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.

Dr. Ross Clark's Study Highlights Wii Fit Balance Board Benefits

Therapists as well as other staff working with the elderly recognize the threat falls carry for older adults. Falls often result in life altering changes including fractures, head injuries, and/or decreased self efficacy making continued independent living difficult for individuals who experience a fall. Volumes exist on this topic. Researchers (Tinetti, Lachman, Howland and many other authors) divide risk factors into two groups – extrinsic and intrinsic.


EXTRENSIC
poor lighting
throw rugs
clutter
multiple medications
ill-fitting or
improper footwear

INTRINSIC
muscle weakness
balance problems
postural hypotension
decreased flexibility
cognitive impairment
vision impairment
fear of falling


Various post-fall therapeutic plans of care as well as fall prevention intervention programs aim to reduce fall risk by identifying and mitigating individual intrinsic and extrinsic fall risk factors.
Dr. Ross Clark of University of Melbourne conducted a study in which he utilized the Wii Balance Board as a tool for identifying center of balance, an important component of standing balance.

Take time to look at the list of fall risk factors. Can other risk factors be addressed using Wii activities? Of course! Post your experience for others to read.

Wii therapy in Columbus: From rehabilitation to special education

Dr. Tim Barrett writes for Examiner.com in Columbus, Ohio. Recently he posted an article explaining the many benefits of using Wii in therapy for a variety of problems. In this article, Dr. Barrett mentions Lon Thornburg. Lon's blog offers so much information to help therapists and families as they care for children with special needs. Robbie Winget, an occupational therapist also shares his enthusiasm about using Wii in therapy with Dr. Barrett.
Soon, this blog will give readers a chance to share their opinions and experiences using Nintendo Wii with those they care for. Keep following and when the survey posts take a little time to complete it.

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!

Wii Purchases Bring Therapeutic Benefits Into Homes

New Wii Consoles flew off the shelves at retail outlets during the pre-holiday shopping sales. During one week in December, Walmart offered a $50 gift card for lucky customers who found Wiis in stock. So now many have a chance to experience Wii at home. In a UK paper an article explains ways to avoid injury when playing new games in the comfort of your own home.
New Wii owners, including those with chronic conditions express various ways they hope to use Wii in 2010. One Wii enthusiast with a spinal cord injury uses Wii to build arm strength. In an article entitled Wiiiiii!: Adaptive Exercise That’s Actually Fun the author offers good suggestions for therapeutic uses of Wii applications as well as suggestions for simple ways to make Wii applications more user friendly for this population.
New Wii owners with Multiple Sclerosis also recognize therapeutic value in Wii Sports and Wii Fit activities. Having Nintendo Wii in one's home allows the participant to pace themselves to avoid fatigue while playing many great games. Many Wii games increase flexibility and endurance.
Families with special needs children bought Wiis for home use. These families look forward to increased social interaction with their children. Social interaction in a safe environment may help improve social skills for these children. Wii activities offer opportunities for spontaneity; this area often challenges children with autism and other developmental delays. Also, during these cold winter months, the Wii offers an easy way to add more physical activity into a child's routine, providing an outlet for energy and the possibly of reducing negative behaviors such as tantrums.
While playing Wii participants need to follow safe practices to avoid injury. Players might also want to add wrist weights to increase the challenge. Parents might also want to speak with their child's occupational therapist for ideas for increasing challenge by altering positioning while playing certain Wii Sports activities.

Wii Sports Activities Encourage Speech in Aphasia Group

The versatility of Wii therapy, sometimes called wiihabilitation, becomes more apparent everyday. Although the software programs were not developed for therapy or with disabilities or rehabilitation in mind, so many of Nintendo Wii software applications offer opportunities for every member of the rehab team.
For those recovering from life events that alter their neurological, physical, or social functioning, the rehab team, led by a pysiatrist and most often comprised of an occupational therapist, a speech pathologist, a physical therapist, a clinical psychologist, a clinical social worker, a recreation therapist, a registered dietitian and a nurse create and carry out the plan of care that will propel the client forward toward a restored state of health. A stroke is one medical emergency that can alter a person's ability to live independently. Some who suffer a stroke experience residual language deficits known as aphasia.
The Adler Aphasia Center in Maywood, New Jersey provides ongoing help to clients and families touched by aphasia. In addition to providing direct services, the staff conducts research. Therapists at this center recently conducted a research study and reported the results of observing communicative acts during Wii group activities. The poster is available online. This study of Wii use in therapy contributes to the growing body of evidence-based resources supporting effectiveness of Wii activities in rehabilitation. Readers can examine the results and learn how Wii-hab influences communicative acts among the aphasic population participating in this original research.

