Few patients think of the hospital as a place to improve their golf swing, play tennis, or rack up a perfect bowling score, but with the use of the Nintendo Wii video game system, patients undergoing physical or occupational therapy at St. Francis Hospital in Poughkeepsie, N.Y, are getting “Wii fit.”
“The Wii doesn’t replace conventional physical therapy,” says Susan Hecht, RN, Nursing Rehabilitation liaison, at St. Francis Hospital. “We use it in conjunction with traditional therapy.” Rehab patients at St. Francis and at other hospitals around the country enjoy Wii-simulated bowling, tennis, driving, and golf, and, in the process, reorient muscles, tendons, and ligaments to the activities of daily living.(Left to right) Susan Hecht, RN, and Candy Perotti, COTA, work with a patient in a “Wii-hab” session.
Although Nintendo doesn’t promote Wii for rehabilitation, a review of the literature shows that it is fast becoming a mainstay in physical therapy units. Even the U.S. armed services hospitals here and abroad are using Wii in physical therapy for injured servicemen and women. St. Francis has been using Wii for about eight months, according to Hecht, who acquired the Wii gaming console for the hospital and says she would like to get a second one. Hecht, a 14-year veteran of nursing who has been at St. Francis for nine years, says she finds patients’ physical improvement from playing Wii games and their enthusiasm for the technology very rewarding.
Wii is a home video game console, launched in the U.S. and other countries in September 2006 (http://en.wikipedia.org/wiki/wii), and Nintendo describes it as “an experience” rather than a game (http://www.nintendo.com/wii/what).
One of its main features is a wireless controller known as the Wii remote, which can be used as a handheld pointing device and detects motion in three dimensions. Its value in physical therapy is that patients must make the moves of the game they are playing as opposed to simply pushing buttons.
As the patient performs the movements, an animated character on the TV screen carries the moves through for him or her. A wrist strap keeps the Wii remote in place on the hand so it isn’t thrown during play. With Wii, you can play simulated bowling, tennis, basketball, golf, baseball, race car driving, and other games, using a combination of physical body moves and button clicks.(Left to right) Susan Hecht, RN, and Candy Perotti, COTA, work with a patient in a “Wii-hab” session.
Focus on rehabilitation
The game requires physical body movements that provide physical therapy for patients to build muscle tone; improve balance, weight bearing, and weight shifting; sharpen eye/hand coordination; and increase range of motion. Wii can be used with patients who have been injured in accidents and those who have lost motor and cognitive skills as a result of a stroke or other brain trauma. “Wii helps to break up their repetitive therapy sessions,” Hecht says. “It refocuses patients from the actual exercises they are performing to having fun while they receive their therapy.”
An unrelated bonus to Wii rehabilitation is that playing helps players improve their real-life games. If the patient has a bad golf swing when playing “real” golf, he’ll have that same issue when playing Wii golf. Practice on Wii may help his swing on the real green. Patients have been open to trying Wii and enjoy it, according to Hecht, who says it simulates all the activities of daily living.
Hecht cites a patient who had been seriously injured in a car accident with trauma to both legs. Wii games helped him to increase muscle tone, and improve his balance, weight shifting, weight bearing, and range of motion. He started playing the games from his wheelchair, and eventually he was able to move to a walker.
Candy Perotti, COTA, occupational therapist at St. Francis, agrees. “The Wii system has been an asset to our rehab unit,” she says. “The system encourages patients to perform the actual movements of the sport. Driving games help patients with visual tracking and scanning. Bowling, tennis, and baseball improve hand/eye coordination.” The game console itself also helps with memory skills, because the patient must remember the steps to use Wii each time, Hecht says.
Wii is just one facet of the patient’s customized rehabilitation plan, Hecht says. The multidisciplinary team meets twice a week to discuss the progress of each patient who is receiving PT and OT. Therapists use Wii if it will best fit into the patient’s overall rehabilitation plan. Some use it to help the patient to warm up for the day’s exercises. Hecht adds that it is most popular with young patients and those who like sports. “It really helps to take the work out of therapy and it gives patients activities that are purposeful and meaningful to them,” she says.
The movements that patients make during Wii games mimic the movements of daily living that patients often need for strengthening, such as reaching, stretching, swinging the arm, holding a utensil, and balancing. For example, boxing builds hand strength so that a patient can use a fork and spoon again.
The Wii at St. Francis resides in the community room, which is a more homelike setting, so that patients can play during their free time if they wish. They also can show their family members how the game works and demonstrate the progress they’re making. Patients who use it in therapy describe it as “great,” “fun,” “realistic,” and “very helpful.” It also provides a way for some patients to communicate more easily and to participate in group activities. “St. Francis will continue to research innovative ways to improve patients’ quality of life and independence during their rehabilitation stay,” adds Hecht.