Can observing children using theWii help us learn more about their weaknesses and develop strategies to use the Wii to augment traditional therapy and educational practice?

My question at the top is quite a mouthful! We are struggling to get valid results from observing students using the Wii and find ways to use it to support their goals. They love to play the Wii and it can be a real motivating factor. Whether we are looking at social interaction and systems that students work in with autism, or orthopedic issues in motor integration and planning, our efforts are showing some positive results as we have used the Wii in several situations this fall.


No Limits to Learning: Wii Therapy: Findings in Motor Integration/planning and Sensory Systems

Amputees are using Nintendo Wii Fit equipment during training sessions as a way of improving their balance and stability.

Every Thursday patients from across the borough meet at Callaghan House in Heywood to go through a tailored exercise programme that improves their strength and stability after having an amputation.

Sharon Wright, Lead Physiotherapist for Amputee Rehabilitation, believes that using the Wii Fit has massive benefits for her patients. She said: “We work with patients for from four months to two years so it’s important that we find new ways of keeping them interested in their exercise and motivated to complete their training.

“After what has been a traumatic experience, the weekly sessions allow our patients to gain back some independence and meet others who know how they feel. Health professionals from the Manchester Disabled Services Centre (MDSC) also attend the sessions so patients don’t have to travel far for appointments, which can be difficult.”

Alan Carouthers, 71, from Rochdale, has been attending the sessions for five months. He said: “I first came with the hope of being able to walk again and started off doing lots of different exercises and physiotherapy. The Wii Fit is great. It is a challenge but using the slalom and football skills games has helped with my balance tremendously and of course it’s great fun.

“It’s really important to come to these sessions because you meet people who understand how you feel but can have a laugh at the same time. It has really built up my confidence and boosted my morale and I’ve been able to make some great friends.”

Heywood, Middleton and Rochdale Community Healthcare in conjunction with Rochdale Amputee Support Group purchased the Wii Fit equipment using a donation from charity Joining Hands for patients to use as part of their weekly exercise rehabilitation programme.

Help and support for amputees and their families can be found through the Greater Manchester Amputee Support Group, which was founded in 2004 by Malcolm Jones, from Rochdale. Malcolm founded the group after becoming an amputee himself and finding he needed more support. He said: “Having an amputation is a traumatic experience so it’s important that people have a support network once they leave hospital to help them and their families adjust.”

The group meets at Rochdale Infirmary on the second Tuesday of every month from 6:30pm in the Rochdale Infirmary outpatients waiting room.

by BARBARA TRAININ BLANK For The Patriot-News
Sunday July 26, 2009, 12:00 AM

Vince Cassaro
Lori Rice of HealthSouth helps Army Maj. Neal Stasny, 43, of Lebanon, work out with a Wii at the rehabilitation center in Wormleysburg. Stasny, who is the deputy chief of staff of information management at Fort Indiantown Gap, is recovering from a stroke. Miriam Dreibelbis had suffered from rheumatoid arthritis for many years. Knee surgery exacerbated the pain in her back, and the West Shore resident ended up in a wheelchair.

Seeking help at HealthSouth Hospitals and Outpatient Centers of Mechanicsburg, Dreibelbis found partial relief in "child's play."

HealthSouth is one of a growing number of outpatient and inpatient facilities that are incorporating Wiihabilitation into their physical therapy and rehabilitation regiments.

Wii (pronounced "wee") is an interactive Nintendo computer game that requires participants to move. A wireless remote connects the player to an on-screen digital icon, which mimics his or her movement in various sports and exercises.

Traditional games available on the Wii Sport software include bowling, tennis and golf. Another game attachment is the balance pad that goes with the Wii Fit software. Players stand on this pad to accomplish such things as walking a tightrope.

"Wii is part of a coordinated approach of physical, occupational and speech therapy at our outpatient facilities," says Laureen Martinelli, site coordinator for the HealthSouth center in Wormleysburg. "It has therapeutic benefits beyond 'straight' exercise. When patients come for outpatient therapy, they've already been through maybe months of conventional therapy. We need different tools to engage the brain, to use new muscles. The graphics of Wii are amazing."

The individuals who come for outpatient rehabilitation and physical therapy at the site include amputees and patients with brain injuries, strokes, Parkinson's disease and spinal cord injuries.

The Lebanon VA Medical Center has had Wii software for two years.

"Initially we introduced it to the long-term care, nursing units," says Jennifer Coy, supervisor of rehabilitation therapies at the VA. "Then we bought it for the rest of the units, including the physical therapy and acute behavioral health units."

According to Coy, Wii "has gone over very well" and brings a lot of benefits, especially for long-term care patients. "It's given them a sense of camaraderie and satisfies their need for competition," she says. "Many of the patients are games- and sports-oriented, especially as our demographic has gotten younger. Wii uses something current that's known to them."

Among the other benefits are that Wii can improve perception, balance and range of motion, the latter especially for physical therapy patients. It also enhances attention span.

One of the other advantages the VA has discovered, says Coy, is that Wii helps fight depression, even if the patient comes just to watch rather than actually participate.

"Wii Sport improves hand-eye coordination and gives the patient a little cardio workout," Martinelli says. "Wii Fit will indicate your body mass index."

For Dreibelbis, Wii was not only effective but "fun."

"It's a nice thing to do," she says. "Wii helps alleviate the tedium of physical therapy exercises and gives patients a sense of progress. Wii worked on my balance, which has always been a problem for me."

Dreibelbis also praised the psychological impact. "I realized I had more capabilities than I thought. It makes you forget about your inabilities," she says.

Like the VA, HealthSouth has found socialization an important part of Wii's appeal and effectiveness.

"It's true Wii means people watching a TV screen, but at least they're moving, and it's interactive," Martinelli says. "It's another tool to add to the therapists' bag of tricks."

