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.

Wii Fit as Therapy for Cancer Related Fatigue

Activities 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 reported on her study 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 reduction in levels of cancer related fatigue (for increased independence in self care), reduction in sedentary lifestyle (for reduced likelihood of post surgical complications such as pneumonia), increase in activity tolerance (for higher levels of independence in home management tasks) and increase in engagement in leisure time activities (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.

Wii Fit for Therapy - A Fun Way to Improve Many Deficits

I 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.
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.
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. Watch the student using Wii Fit with the modification as the therapists also provide hand over hand cueing for accuracy and verbal cueing for encouragement.
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!

For 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 first published projects 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.
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.
Is the Nintendo Wii Fit really acceptable to older people?: A discrete choice experiment found in
BMC Geriatrics 2011, 11:64 (20 October 2011) 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.
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.
The authors of this study present a thorough review of their work, including areas of potential future research brought to mind by this study.
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.

Wii -Like Therapy Even before Wii hit the Market

In 2006, NeuroGym Technologies 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!
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.

Wii-Hab - Utilizing Wii Fit and Other Wii Programs in Therapy

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 Therapy Times 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 Nintendo Wii as a likely adjunct to traditional therapy.
Often my readers write and ask how Wii activities might be useful for their loved one.

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 list of 15 questions 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.
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.

Wii Fit - Therapy for Fall Prevention - WiiHab

The 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 research Kathleen Bieryla 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.
In the same Saturday Evening Post piece, Bryce Taylor, MSPT explains three of his trademark Wii-Hab therapeutic exercises using Wii Fit to improve back health and increase core muscle strength.

Wii in Therapy: Additional chances to Enhance Your Skills

Fall 2010 brings opportunities to learn about Wii modifications as well as to brainstorm with other therapists about creative uses for Wii. Join colleagues for "Wii-Hab: Using Nintendo Wii in a Therapeutic Setting."
Due to demand, Easter Seals Capper Foundation- Topeka, Kansas, added an additional workshop date. Now you can sign up to attend the added session on Friday, September 24.

September 24, 2010 - Easter Seals Capper Foundation, Topeka, Kansas

October 16, 2010 - Penn State Abington Campus - Philadelphia, Pennsylvania

October 29, 2010 - Allegany College of Maryland - Cumberland, Maryland

After attending the workshop therapists will return to their work setting with new ideas about Wii. Be the therapist who knows how to take Wii beyond bowling toward challenging therapeutic activities to improve outcomes in many settings!

Novel Use of Wii Fit Data may have Implications for Therapy

University of Maryland, working with several other Universities, plans to use Wii Fit data generated by an athlete when healthy as a baseline measure of balance ability. These recorded scores would then be available in the event that the athlete suffered a concussion during play.

Although therapists rarely have specific information about a person's baseline status, aspects of this novel application suggest ways that Wii could be utilized in therapy.
Researchers working on this study point to Wii Fit's "objective and practical" qualities which allow trainers to gather data post injury in a client friendly way. Athletes report enjoying activities using Wii Fit.

The enjoyment factor comes as no surprise to therapists who use Wii technology in their practice. Clients of all ages seem willing to engage in Wii therapeutic activities. Though true baseline data for our clients may not be available for comparison, data gathered early in treatment will provide objective scores, that when compared to later records will support not only increases in performance components, but also improvements in activity engagement.

Kansas Optometrists Present Poster on "The Use of the Nintendo Wii Balance Board with the Head Injury Population"

At the recent 6th International Congress of Behavioral Optometry, Dr. Joseph B. Sullivan along with Dr. Julie A. Toon presented a poster detailing their use of the Wii Fit balance programs for adults with head injury.
These optometrists utilize Wii fit balance activities to help address residual visual disturbances affecting balance and spatial awareness including convergence issues, oculomotor problems, and visual field deficits. The presenters also explain that other problems including "muscle paresis, decreased reaction time, reduced stamina and decreased attention span" contribute to the difficulties adults with brain injury experience during recovery.
These optometrists illustrate their use of Wii activities to help adults with brain injury improve the integration of the visual and vestibular systems. These gains are documented on a spreadsheet which allows the doctors to quickly assess changes in BMI, balance percent by side, body test results, Wii Fit age, and performance on activity procedures.
Take a moment to look at this poster. Medical uses of virtual reality continue to increase as improved outcomes using tools available through Wii Sports and Wii Fit are documented. Wiihab proves itself to be versatile, affordable and fun. How have you utilized Wii therapy lately? Post your experiences in the comment section!

