Wii in Health Promotion

A recent vacation opportunity brought to light other clinically relevant uses of the Wii.  The Wii can play a motivating role in Health Promotion and Lifestyle Modification across all ages.  For many who have a more sedentary lifestyle, the Wii proves to be useful tool in encouraging change.  The Wii stimulates those who may usually choose to only watch sports, to get up (or remain seated) and swing the remote at the tennis ball, the golf ball or the baseball.  Others swing the remote to bowl or box.

Photo by abbynormy on Flickr

In the school setting, students who might usually shy away from physical education (PE) classes rush to sign up for PE revolving around Wii Sports and other Wii programs. Teachers have found that the students who are reluctant to play team sports are more than willing to get out of their desks for some friendly Wii competition.  The students like the feedback Wii provides and are motivated by the improvement that the Wii makes readily visible.

In the clinic setting, the Wii has an application in Health Promotion.  Researchers in the area of Fall Prevention (Lachman, M., Howland, J.,& Tennstedt, A.,1998) have identified a sedentary lifestyle as a primary risk factor for falls.  In older adults, a sedentary lifestyle and a fear of falling (Edelberg, 2001) often go hand in hand, creating a reciprocal nature among fall risk factors in the elderly population.  Using Wii as a therapeutic activity with elders allows the clinician to work towards goals such as increasing standing and activity tolerance, improving dynamic balance and reducing fear and anxiety.  The fun nature of Wii along with the built-in reinforcement of improved scores encourages and motivates elders to be more active and engaged in therapy.

Another great therapeutic use of Wii is in Lifestyle Modification Programs.  Lifestyle Modification Programs help clients struggling with obesity, type 2 Diabetes, or other chronic conditions to implement changes in daily routines, reducing disease burden. Initially, the Wii gently introduces increased physical activity into the daily schedule.  For those participants with a history of computer gaming, the Wii allows them the familiar pleasure of gaming while increasing physical activity.  Wii also encourages social interaction and creates opportunity for community building through the creation of bowling leagues and baseball teams. 

Exercising in the virtual environment created through the Wii should not be considered a replacement for exercise in the real world, but Wii Gaming can be used effectively to provide additional activity throughout the day.   The Wii may help those who are extremely sedentary to take initial steps toward increasing activity.   By increasing the level of daily activity, participants may gain strength, endurance and improved balance, leading to improved well-being.

References:

Edelburg, H. (2001). Falls and function: How to prevent falls and injuries in  patients with impaired mobility. Geriatrics. 56(3). 41-45.

Lachman, M., Howland, J.,& Tennstedt, A.(1998). Fear of falling and activity restriction: The survey of activities and fear of falling in the elderly (SAFE).Journals of Gerontology: Series B: Psychological Sciences and Social Sciences. 53B(1). 43-50.

Wii Therapy for Patients with Alzheimer’s Disease

In February 2007, an article appearing in the Journal of the American Geriatrics Society reported that nursing home residents with a diagnosis of Alzheimer’s disease can change the rate of deterioration through exercise. Residents who participate in moderate exercise can experience a significantly slower decline in function than those residents who receive routine care. In this study, individuals in the study group participated in hour long therapy sessions twice a week for 12 months. The therapy program included walking, along with strength, balance and flexibility training. The control group received normal care. This study, which took place in Toulouse, France was lead by Dr. Yves Rolland and measured the effects of the exercise program on individual’s activities of daily living, physical performance nutritional status, behavioral disturbance and depression. This study, which had 134 participants whose average age was 83, showed that individuals in the exercise group improved their activities of daily living scores significantly. Average walking speeds improved significantly in the exercise group also.

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.

Nurses in NY using Wii to complement rehabilitation therapy

A hospital in New York has been using the Wii as part of therapy for more than nine months. As the article reports. Candy Perotti, a COTA from St. Francis hospital in Poughkeepsie had this to say:

"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.