By Charles Q. Choi

The popular Nintendo Wii console offers video games that venture into the world of exercise, but scientists now are taking it further, to help doctors heal the body.

The key behind the Wii is its motion-sensitive wireless controller, the Wii Remote, or the "Wiimote," with which players control actions on screen. Players can swing the controller to simulate countless realistic motions, such as swatting a baseball for a home run. Such technology is becoming increasingly popular — at this year's Electronic Entertainment Expo (E3), Sony and Microsoft both revealed motion-sensitive game controllers.

Playing with the Wii could help surgeons in training improve their fine motor skills and performance in a surgical simulator. Eight trainees were asked to play the Wii for an hour before performing virtual laparoscopic surgery with a tool that simulates a patient's body and tracks the surgeon's movements as he or she operates.

The Wii-playing residents scored 48 percent higher than others without the warm-up with the Wii, working faster and more accurately.

Although the researchers first relied on off-the-shelf Wii games, they will soon release a complete surgical training system they designed for the Wii, where trainees can practice suturing and other procedures.

"There's really no accurate way to train surgeons in the operating room, so it's virtually all the on-the-job training, which is very time-inefficient," explained researcher Mark Smith, an endoscopic surgeon at Banner Good Samaritan Medical Center in Arizona. "There are surgery simulators out there, but these are still very expensive. With the Wii, we have a very easy and inexpensive platform where surgery residents can learn and develop their skills."

"You can even have the surgeons train at home," added researcher Kanav Kahol, a biomedical informatician at Arizona State University. Although the Wii could help surgeons train in virtually any surgical specialty, the researchers are especially interested in using the console to teach robotic surgery, where surgeons can use robots for precise, minimally invasive procedures or to help patients at remote locations.

The Wii is also helping patients with Parkinson's disease gain or maintain their independence with physical activities. Occupational therapists at Medical College of Georgia are using the console with patients to help them exercise.

"One of the therapists uses the Wii for timing and loosening up, and the other uses it for coordination and balance issues," said researcher Ben Herz. "These therapists are thinking way out of the box. They're doing activities that will make a difference in these participants' lives based on what we know about Parkinson's."

Doctors at NewYork-Presbyterian Hospital/Weill Cornell Medical Center are using the Wii to help scan through an ever-increasing workload of patient X-ray and MRI images.

Instead of spending hours at a time navigating through pictures using basic keyboard and mouse clicks, which can lead to repetitive motion injuries such as carpal tunnel syndrome, one cycles through scans with the Wii by just rotating the wrist.

"The remote is very intuitive," explained George Shih, a radiologist at Weill Cornell Medical College, who with his colleagues helped develop the system that links the Wii remote to the diagnostic computer.

At Weill, "Wii-habilitation" therapists are using the console to help patients with burn injuries. For such patients, moving and stretching the skin is very painful, but crucial for a successful recovery.

"If a burn injury is near joints, the healing process makes the skin tight, so the natural tendency is not to move normally," said Roger Yurt, chief of burn surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "However, if the patients don't, the joint itself starts to get stiff, so right from the beginning after a significant burn injury, patients have to start doing physical therapy."

The researchers have found that Wii games not only help the burn patients exercise as they need to, but "get their mind off their disease, accomplish the objectives of the therapy without being routine and boring and monotonous," said researcher and physical therapist Sam Yohannan at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.

"If they're in for multiple surgeries, for an extended period of time, it gives them a little bit of escape, doing some sort of sport with scenery that's typically outdoors," Yohannan added. "And it also improves socialization, and that's a big part of burn rehabilitation and therapy, to get social support."

Such research, or "Wii-search" as Yohannan said he sometimes calls it, "is very cutting edge, and there will be a lot more in the future, to see why and how games can better improve the health of patients. It's a great and inexpensive technology."

By Beth Johnson
Radiation treatments for bone cancer at the age of 11 precipitated a condition that resulted in the amputation of Kevin Clancy’s right leg at age 48. Clancy remembers waking up on November 16, 2008 and noticing that his right foot was unusually cold. “Some of the toes had turned blue,” he recalls. “Ever since I had cancer, I’ve had poor circulation in that leg, but nothing like this.”
He was taken to an acute-care hospital the same day, where doctors discovered that only one artery was working. The decision was quickly made to remove the leg above the knee. The surgery was done November 23, and within 10 days, Clancy was transferred to Providence Hospital’s Amputee Rehabilitation program to begin rehab. Providence Hospital is one of the three integrated care divisions within Providence Healthcare in Toronto’s east end that also offers long-term care and community outreach services.

During his two months at Providence, Clancy was fitted with a prosthetic leg, and made a couple of trips home to determine what changes would need to be made to ensure a smooth transition home. Another step taken to ensure a smooth transition home was introducing Clancy to Providence’s newest service, the Mobility Clinic, where he met with his new physical and occupational therapists.

The new Mobility Clinic is designed for outpatients of Providence Hospital with muscular-skeletal impairments. It ‘fills the gap’ that opens once a patient returns home by continuing to support their therapy needs within a safe, professional, and compassionate environment.

There are two ultimate goals for the Clinic. The first is to provide individualized health-care services to improve functional abilities and promote independence. The second, more important goal, is re-integrating clients into their community and giving clients back their confidence and freedom to take charge and manage their own health care and new lifestyles.

“Kevin was confident while at Providence or at home, but there was a lot of fear each time he faced a new, public environment,” explains Clancy’s wife Christie. “For example, we had to go shopping for a light bulb, but Kevin was hesitant. He knew they were stocked at the back of the hardware store. But he did it – he summoned the confidence he needed to walk to the back of the store, find what he was looking for, get back to the car and return home.” A weekend trip to the hardware store is something we take for granted, but a milestone for someone learning to walk again after the sudden loss of a leg.

