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-hab therapy for people recovering from brain injury -

A professor of adaptive physical education at Skyline College in San Bruno, CA, explains how he uses Wii activities to help clients who continue to struggle with physical and cognitive issues long after the initial brain injury. Chip Chapman describes his work with individuals who may have had extensive therapy in a medical setting earlier, but are seeking help for residual disability in an adaptive physical educational setting now. Professor Chapman speaks about the importance of repetition and consistency with this population. The value of using Wii activities with individuals who have cognitive and physical deficits from brain injury has been documented in the literature. In October of 2008 an article was published in Physical Therapy by J. Deutsch et al which highlighted the value of incorporating Wii activities into a rehab program for an adolescent with cerebral palsy. The child participated in activity for 60 - 90 minutes during 11 different sessions.
Wii brings fun into the rehabilitation process. Fun and engaging activities help make the repetitive work of rehab more enjoyable.

NASCAR INTERSECTS WII THERAPY (WIIHAB) as KYLE PETTY, Racing's Renaissance Man, meets the "Wii" OT

Sometimes unexpected opportunity and inspiration find you. On a recent Tuesday evening in Williamsburg, Va. I met someone who offers both to anyone willing to make the investment. Kyle Petty, known to many through ever popular NASCAR racing, spoke to the attendees of the Electrical Utility Fleet Managers Conference. His engaging speech explained his family's role in building the sport of auto racing. First, he told of his Grandfather, Lee, who was drawn to racing as a way to provide for his family. Next, through engaging stories, he introduced the listers to his now famous father, Richard. Richard loved the sport and drove for the thrill. Kyle explained that he, personally, also loved the thrill of racing like his father. Both Kyle and his wife were excited that their son Adam dreamed of carrying on the Petty racing legacy. Shock and sadness swept over every listener as Mr. Petty explained how that dream would not be realized. As he continued, Mr. Petty transformed our shock and sadness into admiration and hope as we learned how this amazing family turned tragedy into a vision and then into the reality of helping kids with special needs as a way to honor the life and dreams of their son, Adam.
Victory Junction, a camp for kids with chronic medical conditions and serious illnesses operates near Randleman, NC. Since opening in 2004, over 11,000 children and families have been served by programs designed especially for them. Many different populations are served over the summer as well as throughout the year. One aspect that makes this camp so special is that each week is dedicated to a specific diagnosis category, such as autism, cerebral palsy, and burns, among others. Mr. Petty explained the importance of this model. By bringing individuals who struggle with similar problems together, they learn that they are not alone. As therapists, we recognize that grouping in this manner enhances opportunity for peer modeling and social support.
Hopefully, everyone who reads this blog post will consider becoming involved at some level with this great organization. Occupational and physical therapist and students could volunteer as cabin counselors or in another capacity. Your expertise would be appreciated and you would learn so much. Students considering applying for occupational or physical therapy school could also spend a week with the campers and gain valuable experience while giving back so much. Parents looking for something special for their child may find that this camp would provide the care and respite they seek. I plan to contact Victory Junction about volunteering myself. I want to work with these special kids in the fresh air while they involve themselves in real world golfing, bowling, swimming, driving and fishing ... all the things that in the school setting we are luckily able to do in the virtual world through Wii Therapy.

Wii-Hab Meets Medical Illustration

An artist, who received her MFA (Master of Fine Arts) in Advertising Design from Savannah College of Art and Design, which is located in my hometown of Savannah, GA, created wonderful visuals depicting the crucial aspects of Wii-Hab. Angela Moramarco infuses the very human components - the brain, the muscles, the bones and the soft tissue - into the very technical components - the remote and the console - of Nintendo Wii. These great illustrations tell a concise story. Nintendo Wii, when used correctly in a therapeutic setting, helps patients build new connections within the brain and between the brain and the muscles. For some patients therapy can be difficult and repetitious. Wii offers occupational and physical therapists a versatile tool to use as a part of the therapy plan not only for improving strength, endurance, and flexibility but also for improving sequencing and problem solving in a variety of patient settings including pediatrics (autism, cerebral palsey, PDD) and geriatrics (stroke, joint replacement, fall prevention).

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.

Using the Wii Therapeutically in a School Setting: PART 2

Therapists working with the K-8 population, including students with diagnoses across the Autism spectrum, will also need to address perceptual processing problems including:

• right-left discrimination (ability to distinguish or identify left and right directionality)
• form constancy (recognition of objects or shapes as the same regardless of size, spatial orientation, or texture)
• position in space (recognition of the spatial orientation of objects in relationship to the surrounding environment)
• body scheme (perception of one’s own body arrangement in relationship to self and environment which facilitates the individual’s ability to orchestrate purposeful movement through space and focused manipulation of objects)
• figure ground (ability to discriminate or isolate a particular object or shape surrounded by or embedded in a varied background)
• depth perception (ability to recognize three dimensions in objects and self while  perceiving the relationships among and judging  the distances between these objects and/or self)
• spatial relations (ability to sense one’s position or place within the environment in relationship to other objects or people as well as the ability to perceive the relationship of one’s own body parts to each other)
• topographical orientation (ability to plan out a route and follow a route through recognition of landmarks, perception of landmark relationships and directional memory)

 Wiihab using activities and games found on the Wii Sports menu, used in conjunction with other more traditional approaches, targets problems children may have with perceptual processing, especially body scheme.     Do any of you have experience using Wii in a school program?  A group of students in NewJersey used Wii with a 13 year old with cerebral palsy.  Wiihab can also be a great tool for the school based therapist for addressing frequently encountered cognitive problems and psychosocial problems.  The next post will clarify those issues.

Pediatric centers in UK using Wii for children with hemiplegic cerebral palsy

In Newcastle, England, a professor at Newcastle University's Institute of Neuroscience has opened a research study in using video games, including the Wii, as a rehab tool for children with hemiplegic cerebral palsy. Hemiplegia affects one side of the body, and children diagnosed with this disability often neglect the disabled arm and leg. The study is using Wii controllers and laptops with specially designed games to encourage children to use their disabled arm. These adapted games have a lower level of complexity and a lower speed than those commercially available; the study has tested two games and a third will be added.

The principal researcher, Professor Janet Eyre, has noted improvements in the children's use of the less frequently used limb as well as improvements in coordination and social interaction:

"What has been striking to us, and the parents and children, is that by playing the games the children are using their [disabled] arm more in everyday life. We're trying to give them an incentive so that they will use it a lot."

She also notes the social value of using games, which are an integral part of childhood, to de-stigmatize therapy for children and families:

"Children sometimes feel stigmatised by therapy but everyone plays games, and they can play them with their parents or their brothers and sisters."

Therapy may hold a stigma even for adults; using the Wii and other video game / interactive tools may be of use even with older patients who resist therapy or who are unlikely to adhere to recommended courses of therapeutic treatment.