Published: Saturday, November 7, 2009

Submitted by Dr. Alis Vidinas

While you may not be familiar with hydrocephalus, chances are at some time you’ve heard the phrase “water on the brain.” This used to be what hydrocephalus was known as -- although the “water” was actually cerebrospinal fluid, which surrounds the brain and spinal cord. This fluid is what cushions our brains. But too much of it may result in dangerous pressure on the brain tissues and negatively affect how the brain works.

Some individuals are born with hydrocephalus, others develop it. Normal pressure hydrocephalus is the form that occurs most often among older adults. It can be brought on by any one of a number of factors, such as a head injury, an infection, surgery or a brain hemorrhage. Sometimes, there’s no apparent cause. If a cause can be determined and corrected, however, symptoms may improve.

As the condition progresses, the symptoms become more pronounced. In the early stages there may be changes in how the individual walks and in their ability to walk. Legs may feel weak, and the person may fall without warning.

The National Institute of Neurological Disorders and Stroke lists other possible symptoms of normal pressure hydrocephalus as headache followed by vomiting, nausea, problems with balance, poor coordination, urinary incontinence, lethargy, drowsiness, irritability or other changes in personality or cognition, including memory loss. These symptoms, and others, can vary with age, disease progression and each person’s tolerance for the condition.

Many of these symptoms also occur with other illnesses that affect seniors, such as Alzheimer’s and Parkinson’s diseases. Because of this, normal pressure hydrocephalus may be misdiagnosed. Among the tests that may be used to determine whether an individual has this condition are CT scan, MRI, spinal tap and neuropsychological exams. These tests can also rule other health issues in or out. The determination of which test or tests to use varies between individuals and will depend on a number of factors such as their age, symptoms and physical condition.

There are treatment options for persons with hydrocephalus. The most common one is a shunt, or tube, that’s placed in the brain during surgery. The excess fluid is moved away from the brain and absorbed into the circulatory system. It’s important for the patient to continue to see his or her physician regularly after undergoing this procedure to ensure that no infection has set in and that the shunt is working properly and that no adjustments are needed.

How well a patient recovers can depend on how far the condition has progressed and, of course, how well they respond to the treatment. Some people respond extremely well. As with other conditions and illnesses, early detection and intervention is important to eventual recovery. Left untreated, the symptoms generally worsen and lead to death.

When should an individual seek medical attention? It’s always important to be aware of changes to your overall health. Changes in balance, coordination and memory are among those that should be brought to your health care provider’s attention. They could be a symptom of normal pressure hydrocephalus or an indication there’s another issue that needs to be treated. Abrupt changes in someone’s level of awareness or overall mental state require immediate medical attention, and 911 should be called or the person should be taken to an emergency room.

Alis Vidinas, M.D., is a family practitioner at the Henry Ford Medical Center-Fairlane in Dearborn. For an appointment call (800) HENRYFORD.

CityNews.ca Staff

It's one of the most devastating diseases in the world, a silent thief that gradually robs patients of their ability to do all the things they once took for granted, from playing sports to simply going for a walk.

Canada has one of the highest rates of multiple sclerosis in the world, although experts still aren't exactly sure why. They do know it can affect a person's balance and leave them in a wheel chair. And there's no cure.

But now there may be some new hope and it's thanks to the remarkable determination of some patients not to give up - and an amazing invention out of Alberta. Sylvia Bauer is the former and she's putting the latter to good use.

It's called the WalkAide, a miniature computer that stimulates the muscles in the leg and allows some MS sufferers the chance to walk normally again.
"I developed drop foot," she explains. "It means that the muscles that make your foot and your muscles move don't work any more." She had to rely on large awkward braces to move around and getting anywhere was an agonizing chore.
And then she heard about WalkAide, a small device you wear around your legs. It teaches the computer to adapt to your normal gait.

It then electronically stimulates the muscles, forcing your legs to work as close to the way they used to as possible.
"We're artificially replacing muscles that don't work," outlines Yim Lok. She's an orthotist, a person who makes and fits appliances for people with weakened muscles.
And it's not just MS patients who benefit. The WalkAide can also help those with other mobility related ailments, like cerebral palsy or a stroke.




So how well does the WalkAide work? Bauer's braces are gone and she's able to traverse the floors of her home easily. She was also able to take part in the 5K MS Walk earlier this year, something she never would have dreamed possible before.
The device isn't cheap - it costs $4,500. But Bauer thinks it's worth every penny. "This gives you a sense of just living your life normally and not thinking about it every time," she relates.

Want to know more? Take a virtual walk here to find out if the device will work for you.

Publish Date: Sunday,26 April, 2009, at 12:27 PM Doha Time

Dr Shaarani: ‘Two to three years of age is the time to show an affected child to a surgeon

By Bonnie JamesSurgical interventions improve the quality of life of children with cerebral palsy, Hamad Medical Corporation’s consultant orthopaedic surgeon Dr Mohamed Shaarani said yesterday.“Surgery enables many wheelchair-bound children to be transferred to walkers and those who are crippled to get on to wheelchairs,” he explained to Gulf Times on the sidelines of the first cerebral palsy symposium in Qatar.

Children with cerebral palsy have spasticity (stiff or rigid muscles with exaggerated, deep tendon reflexes, for example, a knee-jerk reflex), which can interfere with walking, movement, or speech.“We elongate some muscles and cut some others to make them loose and allow movement and flexibility,” pointed out Dr Shaarani, also a consultant paediatric orthopaedic.

Between two to three years of age is the ideal time to show an affected child for the first time to a surgeon, he added.In a presentation about dental problems in cerebral palsy, Primary Healthcare Department’s senior consultant Dr Mutaz Ahmed observed that incidence of dental decay is higher in this group, mainly due to poor oral hygiene.“Dental caries, gum disease, malocclusion, enamel defects, increased incidence of dental trauma, drooling, and grinding of teeth are among the main problems,” he explained.The incidence of gum disease is three times more among those with cerebral palsy than in the general population. The affected group also have a higher rate of dental enamel defects.“The increased risk for dental trauma can be attributed to problems with balance and muscle weakness in legs,” Dr Ahmed pointed out.Giving sedation, including general anaesthesia, is a very important option when doing dental procedures on an individual with cerebral palsy, as it may otherwise be difficult to control the patient.Highlighting the significance of maintaining proper dental hygiene in those with cerebral palsy the senior consultant suggested that parents should be instructed by dentists in this regard.“Cerebral palsy patients should be seen by a dentist every six months,” Dr Ahmed recommended while observing that electric toothbrush can be very useful for them.

Radiology, seizure disorders, growth and nutrition, medical management of spasticity, roles of physiotherapy, occupational therapy, orthotic, speech therapy and dietician, and education were the other topics of presentations at the symposium.

Posted By: Donna Lowry

ATLANTA - On a recent day, Curry Harris, 14, is walking on a balance beam while wearing glasses with blue lenses that flashes lights on the left side every few seconds.
Curry is undergoing a session at the Brain Balance Center in Peachtree City, where he spends several days a week getting a combination of therapies to strengthen the right side of his brain. Therapists at the Brain Balance Center have diagnosed Curry on the autism spectrum and are working to strengthen the right side of his brain.

Dr. Robert Melillo is a chiropractic neurologist, professor, and researcher in childhood neurological disorders who founded the Brain Balance Centers and says with proper treatment, the symptoms of autism can disappear.

"He (Curry) is a child with typical right hemispheric delays, so we're going to use his left side of his world to exercise his right side of his body and his brain," says Melillo of Curry.

The Brain Balance approach seeks to strengthen either the right hemisphere of the brain for neurological disorders such as autism and ADHD and the left side of the brain for obsessive-compulsive disorder and dyslexia.

The basis of Dr. Robert Melillo's Brain Balance research is a drug-free approach for what he calls disconnected kids.
"What happens is you end up getting a child who can't really use their whole brain at the same time," he explains.

The Brain Balance Centers treats everything from diet to physical, sensory and academic areas. Three months of treatment in the program would cost on average about $6200.

"For instance, word reading would strengthen the left side of the brain, but reading comprehension strengthens the right side," Mellillo explains.

Curry's parents say he's progressed more than they could imagine.
"Curry's grade levels have come up," Aneta Harris, Curry's mom, explains. "His math, I think he's come up 2 or 3 grade levels in math. Reading comprehension has come way up."

"We think we can get a kid to their age level within a 3-6 month period," Melillo insists.

Every kid with autism?
Melillo admits "Not every child is going to get to a normal typical level," and the program may not make major differences in a child on the more severe end of the autistic spectrum, but he believes even those children can show improvement with therapy.