The Clinic helps people overcome fears by instilling a sense of independence through using innovative rehabilitation equipment and best practices. Physiotherapist Dellene Sakaguchi says, “Strengthening exercises help patients learn how to trust their balance again. We use tools such as a ‘core pole’ for total body conditioning.” The Clinics’s state-of-the-art gymnasium includes a variety of rehabilitation equipment, a mock kitchen and laundry room for training purposes, and a Sony Wii game system to strengthen muscles and enhance dynamic balance skills in a fun way.

“We take the time to learn about what each person’s day-to-day life involves then reintroduce them to these activities, and adapt them however necessary,” explains occupational therapist Lynne Mycyk. Staff introduced and adapted exercises and activities that would help Clancy get back to the things he loves doing, such as golfing, cooking and participating in the drum corps.

Staff members also help clients understand their injuries, their rehabilitation goals, and their achievements. Education fosters understanding; when clients see the ‘big picture’, they develop a belief in what they are doing, thereby increasing their chance of success. Beyond the physical rehabilitation provided, a sense of camaraderie and hope permeates the clinic. Clients of the service encourage each other’s progress and celebrate achievements.

With 347 beds, Providence Hospital is one of the largest rehabilitation hospitals in Ontario, and the Amputee Rehabilitation unit alone discharges up to 80 patients annually. The new Mobility Clinic is Providence’s solution to ensuring a smooth continuum of care on the patient’s journey to recovery.

Beth Johnson is the Director of Communications at Providence Healthcare.

By Beth Johnson
Radiation treatments for bone cancer at the age of 11 precipitated a condition that resulted in the amputation of Kevin Clancy’s right leg at age 48. Clancy remembers waking up on November 16, 2008 and noticing that his right foot was unusually cold. “Some of the toes had turned blue,” he recalls. “Ever since I had cancer, I’ve had poor circulation in that leg, but nothing like this.”
He was taken to an acute-care hospital the same day, where doctors discovered that only one artery was working. The decision was quickly made to remove the leg above the knee. The surgery was done November 23, and within 10 days, Clancy was transferred to Providence Hospital’s Amputee Rehabilitation program to begin rehab. Providence Hospital is one of the three integrated care divisions within Providence Healthcare in Toronto’s east end that also offers long-term care and community outreach services.
During his two months at Providence, Clancy was fitted with a prosthetic leg, and made a couple of trips home to determine what changes would need to be made to ensure a smooth transition home. Another step taken to ensure a smooth transition home was introducing Clancy to Providence’s newest service, the Mobility Clinic, where he met with his new physical and occupational therapists.
The new Mobility Clinic is designed for outpatients of Providence Hospital with muscular-skeletal impairments. It ‘fills the gap’ that opens once a patient returns home by continuing to support their therapy needs within a safe, professional, and compassionate environment.
There are two ultimate goals for the Clinic. The first is to provide individualized health-care services to improve functional abilities and promote independence. The second, more important goal, is re-integrating clients into their community and giving clients back their confidence and freedom to take charge and manage their own health care and new lifestyles.
“Kevin was confident while at Providence or at home, but there was a lot of fear each time he faced a new, public environment,” explains Clancy’s wife Christie. “For example, we had to go shopping for a light bulb, but Kevin was hesitant. He knew they were stocked at the back of the hardware store. But he did it – he summoned the confidence he needed to walk to the back of the store, find what he was looking for, get back to the car and return home.” A weekend trip to the hardware store is something we take for granted, but a milestone for someone learning to walk again after the sudden loss of a leg.
The Clinic helps people overcome fears by instilling a sense of independence through using innovative rehabilitation equipment and best practices. Physiotherapist Dellene Sakaguchi says, “Strengthening exercises help patients learn how to trust their balance again. We use tools such as a ‘core pole’ for total body conditioning.” The Clinics’s state-of-the-art gymnasium includes a variety of rehabilitation equipment, a mock kitchen and laundry room for training purposes, and a Sony Wii game system to strengthen muscles and enhance dynamic balance skills in a fun way.
“We take the time to learn about what each person’s day-to-day life involves then reintroduce them to these activities, and adapt them however necessary,” explains occupational therapist Lynne Mycyk. Staff introduced and adapted exercises and activities that would help Clancy get back to the things he loves doing, such as golfing, cooking and participating in the drum corps.
Staff members also help clients understand their injuries, their rehabilitation goals, and their achievements. Education fosters understanding; when clients see the ‘big picture’, they develop a belief in what they are doing, thereby increasing their chance of success. Beyond the physical rehabilitation provided, a sense of camaraderie and hope permeates the clinic. Clients of the service encourage each other’s progress and celebrate achievements.
With 347 beds, Providence Hospital is one of the largest rehabilitation hospitals in Ontario, and the Amputee Rehabilitation unit alone discharges up to 80 patients annually. The new Mobility Clinic is Providence’s solution to ensuring a smooth continuum of care on the patient’s journey to recovery.Beth Johnson is the Director of Communications at Providence Healthcare.

by Holly McCarthy on May 14, 2009
This is a guest post on the EasyStand Blog, contributed by Holly McCarthy, who writes on the subject of the sports management degree programs at an accredited university. She invites your feedback at hollymccarthy12 at gmail dot com.

Kids and Adults with disabilities can benefit from recieve rehabilitative benefits from playing Wii, besides having fun!