New Study Shows Mood Alters reaction to Pain

Results of a recently published study indicate that negative and positive emotions are closely related to pain perception. Lead author, Mathieu Roy, a post=doc student at Columbia, reports that negative emotions are shown to amplify our perception of pain. The subjects reacted more strongly to painful stimuli while looking at unpleasant images than they did when they gazed upon pleasant images.
Wii Bowling seems to have a similar affect on residents of nursing facilities. My personal experiences using Nintendo Wii in therapy suggest that the results of this study ring true. Clients who complain of pain as they stand at a table top doing unilateral or bilateral upper extremity tasks seem relatively pain free as they stand gazing at pleasant Wii scenes, bowling frame after frame. Standing for longer periods while not perceiving pain helps clients boost their confidence while building strength, balance, and endurance for daily activities, functional transfers and functional mobility .

OT Students in North Carolina Research Benefits of Wii

Two professors along with six occupational therapy students from Winston-Salem State University in North Carolina are conducting a study into the effectiveness of Wii activities for Seniors(over 60). More specifically, these researchers will look at the impact of one game in the Wii Sports suite on quality of life, confidence in preventing falls and social skills in a specific population - those over 60 who live in a retirement community. The research team hopes to release the results of the study in January.

Students across the country are planning studies using Wii activities as the independent variable or the tool that is manipulated by the researcher. In the study mentioned above, the researchers have identified three dependent variables, quality of life, confidence in preventing falls and social skills. The researchers hope to find changes in those dependent variables as a result of the "application" of the independent variable which in this case is Wii Bowling. To find the anticipated changes this group of researchers will use a Pre-test, Post-test approach, which means that they will survey each group before the intervention (application of the independent variable) and then again after the intervention. The scores obtained from these 2 surveys will be compared using some statistical test. Usually the results of the statistical test is calculated using a computer program such as SPSS. The Wii intervention will prove to be effective if the difference between the 2 scores(Outcomes)are determined to show statistical significance, in other words, the differences in outcomes are so large that these differences probably are not due to chance.
Research requires perseverance and attention to detail. I look forward to reading the results of this study.

Career TV Features "Wii OT" using Wii in Therapy

Career TV posted a newly created segment featuring the "Wii OT". Watch this video to see how incorporating Wii into therapy helps many clients improve their function.

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.

Grant Award Brings Wii Into The Classroom

Since Nintendo brought Wii to the market in 2006, many avid players who also happen to work with individuals with compromised function recognized this tool’s potential for addressing deficits. A special needs teacher in Ohio saw many great ways that Wii activities could improve student outcomes in his classroom.

The teacher, Kevin McDaniels, applied for funds to purchase the needed equipment for his classroom through Mid Ohio Energy Cooperative, INC’s Community Fund because Kevin recognized that using Wii complimented student time spent in occupational and physical therapy. Using Wii activities in the classroom seems to help students improve hand writing and balance by challenging both their fine and gross motor skills.

Although Nintendo has lowered the price of the Wii Console recently, the dollar amount needed to bring the benefits of Wii into classrooms and rehabilitation clinics may be in excess of usual pre-set budgets. Grants and donations have historically filled budgetary gaps in programs focusing on helping address needs in many communities. Most communities have organizations ranging from service groups to corporations willing to help programs reach out and serve those community members with specific needs.

Interested occupational and physical therapists as well as teachers can learn more about skills for grant writing and finding potential donor organizations by attending a grant writing workshop available often through area high school or college adult learning programs, found through internet searches or through companies, such as Grant Writing USA

Exercising With Wii? This Link Suggests Doing Some Research.

A writer working for a Philadelphia online paper, the Examiner.com focuses on Wii Fit. In her article posted on September 8, 2009 she suggests that Wii Fit enthusiasts compile research to build the evidence needed to support the value of Wii Fit. The author, Raina Casare lists 4 steps Wii Fit players should follow to compile needed support of Wii Fit’s value as a true tool for virtual reality fitness.

As therapists, following these same steps can help us gather data supporting Wii Fit’s importance as a therapeutic tool for occupational and physical therapy.

Many students choose to do research aimed at boosting Wii as a tool for therapy. From time to time, students write to me and ask for help on these projects, but many forget to share the outcomes once they finish. If you completed a study involving Wii, why not post information about it under comments. In truth, these early studies and surveys lay the groundwork for more in depth Wii-Hab research in the future.

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).

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.

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.

Aaron Martin, BASSEDGE, meets the "Wii" OT

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.