Curry's parents say while he is still a work in progress, they're pleased that he no longer has anger outbursts and isn't as socially awkward.
"Socially he has become a little more aware of people around him," his mom explains. "He's giving us hugs at home which weren't done before."
Dr. Melillo will talk about brain balance and sign copies of his book, Disconnected Kids, on April 23 at 7:00pm at the Sheridan Suites at Cobb Galleria.
The Brain Balance Centers located in Roswell, Suwanee and Peachtree Center will have a booth at theGeorgia Walk for Autism on May 3 at Atlantic Station.

By Caroline Gough
A CHILD with a rare medical condition is responding well to an alternative therapy.
Tristan Forsdyke has had several sessions of Bowen Technique.

The 18-month-old has had hemiplegia since he was just five weeks old. It is a neurological condition which weakens one side of the body and affects one child in a thousand.

It is sometimes described as a form of cerebral palsy and the effects are similar to those of a stroke but it does not shorten a sufferer's life. Tristan wears a splint on his arm and an insole in his shoe to help with the weakness on the right side.

His mum Tess Forsdyke said: "He really enjoys the sessions.

"I've tried the technique myself as I wanted to know what he was experiencing.

"We have seen a real improvement in him since he started the sessions and he is making more attempts to use his weaker arm now."

The Bowen Technique is a gentle, deeply relaxing, physical therapy that frees the body to attain its natural balance and healing, addressing the body as a whole.

It often extends beyond the presenting symptom to the healing of underlying causes of illnesses.

In a session, the patient lies on a bed, wearing loosely fitting clothes and relaxes.

Tristan just sits in a chair as he is so small.

The therapists – Judith Watson and Norman Ogden – apply a series of movements along the spine and at specific points throughout the body. It is the deeply relaxed state which seems to act on the body's self-governing nervous system to enable it to regain its own natural balance. Mrs Watson said: "A very gentle technique for children was developed by Howard Plummer around 15 years ago involving moves over soft tissue – a slight variation of Bowen Technique.

"Mr Plummer has had fantastic results with children with cerebral palsy, autism and ADHD and dyspraxia.

"In some ways, Tristan has been a case study for us, his right arm and hand were badly affected and have improved.

"It's very effective for people who have had a stroke as the body is designed to heal itself."

The technique uses a high degree of physical manipulation and works with babies, children and the elderly.

Bowen is effective in treating a host of ailments including shoulder problems, RSI, back pain, sports injuries, migraine, respiratory problems, fatigue and stress.

"Clients frequently comment on how good they feel and how quickly they relax – as if they had just had a full body massage," said Mrs Watson.

Mrs Forsdyke organised an aquacise fund-raiser in December which raised £175 for the charity Hemihelp, which aims to promote the rights and well being of children with hemiplegia by providing information and support and by raising general awareness of the condition. Smart Therapies is in St Hilda's Business Centre, The Ropery, Whitby is run by Judith with Norman Ogden.

Further details are available at www.smart-therapies.co.uk.

For further information on hemiplegia visit www.hemihelp.org.uk

When a thank you letter arrived from The American Red Cross for the one-piece Nordic Walking Poles that were donated to Walter Reed Veterans Hospital by SkiWalking.com and The American Nordic Walking System it was one of hundreds of confirmations that one-piece Nordic Walking poles prove to be safer, lighter and much more durable than twist-locking adjustable length/telescoping/collapsible poles.

Glen Arbor, MI, April 15, 2009 ---- Nordic Walking instructor, running and ski coach, Pete Edwards, discovered five years ago that Nordic Walking Poles were not just for expert skiers deprived of snow, but doubled as an aid for those with balance and stability issues. He started volunteering to host free Nordic Walking Clinics at Multiple Sclerosis (MS), Parkinson's (PD) and Diabetes support group meetings. A couple years later he donated dozens of pairs of durable one-piece Nordic Walking poles to Walter Reed Veterans Hospital in Washington, DC. He has also shipped free Nordic Walking poles directly to injured soldiers returning from Iraq and Afghanistan after talking to their spouses and/or parents. Family members, doctors and physical therapists have been amazed by the improvement in posture, balance, stability and gate thanks to the use of Nordic Walking Poles in the correct lengths.For over 25 years Edwards has been coaching runners and skiers. His skiers have been ski walking and hill bounding with poles during the warmer months when snow could not be found.

After a knee injury ended his marathon running career, his Nordic Walking Poles saved the day – allowing Edwards to Nordic Walk and even Nordic Run (running with poles) pain free.Using the perfect length Nordic Walking Poles helps us to automatically walk with a super straight back - better walking posture is biomechanically a good thing. This improved walking posture when combined with the unique 4-Wheel-Drive type action of walking with poles radically reduces the stress to the shins, knees, hips and back. Nordic Walking is low impact and yet provides a highly effective workout - burning more calories and working more muscle groups than regular walking.Nordic Walking has been the fastest growing fitness activity in Europe for several years. Over seven million Europeans are walking with poles - in the city, in the country and up in the mountains. Walking with poles helps to burn more calories than regular walking, improves balance/stability, radically reduces the stress to the weight bearing joints and provides a workout for your upper body by engaging your arms and legs – a lot like cross country skiing.Nordic Walking’s winning combination of improved posture, a unique 4-Wheel-Drive type action and shock absorbing benefits are helping many individuals to walk comfortably again.

Nordic Walking Poles are helping individuals with balance issues, knee issues or new knees, hip issues or new hips, back issues (including those with rods in their back), weight issues, multiple sclerosis (MS), parkinson’s disease (PD), neuropathy, arthritis, bursitis, scoliosis, lumbar stenosis, fibromyalgia, post polio, osteoporosis, stroke recovery, cancer recovery and other limitations to walking. Nordic Walking poles are helping thousands of Americans get off the couch, successfully get outside, start walking safely and effectively launch much needed walking campaigns.Individuals that use canes and/or walkers often find that Nordic Walking Poles are much more comfortable and stable than their canes or walkers. Individuals that find pushing a shopping cart comfortable find that Nordic Walking poles provide even more support and much improved balance, stability and versatility. The feedback from amputees, individuals with head trauma and others with balance issues is consistent – the poles really do improve balance and stability.From a fitness standpoint, walking with the correct length poles and proper technique can burn up to 40% more calories than regular walking. Walking with Nordic Walking Poles can turbo charge any walking campaign.Real Nordic Walking Poles are equipped with comfortable fingerless glove type straps, durable metal tips (for use on trails, the beach, snow and ice) and special rubber tips/paws that are removable and designed for use on pavement and other hard surfaces. All poles from http://www.skiwalking.com/ and The American Nordic Walking System are also equipped with patented straps (patented by the Salomon Ski Company).Thanks to the efforts of Pete Edwards, SkiWalking.com and The American Nordic Walking System, individuals of All ages and All fitness levels, are safely unlocking the calorie burning and aerobic benefits of walking, hiking, trekking and running with poles. These durable one-piece poles prove to be safer, lighter and much more durable than cheap twist-locking adjustable length/telescoping/collapsible poles. Nordic Walking Poles from SkiWalking.com and The American Nordic Walking System also includes a free Nordic Walking DVD and there are a variety of exertion options to choose from regardless of age, balance and/or fitness level.

By Gerry J. Gilmore American Forces Press Service
Innovative therapies that have assisted previously comatose patients regain consciousness may be incorporated on a greater scale to treat troops diagnosed with traumatic brain injuries, a brain injury expert said Mar. 23.

Dr. Philip A. DeFina, chief executive and scientific officer at the not-for-profit International Brain Research Foundation Inc., in Edison, N.J., said that, over the past four years, electronic brain stimulation, oxygen-induction, drugs and other therapies were used to bring 43 people, including five injured soldiers, out of minimally-conscious or vegetative states. DeFina, an Army veteran, is also the chief consultant for the brain injury program at the Kessler Institute for Rehabilitation, a for-profit hospital in West Orange, N.J. He was one of several civilian and military guest speakers who attended March 23’s Reserve Officers Association-sponsored seminar in Washington, D.C., on mental health care. Brain injuries can occur because of blunt-force trauma to the head, explosions, and penetrative wounds, DeFina explained. Such injuries, he said, cause oxygen starvation in the brain, from which damage ensues. “There are a number of different types of (brain) injuries that we’ve been dealing with -- all of which have been responding to the protocols,” he said. “What we’re doing proactively, with our consortium of doctors and scientists,” he said, is “to electrically and chemically stimulate the brain.

” Other treatments employed, he said, include drugs and oxygen-inducing regimes, such as hyperbaric oxygen therapy, where the brain is inundated with oxygen. The goal, he said, is to balance the electrical and chemical activity in the brain. “Once we can stabilize electrical-chemical activity, we can optimize what the brain’s capability is at that point,” he said. Doctors can employ functional imagery techniques to examine the state of a person’s neural markers, which are the chemical and electrical patterns within the brain, he said. “We can then use that to guide us for treatment and to predict recovery,” he said. The prognosis for recovery for the five injured soldiers was “close to zero,” he said, before they underwent the treatments at the Kessler institute.