The Nintendo Wii has been one of the most popular game systems this decade and has even been used in rehabilitative applications for people coping with a variety of ailments. A little over a year ago doctors in Canada thought of using the system, which had been used as entertainment for young spinal cord injury recovering patients, and as therapy for patients after strokes.
What they began to realize is that this system, the Nintendo Wii, could be just what is needed to help with rehabilitation because of its ease of use and friendly interface. There are several benefits of using the Wii in rehabilitative treatments (commonly termed at Wii-hab), a few of which will be explored below.
Balance - Whether the patient is standing or sitting in a wheelchair, the controllers used to play the Wii console require balance and proper form for the best results. Using a standing frame while playing Wii can promote movement while standing, which research has shown to improve bone mineral density and strengthening.
Hand-Eye Coordination - Over time, hand-eye coordination improves through the use of video games. This is especially true of the Wii since the players’ movements are mimicked on the screen.
Entertainment - Therapy becomes more enjoyable when put in the context of a game. People who use a standing frame for Physical or Occupational Therapy can prolong their standing time by “multi-tasking” by playing Wii.
Competitive Spirit - The competitive spirit in patients who may not otherwise be able to compete is awakened. This can be great for increasing social skills as well as self-esteem.
Extension of Therapy to Home ­- While many things that are found in a therapists office are far too cost-prohibitive to be kept at home, the Wii is an affordable method of treatment that can be taken beyond the office and into the home for around $250. Additionally, friends and family can play along and join in the fun.
Helps With Memory, Problem Solving, and Decision Making Skills - All of these skills are honed through the use of video games according to studies, which may or may not be good news for parents. Playing sophisticated games helps with short-term, long-term, and muscle memory. Strategic games require problem solving and decision making skills, all of which help to enhance the experience.
The Nintendo Wii is finding enthusiasts of many abilities these days. Games and hardware have made participating in many activities from the comfort of your own home possible with a small price tag that can bring benefits to those in and out of rehabilitation care.
Have you used the Nintendo Wii for rehab or fun? What games have you enjoyed the most?

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.

Well since I have been off for the Christmas break I have been able to chill out and experience the joy of the Wii. To begin with I decide to go diving into the Endless Ocean to see what the treasures lay beneath the ocean



Then I kind of lost track of time, because I knew I was going to the Grand Prix with Mario to check out the competition and to have a race with the best in the hope I would come first



After that tiring event I decided that I needed a bit of a break and needed a little bit of a stimulating challenge something I could really think about, so I enrolled at the Big Brain Academy

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.”

Dayle Sundberg of Estelline works with residents at the Golden Living Center and the Estelline Nursing and Care Center earlier this month, spending 30 minutes with those who wanted to benefit from a unique therapy called Art Without Boundaries.



Through the simple acts of singing, movement , painting and storytelling, Dayle Sundberg of Estelline is helping individuals with brain disorders bring everyday, pleasurable moments into their life.

Sundberg has started the first South Dakota chapter of Art Without Boundaries after completing an extensive online course and doing her hands on training with founder and mentor Noell Hammer. This is the first chapter in South Dakota, but there are chapters in six other states.

Art Without Boundaries uses MnemeTherapy, a cutting-edge whole brain therapy for individuals with brain disorders or issues. "This is not art therapy," said Hammer, "but rather a way to speak to the brain in a different way."

Hammer and Sundberg visited the Golden Living Center in Lake Norden and the Estelline Nursing and Care Center earlier this month, spending 30 minutes with willing residents. The session started out with the singing of a familiar song, left-to-right body movement, the painting of a picture and ended with storytelling about the painting .

"I had no idea how it would affect my heart," Sundberg said of her experience with her first two patients. As she worked with a stroke patient who had difficulty speaking, by the end of the 30- minute session the patient was getting some vowels and sounds out and was able to say "I love you."

"Everyone was weeping for joy with the hope it gave," said Sundberg. "I didn't' realize how big of an impact it was going to be."

Hammer stresses that is not the artwork, but the process which strives to stimulate sustained attentive focus.

"Our goal is to provide a rewarding experience . We are not trying to cure the patients, but provide every day pleasure," Hammer said.

But during the process many of her clients over the past 10 years, ranging in age from 2-107 , have had incredible results, including amazing paintings, significant improvement in verbal skills, mobility, combativeness, spatial acuity and understanding instructions.

"The therapy is something I would have wanted to do with my mom but couldn't ," Sundberg said of her mom, who spent the last five years of her life with injury-related dementia. "It would have been wonderful to get a glimpse of her again."

Having a parent with a brain injury was one of the reasons Sundberg chose to complete the training and open an Art Without Boundaries chapter in South Dakota.

"It was a good fit for me as I love old people and have had experience working with dementia patients," Sundberg said.

Sundberg has a Bachelor of Fine Arts from the University of South Dakota with a specialization in sculpture and also saw this as a natural progression for her art.

MnemeTherapy works on individuals with all types of dementia: Alzheimer's disease, Huntington's disease, Parkinson's disease, stroke victims, Pick's disease, (frontotemporal dementia), Lewy Body disease, and with younger children and adults with Asperger syndrome, pervasive developmental disorder, ADD, ADHD, autism, and cerebral palsy.

Caregiving institutions such a nursing homes and assisted living center, as well as private individuals with short-term rehab or disorders, are encouraged to make an appointment with Sundberg by calling her at 605-873-3030 or 605-769-0811 .

For more information about MnemeTherapy and Art Without Boundaries, visit http:// www.artwithoutboundaries.org or www.artwithoutboundaries.org/DS.html.

-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."

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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."

A Eugene-based scientist is testing a robotic device intended to help people improve their handwriting

Sue Palsbo watches 11-year-old Mizuel Alfaro as he tries out a device that her company has assembled to help people with their handwriting.

