The Wii Factor

The June issue of Eye on Innovation described the use of virtual reality and video games in medicine. Virtual reality techniques, involving three-dimensional imaging and surround sound, are increasingly being used in diagnosis, treatment, and medical education.

Virtual reality game technology using Wii™, created as a home video console which can be used as a handheld pointing device and detects movement in three dimensions, is now being integrated into treatments from stroke rehabilitation to Parkinson’s disease. Wiihabilitation, or the use of the Nintendo Wii in rehabilitation, has been successful in increasing patients’ motivation and encouraging full body movement. Several examples from Dialog databases illustrate Wii’s effects.

Example 1: Rehab bowling helps stroke victim

After a stroke leaving a 23-year-old Chicago student with little to no feeling in his left arm and leg, and unable to get out of bed, dress himself and accomplish many of the necessities of daily living, Mark started his physical therapy (PT) using Wii video games. The different games, his favorite being bowling, prompted him to use his left arm to throw his bowling ball. According to Mark, “The grip on the controller and throwing with his left arm has brought back some feeling in that arm.” And, instead of PT being “pain” and “torture” Mark is now enjoying his physical therapy.

A pilot study focused on movements of stroke victims' impaired arms to help both fine (small muscle) and gross (large muscle) motor function. Researchers found significant motor improvement in speed and extent of recovery with the Wii™ technology. "Basically, we found that patients in the Wii™ group achieved a better motor function, both fine and gross, manifested by improvement in speed and grip strength."

[Virtual reality game technology using Wii™ may help recovering stroke patients improve their motor function, according to research presented as a late breaking poster at the American Stroke Association's International Stroke Conference 2010.]

Example 2: Wii motivates Parkinson patients

It's Sam's turn at bat. He steps up to the plate, awaiting the pitch. A 70-mph fastball soars toward him. He swings and connects with the ball. Foul ball! Everyone cheers for him anyway.

This baseball game's not taking place on a field, and there's no real bat or ball to be seen. Sam is playing the Nintendo Wii as part of his occupational therapy. He is among 30 Parkinson's disease patients participating in a Medical College of Georgia study to determine if occupational therapy enhances the treatment of the disease.

Wii, which features simulated movements such as throwing a bowling ball or hitting a baseball, responds to a player's movements rather than cues from a controller, so players can do full body movements and see their progress on a screen. According to one therapist, "I think we’ll be using virtual reality and games a lot more because it provides a controlled physical environment that’s safe, fun and motivational. A patient doesn't have to go to a bowling alley and worry about environmental problems or distractions. The games require visual perception, eye-hand coordination, figure-ground relationships and sequenced movement, so it's a huge treatment tool from an occupational therapy perspective." Participants show significant improvements in rigidity, movement, fine motor skills and energy levels. Perhaps most impressively, most participants' depression levels decreased to zero,” says Dr. Ben Herz, program director and assistant professor in the School of Allied Health Sciences Department of Occupational Therapy.

The Wii has been popular with both participants and therapists."Because the Wii is interactive and you have to do certain functional movements to be successful, it's an effective modality for working with Parkinson's patients," says Dr. Herz. "One of the therapists uses the Wii for timing and loosening up, and the other uses it for coordination and balance issues."

Conclusions

Superiority of virtual reality methods in comparison with conventional procedures currently in use is still unproven. Larger samples, adequate controlled study design and follow-up, greater homogeneity in the selection criteria and parameters measuring motor impairment and recovery are necessary. Yet it appears that virtual reality is here to stay and will increasingly be used widely in a number of areas of healthcare.

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