“The brain heals,” DeFina said, noting there are “different levels of improvement” among patients who’d formerly been minimally conscious and/or unresponsive. After treatment, some people “wake up and some people can communicate,” DeFina said. Other people, he said, may be able to perform simple tasks or return to work. “So, we have different levels of the ability to recover,” he said. And, applying such innovative therapies to patients with mild to moderate forms of traumatic brain injury, he said, produces “dramatic results.” Congress has set aside about $6.4 million in Fiscal Year 2009 appropriations funding, DeFina said, so that the foundation can conduct continued research and development of the new therapies in cooperation with military health care organizations. “We’re in the process of accessing those funds,” he said. The foundation has developed close relationships with several Defense Department healthcare components, DeFina said, including the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, headed by Army Brig. Gen. (Dr.) Loree K. Sutton. “Within the last year, we’ve had probably about 30 military doctors from the Army and Marines come visit Kessler to look at the program, including General Sutton,” DeFina said. “We’ve briefed them, we’ve given them formal presentations on all the science, and then showed them the patients that are there. “We’ve gotten a really good response from that,” he said. Many innovative therapies, DeFina said, have been used in a “stand-alone” manner to successfully treat patients with brain injuries. Yet, using those therapies in combination “is even more powerful,” he said.

By Judy Winter; 258 pages. Subtitle: Raising the Bar of Expectations




Winter combines her talents for journalism and parenting in a book that is part inspiration, part how-to, and wholly optimistic about your family's survival as you take on the challenge of raising a child with special needs. It's a particularly useful guide to those just starting out on the journey of dealing with special needs, and hearing from everybody that it's too hard and their life is over and their situation is tragic. Breakthrough Parenting offers a much-needed antidote to all that gloom and doom.


Pros
Takes an upbeat approach to the challenging task of special-needs parenting. Gives parents of children newly diagnosed a voice of experience to guide them, Full of specific tips for a variety of situations and relationships. Includes inspirational stories of individuals with disabilities succeeding. Offers listings of resources with every chapter

Cons
More useful to those just starting out than those who've been at it a while. May seem too upbeat if you're really struggling. Book was published in 2006, so some resources may not be up to date

Description
Part One: Welcome to Breakthrough Parenting for Children With Special Needs

Chapter 1: The Perfect-Baby Dream
Chapter 2: First You Cry
Chapter 3: No Labels, Yes Hope
Part Two: Guidelines for the Preschool Through College Years
Chapter 4: The Pre-K and Elementary Years
Chapter 5: Middle School, Junior High, and High School
Chapter 6: Advocating for Techniques and Programs That Work
Part Three: Focusing on the Family
Chapter 7: Embracing a New Definition of Family and Planning for the Future
Chapter 8: Preserving Your Marriage, Caring for Yourself, and Surviving the Death of a Child
Chapter 9: Meeting the Needs of Siblings
Part Four: Honoring Special Needs Excellence
Chapter 10: Honoring Special Needs Excellence
A Conversation With Timothy P. Shriver, Ph.D.
A Conversation With Dana Reeve

Guide Review - Book Review: Breakthrough Parenting for Children With Special Needs
Learning that a child has special needs can be traumatic for parents -- in no small part, because professionals tend to present it as the End of the World. They'd do a much better service by passing on this book, which acknowledges the grief that must be processed but also provides an action plan for getting on with your life and your child's.

Each section of the book starts off with a "Bill of Rights," including one for children and young adults; parents; siblings; and professionals. Among the rights Winter bestows on parents are the right to "Grieve the loss of a child with special needs" and "Ask tough questions, including Why? -- but also to "Celebrate your child's birth," "Move about freely in society with your child," and "Be proud of your child's accomplishments." Since our children are so often looked upon as nothing but tragic, I appreciated the balance.

Illustrating the points on hoping for the best for your child are stories of individuals with special needs and their families breaking expectations and living their lives. Also helpful are lists of resources at the end of each chapter that can send you off in pursuit of information for your particular situation.

If you've been a special-needs parent for a while and found your way to advocacy and empowerment and favorite resources of your own, the tips and pep talks here may be less useful than if you'd found them in the early days. Still, as your child grows and changes and moves on through school, there are always new suggestions that can help. And it may inspire you to think about how you can pass on your experience to parents starting out with trepidation, in a support group, a blog, or even a book of your own.

By Dr. Neetu Dhiman - Richmond Review

Chronic pain and inflammation are conditions that many suffer from and can trigger a host of imbalances in overall health if left untreated.

While I was in my fourth year of naturopathic medicine I came across a technique that I have used in my practice with quite promising results. The Bowen technique is based on the philosophy that we are all born with a certain blue-print of health and balance. With gentle non-invasive stimulation of neurovascular bundles, muscles and tendons, the body will be put in a resting state and innately know how to self heal and restore balance.

Tom Bowen, born in Australia, developed the manipulative therapy known as the Bowen technique. After serving in the Second World War, Bowen became interested in ways of alleviating human suffering. He noticed when he made certain moves on a body it had particular effects. He developed the technique without training in any health care field.
I was drawn to the Bowen technique due to the philosophy of “less is more.”

During a session, several moves are performed in a choreographed order with set breaks between moves. The patient is fully clothed and lying face down on a massage table. Treatments initially are once per seven days, with the treatments continuing to work during the week. The goal is the permanent reversal of pain, assuming re-injury has not occurred. If the pain has not started to shift at the end of five sessions, there is a re-evaluation to determine if Bowen is in fact the correct treatment for this condition or if there is in fact an underlying condition preventing healing from occurring.

Additional reasons for chronic pain aside from structural imbalance could include:
•Adrenal insufficiency: The hormone cortisol helps us respond to the demands on our body during times of prolonged stress or chronic pain. It is our body’s main anti-inflammatory hormone.

When cortisol levels drop after patients experience prolonged periods of elevated stress or pain, the body can respond with chronic pain and inflammation.

•Thyroid function: The thyroid gland produces hormones, which are responsible for our metabolism. Low thyroid function can be one of the main underlying causes of chronic pain, and possibly the reason repeated massages, adjustments, and Bowen treatments are required. In some instances, if the bodywork treatment you are currently undergoing is only providing relief with repeated sessions, adrenals and thyroid status may be worth investigating.

•Food sensitivities and toxic burden: Prolonged exposure to environmental toxins and heavy metals can result in chronic pain and inflammation, water retention and muscle rigidity. It is common that certain foods can trigger an inflammatory reaction in the body. I have found gluten to be one of the major disruptors of the central nervous system. When I am treating nervous system issues and nerve related pain, I always consider an underlying gluten sensitivity. Individualized detoxification protocols and food sensitivity testing may be essential to reverse the chronic pain and inflammation in certain individuals.

As in nature, every organism is self-regulating. There is always an underlying reason for the pain or inflammation. It is our body’s natural defense mechanisms, trying to immobilize the joint and protect the injured area. Often anti-inflammatories such as steroids or non-steroidal anti-inflammatories will mask this healing process and the “dis-ease” process will spread deeper in the body.

The Bowen technique is phenomenal for treatment of chronic pain from motor vehicle accidents. These have been my most successful cases. Chronic pain of sciatica, sports injuries, constipation, digestion, hernias, neck injuries, frozen shoulder, nerve pain, tendonitis, infertility, PMS, hormone imbalance, scoliosis pain, just to name a few.

The Bowen technique has amazed practitioners of all disciplines and can be an integral part of a successful treatment plan for healing chronic pain and inflammation. Although it is not a new technique it is still fairly unheard of in Canada. For more information see www.bowtech.com, and spread the word to family and friends across Canada.

Dr. Neetu Dhiman is a naturopathic physician and certified advanced Bowen therapist. drdhiman@yourbriohealth.com

Mar 9, 2009 by Alexandra Shimo
China is not normally considered a world leader in surgical advances, but according to a number of its doctors (and the Canadian patients they’ve treated), it has leapfrogged ahead in stem cell treatments. A growing number of people are travelling to China for a $30,000 experimental treatment: stem cell injections. Most, like New Brunswicker Jean Christophe Haas, 40, decide to go because they have a debilitating illness and there isn’t much that Western medicine can do for them.

Haas has Machado-Joseph disease (MJD), a terminal neuromuscular disease that affects the body in a similar way to Parkinson’s, paralyzing it gradually. Although he was diagnosed 20 years ago, it took some years for the symptoms to become noticeable. At first, only his sense of balance and his coordination were affected. Then his speech began to suffer and he started slurring his words. In 2004, he had to stop work as an army mechanic because his motor skills were no longer up to par and, in the past couple of years, he started seeing double. His family felt an overwhelming sense of panic, especially because Haas’s mother had the same disease, and his grandmother died of it. His desperation was compounded by the sense that Canadian doctors had given up on him completely; one told him there was nothing to do but to accept his fate of an early death, says his wife, Cherie Haas. “It’s awful for a young man with a family to go in and hear that. It’s heartbreaking.”