Rehabilitation scientist Sue Palsbo, of Eugene, says the new generation of interactive video games, such as Nintendo’s Wii, can be a lot more than just fun and games.
The gaming systems can be powerful, yet affordable, tools to improve the lives of people with disabilities and people who are recovering from injuries.
“You go to hospitals now and therapists are talking about ‘Wii-habilitation,’ ” Palsbo says. “The games engage adults and kids to move their bodies in ways that you’re trying to achieve with exercises, but people get bored with exercises.”
So about five years ago, when Palsbo spotted a device for telesurgery at a medical conference, she thought it could be adapted to help people improve, or regain, their ability to write.
Palsbo began to work on her idea and, later, the Canadian software engineer who had programmed the telesurgery device told her about the Novint Falcon, an inexpensive, off-the-shelf gaming accessory that could be modified for her purposes.
That put Palsbo, a research professor at George Mason University in Fairfax, Va., on the path to create My Scrivener, a system to provide repetitive motion training for people who have trouble with fine-motor control of their hands.
Typically, such practice is provided by a therapist working hand-over-hand with a student or patient, which is labor intensive, costly and inexact.
Palsbo hopes My Scrivener will be a less expensive and more efficient way to help a wide range of people, from children with disabilities trying to print more legibly, to Iraq war veterans relearning how to write after suffering from traumatic brain injuries from roadside bombs.
Palsbo’s initial focus is to develop an instrument that therapists can use with children in the classroom. She’s also working with a group from George Mason University, including Lynn Gerber, director of the university’s Center for Study of Chronic Illness and Disability, to explore how the technology might be able to help wounded Iraq war veterans.
“It does have good application for the school environment,” Gerber said. “But if you look at it more broadly, as I did, it’s capable of doing many more things.”
In one fell swoop, she said, the device could be used as a therapeutical tool, it could provide a therapist or clinician with objective measures of a patient’s progress, and it has potential as a diagnostic tool to identify abnormalities in brain function.
Palsbo’s path to develop My Scrivener also led her and her family to Eugene from Virginia two years ago. Palsbo said she had long wanted to live in the Pacific Northwest, and her family has been happy with Eugene’s cultural opportunities and easy access to the ocean and the mountains. They plan to stay in the area and grow their business, Obslap Research, here.
(Palsbo’s first choice for a company name was taken, so she quickly had to come up with an alternative. Obslap is Palsbo in reverse.)
Ultimately, “our hope is we’ll find an investor, and we’ll build the company here, and we’ll be a going concern,” she said.
Last week, Sue, the company’s CEO, and her husband Art, its CFO, showed off My Scrivener to the Robotics Club at Kennedy Middle School.
Many of the club’s 20 members took turns typing in their names, then grasping the Bic pen inserted in the device as it marched across the page, leaving each name printed neatly in blue ink.
“Even robots have better handwriting than I do,” cracked one of the middle schoolers.
It has taken two years for Palsbo, with $575,000 in funding from two Small Business Innovation Research grants from the U.S. Department of Education, to reach this point. And there’s still a long way to go before the invention will be ready to market next year.
“As a research scientist, I’m totally committed to evidence-­based research,” Palsbo said. “I do not want to put something out that looks really cool and really spiffy, but doesn’t actually improve fine-motor skills.”
Palsbo also recognizes therapists’ need for the system to include objective measures of legibility.
To create those, Palsbo plans to study the variability in the handwriting of typically developing children with good penmanship. Palsbo is recruiting 18 such children from the local area — three each from kindergarten to grade 5 — to spend about 20 minutes writing with My Scrivener during the winter holiday break. Each of those students will receive a $20 gift certificate from Smith Family Bookstore, Palsbo said. Families with children who are interested in participating may contact Palsbo at 505-7591.
Then, in February or March, Palsbo will begin research trials with 60 local children in special education classes, whose individualized education plans include a goal to improve handwriting. The kids will use My Scrivener for about 30 minutes a day for three weeks, she said.
Palsbo also will be seeking FDA approval of My Scrivener as a medical device.
“If scientific study can prove it’s safe and effective, that the therapists like it and can use it, then at that point we’d seek investors,” she said.
Palsbo has collaborated with numerous partners to create My Scrivener.
George Mason University filed the patent application and will license the intellectual property back to Obslap Research exclusively, Palsbo said.
Palsbo contracted with Oregon State University’s Mechanical, Industrial, & Manufacturing Engineering department to create the attachment to the Novint gaming accessory. The system’s software was developed under contract by the Eugene firm Lunar Logic.

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Rehabilitation scientist Sue Palsbo, of Eugene, says the new generation of interactive video games, such as Nintendo’s Wii, can be a lot more than just fun and games. The gaming systems can be powerful, yet affordable, tools to improve the lives of people with disabilities and people who are recovering from injuries. “You go to hospitals now and therapists are talking about ‘Wii-habilitation,’ ” Palsbo says. “The games engage adults and kids to move their bodies in ways that you’re trying to achieve with exercises, but people get bored with exercises.” So about five years ago, when Palsbo spotted a device …

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.

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.”

Video games keep patients engaged

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

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

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

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


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


Unathletic can benefit


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

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

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

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

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

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


Programs measure balance


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

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

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

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

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

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

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

20 November 2008—Rehabilitation specialists have taken to Nintendo’s Wii game console as a way to help motivate patients during physical therapy and rehabilitation. The latest addition to the Wii-hab phenomenon is perhaps its coolest—Air Guitar Hero. Researchers at Johns Hopkins University have made the popular Guitar Hero game into a tool for amputees who are being fitted with the next generation of artificial arms. With a few electrodes and some very powerful algorithms, amputees can hit all the notes of Pat Benatar’s “Hit Me With Your Best Shot” using only the electrical signals from their residual muscles.

