30 December 2008

Wii system helps local patients recover from stroke, disabilities

-BLOOMINGTON -- "Nice shot," David Wickenhauser said as Judy Erickson's chip shot made it onto the green. Wickenhauser then helped Erickson to select the correct club for putting.

Wickenhauser, 36, and Erickson, 56, weren't golfers on one of Bloomington-Normal's many golf courses. They are BroMenn Adult Day Services' clients recovering from serious illnesses. They were swinging a remote while walking around in front of a large-screen television in the family room at Adult Day Services, 202 E. Locust St., as other clients watched.

The Wii -- the popular video game system -- is being used as a part of rehabilitation with patients on the Acute Rehabilitation Unit of BroMenn Regional Medical Center in Normal and with clients at Adult Day Services.

Balance, coordination, endurance and fine motor skills are among body functions that may be improved through use of the Wii, said Rebecca Wheat, manager of Adult Day Services.

Erickson, of Bloomington, a GTE retiree recovering from a stroke, said playing the Wii has helped her arm strength and hand-to-eye coordination.

"You have to use your brain," she said with a smile.

But, mostly, the Wii is fun, she said. "I like doing it (playing the Wii) with David."

"It's just fun," said Wickenhauser, of El Paso, who suffered severe memory loss and lost his ability to walk without assistance after getting kidney cancer, a rare liver disease called Stauffer's Syndrome and encephalitis.

Wickenhauser said playing the Wii has helped him with concentration, patience, endurance and balance.

Erickson and Wickenhauser illustrate why BroMenn acquired two Wii systems several months ago and the subsequent success.

"We sometimes, as therapists, get a bad rap from patients who think therapy is work," said Paul Trumbull, a physical therapist and director of rehabilitation services at BroMenn Regional Medical Center. "The Wii makes therapy fun. It makes it easier for them (patients and clients) to participate."

Trumbull became aware of Wii systems being used as part of rehabilitation elsewhere in the country and began investigating.

He found that it was too early for any conclusive studies about the Wii in therapy. But therapists talked and wrote about the benefits their patients had experienced. In addition, the Rehabilitation Institute of Chicago was beginning a course for therapists on how to use the Wii in therapy.

"For most therapists, it's intuitive that it would work well," Trumbull said.

The Wii requires players to move while playing a game being shown on a television screen. Players, holding a remote, mimic motions for the game, whether it's golf, bowling, tennis, boxing, dancing or a cooking activity. Characters on the screen represent the players and do what the players do, so the players can see the accuracy of their moves.

"We can vary the situations that the patients are in," Trumbull said.

Trumbull and other BroMenn rehabilitation leaders discussed potential benefits and decided to acquire two Wii systems last spring.

Adult Day Services already had a large-screen TV in its family room, so only had to spend about $400 for a Wii. The Acute Rehabilitation Unit received a $1,500 grant from Sam's Club for a Wii and a large-screen TV, which BroMenn put in the unit's therapy gym.

Acute rehab patients -- whose ages range from their 40s to their 90s -- are hospital patients who need more intensive therapy before returning home, Trumbull said. Often, they have had a stroke or a brain tumor, or have had orthopedic or spine surgery.

The Wii is used as a part of therapy in acute rehab three to four days a week, Trumbull said. About 60 percent of acute rehab patients are using the Wii. The typical patient stays in acute rehab for 11 days.

"One of the nice things about the device is you could find an appropriate way to use it with just about any patient," Trumbull said. "The bowling is most often used.

"I don't have any hard and fast data saying that people are getting better faster (because of the Wii)," Trumbull said. "But it feels as if they are. What I'm really finding is they're enjoying it."

Adult Day Services averages 20 to 30 clients each day. Most of the clients are older adults who want some place to go during the day for socialization and mental and physical stimulation while their family members are at work, Wheat said.

"A lot of our clients need help with fine motor coordination (using their fingers, hands and arms) because of a stroke or physical weakness that came with age or lack of use," Wheat said. Cutting up food and writing are among daily activities that become more difficult with fine motor weakness.

Wii helps because clients are moving their entire body without realizing it, Wheat said. Knowing where to stand and swing helps with balance and coordination, she said.

For example, during their Wii golf game on Dec. 8, Wickenhauser and Erickson walked around to get themselves into the proper position, clicked the remote buttons to select the right golf clubs and swung the remote to simulate a golf swing. They did that for about an hour.

"There's a lot of hand-to-eye coordination to get the characters to do what you want them to do," Wheat said.

"I would say a dozen or more of the clients use the system," she said. "The others benefit by watching it."

When he began using the Wii in the summer, Wickenhauser -- still undergoing rehabilitation for his life-threatening illnesses -- needed help standing and was frustrated with anything that required concentration.

"It (Wii) makes you use your brain," he said. "If you want to do well, you have to concentrate."

The Wii has helped Wickenhauser to improve his coordination and fine motor skills, Wheat said.

Erickson still uses a quad cane to walk but doesn't use it while she's playing with the Wii. "It's helping to improve her balance and endurance," Wheat said.

Another client, who was withdrawn, has become more sociable since playing the Wii, she said.

Wheat said the Wii is an example of therapists reaching out to people who may have played video games.

"We're trying to keep our programming up to date," she said.

Wickenhauser said playing the Wii reminds him of his teen years playing video games in the arcade at the mall and his college years when he worked and played golf at El Paso Country Club.

Then he laughed.

"I still can't putt."


What's a Wii?

For novices, here's a quick lesson on the Wii:

--Wii is the popular home video game system released by Nintendo in 2006. Nintendo said it chose the name because Wii sounds like "we," which emphasizes that the Wii system is for everyone.

--The distinguishing feature is its wireless controller, the Wii remote, which is used as a handheld pointing device to detect movement in three dimensions.

--Holding the Wii remote, players mimic motions for a game, such as golf, tennis or dancing. Characters on the television screen do what the players do, so the players can see how well they are performing.

SOURCES: Nintendo, Wikipedia

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