Ms. Haas searched the Web and found stories of other MJD patients who seemed to have been helped by stem cell therapy at various Chinese hospitals. Many of these good news stories are posted on personal blogs or on the websites of the clinics offering the treatments. There are thousands of these testimonials, suggesting that hundreds of people go every year, says Timothy Caulfield, Canada Research Chair in Health Law and Policy at the University of Alberta, who has published studies on this issue.

Advertising on the Internet, these Chinese medical centres promise to treat a surprisingly extensive range of diseases and conditions, including ALS, autism, brain injuries, cerebral palsy, epilepsy, multiple sclerosis, Parkinson’s, spinal muscular atrophy, septo-optic dysplasia (which can cause seeing difficulties, blindness and mental retardation), spinal cord injuries and stroke. Foreigners are a major source of funds for the clinics. Some doctors like Dr. Huang Hongyun, a neuroscientist at Beijing Xishan Hospital, have treated many patients from outside China, including some from Canada, and he has published a number of papers in Chinese medical journals tracking patients pre- and post-procedure. And yet some North American doctors are critical of how the data was compiled, and skeptical of the treatments on offer.

Once Jean Haas decided to go, he told his plans to Guy Rouleau, a neurologist at Centre Hospitalier de l’Université de Montréal, who said there were slight risks of complications, and that it would probably be a waste of money. But otherwise he didn’t try to dissuade him. Raising the money for the trip was easier than expected: much of the town of Oromocto, N.B., pitched in to raise the $30,000, with neighbours’ kids shovelling driveways to help out, and the military and community organizations hosting breakfasts and fundraisers. In April 2007, he and his wife travelled to Shenzhen, China, and stayed a little more than a month. During that time, Haas had six injections of stem cells into his spine, and an intense program of physiotherapy, exercise, massage and acupuncture. The results were immediate, he says—his balance improved just a few hours after the first procedure. Back in Canada, his neurologist confirmed that Haas had indeed gotten better: he had about 10 to 15 per cent more movement, according to Rouleau, who examined him before and after the trip. It’s difficult to speculate why this occurred, but Rouleau believes the intense physiotherapy was the primary cause.

When the couple returned from China, they wrote about their experience on the Web. Word got around, and soon hundreds of people were calling them, Cherie says. A couple whose husband had a similar neurodegenerative disease even drove from Quebec to see them, and the man subsequently decided to make the stem cell trip. Another couple flew in from Taber, Alta., and decided to go to China after seeing the home videos of Haas’s progress. Those gains were partly due to the attitude of Chinese doctors, Cherie believes. They would tell Haas to push himself to his limit and even try to “retrain his brain,” she explains. “We saw miracles while we were over there. We put the word out because I know this works.”

Even if patients experience gains, it’s important to determine whether they are from the treatment, the exercise program or a more positive frame of mind. Any advances could be merely the placebo effect, as people often feel better after being treated, even if the procedure hasn’t worked and the gains won’t last, explains John Steeves, a professor at the college for interdisciplinary studies at the University of British Columbia who specializes in spinal cord injuries. Finding out whether any treatment really works requires clinical trials, and although Dr. Huang has published the results of his trials in Chinese medical journals, this data does not conform to international standards of medical analysis. Indeed, Steeves believes Huang deliberately flouts these standards to help his bottom line. “Dr. Huang has no interest doing a valid clinical trial because if it doesn’t give him good results, his income would dry up immediately,” he says from his Vancouver office.

Patients, like Haas, who seem to have been helped by stem cell treatments, are often eager to share their stories. They may become advocates for the Chinese medical centres; Haas’s story is publicized on the website of the company that organized his medical tourism trip. By contrast, it’s more difficult to find people who haven’t gotten better, or are worse after spending $30,000 on an experimental procedure. This might be because they feel duped, or because the Chinese stem cell treatment emphasizes empowerment—a “you can do it attitude.” Those who can’t “do it,” who go through the rigorous training program and end up no better off, may feel unlucky, cheated, or they may take the lack of success personally and feel that they have somehow failed.

Missouri resident Jeff Carneal, 38, doesn’t feel like a failure, but having spent so much money, he is frustrated and disappointed. He lost the use of his legs when he fell off a stepladder while fixing his father’s barn. He has spent the past six years working with different doctors trying to learn to walk again, even flying to Quito, Ecuador, for an experimental operation (nerves were removed from his legs and grafted onto his spinal cord, which cost a lot, but didn’t really help). When a Maclean’s reporter first met Carneal at the Beijing Xishan Hospital after stem cell treatment, he was enthusiastic and believed the operation he’d had a couple of weeks earlier had alleviated some of the shearing leg pain he’d felt ever since his accident. But when contacted a few weeks after he returned to the United States, he was more downbeat, and said the operation hadn’t really made any difference.

Negative outcomes aren’t widely reported, but they are more common than the Chinese hospitals would have you think, says James Guest, a professor of neurological surgery at the University of Miami. He visited Huang in Beijing in the summer of 2004 to sample and test the fluid being injected into foreign patients. The results were inconclusive, he says. Following this, he went a step further, and examined spinal cord injury patients pre- and post-treatment in China. The results, published in 2006 in the journal Neurorehabilitation and Neural Repair, make clear the difference between what the doctors see and what patients want to believe. Of the seven, six thought they recovered some limb movement, although in most cases the physicians measured very little difference.

A few had concrete gains: a 19-year-old had chronic, burning back pain that eased enough for the patient to stop taking painkillers. Another patient had fewer muscle spasms after the procedure and could angle his left hand a little more, although he phoned Guest six months later to say the surgery had not made any permanent difference. On the downside, there were also post-treatment complications: a 22-year-old contracted meningitis, pneumonia and gastrointestinal bleeding, which were managed with heavy medications, and another had a fever and confusion along with a drug rash. Guest is critical of the Chinese stem cell treatments: he believes some doctors are “motivated by profits” and “they place patients at risk for therapies which have minimal effect.”

Eight months after travelling to China, Haas was struggling with the symptoms of Machado-Joseph disease. He was having problems walking and was falling again. The family still had some money left over from their fundraisers, so they decided to make another trip to China, and took out a small loan. In March 2008, he and his wife went to China, this time to Qingdao in eastern China—the first hospital wouldn’t accept them since it was now prioritizing Chinese nationals over foreigners, explains Cherie. After four weeks of treatment, Haas had more energy and there were slight improvements in his balance and speech, he says. However, the gains lasted all of two months and today he’s just as bad as before the first trip. Nevertheless, despite the costs, and the dubious rates of success, the family would like to return again if they could afford it. “I would go tomorrow if we could,” Cherie says. “It gave people hope.”

12 Feb 2009

Researchers from Northwestern University's Feinberg School of Medicine appear to have reversed the neurological dysfunction of early-stage multiple sclerosis patients by transplanting their own immune stem cells into their bodies and thereby "resetting" their immune systems.



"This is the first time we have turned the tide on this disease," said principal investigator Richard Burt, MD, chief of immunotherapy for autoimmune diseases at the Feinberg School. The clinical trial was performed at Northwestern Memorial Hospital where Burt holds the same title.

The patients in the small phase I/II trial continued to improve for up to 24 months after the stem cell transplant and then stabilised. They experienced improvements in areas in which they had been affected by multiple sclerosis including walking, ataxia, limb strength, vision and incontinence. The study will be published in the March issue of the Lancet Neurology.

Multiple sclerosis (MS) is an autoimmune disease in which the immune system attacks the central nervous system. In its early stages, the disease is characterised by intermittent neurological symptoms, called relapsing-remitting MS. During this time, the person will either fully or partially recover from the symptoms experienced during the attacks. Common symptoms are visual problems, fatigue, sensory changes, weakness or paralysis of limbs, tremors, lack of coordination, poor balance, bladder or bowel changes and psychological changes.

Within 10 to 15 years after onset of the disease, most patients with this relapsing-remitting MS progress to a later stage called secondary progressive multiple sclerosis. In this stage, they experience a steady worsening of irreversible neurological damage.

The 21 patients in the trial, ages 20 to 53, had relapsing-remitting multiple sclerosis that had not responded to at least six months of treatment with interferon beta. The patients had had MS for an average of five years. After an average follow-up of three years after transplantation, 17 patients (81 percent) improved by at least one point on a disability scale. The disease also stabilized in all patients.

In the procedure, Burt and colleagues treated patients with chemotherapy to destroy their immune system. They then injected the patients with their own immune stem cells, obtained from the patients' blood before the chemotherapy, to create a new immune system. The procedure is called autologous non-myeloablative haematopoietic stem-cell transplantion.

