Rice University Students Modify Wii for use in Therapy

Creative students from Rice University in Houston, Texas developed a Wii-Hab system to help patients during therapy at Shriner's Hospital. This new use of Wii in therapy, based on Wii balance board technology, helps improve balance and decrease dependence on balance aides. Team Equiliberator worked together to develop a system that proves to be relatively inexpensive, yet effective in encouraging participants to work toward improvements. These balance gains occur as the players enjoy age appropriate fun. Watch the video and read the article to learn how these students used Wii balance boards along with their own newly developed hand rail sensor system to create a Wii based therapy activity that also produces data for quantifying changes (improvements) in balance.

Wii Use for Therapy After Stroke

A study lead by Dr. Gustavo Saposnik, director of Stroke Outcomes Research Unit, St. Michael Hospital’s (Toronto) , shows the value of Wii activities for individuals in therapy following a stroke. WiiHab - Rehabilitative Therapy Using The Wii by "THE WII OT" previously brought this study to readers' attention in February of 2010.
Recovering from a stroke requires a long process involving repetitive actions in order to provide the brain an opportunity to "rewire". For most stroke patients, who may naturally suffer depression following the loss of function, this requirement of repetitive, long-term therapy falls by the wayside. Wii offers this population a way to expand the benefits of occupational and physical therapy into the home setting, reaping improved outcomes while discovering a new, motivating use for leisure time.

Wii -Like Therapy Even before Wii hit the Market

In 2006, NeuroGym Technologies introduced a training system for use in rehab called the NeuroGym Trainer. This computer based technology offered therapists a way to provide rehab patients with visual and auditory feedback. A therapist could use this system to help patients learn to shift their weight, to help strengthen a targeted muscle group, or to help improve coordination. This system utilized sensor pads and a video game format. Many goals mentioned in the NeuroGym Trainer video can be addressed using Wii Fit and/or other Wii applications. Watch the video. How do you think you could Wii activities in similar ways? Do you have patients on your case load with goals that could be addressed with Wii activities? The patients would have more fun!
I have a client who hopes to move from the skilled care unit to the personal care unit. This client needs to dress and undress the upper and lower body with set-up only in a reasonable amount of time each day. Standing tolerance as well as dynamic balance must improve before that functional goal can be obtained. Playing "Fishing" (Wii Play) while standing requires dynamic balance while building endurance. This game will also require problem solving and visual discrimination. Honing those skills will also help this client dress in a timely fashion. I plan to get this OT client Wii fishing during the next therapy session and meet that functional goal in two weeks with the help of Wii-Hab.

Wii-Hab - Utilizing Wii Fit and Other Wii Programs in Therapy

The utilization of activities offered through Nintendo Wii continues to gain popularity with rehab therapists working with multiple populations. Just recently, an article from the Boston Herald appeared online in Therapy Times highlighting the improvement a young girl experienced following therapy for a traumatic brain injury. Not so long ago, an article about Rep. Gifford's rehab mentioned Nintendo Wii as a likely adjunct to traditional therapy.
Often my readers write and ask how Wii activities might be useful for their loved one.

Addressing specific cases would be difficult through an online platform such as this blog. So mostly, it is suggested that those looking for a therapist use care in selecting the setting for their particular situation. On MASTERSDEGREE.COM the writer provides a list of 15 questions to help those looking for a therapist of any type know what questions to ask before signing up. In the rehab setting, the opportunity to hand pick the therapist is rarely available. But usually rehab therapists, OTs especially, use a client-centered approach, assuring that the plan of care targets the individual's needs and learning style. If the therapist is familiar and comfortable with technology and Wii equipment is available, a high likelihood exists for including Wii activities since so many therapeutic objectives (as mentioned throughout this blog) can be addressed in an engaging way.
If your facility has either not embraced Wii technology yet or has put Wii away on a shelf, contact me at OTRMershon@gmail.com. I will work with your facility mangers to bring a Wii-Hab Workforce Training Session geared toward your specific population to your location.

Wii Fit - Therapy for Fall Prevention - WiiHab

The Saturday Evening Post online published a piece by Peter Perry about the potential of Wii Fit for improving balance. Take a moment to read about the research Kathleen Bieryla of Bucknell University has completed. Kathleen, an assistant professor of biomedical engineering, focused on improving clinical measures of balance in older adults by using activities in Wii Fit.
In the same Saturday Evening Post piece, Bryce Taylor, MSPT explains three of his trademark Wii-Hab therapeutic exercises using Wii Fit to improve back health and increase core muscle strength.

"Wii Therapy" in Detroit

Watching this video explains some of the benefits from the perspective of the patients using Wii in therapy. If a patient finds the therapy engaging they will be more involved. Hopefully then, the patients will push harder toward the goal and remain adherent to the plan of care. In this video, you will also hear the OT, PT and speech therapist explain why they find Wii-Hab to be such a useful tool to use in this setting.

Wii - Therapy in the broadest sense

In the UK like elsewhere, senior health and wellness are serious concerns. One administrator of a senior housing center developed an unique program for the residents to enjoy.

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.