Medical News: Multiple Benefits Seen for Exercise in Seniors - from MedPage Today

An article appearing in Medscape's Medical news Multiple Benefits Seen for Exercise in Seniors summarizes much of the evidence gathered about benefits of an active lifestyle. "Successful survival", defined as "living past 70 in general good physical and mental health", occurred more often in study participants who had a most active lifestyle during the period 10 to 15 years prior to 70 when compared to a cohort who had a most sedentary lifestyle during that same period.
Since encouraging regular physical activity in the most sedentary adults fosters long lasting benefits, healthcare providers as well as family and friends often hope to find ways to promote change.
Changing various health behaviors occurs through a process. Many theories of health behavior change offer insight into ways to maximize success for those attempting to alter behavior. One theory in particular, the Transtheoretical Model (Stages of Change), explains behavior change as a journey through various phases of awareness and action. Each phase leads to increased awareness of the need for change. Those along the journey of change gain confidence in their ability to make and maintain the desired modification.
Nintendo Wii activities play an important role as a fun way to bring exercise into an individual’s daily schedule. Individuals in the "pre-contemplation" stage, when exposed to activities in Wii Sports and Wii Fit, may increase their awareness of both their need for exercise and their need to improve endurance and balance. This awareness may help them move to the "contemplation" stage. Since Wii Sports and Wii Fit bring a fun factor into exercise, individuals may decide that moving more can be enjoyable. In fact, they may begin to view physical activity while using the Wii not as exercise but as just a fun activity, helping the individual move on to the "preparation for action" stage. Furthermore, Wii Fit activities provide great feedback and can be played together with others (two aspects of other theories of learning and change). As a result, individuals may begin to engage regularly in the use of Wii Sports and Wii Fit activities. Once these individuals are well entrenched in this "action" stage, the individual is well on their way to a less sedentary lifestyle.
Ford Vox, MD explains however, that activities offered through Nintendo Wii games should not be used as a replacement for the actual sport. But for those individuals who have a sedentary lifestyle, not participating regularly in any physical activity, Wii offers a motivating vehicle to change.

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.

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.

  

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.  

Using the Wii Therapeutically in a School Setting: PART 1

Jan from Maine writes on October 23, 2008:

Hi There,

I am an OT who would like to use Wii with my kids in the school setting. I am writing a grant for funding this and would like some feedback as to which program might be the best for my K-8 population and with my Autistic population.

Thank you!

Jan from Maine

Thank you, Jan, for your question. This question, of course, covers a very broad subject, so I will break it down into several important areas.  If more specific or timelier information is needed, Jan from Maine could leave a comment with her email address and I could address those specifics directly.

My response to this question will appear in multiple posts.  In the first few posts, I will outline and define several potential areas for occupational therapy intervention for the K-8 population, with a special focus on areas of OT intervention for those with autism.  The second group of posts will give examples of specific Wii activities to address these areas.  And finally, I will suggest some current research to use as supporting literature for a grant proposal. 

Some potential areas for intervention in the K-8 population include but are not limited to:

• Motor
  
• Perceptual
  
• Cognitive
  
• Psycho Social 

Occupational therapy intervention areas for children in this population with Autism include but are not limited to:

• Psycho social
  
• Sensory (processing) Integration
  
• Cognitive
  
• Perceptual
  
• Motor

Deficits in any of these areas can make classroom and daily activities challenging.  Identified students receive needed intervention from Occupational, Physical and/or Speech Therapists. The Nintendo Wii is emerging as a popular tool for therapists working with school aged children with special needs.  Wiihabilitation incorporating Wii Sports and Wii Fit can be used to address many of these frequently encountered problems and strategies for incorporating Wiihab in School based therapeutic programs will be discussed in detail in the latter parts of this segmented post.

Movement disorders in the K-8 (including those with Autism) may result from neuromusculoskeletal issues as well as from a complex mix of perceptual, muscular and motor issues.  Musculoskeletal involvement may result in:

• Alterations in muscle tone – (spastic- increased or flaccid- low/decreased)
  
• Decreased range of motion and/or strength
  
• Poor endurance
  
• Decreased postural control – alignment (standing or sitting)  

Additional motor or movement problems stem from a complex mix of deficits across several systems and may manifest as problems with:

• Coordination –both gross and fine (dexterity)
  
• Bilateral integration (using both sides of the body cooperatively, either simultaneously or alternately)
  
• Crossing the midline (passing one extremity across the midline of the body into the opposite side)
  
• Motor planning (praxis- the ability to perceive [visualize], organize and execute a motion or action accurately)
  
• Visual motor integration (the combined ability to visually perceive an object while accurately grasping and manipulating the object efficiently to complete the desired task)

Problems in any of these areas contribute to a student’s difficulty with classroom and self care activities.

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.