"We focus on destroying only the immune component of the bone marrow and then regenerate the immune component, which makes the procedure much safer and less toxic than traditional chemotherapy for cancer," Burt said. After the transplantation, the patient's new lymphocytes or immune cells are self-tolerant and do not attack the immune system.

"In MS the immune system is attacking your brain," Burt said. "After the procedure, it doesn't do that anymore."

In previous studies, Burt had transplanted immune stem cells into late-stage MS patients.

"It didn't help in the late stages, but when we treat them in the early stage, they get better and continue to get better," he said.

"What we did is promising and exciting, but we need to prove it in a randomised trial," Burt noted. He has launched a randomised national trial.

(Source: Northwestern University : Burt R. Stem cell therapy for patients with multiple sclerosis failing interferon A randomised study. Lancet Neurology. : February 2009)

By GREGG L. PARKER
For the Madison Spirit writeone35758@yahoo.com
Business focuses on pediatrics as well as programs for adults

Eagle Rehab Physical Therapy and Wellness not only helps adults return to a normal lifestyle but reaches children in a way they enjoy: therapeutic play.

Scott and Stephanie Pruitt are registered physical therapists. Scott works with adult patients. Stephanie is responsible for pediatric therapy and is chief financial officer. "It's really two separate parts of one clinic," she said.

The clinic covers 6,000 square feet. One-third of the clinic is dedicated to pediatrics and includes a pediatric gym, baby room and handwriting room, she said. "We utilize a long, wide hallway for riding bikes, running, scooter boards and other fun therapeutic activities that require lots of space."

The therapeutic equipment includes bikes, tricycles, a trapeze bar, ladder, balance beam and manipulative toys to engage children during treatment.

Children's therapy relies on a child's main interest: playing. In therapeutic play, Stephanie Pruitt may have children walk up steps, slide on their stomach and wheelbarrow-walk to repeat the exercise. On a swing set with platform, sling and tire swings, "children can fly like a bird by laying on their stomach. One favorite is bumper balls, using big physioballs to gently bump to work on dynamic balance, eye-hand coordination and deep pressure."

Eagle Rehab is fully equipped to do casting for orthotics, often required for children's treatment. "We're trained to fit and monitor orthotic use," she said.

The clinic tries to know the most current medical techniques in order to offer its patients the best treatment, Pruitt said. "Children with cerebral palsy show excellent progress with the postural restoration program. These exercises and techniques have prevented one patient from having hip surgery," she said.

Eagle Rehab treats children with torticollis or head tilted to one side, plagiocephaly or skull flattening, spina bifida, developmental delay, fine motor delay and orthopedic injuries.

"Sensory integration is a hot topic in therapy. Children with sensory processing disorders make up the bulk of my caseload," she said.

In addition to pediatric physical therapy, the clinic offers a wellness program, massage therapy and orthopedic and sports physical therapy for adults.

Eagle Rehab sees patients by physician referral, an Alabama requirement. Parents choose a child's individual therapist.

The clinic has eight employees: three therapists, two assistants, one massage therapist, one marketing representative and one office manager.

The Pruitts graduated from the University of South Alabama College of Allied Health Professions with degrees in physical therapy in 1998. They have three sons: 8, 6 and 4 years old. Stephanie said her sons are "my biggest source of education with my pediatric career."

Hours are from 7 a.m. to 6 p.m. on Monday through Friday. Pediatric patient appointments are Monday, Wednesday and Friday from 9:15 a.m. to 3 p.m. and Tuesday from 1 to 5 p.m. Call for other appointment times.

Eagle Rehab is located in the Madison Professional Centre, 44 Hughes Road, Suite 1050. For more information, call 325-5400, send a fax to 325-5469, send e-mail to eaglepeds@knology.net or visit www.eaglerehabpt.com.d

Sitting in the quiet solitude of my own four walls, my mind and thoughts will gently carry me back to very clear images of my past. These vivid memories are a touch tone towards greater understanding and healing of past experiences that I have had. In a blink of an eye, it doesn’t seem real all the time that has gone by since my father’s passing and my grandmother and Uncle’s physical deterioration with Parkinson’s disease.

These three important people in my immediate circle, where products of another era. It was difficult for them to express how they felt and what they desired. But, they were all souses of life giving lessons to me whether I agreed with them or not. They were an instrument towards my understanding the generations of dysfunction and lack of hands on affection in my family, and the wisdom of a young child who saw beyond the whelm, and wanted to move beyond, and towards the light of a better way of living, interacting with others, and being harmonic within the world around me.

All of these people were viewing someone very close to them, dealing with a disability, in a time that was thought to make a normal life impossible. I was from the very beginning, determined to live as though I didn’t have the limitations of my body, or, the “crippling attitudes” of the larger society to deal with. It would never have seemed possible for me to go out into this world and thrive with the attitudes and beliefs I was brought up with. Because, most of my family; especially my mother, was caught up in the daily business of dealing with a disable child and everything that came along with it. While my father came from even an earlier generation than my mother, and he had lost his mother, and was raised by a grandmother, so his focus was on earning a living. That left little time for anything else.

I had to figure out a lot for myself because my father passed away when I was only fourteen. This was just one experience in a period of several years that I lost loved ones. This forced me to be very self reliant, confident, and interdependent. So, it was all put upon my mother to raise my older sister and myself. Although, my dear Mama Katie didn’t quite know how much I could handle, or, how to totally express herself to me or say what was on her mind; she truly understood that I needed a lot more to become the person I was meant to be.

It is hard to remember what a radical idea this was in a time of separation for our community very similar to the segregated south. My mother had to remember the balance I needed, so that I could thrive, grow and develop my inner and outer self. My mother needed to understand two great truths. First, that there needed to be time to relax, regroup, and rest. And secondly, this was even harder, I knew there were thing I needed to accomplish which she wanted to protect me from.

The first time my mother ever had the courage, the strength, and the ability to acknowledge her own error in thinking there were limits to what I could do, was the day I earned my college degree. Who would have thought, that a dysfunction so deeply rooted, could have melted 35 years of pain, hurt, and lose. I was able to use my own positivity to help heal my own wounds, as well as try to restore the physical strength of loved ones in agony. It takes a really strong person to not fall into the trap of isolation and self pity.

All of us reading this magazine had channeled this kind of strength and will power to lead a life and beyond that which experts tried to limit us too. I never fully recognized my inner strengths. But each and every hurdle, blockade and barrier I came across, which called me to full attention, I knew I had to face. I knew I had to deal with it, and I knew I could not run. I had to take the bull by its horn, and all that came with it.

I also knew that I could neither avoid, or refrain, nor deny. My strengths came out of experiences that I just mentioned. This would help me to help others when they needed me the most. When my uncle struggled with Parkinson’s, I was able to give him my positive ways of thinking to deal with his disease and the pain it inflected upon him for well over 10 years. Throughout my life, achievements have come out of my own struggle and the inner resources I have used to maintain a strong mind, body and spirit.

Written by Rene Millman

If you thought that computer games were bad for children and turning us into a nation of couch potatoes then think again. The Wii Fit has helped one girl to walk again after years of paralysis.

Nicole Cahill, 10, of Enniscorthy in Wexford, Ireland managed to walk again after for years in a wheelchair.

She received treatment in a New York hospital, attending therapy courses for six days a week.

While she had conventional treatments, such as hydrotherapy, it was the Wii Fit that the girl took a shine to and which helped her back on her feet again.

"The Wii Fit has really helped. It's great because there are so many balancing and stretching exercises on it," Nocole's mum, Mairead told the Irish Herald. "I also do yoga with her at home, and she does exercises on a ball. The Wii has taken an awful lot of pressure off her as well."

The balance board has been helping the girl strengthen her legs and regain her balance. Nicole had spent six month at a New York rehabilitation centre after a virus she contracted left her in a wheelchair at the age of six.

Wii rehab improves balance and mobility for stroke patients at Trafford General Hospital in the UK. A Stroke patient held a fundraiser to raise enough money for a Wii, Wii games and a plasma TV. Fund raising is a great way to obtain the latest technology with minimal cost to your company or organisation! What could you do?

Fun and games, the key to rehabilitation
Thursday 18th December 2008

STROKE patients at Trafford General Hospital are enjoying rehabilitation - in the form of video games - to help their co-ordination, balance and physical mobility, thanks to fundraising by a former patient and his friends at Urmston Men’s Club.

Jim Cork, 69, from Urmston, used to be the compere at Urmston Men’s Club and was treated at Trafford General when he had a stroke in August 2007.

He wanted to help other patients on the stroke unit, so organised a fundraising evening last summer at Urmston Men’s Club.

The evening raised more than £1,400, enabling the purchase of a Nintendo Wii console and plasma screen for Trafford General’s stroke unit.

Wii is a computer games system that detects players’ movements and translates them into the action on screen.

