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?

"Technical Difficulties" - What if the Wii isn't Working?

If the technology that supports the Wii Gaming System is not working, is the OT out of luck? No, but she better be able to quickly figure out another therapeutic activity to substitute in its place.

Last week, a technical difficulty at a facility where I was working brought down the entire cable/TV system, and even after trying to follow the cable company's detailed directions for use, no picture appeared on the screen. Just as we were getting ready for a Wiihab session, we realized we were out of luck.

The patient was in occupational therapy to improve upper body strength along with overall endurance and activity tolerance following a recent hospitalization for an infection. Prior to the recent hospitalization, this particular patient ambulated short distances with a rolling walker while wearing bilateral static ankle supports. Functional transfers from bed to wheelchair and from wheelchair to power rover were independent.

Following hospitalization, this patient required contact guard for all transfers. Dressing and bathing, which were performed with modified independence before hospitalization, required minimal assist to contact guard following the hospitalization. The plan of care was designed to restore the patient to the prior level of independence.

Therapeutic exercises for upper body strengthening, therapeutic activities to increase endurance, balance and standing tolerance, and retraining in energy conservation techniques for self care filled the treatment time. Following a unit of traditional graded upper body exercises, the patient usually participated in several games of Wii Tennis. Prior to the initial injury, tennis was an enjoyable activity for this individual and introducing Wii Tennis into the treatment plan brought new enthusiasm for therapy. Keenness for therapy was assessed by the patient’s insistence on being seen promptly. This eagerness for treatment replaced the past behavior of cancelling appointments or disregarding appointment time.

When the Wii didn’t work, both the therapist and the patient were understandably disappointed. As a substitute for swinging arms through complete range of motion while serving and returning the virtual tennis ball, the patient had to transfer black and orange cones from tabletop to upper shelf and back again. Instead of guarding the patient myself to protect against possible falls as the swing of the remote sent the ball across the net, another person in the clinic had to become involved in the treatment session to either stand along side the patient or to toss the beach ball toward the patient. Though the physical aspects of the activities used as an alternative to the Wii game may have been equivalent, the cognitive and psycho-social aspects seemed far lacking. Even if I could mope or gloat in response to the work, my patient seemed to miss the reaction of the personal avatar painstakingly created during the first Wii session. And though the movements were all completed, I sensed little, if any, push or determination with stacking the cones or batting the beach ball.

“I hope they fix that Wii before my next session”, was all that was said when therapy ended.

I was in complete agreement!

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.