29 November 2008

Know pains, know games

Get up, sit down, take a step, reach across your body.
Sounds simple enough, but not when you’re hurting.

Now imagine the mental drudgery of having to repeat grunt-and-groan exercises multiple times using those same physical tasks in order to stop the pain. It demands work that can be flat-out boring.

But in the past couple of years, physical therapists across the country have begun using Nintendo Wii (pronounced “we”) video games to make getting up off the couch a lot easier—physically and mentally. Some in the profession have nicknamed it “Wii-habilitation.”

Dr. Lori Anderson, physical therapist in the rehabilitation department at Ely-Bloomenson Community Hospital, came across the idea at the Minnesota State Fair last summer when she stopped by the American Physical Therapy Association booth. She gave the games a try and liked them so much she bought one for herself.

In October, as part of National Physical Therapy Month and their slogan “it’s all about movement,” Anderson took her personal Wii game to work. She wanted to give it a test run with physical therapy patients and nursing home residents.

The game was an instant hit. She said a couple of the nursing home residents tried it and talked about it for days.

“The patients really love it. They find it fun and don’t feel like they’re exercising,” she explained.

The video technology allows participants to play virtual sports games and simulate other physical activities on a television monitor by using a wireless hand-held controller. Players move their arms and legs, and shift their weight in motions that replicate their use for the sport or activity.

Anderson said the games benefit people who have neurological problems like traumatic brain injuries or strokes. But the games are also good for reconditioning general strength and endurance, post-surgical recovery and spinal cord injuries. The activities are well-suited for geriatrics at risk of falling or who have sustained a fall, and those in need of basic eye-hand coordination. The physical movement required increases and strengthens heart rate.

Beyond the physical benefits, the games are a particularly refreshing alternative to traditional forms of therapy that can be viewed as monotonous and dull.

According to Anderson, motivating patients is one of a therapist’s biggest challenges. But the Wii games have a magic touch.

“Just getting patients to stand up can be mundane,” she said. “But if you have them bowling [with Wii] they don’t want to sit down until that game is done.”

Along with bowling, games include sports like tennis, baseball, golf and boxing.

Other versions of Wii focus on balance for activities such as skiing, snowboarding, soccer and hula-hooping. Players actually stand on a balance board and practice shifting their weight.

“Many people don’t realize how poor their balance is. They also don’t realize that balance is a skill and it gets better with practice,” Anderson said.

What’s more, she said patients derive inspiration because the game keeps score and they can assess their progress.

The Cook Hospital has been using Wii games in their nursing home and for adult day services for about two years.

According to Director of Rehabilitation Brian McCarthy, the activities for the adult day services keep patients from “just sitting around at home.”

“The key as we age is to keep moving and Wii games have been a great help,” he said.

Additionally, residents who are wheelchair-bound in the nursing home have discovered a variety of activities to do from their chairs, like bowling. McCarthy said interest in the games has really improved resident participation overall.

“When patients participate with Wii, they’re much more alert and it’s much more fun than standard therapy like reaching up to put a ring on a cone.”

He added that he knows of some nursing homes that have established bowling leagues for wheelchair residents.

Though often thought of as kids’ entertainment, Wii systems are cross-generational and suitable for therapy in all age groups.

Ely resident Phyllis Kurre-Post is one of Anderson’s therapy patients at EBCH. Kurre-Post suffered a broken vertebra and ribs from a fall, and her balance and leg strength have weakened over time. But she’s becoming somewhat of an aficionado at the Wii bowling game.

During their therapy sessions, Anderson helps her shift weight from side to side when sending “the ball” down the alley. Getting a feel for when to release the controller button also helps improve Kurre-Post’s eye-hand coordination. She said she thinks it’s beneficial.

“It’s been quite interesting,” Kurre-Post said, then added, “I don’t do much at home other than walk, so I better keep coming here.”

Her husband, Gus Post, said he hopes she regains her ability to walk independently with less fear of falling, especially in winter.

“Icy weather is a concern. It gets tough here in Ely,” he said.

For children, the games can help enhance overall motor skills and coordination, and reduce clumsiness sometimes associated with childhood development. Kids who might have avoided conventional sports can find the games exciting, too.

Both Anderson and McCarthy see definite therapeutic potential.

Anderson said the hospital hasn’t purchased any Wii games yet for the EBCH therapy department, so until then she’ll continue to bring hers in periodically.

However, she said the price for Wii games is often affordable and patients can continue their rehabilitation at home. She estimated a start-up system, which includes the sports games, runs about $250. Add-on games and associated equipment for specific sports usually range from $40-$80.

“When you consider the cost of traditional therapy equipment, Wii games are a decent price that can be used for a wide variety of patient therapy and diagnosing,” she said.

With the holidays around the corner, the games could be a stocking stuffer to bond family members of all ages for entertainment and a healthier New Year.

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