Players can engage in virtual rounds of golf, bowling competitions and even boxing matches by using the Wii remote control to hit the ball, bowl or throw a punch.

It means stroke patients at Trafford General will be able to use Wii to aid their recovery in a fun way by having bowling or golf competitions with each other.

The Wii system will mainly be used during recreation time and will be in addition to the usual therapies provided to stroke patients.

The games can be played from either a standing or a sitting position, making them suited to patients of different ability levels.

Jim said: “The unit has given me a lot of help so I wanted to say thanks. I hope that patients on the unit enjoy using the Wii and that it helps them in their recovery.”

Stroke unit physiotherapist, Sjoerd Jorritsma, said: “We would like to thank Jim and his friends at Urmston Men’s Club for this fantastic donation, which will help patients recovering from stroke. As well as being fun, there is some anecdotal evidence that Wii has therapeutic benefits by encouraging people who have experienced stroke to be active and practise their eye-hand coordination, balance and concentration.

“These are all skills that can be affected by stroke but rehabilitation can help people improve and make as good a recovery as possible. Our patients will now be able to use Wii as an additional part of that rehabilitation.”

Urmston Men’s Club president, Peter Radley, said: “Urmston Men’s Club is proud of its efforts in supporting local charities, and particularly Trafford General Hospital, and we will continue with our support. We wish the stroke unit continuing success with its efforts for local people. Due to Jim’s high profile on our committee, it was fitting to offer our support on this particular occasion.”

-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

MANSFIELD -- He's 67 and recovering from a stroke, but Joe Lakes bowls, boxes and plays golf.


Since the Nintendo Wii was introduced into the occupational therapy program at MedCentral/ Mansfield Hospital, manager Trey Counts said patients have benefited in a variety of ways while enjoying familiar sports all year long.

"The Wii is being used more and more in the rehab setting," Counts said. "We have a lot of patients who have a history of playing sports and being active, so it's nice to be able to offer this to them," Nintendo says on its Website.

The Wii is an interactive videogame system.

"A distinguishing feature of the console is its wireless controller, the Wii Remote, which can be used as a handheld pointing device and detect movement in three dimensions."

Medical News Today reported Wii is being used for rehabilitation in hospitals around the country.

"You have to do the majority of the movements involved in the real-life activity," Counts said. "There are buttons involved, so it's not exactly the same as in real life, but it can become very engaging."

The occupational therapy department, which treats those with head injuries, multiple sclerosis, Parkinson's, amputations, etc., currently offers 10 different games. Counts said they plan to offer the Wii Fit as soon as one becomes available for purchase.

"Everyone seems to be sold out of them," he said. "These games help the patients work on endurance, balance and range of motion. Some games involved cognitive skills, like sequencing, memory and keeping score."

Lakes said he had a stoke on Nov. 1, which impaired the left side of his body.

"I'm just starting to get feeling back in there, but I had to learn how to balance myself all over again," the Mansfield man said. "The Wii has been great for that. I've tried the bowling and the boxing. With bowling, if you lunge forward too much that can throw off your balance."

Lakes said using the Wii was not difficult.

"Plus, it adds a little bit of fun," he said.

Counts said he believes those as young as 3 and as old as 90 would easily be able to pick up the skills.

"We use these in the rehab stage and have gotten a lot of positive feedback," he said. "We can choose the games based on their goals, but also to get them back into their old habits. If they like to play golf, we can have them play the Wii golf game to get some of those skills back. It's fun, and they don't even realize they're working on balance and endurance. I mean they'll really get fatigued playing some of these."

Occupational therapist Charles Prinz said the Wii doesn't take away from other activities.

"This is just an addition here," he said. "It just makes things a little easier on us. A bowling simulation makes it easier because in the gym, we'd have to have one of our staff members there to set back up the pins and retrieve the ball. Now this frees up someone to do something else."

Prinz added the Wii is not forced on anyone.

"If someone doesn't like sports, then we wouldn't offer this to them," he said. "They'll spend anywhere from 15 minutes to an hour on here. Everyone really seems to enjoy it."

Strokes are both common and preventable: 80 percent of strokes are preventable. Recognizing the symptoms and acting fast to get medical attention can help save lives and limit ensuing disabilities a stroke victim may suffer.

In medical jargon, a stroke is a cerebrovascular accident (CVA) and it occurs when a blood vessel in the brain suddenly becomes blocked or bursts. When this happens, blood fails to flow to that area in the brain, cutting off oxygen and nutrients to the brain cells there.

With no blood supply, the brain cells and nerves will die and the capacities that area of the brain controls will be lost, temporarily or permanently. When strokes are severe the sufferer can become paralyzed, unable to speak, or even go into a coma, depending on where the stroke occurs and how much of the brain is damaged.

Strokes can strike anyone at anytime, regardless of sex or age. Typically, stroke symptoms start suddenly, within seconds to minutes, and in most cases do not progress further. On average, two million brain cells die every minute following a typical stroke, which increases the chance of permanent damage, disability or death.

Stroke is the leading cause of disability among adults in the world today and one of the leading causes of death after cancer and heart disease. Disability affects 75 percent of stroke survivors, which can hamper their ability to work.

"The effects of stroke often place a significant burden of care on the patient's family because the stroke survivor often needs assistance in everyday activities we take for granted -- walking, eating, going to the toilet, talking," said Dr. Keith Goh, consultant neurosurgeon at International Neuro Associates, part of Novena Medical Centre and East Shore Hospital in Singapore.

"In addition to physical disabilities, 30 to 50 percent of stroke survivors suffer post-stroke depression -- they may be irritable and withdrawn, have trouble sleeping, and their self-esteem may suffer. In some cases, depression can reduce motivation and worsen patient's condition," he said.

With the effects of stroke being so often drastic, it's good news that they can be prevented. Three vital facts about stroke can help those at risk prevent them from occurring. First, what are the risk factors? Second, what tests can be done to assess an individual's risk? Third, what can be done to prevent a stroke?

Risk factors


Stroke occurs more often in people who fit the following categories. Strokes are more frequent in men than women, more frequent in the over-50 set. Habits and lifestyle choices mark other higher risk groups, including people who are overweight; have high blood pressure or diabetes; smoke tobacco, drink alcohol, and are under stress; do not exercise; and eat a diet high in salt and fat. Anyone with a history of heart disease in themselves or their families has a higher risk of stroke as well.

Signs, symptoms and medical tests


If you have one or some of the following signs or symptoms, even for a short time, you may have experienced a stroke. These include: sudden loss of vision; weakness in the face, an arm or a leg; difficulty talking or understanding speech; or severe headaches, dizziness or loss of balance. Your doctor may advise testing such as computerized tomography (CT) or magnetic resonance imaging (MRI) which provide images of the brain so she or he can look for signs of a stroke. Often the doctor will also ask for an angiogram, to study the blood vessels, or a perfusion scan to assess the pattern of blood flow. Several blood tests are commonly ordered to assess the overall risk of stroke.

F.A.S.T is a simple test for detecting stroke symptoms early. This will allow for immediate and appropriate medical care, which can help prevent death from strokes, and reduce the severity of disability after one occurs.


F = FACE


Ask the person to smile. Does one side of the face droop?


A = ARM


Ask the person to raise both arms. Does one arm drift downward?


S = SPEECH


Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?


T = TIME


If a person has trouble with any of these simple commands, emergency services should be called immediately.


Stroke prevention


If you have any risk factors described above, your doctor will advise you on how to reduce the likelihood of a stroke. Regular medical check-ups to monitor and treat high blood pressure, diabetes mellitus, high cholesterol and heart disease; leading a healthy lifestyle, regular exercises, stress reduction and not smoking will help to prevent an onset of stroke.

"Sometimes medication will need to be given, such as anti-platelet drugs or anti-coagulant drugs, to prevent blockage of a blood vessel. And if there are blood vessel abnormalities, which may lead to bleeding in the brain, then surgery may be needed," said Dr. Charles Siow, a consultant neurologist, also on staff at International Neuro Associates.

Everyone has some stroke risk. While some factors are beyond your control, regular check-ups and early detection can help reduce the likelihood and reduce the severity of any stroke you do experience. The Neurosurgery and Neurology Specialists of International Neuro Associates provides a stroke risk assessment consultancy service, where a panel of blood and radiology tests are performed to assess a patient's risk of stroke. Costing S$1,500 (US$1,015), the stroke risk screening package includes; MRI and MRA scans; blood tests (FBC, renal panel, HBA1C, lipid panel, CRP, PT/PTT); ECG; clinical assessment and consultation with a neurologist or neurosurgeon.

The parents of Cassie Merrill first noticed something was wrong with their daughter at a young age.

Whereas most children begin sitting up on their own about 6 months and will learn to pull themselves up and walk by their first birthday, Cassie continued to crawl like a wounded soldier, dragging her legs behind.

