Wii - For Seniors - Benefits identified

 

At the 2010 annual meeting of the American College of Sports Medicine held in Baltimore, MD in June, Elizabeth Orsega-Smith, Ph.D presented a poster highlighting the results from her study exploring the many benefits of playing Nintendo Wii for Seniors. The pilot study, led by Dr. Orsega-Smith, an associate professor in the department of health, nutrition, and exercise sciences at the University of Delaware, Newark focused on the value of Wii as a way to help seniors burn more calories and become more active. Dr. Orsega-Smith reports that in addition to physical activity levels, other measurable variables include "psychosocial levels, self-esteem, social support, and quality of life,”

According to Dr. Orsega-Smith, this pilot study is only the beginning. These researchers hope to expand the study, incorporating functional measures such as "Timed Get Up and Go Test" as well as the "Berg Balance Test".

For occupational and physical therapists, the results of this study should encourage the use of Wii in therapy in the geriatric setting. Since sedentary lifestyle is a major risk factor for falls, increasing activity and feelings of well being in the Senior population may help reduce overall health care costs through a reduction in fall risk.

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."

Wii in Therapy: Enhance Your Skills

Fall 2010 brings opportunities to stretch your imagination by learning about modifications as well as brainstorming with other therapists about creative uses for Wii. Join colleagues for "Wii-Hab: Using Nintendo Wii in a Therapeutic Setting."

September 23, 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!

WiiHab - Therapy Blog listed in "Top 50 Occupational Therapy Blogs."

Readers may like to know that WiiHab- Rehabilitative Therapy using the Wii by the "Wii OT made the list of the "Top 50 Occupational Therapy Blogs." (To view this list, click July 2010 under Blogs in the left-hand margin.)
Wiihabilitation, a site out of England posted a headline recently: Wiihabilitation increases participation in therapy. This headline refers to a work published in VIRTUAL REHABILITATION in August of 2008 by Ramchandani, A. Carroll, K. Buenaventura, R. Douglas, J. and Justin Liu from Stanford Univ., Stanford, CA.
Options for using Wii in therapy abound. Adaptations make Wii useful and engaging across patient populations, limited only by the imagination of the therapist.

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.

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!

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 Therapy - For War Vets and Burn Victims

On Saturday, March 27, 2010, over 30 therapists attended Stockton College's Seminar: Wii-Hab - Using Nintendo Wii in a Therapeutic Setting. Everyone who participated went away with new ideas for their setting.
One participant asked a great question about configuring the Wii Fit balance board for amputees. The questioning therapist wondered if the Wii Fit balance board would configure properly if the one on the board wore a prosthesis. The answer was yes, since the balance board responds to pressure applied it.
Many war veterans must learn to walk again using prosthetic limbs and games offered using Wii Fit help speed their recovery. A fellow soldier and his wife are working hard to help wounded vets gain access to this valuable tool. According to an article appearing online at www.wtop.com, "Air Force Staff Sargent David Flowers and his wife founded Wii's for Warriors, a group that gives away free Nintendo Wii Fit to amputees at Walter Reed."
Seminar attendees also learned about the value of games like the ones available through Wii applications for burn victims. At a hospital in New York City, a study is underway to assess if burn victims improve more quickly using a Nintendo Wii game in therapy or traditional cooking activities.

Easy Reference Chart: Use of Nintendo Wii in Occupational Therapy

In October 2008 ADVANCE FOR OCCUPATIONAL THERAPY published a chart highlighting Use of Wii Sports games for various therapy uses. I developed this chart as a precursor to the Wii-Hab Workshop. Since that date, many OT and PT students, with the help and guidance of faculty and mentors have developed research projects aiming to determine the therapeutic value of Wii or other video gaming systems. Last year, a student from Keuka College surveyed therapists about their use of Wii in therapy. This year a group of Danish students contacted this blog looking for help in finding articles supporting the use of Wii as a therapeutic tool. OT programs in the United States are also gathering and reporting Wii related data. PTs as well are busy adding to the knowledge and building proof that activities offered through Nintendo Wii programs help improve outcomes.
In April, The AOTA 90th Conference and Expo will feature at least 11 sessions related to using Wii in therapy.
Next weekend the Wii-Hab Workshop at Stockton College, Pamona, NJ is filled, but Anne Arundel Community College in Annapolis, Maryland still has space for the April 10th seminar. Penn State Abington is still accepting registration. Speak to the continuing education department about available discounts.

