news piece points out that playing games on a Wii system not only reduces anxiety about treatment but also encourages movement. <br />The <a href="http://www.wsmv.com/health/28203198/detail.html">second article about patients at Vanderbilt Children's Hospital</a> features a video that focuses on key aspects of Wii-Hab. Watch the video to see and hear both a mother and a physician explain some of the benefits Wii brings during occupational and physical therapy for a child diagnosed with autism. A couple of benefits discussed include improving muscle tone and encouraging physical engagement with the environment.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com3tag:blogger.com,1999:blog-6742573982876028982.post-15059486186294431522011-06-10T00:09:00.001-04:002011-06-10T00:09:21.994-04:00New Hardware For Wii - Will it enhance Therapy?Check out this trailer for the new controller Nintendo hopes to launch in 2012. What are your thoughts on therapeutic value and/or possibilities for clinical application? <br />Will this device require the participant to be at a higher level? Looks like one needs both hands to make it work. Take a look and post a comment.<br /><br /><br /><iframe width="560" height="349" src="http://www.youtube.com/embed/4e3qaPg_keg" frameborder="0" allowfullscreen></iframe>Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-70603713097122004202011-04-13T09:24:00.003-04:002011-04-13T09:44:23.231-04:00Rice University Students Modify Wii for use in Therapy<iframe title="YouTube video player" width="640" height="390" src="http://www.youtube.com/embed/TcDUL_O4-GU" frameborder="0" allowfullscreen></iframe><br /><br />Creative students from Rice University in Houston, Texas developed a Wii-Hab system to help patients during therapy at Shriner's Hospital. This new use of Wii in therapy, based on Wii balance board technology, helps improve balance and decrease dependence on balance aides. <a href="http://www.eurekalert.org/pub_releases/2011-04/ru-wkt041211.php">Team Equiliberator </a> worked together to develop a system that proves to be relatively inexpensive, yet effective in encouraging participants to work toward improvements. These balance gains occur as the players enjoy age appropriate fun. Watch the video and read the article to learn how these students used Wii balance boards along with their own newly developed hand rail sensor system to create a Wii based therapy activity that also produces data for quantifying changes (improvements) in balance.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com3tag:blogger.com,1999:blog-6742573982876028982.post-80886616799410387632011-04-08T07:52:00.008-04:002011-04-08T08:26:56.253-04:00Wii Use for Therapy After Stroke<a href="http://www.torontosun.com/news/torontoandgta/2011/04/07/17915391.html">A study lead by Dr. Gustavo Saposnik</a>, director of Stroke Outcomes Research Unit, St. Michael Hospital’s (Toronto) , shows the value of Wii activities for individuals in therapy following a stroke. <span style="font-style:italic;">WiiHab - Rehabilitative Therapy Using The Wii by "THE WII OT"</span> previously brought this study to readers' attention in <a href="http://wiihabtherapy.blogspot.com/2010/02/canadian-researchers-demonstrate.html">February of 2010</a>. <br />Recovering from a stroke requires a long process involving repetitive actions in order to provide the brain an opportunity to "rewire". For most stroke patients, who may naturally suffer depression following the loss of function, this requirement of repetitive, long-term therapy falls by the wayside. Wii offers this population a way to expand the benefits of occupational and physical therapy into the home setting, reaping improved outcomes while discovering a new, motivating use for leisure time.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-26287265290700709622011-03-15T20:07:00.001-04:002011-03-15T20:27:05.266-04:00Wii -Like Therapy Even before Wii hit the Market<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGNtIGd4NzuZ3ZiJZZnOyClRU_EFSbxfzxpcDVCX0aElt9IIlspfTlJL1pNm74deEF1HPC52hAmGmLAkchz48Hzr7ps4YmRQWmiyR2qrErvzJOc24i9f5GhylWMLezSETOMMXDmWoc0nS3/s1600/wiigames4_f.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 175px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGNtIGd4NzuZ3ZiJZZnOyClRU_EFSbxfzxpcDVCX0aElt9IIlspfTlJL1pNm74deEF1HPC52hAmGmLAkchz48Hzr7ps4YmRQWmiyR2qrErvzJOc24i9f5GhylWMLezSETOMMXDmWoc0nS3/s320/wiigames4_f.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5584118024500219810" /></a><br />In 2006, <a href="http://www.neurogymtech.com/video/flash.php?view=trainer">NeuroGym Technologies </a> introduced a training system for use in rehab called the NeuroGym Trainer. This computer based technology offered therapists a way to provide rehab patients with visual and auditory feedback. A therapist could use this system to help patients learn to shift their weight, to help strengthen a targeted muscle group, or to help improve coordination. This system utilized sensor pads and a video game format. Many goals mentioned in the NeuroGym Trainer video can be addressed using Wii Fit and/or other Wii applications. Watch the video. How do you think you could Wii activities in similar ways? Do you have patients on your case load with goals that could be addressed with Wii activities? The patients would have more fun! <br />I have a client who hopes to move from the skilled care unit to the personal care unit. This client needs to dress and undress the upper and lower body with set-up only in a reasonable amount of time each day. Standing tolerance as well as dynamic balance must improve before that functional goal can be obtained. Playing "Fishing" (Wii Play) while standing requires dynamic balance while building endurance. This game will also require problem solving and visual discrimination. Honing those skills will also help this client dress in a timely fashion. I plan to get this OT client Wii fishing during the next therapy session and meet that functional goal in two weeks with the help of Wii-Hab.