“She was doing the army crawl,” her father, Dave Merrill, recalled recently from his daughter’s hospital room. “It was almost as if she didn’t realize she had anything from the hips down.”

When his daughter did begin walking, her ever-tight calf muscles forced Cassie to walk on her toes, throwing off her balance and posture. Before her second birthday, she was able to move about slowly with the aid of a tiny walker and, with some difficulty, finally took her first independent steps at the age of three.

Diagnosed with spastic diplegic cerebral palsy, Cassie, now 7, eventually grew strong enough to walk alone with the help of braces, physical therapy and periodic Botox injections to ease her rigid muscles.

But a surgery now offered in central Illinois is providing some welcomed treatment for Cassie and other young patients living with the ailment.
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Dorsal rhizotomy

In late October, Cassie was one of the first to undergo a dorsal rhizotomy at the Children’s Hospital of Illinois at OSF Saint Francis Medical Center.

The operation, of which only a handful have been done in Peoria, involves selectively cutting some nerve fibers running through the spinal cord to reduce spasticity — the increased tension that tightens and shortens muscles. By turning certain nerves permanently “off,” the operation relieves tension in the legs and improves a patient’s ability to walk.

“In a child with spasticity, some of those nerves are hyperactive,” said Dr. Julian Lin, a pediatric neurosurgeon at the Illinois Neurological Institute at St. Francis. “This operation removes some of that.”

What is it?

Cerebral palsy is a lifelong neurological disorder caused by abnormalities during the brain’s development either in utero or within a year or two after birth. The disorder, of which there are several different forms, often causes stiff, spastic muscles in the legs and sometimes the arms and ultimately affects the body’s ability to move, balance and maintain posture and muscle control.

During the procedure, physicians sort through the nerve rootlets and stimulate each one electrically. By examining the response from muscles in the legs, doctor can identify which of the rootlets cause serious spasticity. Those rootlets are then cut, lessening the messages sent from the nerves to the muscles and reducing the tension.

Conventional treatment for cerebral palsy usually includes a mix of physical therapy and drugs to reduce tremors and spasticity and to help relieve muscle pain, Lin said. But those remedies could only go so far and rarely treat the underlying cause of the disorder.

Lin said the hours-long operation is fairly invasive and involves a painful recovery. Most candidates for the surgery will undergo a four to six week hospital stay afterwards, followed by months of physical therapy.

The results, however, are promising. A study published this month in the journal BMC Pediatrics examined the dorsal rhizotomies of 35 children five years later and found not only was muscle tone immediately reduced after the operation but it remained so throughout the years.

A few weeks after her surgery, Cassie’s parents already saw a difference in how their daughter positioned and moved her legs but noted, because nerves were severed, that she would have to retrain her muscles.

“Now her muscles have to relearn. Her whole body has to relearn proper gait and strength,” said Cassie’s mother, Pam Merrill. “To someone else who looks at her, they say that she can’t walk. Not yet, but she is going to have a lot better chance at walking upright and more securely now.”

The surgery has been offered for years in big cities throughout the Midwest, including St. Louis and Minneapolis. St. Francis now offers it to patients, a welcomed benefit for the Merrills, who live in Hudson in McLean County.

“I think how much better it is that she is right here, 50 minutes away,” said her mother. “For the family and child support, you can’t beat it by having it close to home.”

Despite curved spine, Bryn Mawr student is a budding ballerina
By Jazzmen Tynes

At 13, Isabel Montague has played nearly every character in "The Nutcracker."

This year, she's the star in the Baltimore Ballet Company production Dec. 13-14 at Goucher College's Kraushaar Auditorium.

The Bryn Mawr School eighth-grader "is a very dedicated student here and she's worked incredibly hard," said Cem Catbas, half of the husband-and-wife team that runs the company, where Isabel studies.

While dedication is a given for any serious dancer, Isabel's work ethic has been severely tested.

At age 10, she was diagnosed with scoliosis, a medical condition in which the spine curves from side to side.

Determined not to let that derail her dreams of being a professional dancer and one day owning her own dance studio, "I worked harder to overcome the challenge," she said.

"My spine is curved in two different directions, so I have to sleep in a back brace every night," she said. "It's harder for me to balance when I'm wearing my pointe shoes, so it makes me work harder constantly.

"When the doctors told me, I thought, 'OK, I have it. It's just another thing for me to work on and overcome,' she continued. "I was determined not to let it affect my dancing. If you don't have that kind of determination, not just in dance, but at home, in school and in life, it's almost impossible to achieve your goals."

After a full school day, Isabel, of Sparks in Baltimore County, practices for about three hours a night, eight hours on weekends.

Despite the rigorous practice, she said, the hard work is worth a sore back and toes and late nights spent finishing her homework assignments before heading off to bed.

"You have to make sacrifices," she said. "I've performed in this play for so many years, it's an annual tradition for me.

"It's always been a part of my life and I can't imagine a year without it."

In the past nine years, Isabel has played numerous characters in Baltimore Ballet productions of "The Nutcracker," including an angel, a mouse, a gingerbread man and a doll.

"It was almost natural for her to play Clara next," Catbas said. "She's played so many parts already and she was our Clara understudy last year.

"It was almost expected that she'd get the part this year."

The performances sell out every year, but the thought of a packed house doesn't frighten Isabel.

"I've been at the studio so many times and I've seen all the dances performed before, so I have an idea of what it's supposed to be like," she said. "I'm a little nervous about doing some of the lifts, but overall I'm mostly excited."

Catbas said he's watched Isabel grow as a dancer in her years with the Baltimore Ballet.

"Recently, she's been helping teach the younger children," Catbas said. "She shows incredible control and talent working with the young dancers. I was impressed with her maturity and how well she handles them."

For 'Nutcracker' ticket information, call 410-337-6333.

For 30 minutes every Thursday afternoon, the music room is quiet except for the tickling of small fingers on the keyboard and the occasional giggle.

It doesn’t matter that cerebral palsy has compromised Madelynn Legge’s motor coordination. For those moments, the 5-year-old from Scituate sits on the piano bench or nods her head to the rhythmic tunes of the ivory keys. Horn, slide whistle and kazoo, she gets moving.

Eve Montague has taught Madelynn since she was 2 to use music as a way to improve coordination, gait and balance.

For the past four years, certified music therapist Montague has been using song and sound to open the world to disabled individuals at the Duxbury campus of the South Shore Conservatory.

Montague, 48, of Pembroke, uses music to create an environment where her students can explore their own world with freedom and safety.

“Music has been a pathway for those with communication barriers to find their voice and express their needs and wants,'' Montague said.

Madelynn can’t talk and finds it hard to produce enough sound to laugh, says her mother, Melanie Legge.

“Most people take laughing for granted,'' Legge said. “For our daughter, laughing occurs when her father does a running cannon ball into the swimming pool for the sheer delight of hearing Madelynn laugh.

“Eve has this same effect on Madelynn.''

That effect was evident from the start when Legge saw her daughter stand on her own for the first time, mesmerized by Montague and her music, almost forgetting about her lack of balance.

Patient and energetic, Montague pours her heart and soul into the 30-minute session, Legge says.

Rhonda Carson says her son Billy, 26, born with Down syndrome, didn’t play the piano before he began working with Montague.

Carson says Montague has Billy pick out a few songs on the keys and he sings now with more rhythm.

“When Billy sings with Eve, you can hear them all the way down the hall,'' Rhonda chuckles. “She brings out the music in him.''

Before coming to the conservatory, Montague spent 12 years as coordinator of the creative arts department at the Massachusetts Hospital School in Canton, a nonprofit servicing children with neuromuscular, progressive diseases.

It was there she developed a performing arts program and a music therapy internship program.

Montague says, “I was excited by the idea that the power of music could transcend learning challenges and help individuals lead as independent lives as possible.''

Montague said music helps people relax and reduce pain and anxiety. It also guides them to work within structure and demands. Montague tailors her teachings to suit each student’s needs.

Madelynn, who could not speak or walk, has developed into a steady walker who can even run.

“Music has helped organize her motor patterns,'' Montague says.

And the joy is not all Madelynn’s.

“I have the opportunity to witness the power of music as it opens new learning channels for those who struggle with more traditional forms of learning,'' Montague said.

“Seeing growth as an individual becomes more confident, empowered and independent in their life-long learning – and knowing I may have opened some doors for them – is truly powerful.''

For patients on Unit 58 at the Foothills Medical Centre, rehab can be fun and games.

The unit, home of the centre's Tertiary Neuro Rehab Program, utilizes a Nintendo Wii video game system as part of its rehabilitation efforts for patients with brain and spinal cord injuries, those who have suffered strokes and others with different neurological diagnoses.

Andy Ganden, a recreational therapist on the unit, says the Wii is just one of many tools used for rehab but adds it's a valuable one.