The new research, which will be presented this Friday at the IEEE Biomedical Circuits and Systems Conference, in Baltimore, is one component of a program sponsored by the U.S. Defense Advanced Research Projects Agency (DARPA). The Revolutionizing Prosthetics (RP) 2009 project, spread over 30 research institutions worldwide and led by the Johns Hopkins University Applied Physics Laboratory (APL), in Laurel, Md., is developing a mechanical arm that closely mimics the properties of a real limb.

Besides developing two prototype mechanical arms, the project has also pioneered a nerve surgery for controlling the limbs. The nerves that once controlled an amputee’s arm are still intact even after the limb is lost. By rerouting these nerves into the chest muscles and affixing electrodes to pick up the electromyographic (EMG) signals, the RP 2009 researchers were able to use those signals to control a mechanical arm. As a result, the user feels as if he were controlling his own arm.

Though the surgery has worked so far to move an arm with six degrees of freedom, that arm still cannot enable individual finger movement—the ultimate goal of the project.

Dexterous motion of individual fingers poses a tricky software problem. To establish a clear link between mind and machine, the software that translates between EMG signals and the mechanical arm must be trained to understand what the different muscle signals mean. Pattern-recognition algorithms have to be trained by correlating input signal patterns (from muscle contractions) with the intended outputs (opening the mechanical index finger).

The amputee does this training with the help of what’s called a Virtual Integration Environment (VIE)—a virtual-reality training tool in which an onscreen animated arm mimics the user’s intended movements in real time, based on inputs from multiple electrodes attached to the user’s residual arm.

For the training, you sit in front of a screen and obey repeated commands to “close ring finger,” “open index finger,” “close middle finger,” and so on, to get the machine to create an accurate map of your singular myoelectric control mechanisms. What the algorithms and training programs are there to do is to map the subjective experience of the amputee flexing a ring finger to the movements of the virtual arm in the VIE.

That’s a lot harder than it might seem. The trouble comes when the myoelectric impulses of one finger need to be separated from the others. Press your thumb against your middle finger, and you’ll see the problem. If you can’t even easily actuate separate fingers with your native hand, how exactly is an algorithm supposed to figure out an amputee’s intentions from muscles in the chest or upper arm? And, because a movement might be slightly different every time you do it, it needs to be repeated countless times during training for the control algorithm to latch onto the essential signal.

That calibration and training process is as tedious as it is discouraging. “By 3 p.m.,” says APL engineer Robert Armiger, “[DARPA volunteer and double amputee] Jesse [Sullivan] has had lunch, and he’s tired, just like you and I are tired after working all day. It’s hard for him to keep his concentration up.” Further motivation was needed.

The researchers had experimented with games before, notably a variation on Pong. You could move the Pong paddle by “opening and closing” your virtual hand, but that movement is not relevant to opening and closing individual fingers. Though playing the game worked better than simply obeying repetitive commands, Armiger says it was useless for calibrating fine motor control. He also wanted a game with metrics that were a bit more real-world compatible. In the context of prosthetics, that would mean activating muscles to open and close “fingers” in real time, reacting quickly to a stimulus.

Inspired by Wii-hab, Armiger and colleague Jacob Vogelstein borrowed a colleague’s copy of Guitar Hero and attacked the controller with a soldering iron. They rewired the standard guitar-shaped controller to take instructions from the VIE.

Next they substituted muscle contractions for button presses. In particular, they had to rejigger the inputs. Two-handed gamers normally play by using one hand to press colored “fret” buttons to correspond to the correct notes while using the other hand to push a “strum” button in time with the note. Onscreen, these same five colored buttons scroll down the display in time with the notes the players are supposed to hit. To correctly play a note, the player must press the right color fret button and the strum button with the opposite hand.

But Vogelstein and Armiger wanted to use the game to train an amputee. So first they needed to make the game’s controls one-handed. They did that by wiring the two controls together so that an input from a muscle contraction would be read by the VIE as a simultaneous “fret” and “strum.”
For the research reported this week, Armiger and Vogelstein used three normally limbed volunteers, and only three of the five fret keys were used: red, green, and yellow. Once the skin on the subjects’ upper arms was wired up with about 10 electrodes, the subjects could control the keys by moving their fingers: for the red key, they pressed the tip of their index finger to the tip of their thumb; for the green key, the middle finger; and for the yellow key, the ring finger. After five trials, the three research subjects scored between 50 and 70 percent on the game’s “easy” setting.

In mid-October, Armiger and Vogelstein traveled to RP 2009 partner Duke University, in Durham, N.C., to test the system on its target demographic, in this case Iraq veteran Jon Kuniholm. Kuniholm’s right hand was lost to shrapnel three years ago. About to finish his Ph.D. at Duke’s Center for Biologically Inspired Materials and Material Systems, Kuniholm has been a volunteer for the DARPA program for the past two years and is the outspoken founder of the Open Prosthetics Project, an open-source Web site, independent of DARPA, that aims to make prosthetic-arm technology as open source and collaborative as Linux and Firefox.

With electrodes attached to his residual arm, Kuniholm was able to operate the frets using signals from the muscles there. “It’s fun,” says Kuniholm, who achieved the highest score reported by the experimental subjects: 70 percent. Kuniholm says that while Air Guitar Hero is the only game so far that requires individual finger movement to train an amputee to deal with those muscles again, the real success is in striving for a realistic goal. “You’re doing something simple,” he says. “It’s not rocket science. But you have to do it fast and you have to time it right.”

Kuniholm has big plans for Air Guitar Hero. He and Armiger want to use it to train people who use less advanced commercially available artificial arms. Kuniholm’s goal with the Open Prosthetics Project is to create tools that will prime the pump of prosthetics innovation but “won’t consist of several thousand dollars of computing equipment.” In fact, DARPA is in the process of making the APL-created video-game interface software open source, Kuniholm says, “so that we can all begin hacking away.” He hopes to have the source code available for prosthetics control beginning in January. “We’re in the process of getting some more data and experience with it,” he says. The next step is finding lead users at Walter Reed Army Medical Center. “But Air Guitar Hero is just a demo,” he insists. “We want to get this platform out there so people can start downloading it and start modifying other games.”

