Prospective OT student writes about Wii As A Therapy Tool

Whitney Kramer, a student at Michigan State University used Wii technology in a classroom and recognized many aspects of Wii that she plans to later use as a therapist. Follow the link to read what she observed.

CEP 452 - Technology and Education: Wii As A Therapy Tool: "I know this class is primarily about technology and its uses in the classroom, but as a kinesiology major myself, I tend to look at t..."

Wii Related Therapy Benefits Highlighted in Research

Researchers with the department of Occupational Therapy at Kaohsiung Medical University in Taiwan have an article in press entitled Effectiveness of virtual reality using Wii gaming technology in children with Down syndrome.
Children with Down syndrome (DS) between the ages of 7 and 12 were randomly assigned to one of three groups: standard OT interventions (SOT), VR using Wii technology interventions (VRWii) or the control group. Sensori motor functions were the targeted outcome measures and were assessed pre and post intervention using The Bruininks–Oseretsky Test of Motor Proficiency-Second Edition(BOT-2)(Bruininks &Bruininks,2005), The Developmental Test of Visual Motor Integration(VMI)(Beery, 1997), and The Test of Sensory Integration Function (TSIF)(Lin, 2004). Activities offered through Wii Sports were chosen for the VRWii intervention group. The results of this study indicated that the group of DS subjects who received Wii therapy demonstrated statistically significant improvement in motor proficiency, visual-integrative abilities and sensory integrative functions as compared to the SOT and control groups.
Evidence continues to mount in support of Wii-hab for improved outcomes in many populations. In this study as well as in the study published in October of 2008 by Judith E Deutsch, Megan Borbely, Jenny Filler, Karen Huhn and Phyllis Guarrera-Bowlby the authors comment on the intrinsic values of Wii technology including engagement, encouragement and feedback. Furthermore, Wii provides an opportunity for atypical children to interact with peers both with or without similar disabilities.

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.

OT includes Nintendo Wii in "Playroom" Based Therapy

Children who perceive sensory input differently than their peers, often struggle at home and at school. These kids face difficulties in day to day life, struggling not only with self care activities like with dressing and feeding, but also with classroom tasks such as attending to classwork, manipulating pencils and paper and absorbing instructions. Lindsey Stamper, an occupational therapist in Paducah, Kentucky works with many kids with neurological impairments, helping them to "slowly expand their capabilities." She provides this help in a SENSORY PLAYROOM.
Using balance balls, swings, a padded floor and Nintendo Wii & balance board activities Lindsey helps kids improve their ability to process sensory input and to engage in activities of daily living with less difficulty.
An approach utilizing sensory integration techniques proves successful in mitigating problems in children who experience neurological processing deficits. Many Wii applications either independently or in conjunction with other sensory diet components enrich a child's sensory experience while helping the child reach processing goals. The Wii, an increasingly familiar video gaming system, contributes therapeutic opportunities to address proprioceptive, vestibular, tactile, auditory and visual needs in a non-threatening and fun fashion.
Are you a parent or therapist interested in sensory processing disorders and in helping kids who deal with the resulting problems? Please post a comment and start a discussion. How do you think activities using Nintendo Wii games -"wii-hab" - can help a child you know?

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!

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.

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.