WiiHab in the Forefront - Preview of Premier Issue of G4H - GAMES FOR HEALTH -Journal Now Available

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, Games for Health Journal: Research, Development, and Clinical Applications, 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 preview is available as well as an opportunity to sign up for a biweekly eNewsletter.
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 Games for Health Journal: Research, Development, and Clinical Applications to boost your own confidence for using Wii and other gaming systems during therapy sessions.

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.

Nintendo Wii Boxing Tournament Highlights Benefits of Therapy

October 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 PT department 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.

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 Mershon W. Hinkel 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 WiiHab: Using Nintendo wii in a Therapeutic Setting.

Rice University Students Modify Wii for use in Therapy

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. Team Equiliberator 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.

Wii Use for Therapy After Stroke

A study lead by Dr. Gustavo Saposnik, director of Stroke Outcomes Research Unit, St. Michael Hospital’s (Toronto) , shows the value of Wii activities for individuals in therapy following a stroke. WiiHab - Rehabilitative Therapy Using The Wii by "THE WII OT" previously brought this study to readers' attention in February of 2010.
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.

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 Therapy" in Detroit

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.

Wii Add-on May Enhance Use of Wii in Therapy

(Image from: http://seattletimes.nwsource.com/html/technologybrierdudleysblog/2009290380_e3_nintendo_previews_next_wii.html)

Nintendo announced last year a plan to market an add-on called a Wii Vitality Sensor.
Many OTs and PTs will think this add-on looks like a tool often used in the clinic. The Wii vitality Sensor looks and works like the familiar pulse-ox device often used to measure pulse and oxygen concentration in a client's blood. Now Nintendo plans to use that data to provide feedback to players and to control actions of a player's avatar.
Like the balance board, this new add-on will expand the therapeutic value of Wii activities while making recording improvements much easier during therapy.

Special Wii Software designed for Therapy

Kaasa Health GmbH of Düsseldorf has developed software - Wiiware- specifically for use in a clinical setting. This program focuses on balance training making that often boring and monotonous work fun. Building on the fact that the balance board is a force plate capable of extracting data about one's center of balance and ability to shift weight, this specifically designed game environment helps those with balance issues improve. Since balance ability influences fall risk in seniors, playing this video game might be a key component in reducing the occurrence of falls and the associated physical, emotional and monetary costs in elders. Using Wii Fit in therapy was shown to improve balance and ability to walk with a walker when a group of therapists added 4 sessions of Wiihab to a regular therapy program. Now, with the development of specific software program for rehab, more therapists may begin to incorporate Wii into the clinical setting.

Special Wii Software designed for Therapy

Kaasa Health GmbH of Düsseldorf has developed software - Wiiware- specifically for use in a clinical setting. This program focuses on balance training making that often boring and monotonous work fun. Building on the fact that the balance board is a force plate capable of extracting data about one's center of balance and ability to shift weight, this specifically designed game environment helps those with balance issues improve. Since balance ability influences fall risk in seniors, playing this video game might be a key component in reducing the occurrence of falls and the associated physical, emotional and monetary costs in elders. Using Wii Fit in therapy was shown to improve balance and ability to walk with a walker when a group of therapists added 4 sessions of Wiihab to a regular therapy program. Now, with the development of specific software program for rehab, more therapists may begin to incorporate Wii into the clinical setting.

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!

Watch: Wii Used for Therapy...Wii-Hab

Madonna rehab released a video showing therapists working with a few patients with brain injury using Wii in therapy.
The cation below the video reads:
"Madonna Rehabilitation Hospital features the Wii and similar games as part of its CARF accredited brain injury program. In conjunction with other rehabilitation methods, the Wii games help improve balance, coordination, visual and motor skills. In addition, the games help "re-wire" the brain as patients with brain injury improve cognitive skills involved with problem solving, following directions and social interaction."

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!

Funny Videos of Wii Injuries and Accidents

Mention of Wii injuries and accidents frequently occurs in this blog. Check out this collection of funny videos showing accidents as they happen. A clever occupational therapist could employ these videos during a therapy session with a goal of increased safety awareness, improved sequencing, or most any other cognitive focus. A therapist might have the client first review the Play It Safe checklist, second watch the videos and third discuss what unsafe practice led to the accident. Simple, yet effective! Another way to creatively incorporate Wii technology into your day to benefit your client with cognitive issues from TBI, stroke, PDD, Autism, Alzheimer's, and/or change of mental status to name a few. The concept of using Nintendo Wii in therapy, an approach known as WiiHab, Wii-Hab or Wiihabilitation, broadens!

