29 November 2008


Video games keep patients engaged

While nobody is recommending joint replacement as an enjoyable option for your next vacation, the often-arduous rehabilitation process just got a lot more fun.
Patients at the Westland House in Monterey are improving their strength, balance, dexterity, coordination and flexibility by playing games on Wii, Nintendo's virtual-reality video experience that allows players to simulate the physical actions of activities like tennis, boxing, golf, baseball, soccer, bowling and a multitude of others.

The physical motions necessary to play those games on the Wii system are proving to be effective treatment for a wide range of rehabilitation clients, including those recovering from strokes, joint surgery and brain-injuries, as well as people who suffer from acute and chronic pain.

"This doesn't replace any of the rehabilitation techniques we've been using, but it's a valuable adjunct to what we're doing here," said physical therapist Sherry Brient, rehabilitation supervisor at Westland House. "These are being used nowadays at schools, convalescent homes, senior centers. More recently, the rehab community has discovered Wii as a good tool to enhance the rehab process. We initially had a loaner here, but we liked it so much that we bought our own system."

A hand-held control interacts with a receiver. A television screen shows an opponent — a tennis player, a boxer, a baseball pitcher. Or a golf course. Or a realistic bowling lane with pins waiting at the opposite



"I actually worked with a man who had been a boxer when he was younger, so we tried him out with the boxing game," said Tony Fusco, an occupational therapist at Westland House. "He was dealing with some brain issues, and it was the first time I ever got a smile, or any kind of real reaction out of him."

Unathletic can benefit

The enjoyment factor is a major part of the reason rehabilitation specialists are sold on the Wii as a therapy tool. Routine exercises — weight training, aerobics, etc. — that are designed to help a patient regain strength, balance, endurance, flexibility, dexterity and coordination often can become tedious. The patient can lose interest.

"It keeps the person entertained, more involved in their care," said Shilpa Oza, an occupational therapist. "They're having fun while they're exercising, so they tend to be much more engaged in what they're doing."

People with no athletic history, and little ability, can benefit from Wii and enjoy the games, because many of the game programs are designed to accommodate various ability levels. Ex-athletes and weekend warriors are naturally enamored.

"It works really well because a lot of our patients have a history with some of the sports that are available on Wii," Fusco said. "They like to play, they have some skills, and it's realistic for them. I've worked with a lot of tennis players, a lot of golfers, a lot of bowlers."

Kate Staples, a Seaside resident who suffered a stroke about a month ago, carried a 160 average as a young bowler and was excited to add Wii's bowling game to her rehabilitation.

"It was a lot of fun. I enjoyed it a lot more, both mentally and physically, than the regular exercises," she said. "I wasn't very good at it because it's a little bit different than real bowling, but it gave me confidence because it helped me regain some of my balance."

Programs measure balance

Pacific Grove resident Daphne Winters, another stroke victim, hasn't bowled since she was "in my 20s," she said, but fell in love with Wii during her physical therapy sessions.

"I did a lot of other kinds of exercises, like walking on a treadmill with my legs tied together with elastic, but the bowling was great. I got three strikes in a row," she said with a laugh. "I had to work at it a little bit, though, before I could figure out how to get the curve back in my ball."

Specific programs are designed to measure a person's balance. In one game, the player walks on a virtual balance beam, watching his cartoon counterpart move across the video screen. Too much weight on one foot will cause the cartoon character to lean to one side, waving his arms frantically, as if to regain balance. Over-adjust, and the character wobbles the opposite way.

Another balance-oriented program shows the cartoon character standing on a round disc. The player attempts to maneuver a ball into a hole in the disc by adjusting his balance to tilt the platform. If balance is poor, the ball will roll off.

"We can learn things about the patient by watching them as they play," Fusco said. "We can see whether they have issues with hand-eye coordination, or cognition. We can see how they process some of the instructions. A lot of games are too difficult for certain patients, but we can modify the games to accommodate those people."

One of the most-attractive aspects of using the Wii as an enhancement to normal physical-therapy methods is that the games can be played at home, after treatment at the Westland House has ended. Some patients purchase a unit for home use and use it as a viable and fun way to exercise.

"We've had a lot of patients who, when they're done here, say 'I'd love to get one of these,'" Brient said.

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