For their next game-interface modification, the APL team is eyeing Wii Tennis so that people with more radical amputations can also benefit from the motivating powers of the Wii. “We want Jesse to be able to play, too,” says Vogelstein.

The real goal is to get the software into as many hands as possible, Kuniholm says. And in that sense, the story of Air Guitar Hero mirrors the larger Revolutionizing Prosthetics project. In the end, DARPA and Johns Hopkins want to make both the arm’s hardware and the interface software, including the VIE, open source so that prosthetic-arm research innovation can evolve organically.

There is no doubt that the Wii Fit has becoming something of a gaming phenomenon. In fact it has become completely synonymous with the Wii console itself, a kind of flagship title which rivals Microsoft and Sony can only gaze upon in envy.
Its success is due to the fact that its appeal is wide, it appeals to both the old and young and most importantly it reaches people who are not traditional gamers. In fact it's probably fair to say that Wii Fit fans will never have played on a home gaming console before.
This across the board appeal has been well documented elsewhere, yet one area which is still in its infancy is the idea of Wii Fit being used as a serious tool in the medical sphere.
The game is starting to find fans in hospitals, old people's homes and physiotherapy units across the world and both patients and staff alike are starting to see the benefits.
22 year old Nathan Ellis from Lancashire, England suffered horrific injuries to his limbs when he was unfortunately hit by a car. Thankfully he survived, and as a 12 month stretch of physiotherapy loomed Nathan suggested that using Wii Fit as opposed to traditional methods of physiotherapy may provide the necessary fun factor which would help him get through the long and occasionally painful treatment sessions.
The idea was a deemed a great success and resulted in both the Royal Preston and Chorley and South Ribble Hospitals in the North West of England introducing Wii Fit as a legitimate tool to assist their younger patients requiring physiotherapy.
Lesley Walters, the head of physiotherapy at Lancashire Teaching Hospitals NHS Foundation Trust, recognised that by adopting play or diversion techniques you can assist children to overcome discomfort and stiffness whilst undergoing physical therapy.
At the other end of the age spectrum, the elderly have also discovered Wii Fit provides a great activity with some residents deciding that knitting and bridge are out and Wii Fit and the Balance Board are in.
Some staff members at the WilMed Nursing Home in Milwaukee USA had the game at home, and decided that some of their residents may enjoy it. They were right.
It proved to be a big hit with residents even up to the age of 84, with resident Everlyn Dawson getting out of her wheelchair to try her hand at bowling. Although she initially got a nothing more than a 'gutter ball' she smiled and with determination said "I hope I am getting better at bowling, it's certainly a lot of fun. It's nice and I look forward to doing it.'
And it's not just the gaming scores which are seeing improvement, Susan Swain, the in house physical therapy assistant, feels that an improvement in hand eye co-ordination is noticeable too, and most importantly, there are a lot more smiles too.
So far we have looked at two examples of how the Wii Fit can be of use in two separate environments which are at opposite ends of the age spectrum. Finally it is worth adding that Wii Fit is also being adopted as a method of physio therapy for athletes in recovery from a variety of sports related injuries.
Sue Stanley-Green, a professor of athletic training at Florida Southern College in Lakeland, told Reuters Health, 'We are looking to incorporate Wii Fit into the athletic training room as far as rehabilitation, for example, on post-operative knees and ankles.' It is the fun aspect of Wii Fit which makes the game so attractive for this purpose, with many people finding it takes the repetition and monotony away from such exercises
These three areas have all utilised Nintendo's Wii Fit either as a means to provide fun and entertainment for the elderly, a method of distraction for youngsters undergoing sometimes painful physiotherapy , or athletes who find repetitive exercises easier to swallow when then they are coated in the fun guise of the Wii Fit.
Whatever you think of the Wii Fit, it's surely going to be a long time before another game will have both the same level of appeal and functionality.

Owen Taylor is a long time fan of the Wii console and takes a special interest in the Wii Fit game, he has found it's mixture of gaming and exercise a revelation and loves to spread the word.
He contributes to a website called http://WiiFitFrenzy.co.uk which offers a fantastic Nintendo Wii Fit Stock Finder for those who are looking for UK and US Wii Fits.
You will also find News, Games and Accessories as well as a comprehensive FAQ/Help Guide.

"The original purpose was for an activity to give (residents) something to do and then once we had it, we realized the potential to use it for therapy as part of the rehabilitation program here," said Korey Flick, activities director.

Nintendo Wii is an interactive video game system, allowing players to "experience" golf, tennis and bowling, among other games.

"It was a good way for the staff to interact with the residents in a social and nonmedical way, which was good for everyone," Flick said. "We've tried golf and we've tried tennis. Bowling's the one that everyone's the most successful with. Generally on a Thursday we set it up for the day and the residents and the staff rotate."

Local nursing homes and health facilities throughout Schuylkill County are jumping on board the technology trend that they say helps residents with cognitive abilities and motor skills.

Nintendo Wii systems were also donated by Family Home Medical Support System of Mount Carmel, 121 E. Fifth St., to the Shamokin-Coal Township, Mount Carmel and Kulpmont senior action centers.

The Schuylkill Regional Resource Center, 138 W. Centre Street, Mahanoy City, hosts a "Wii Wednesday!" each week from 1 to 3 p.m.

Physical therapists at Genesis HealthCare Orwigsburg Center and Schuylkill Center, long- and short-term skilled nursing centers and rehabilitation facilities in Orwigsburg and Pottsville, are using Nintendo's Wii video game technology to help patients after an illness or injury.