Fall, Football, and Wii-Hab

Occupational and physical therapists in the Northeast have two upcoming opportunities this Fall to attend Wii-Hab: Using Nintendo Wii in a Therapeutic Setting. Therapists in the Baltimore/Washington area can still sign up for this course being offered at Anne Arundel Community College on Saturday, November 21, 2009. To sign up, contact Continuing Education by phone at 410-777-2325 or email at iscenter@aacc.edu This course runs from 8AM until 4PM. If your favorite football team has any kick off time other than NOON, attendees will be able to enjoy both experiences in one day. Call today to secure a spot in this interactive and engaging continuing education opportunity.
On December 5, 2009, therapists in South Jersey may attend this Workshop at Richard Stockton College of New Jersey.
Sign up today and enjoy this opportunity.
OTs, PTs, COTAs, and PTAs will gain continuing education credit in a fun, active program that will help build confidence in using new technology with clients who have various diagnoses including joint replacement, stroke, cancer related fatigue, COPD, and others.

Wii Benefits Across the Life Span

Students worked together to create a video touting the benefits of Wii-Hab. In this snappy video, viewers get an idea of how Wii is used to encourage improved muscle strength and flexibility in adults.

Children also benefit from using the Wii in therapy. The blog entry posted on October 5, 2009 shares with readers a story about Wii use in a classroom as an addition to traditional therapy. News station KEPR CBS 19 in Pasco, Washington posts a video of Wii being used in a school setting by therapists to improve coordination and balance.

Read Lon Thornburg’s great blog to learn more about creative uses of Wii with children who have developmental disabilities.

Workshops Expand Therapists' Ability to Incorporate Nintendo Wii

Allegany College of Maryland hosted a "Wii-Marathon" for therapists October 2 and October 3. Therapists arrived from many states including West Virginia, Virginia, Pennsylvania and New York to learn more about the therapeutic uses of Wii technology, an affordable, portable and easy to obtain therapeutic tool.
Penn State Abington, located in a suburb of Philadelphia, will host the next workshop. On October 21, 2009 occupational and physical therapists, along with Nurses and Nursing Home Administrators can be a part of this educational, interactive experience . Space is limited, so contact Penn State Abington Continuing Education to grab one of the few remaining spots.

WiiHab - Using the Nintendo Wii in a Therapeutic Setting

Therapists throughout Maryland, Pennsylvania and New Jersey will have the opportunity to learn more about using Wii in therapy during the Fall months. On both Friday, October 2 and Saturday, October 3, Allegany College of Maryland located in Cumberland, Maryland will host the Wii-Hab workshop. On Wednesday October 21, 2009 the Wii-hab Workshop will be held at Penn State Abington. This location is in easy driving distance from Philadelphia and any of the suburbs. The Penn State workshop has been approved for 6 CEUs for Registered Nurses, expanding the appeal for this interactive seminar. The Wii-Hab workshop will be offered at Anne Arundel Community College on November 21. Therapists from the Baltimore/Washington area will like this location. For therapists living in New Jersy, the December 5 date at Stockton College will be great for them. Sign up early! Tell a friend.

WiiHab in the News Throughout The Summer (Part 1)

Frequently, during the summer months articles appeared in newspapers, on television, and in blogs explaining the benefits people gain when Wii activities are incorporated into their rehabilitation programs. In June, the El Paso Times printed an article about Del Sol rehabilitation center’s use of the Wii in their Physical and Occupational therapy programs. The accompanying picture tells the whole story! Also in June, Hulig News ( an independent public news organization) placed a great story on line about a patient at University of Wisconsin, Madison’s American Family Children’s Hospital. This story offers some insight into the versatility of Wii as a therapeutic activity. More positive reviews of Wiihab can be found when you read an article from June 15, 2009 in the Vail Daily. Therapists in Silverstone, Colorado include many different Wii programs into the plan of care for their patients. They report improved outcomes, particularly with knee replacement patients. A study which will contribute to the evidence-base for using Wii in therapy for knee replacement patients is taking place in Toronto. Researchers hope to complete this study by the end of the year.

Using Nintendo Wii in Therapy: Benefits Seen Over Time

WiiHab - Rehabilitative Therapy Using the Wii by the "Wii OT” has been up and running for over a year now. Thank you for all of your visits and emails. So many people have responded to my blog. Not only have other occupational and physical therapists and students sent emails and responses but also family members whose loved ones are recovering from TBI, stroke or joint replacement and are benefiting from using Nintendo Wii have contacted me from time to time. And these responses have come from many states like Pennsylvania and Georgia and from countries far and near to the USA like England, Sweden and Canada. The use of Nintendo Wii as a therapeutic tool continues to spread, while therapists, researchers, and patients alike continue to recognize the advantages of including this tool in plans of care.

Just the other day, another article appeared in print and online about the benefits of using Nintendo Wii to help people recover from injury, illness and surgery. This article highlights 2 important points. First, mention is made that Wii offers an opportunity for socialization, helping reduce feelings of isolation. Second, this overview states that using the Wii is fun. Bringing fun into therapy helps patients who are dealing with a changing health status to reduce feelings of anxiety. Learning to use adaptive devices or learning to do familiar things in new ways is easier when feelings of isolation and anxiety are reduced. Reducing feelings of isolation and anxiety is such an important part of therapy.

So again, thank you for your support. Post your experiences in the comments section for all to see.