Intergenerational Value: Wii for Fun - Therapy in Itself

A child who visits his Grandma in an assisted living facility decides the residents need a bit of excitement. He raised funds and purchased a Wii system for that facility. Now the residents keep themselves busy with bowling and baseball.
In my workshops, therapists hear about ideas for finding funds to help them bring the benefits of Wii into their facilities. Just recently, the executive director of Twilight Wish Foundation spoke at a meeting I attended. She suggested that perhaps her organization could work with community groups, such as Little League Teams or other sports organizations, interested in helping to purchase Wiis for elders in group living arrangements. This idea promotes interaction between generations and communities.
The intergenerational benefits the Wii brings benefits not only to grandparents and young children but also to parents and children with special needs. The Wii provides a great tool for parents who strive to help their children who struggle with sensory integrative issues, social issues as well as motor challenges.
One motor skill that families can address using the Wii is balance. Challenge the child's balance skills by playing games they love while placing them in creative positions. Since many Wii games can be played while standing or sitting, Wii provides an activity many are able to enjoy. Whether for therapy or fun, Wii provides a way for members of various generations to interact, improving quality of life for each participant.

Canadian Researchers Demonstrate Efficacy of Wii-Hab Following Stroke

The American Heart Association held the 2010 International Stroke Conference in San Antonio, Texas, February 24 - 26, 2010. The results of a study led by Gustavo Saposnik, MD and conducted at St. Michael's Hospital in Toronto were presented. This poster presentation explained the objective of this study as " to evaluate feasibility, safety, and efficacy of VR using Nintendo Wii gaming technology on motor function during stroke rehab." Readers may view the abstract of this poster beginning on page 3 of this link.
The outcome of this research is detailed in the chart accompanying the abstract found at that link.
Several news writers have summarized the results. In the Bloomberg Businessweek summary, Dr. Saposnik is quoted as saying, "Basically, we found that Wii therapy produced a 30 percent better improvement than recreational therapy in the time it took for the Wii patients to execute a task, and in how well they were able to execute a task."
In this study, the group assigned to recreational therapy preformed activities such as playing with cards and manipulating blocks in the game 'JENGA'. The intervention group participated in Wii activities including Wii Sports tennis and Wii Cooking Mama tasks.
Those participants in the intervention group demonstrated that "VR using Wii is a novel, safe and feasible strategy to facilitate motor function after sroke."

Nintendo Wii for Fun and for Therapy: Sign up for a Spring Workshop

Regulars at the Los Altos Hillview Recreation Center in California's Silicon Valley now find Wii games engaging and entertaining. The center’s director purchased the Wii with grant funds back in 2008, but the system stayed on the shelf until a volunteer dusted it off and put it into play. A local real estate broker and attorney brought her enthusiasm and expertise to the center, teaching many how to bowl or how to complete a successful ski jump. Watch the video to see these folks in action.
This video provides a great example of using Wii for fun while giving therapists an opportunity to look for ways to change the experience, making it a therapeutic session. First, notice that neither player follows one of the most basic “play it safe” rules. Always use the wrist strap and non-skid remote cover to reduce the risk of a flying remote. Second, in a therapeutic setting, warm-up stretches, passive range of motion or flexibility activities should precede the engagement in Wii activities. Also, during the video, the lady bowler indicates that she feels fatigue or slight strain in her arm following a few frames. A therapist would monitor a player, making sure not only to avoid overuse but also to apply ice if the participant feels fatigue or pain.

Another thing a therapist might do to increase the therapeutic value of Wii would be teach pursed-lip breathing and cue the participant in the proper use of this breathing technique during the activity. One might even print out the patient education sheet and give the sheet to the patient. The information on the handout will help both the patient and family members fully understand the technique for pursed-lip breathing and the importance of using this breathing technique during activities of daily living.

Wii offers endless opportunities for strengthening targeted muscle groups, challenging cognition, improving coordination, increasing endurance, and building confidence.
Therapists wanting to gain more experience with using Nintendo Wii in therapy may attend one of the Wii-hab workshops scheduled for this spring. On March 27, 2010 Stockton College in Pomona, NJ will be the host.

On April 10, 2010, Anne Arundel Community College is offering this workshop. The class will be held at the Arundel Mills Campus bringing this great opportunity to therapists from the Washington Baltrimore area.
To sign up, contact Continuing Education by phone at 410-777-2325 or email at iscenter@aacc.edu

And on May 1, 2010 Penn State University Abington Campus will sponsor this workshop. Occupational, physical, and speech therapists as well as hospital administrators and nurses working in rehabilitation from both the Delaware and Lehigh Valley areas will find the Penn State Abington Campus a convenient location.

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.