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com2tag:blogger.com,1999:blog-6742573982876028982.post-11515296855495525372011-03-05T08:34:00.000-05:002011-03-05T12:27:15.482-05:00Wii-Hab - Utilizing Wii Fit and Other Wii Programs in Therapy<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgh-zqStfTifmvxUD22s_r8fSw5E__reXYbOY5XFBvyFTe3ztxKN7_ZCOKpprSF5jvrXkqYjYPqczeRQ1AiaM0kieKLXpyGT4Y-ldgYchQdG1MmOPW0oNooxMN6bAXNh2prsl_bux9M1EHo/s1600/wiihabweb.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 240px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgh-zqStfTifmvxUD22s_r8fSw5E__reXYbOY5XFBvyFTe3ztxKN7_ZCOKpprSF5jvrXkqYjYPqczeRQ1AiaM0kieKLXpyGT4Y-ldgYchQdG1MmOPW0oNooxMN6bAXNh2prsl_bux9M1EHo/s320/wiihabweb.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5578747863931582562" /></a><br /> The utilization of activities offered through Nintendo Wii continues to gain popularity with rehab therapists working with multiple populations. Just recently, an article from the Boston Herald appeared online in <a href="http://www.therapytimes.com/Hit_and_run_Victim_Goes_Home_With_Wii_Bit_of_Help/content=0602J84C487E5084408040441">Therapy Times</a> highlighting the improvement a young girl experienced following therapy for a traumatic brain injury. Not so long ago, an article about Rep. Gifford's rehab mentioned <a href="http://www.gosanangelo.com/news/2011/jan/22/updated-rehab-aims-to-improve-life-for-giffords/">Nintendo Wii as a likely adjunct</a> to traditional therapy.<br />Often my readers write and ask how Wii activities might be useful for their loved one. <br /><br />Addressing specific cases would be difficult through an online platform such as this blog. So mostly, it is suggested that those looking for a therapist use care in selecting the setting for their particular situation. On MASTERSDEGREE.COM the writer provides a <a href="http://www.mastersdegree.com/blog/15-questions-for-finding-the-right-therapist/">list of 15 questions</a> to help those looking for a therapist of any type know what questions to ask before signing up. In the rehab setting, the opportunity to hand pick the therapist is rarely available. But usually rehab therapists, OTs especially, use a client-centered approach, assuring that the plan of care targets the individual's needs and learning style. If the therapist is familiar and comfortable with technology and Wii equipment is available, a high likelihood exists for including Wii activities since so many therapeutic objectives (as mentioned throughout this blog) can be addressed in an engaging way.<br />If your facility has either not embraced Wii technology yet or has put Wii away on a shelf, contact me at OTRMershon@gmail.com. I will work with your facility mangers to bring a Wii-Hab Workforce Training Session geared toward your specific population to your location.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com1tag:blogger.com,1999:blog-6742573982876028982.post-71612230120096562922011-01-11T21:21:00.004-05:002011-01-11T21:59:47.172-05:00Wii Fit - Therapy for Fall Prevention - WiiHabThe Saturday Evening Post online published a piece by Peter Perry about the potential of Wii Fit for improving balance. Take a moment to read about the <a href="http://www.saturdayeveningpost.com/2010/11/03/wellness/general-health/wiifit.html">research Kathleen Bieryla</a> of Bucknell University has completed. Kathleen, an assistant professor of biomedical engineering, focused on improving clinical measures of balance in older adults by using activities in Wii Fit. <br />In the same Saturday Evening Post piece, <a href="http://www.physioguru.com/index.php?option=com_content&view=article&id=67:bryce-taylor-an-entrepreneur-in-physiotherapy&catid=84:physiotherapy-blog&Itemid=77">Bryce Taylor</a>, MSPT explains three of his trademark Wii-Hab therapeutic exercises using Wii Fit to improve back health and increase core muscle strength.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com4tag:blogger.com,1999:blog-6742573982876028982.post-75551854595741688372010-12-05T10:37:00.003-05:002010-12-05T10:49:34.399-05:00"Wii Therapy" in Detroit<object width="640" height="385"><param name="movie" value="http://www.youtube.com/v/Ulag6Hj1diE?fs=1&hl=en_US"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/Ulag6Hj1diE?fs=1&hl=en_US" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="640" height="385"></embed></object><br /><br />Watching this video explains some of the benefits from the perspective of the patients using Wii in therapy. If a patient finds the therapy engaging they will be more involved. Hopefully then, the patients will push harder toward the goal and remain adherent to the plan of care. In this video, you will also hear the OT, PT and speech therapist explain why they find Wii-Hab to be such a useful tool to use in this setting.Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com0tag:blogger.com,1999:blog-6742573982876028982.post-44098696967747397212010-12-04T10:24:00.004-05:002010-12-04T10:37:29.109-05:00Wii - Therapy in the broadest senseIn the UK like elsewhere, senior health and wellness are serious concerns. One administrator of a senior housing center developed an unique program for the residents to enjoy. <object width="640" height="385"><param name="movie" value="http://www.youtube.com/v/x8AKYpJhpMw?fs=1&hl=en_US"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/x8AKYpJhpMw?fs=1&hl=en_US" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="640" height="385"></embed></object>Mershon W. Hinkel, MSPH, OTR/Lhttp://www.blogger.com/profile/16569790584358353811noreply@blogger.com4