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Font:****"There's therapeutic value to it," Ganden says of the innovative gaming system that responds to body movement, as opposed to other gaming systems that use a standard controller.

"We use it to reintroduce patients to previously-learned skills. It can help with eye-hand co-ordination, memory and retention. Plus, it has a nice competitive flavour to it but that's not the focus," adds Ganden.

Patients can play virtually any sport from tennis to bowling to boxing, as well as more rehab-focused games that sharpen cognitive skills, according to Kim Francis, a recreational therapist and clinical leader on the unit.

"A lot of patients are in wheelchairs and many have limited use of their hands and arms," she says.

"They can't play traditional video games because of the fine motor skills and dexterity needed," she says, twiddling her thumbs mimicking playing a conventional video game.

"We can adapt the Wii to meet different needs."

Take Jack Veldhuyzen, for instance. He was an avid golfer before he came to Unit 58 with Guillain-Barre syndrome, a serious disorder that occurs when the body's immune system mistakenly attacks part of the nervous system. It leads to nerve inflammation that causes muscle weakness, which continues to get worse.

The syndrome forced Veldhuyzen off the golf course but he was able to play many rounds of Wii golf with Ganden during his rehabilitation.

"It helped with balance, motor skills and with confidence," says Veldhuyzen, who recently played his first 12 holes of real golf since being released from the hospital.

"It lets you get back into doing things. It just helps prepare you to get back into normal life again," said Veldhuyzen.

That's what Francis and Ganden hoped would happen.

"It gives our patients a little bit of confidence in terms of if they golfed before, they can do a bit of golfing here, although it's a different kind of golf," Francis said.

"It's a game situation where they can have a positive experience without really putting themselves on a golf course where they might fail."

Francis says the mental boost that the gaming system provides is as important as the physical benefits. At a basic level, the video game gives patients an enjoyable thing to do during their lengthy hospital stay.

"The tertiary patients are here for a long time," says Francis. "It's not just a six-day stay. Institutionalization does happen. With stuff like the Wii, we can help temper it a little."

"As well," adds Ganden, "we can play games where we have teams and the patients learn how to work together and build social skills. It's like a virtual experience. It's good preparation for the real deal."

As valuable as the Wii has been for the patients, Francis says it's also been a positive experience for the Unit 58 staff.

"From a team-building perspective, it's been great," she says.

"We'll come in here during our lunch and compete against each other. We just have fun and we laugh. It's a byproduct I never would have thought of."

Chris Simnett works for the Calgary Health Region

While gamers spend countless hours in front of television screens and battle thumb fatigue on a daily basis, they may meet their match if they do battle with some local therapy patients.

The Thibodaux Regional Medical Center’s Outpatient Rehabilitation program has found a new, fun way to carry out its mission and in the strangest of ways … video games.

The program is one of a kind in the bayou region, using the Nintendo Wii gaming system to aid in outpatient physical rehabilitation.

“We’ve used the Nintendo Wii for the last five months with appropriate patients in our clinic,” said Jason Ledet, program director of both in- and outpatient programs for Thibodaux Regional Medical Center.

He said appropriate patients fall under several categories including patients with balance issues, strokes and brain injuries.

“The patient has to be capable of some physical activity before being allowed the use of the treatment,” Ledet said.

Rehab officials say they have received positive feedback from the gaming system’s use.

“Most of our patients really enjoy it; the kids love it,” physical therapist Jennifer Matherne said. “Some of our older patients enjoy it too; those with head injuries or strokes – it’s a challenge for them but it also let’s them play a little and help them to remember they can still have fun.”

Ledet said the particular game used is dependent upon the patient and their needs.

“We’ve used tennis, golf, bowling and especially the Wii fitness game which we use to improve balance and weight shifts,” he said.

The use of the system has been a motivating factor in the clinic and all of the games used are designed to help the patients with visual goals.

“It also challenges our patients on a competitive basis; we have patients that love to compete against each other,” Ledet said.

He said he recalls walking into a therapy session and witnessing a contest between a young and much-older patient.

“It was great to see the generation gap bridged and to see two completely different age groups combining, connecting and working together towards the same goals,” Ledet said. “You do see that very often in this line of work.”

While the Nintendo Wii has only been on the market for a few years, medical experts have been unable to conduct long-term studies on the effectiveness of the system, but local therapists say they can see the benefit of the unorthodox training.

“I believe it does work, in conjunction of course with other, more traditional therapeutic techniques,” Matherne said. The gaming treatment works especially well for “neurological patients who have trouble with balance, basic coordination, hand-eye coordination, lower extremity coordination and endurance. We also use the games to assess the patient’s ability to follow a task from start to finish.”

She said the new system allows for a self-motivating rehab session.

“Patients have to stand for an entire game of bowling, but the fact that there is some fun involved helps motivate the patient to follow through,” Matherne said. “We always try to make therapy sessions fun and challenging. The use of the Wii has made this easier for us because it really helps when the patient is looking forward to their session.”

Thibodaux Regional Medical Center isn’t the only facility that has welcomed the use of the trend-setting technology.

The Terrebonne Parish Library System offers exercise sessions twice a month for senior citizens using the Nintendo Wii. Classes are scheduled for 2 to 3:30 p.m. the second Monday in the large meeting room of the Terrebonne Parish Main Library, 151 Library Drive, Houma.

“It’s a chance for senior citizens to meet new people, socialize and have a good time while they exercise,” said Sarah Stewart, circulation clerk and Nintendo Wii presenter. “We also have a golf program if we have any retired golfers out there who would like to set up a session with the library.”

Karen Brunet from the East Houma Branch library said the gaming system can be requested for any Terrebonne Parish Branch library if enough interest is expressed in such a program.

“It’s a new element in the therapeutic world, and we will continue to use it as long as we have patients that are appropriate for its use,” Ledet said. “Our mission is to improve quality of life and maximize a person’s ability to perform daily tasks. We assist patients in developing new skills, relearning lost skills and making adjustments in their everyday lives.”

For information on Thibodaux Regional’s Rehabilitation Services/Programs, call 493-4435 or 493-4782 or visit www.thibodaux.com/rehabilitation.html. A physician’s prescription is needed for outpatient services.

For information on the senior-citizen exercise program at the Terrebonne Parish Main Library, call 876-5861. Registration is not required and the program is free and open to the public.

Exercise the Wii way

Senior citizens’ therapy utilizes game system

Willietta Jackson, right, an occupational therapist assistant, helps Golden Living Center resident Claudia Demarnville use the Wii controller during a game of bowling.

Many years ago it was bowling alleys, heavy balls, and goofy shoes. These days, all she needs is a small controller, her Nintendo game system and a television.

“I always liked bowling,” said the rehabilitation patient at the Golden Living Center in Edwardsville about the Nintendo Wii bowling game. “I’d never heard of it before coming here. I enjoy it more. It’s good for my arm.”

Neff is just one of several Golden Living residents taking advantage of a new rehabilitation activity the center now offers. In July, the center’s therapists began using the Nintendo Wii, which is a video game system that has players physically move a hand-held controller to control the game’s action, as part of their physical therapy sessions.

“It can get boring at times,” said Armi Pecana, rehabilitation program coordinator for the center. “We try to change exercises, but it’s still exercise. (The Wii) is just a fun thing to do for everyone.”

Pecana said that the motions the patients make with the Wii controller help with problems such as balance, coordination and range of motion. The repetitive movement of rolling a bowling ball or casting a fishing line, Pecana said, are similar to other, traditional exercises, but with a more interesting twist.

The most popular games among the center’s residents are bowling, fishing, hunting and pool. Pecana said even the patients who don’t always participate in the games enjoy watching others play, and act as a cheering section for the competitors. In addition to therapy sessions the game system is used in recreation and social activities.

“They feel a sense of self-satisfaction,” said Patti Young, facility director, as she watches one patient throw her hands in the air in celebration of a strike. “They smile more than with traditional therapy.”

Friday morning therapy has become something to look forward to, Young said in a T-shirt that shows the iconic Rosie the Riveter holding a Wii controller with the slogan, “Wii can do it.” Between the snacks of popcorn and fruit to the cheering and game-playing, Young said the center is full of energy when the Wii is turned on.

The idea for using the Wii, Young said, came from the director of operations for the entire Golden Living community after reading about other places across the country that had already started the program. In addition to the Edwardsville location, the Golden Living Center in Lansing has also started its own Wii program.

Young said the installation of the Wii program is relevant as a younger generation enters the work force. She said technology is becoming more important and the center wants to move forward and take advantage of that whenever possible.

Because of the success of the Wii program, Young said she’s got big plans for the future. She would like to purchase a music game so the center could form a community band and members could play different instruments. She also thinks that a dance game might be appropriate for some patients.

“I think it’s very progressive step, utilizing technology with our senior population,” Young said. “As our population changes and we see more baby boomers with their cell phones and wireless Internet, we need to adapt.”