"It's good cognitive activity to keep the mind active," said Amanda Schwalm, a speech language pathologist at Tremont Health and Rehabilitation Center "In that respect, it's working on your deductive reasoning skills, and that's a big part of what I do for short term to home (care.)"

When the Tremont Health and Rehabilitation Center -- a 180-bed skilled nursing facility for short-term and long-term care -- first got the system in August, the staff and residents split into teams, challenging each other and bringing a social layer to the work environment.

Kristy Deeter, an occupational therapist, said all residents have access to the system, adding that bowling is the game of choice for many.

"What it helps for people in therapy is, number one, they're getting some arm movements -- full range of motion," she said. "That movement's a natural movement for the arm, so I think that's why we've been more successful with that one."

"It builds up the muscles and it makes the brain think," resident Dave Wolfe said. "It's a lot cheaper than going to a bowling alley."

Wolfe shows up to the activities room each week to play. Facility administrator Dan Daub counts Wolfe among the "rowdy bunch," of cheering and excitable players.

"I used to do regular bowling, but this is a lot different," Wolfe said Tuesday, gearing up for his turn against resident Nancy Gibble. "Today I can't get a strike to save my soul."

But Wolfe spoke too soon, tossing a strike in his next shot.

Gibble bowled 130, saying she doesn't really care who wins, she just tries to do the best she can.

Is competition a factor in the virtual sport?

"There is to an extent, but it's mostly all in fun and trying to beat your score from the week before," Gibble said.

"It's kind of a growing trend and a unique way to get therapy done, so we're glad we could latch on to that," Daub said.

Nathan Ellis, 12, with physios Zoe Pilborough and Julie Sutcliffe

By Aasma Day
When 12-year-old Nathan Ellis was knocked over by a car he suffered devastating injuries and was lucky to live.
The youngster then faced 12 months of intensive physiotherapy to regain full use of his shattered limbs.

But it was then that Nathan, of Ashton, Preston, came up with a bright idea to make the exercises and treatment more fun.

And his concept of using the highly contagious Wii Fit computer game for treatment proved such a success it has now been introduced for patients in both the Royal Preston and Chorley and South Ribble Hospitals

The Nintendo Wii Fit is a video game which encourages exercise through active games interacting with the screen.

It has now been introduced into physiotherapy departments to aid the rehabilitation of young patients.

Nathan was knocked down by a car on Riversway, Preston, in September 2007 and broke both his legs and his right arm.

Nathan said: "I had a severe accident. I was in hospital for two weeks and had 12-months' physiotherapy and support to help get fit and get my mobility back and now I'm walking and back to normal.

"I thought it would be a good idea to get a Wii Fit for patients like me to help with their exercises. I'm pleased it is here and it's great fun."

As a result of Nathan's brainwave, staff at Lancashire Teaching Hospitals NHS Foundation Trust have purchased two consoles and the fitness games to benefit youngsters undergoing treatment.

Lesley Walters, head of physiotherapy at Lancashire Teaching Hospitals NHS Foundation Trust, said: "We provide a paediatric and adolescent physiotherapy service.

"One of our patients suggested it would be a good idea and new and fun way to get youngsters to undertake physiotherapy.

"Physiotherapy sessions for children and young people often use play or diversion techniques to get them to overcome any discomfort or stiffness they may feel.

"Wii Fit is a great way of using computer games to stimulate interest while performing exercises which can be uncomfortable.

"We encourage people to have fun while undergoing physiotherapy and the use of a computer games console which encourages fitness is a fantastic innovation for physiotherapy.

"Two consoles have been purchased and we will be using them in our paediatric and adolescent physiotherapy services at Royal Preston and Chorley and South Ribble hospitals.

"It is being used in an increasing number of NHS Physiotherapy departments and I'm sure that it will prove very popular in Lancashire."

The consoles were bought with funds from the Incubator Appeal which uses donated loose change, old money and foreign currency for good causes at the trust.

by: Karen Bennett

The Nintendo Wii it seems, puts pay to the concerns in recent years over the inactivity in children due to their interest in video games consoles. The Wii console really sets itself apart from the rest with its revolutionary motion sensitive controller, which actually requires movement in order to play the games. The Nintendo Wii comes with the game Wii Sports, which includes tennis, baseball, bowling, golf and boxing. In tennis you will be swinging the remote as if it were a tennis racket and flicking it up to toss the ball into the air with a quick swing to serve. The other Wii Sports games work in a similar way simulating controller movements for like movements onscreen. Boxing however is the only Wii Sports game that uses the nunchuk attachment and is the most physically exhausting game of them all. In order to hit your opponent in the head or body, you will have to aim high or low with your swings. There are three different activities with each game. In training mode, you will participate in random challenges, after which you will be assigned a fitness age, based on your performance. Sound familiar? The Nintendo DS game, Brain Training comes to mind...a physical version perhaps? The important thing here is that gamers are becoming more physically active without even realising it - you could say it has a 'kill two birds with one stone' effect, combining video game play with physical activity. Given this 'physical' nature of the Wii, I wouldn't be suprised if parents rushed out to buy the Nintendo Wii just to get their kids off the sofa! Another great thing about the Nintendo Wii is that it appeals not only to children and teens but to adults too, so its something the whole family can enjoy. Could the Nintendo Wii revolutionize the way we play video games in the future? It will be interesting to see what Nintendo's competitors come up with next - this could be a tough one to beat!
About The Author
Karen Bennett For more information on the Nintendo Wii and to find cheapest prices, visit my website http://www.compareconsoleprices.co.uk

California Physical Therapists Promote Nintendo Wii for Core Strength and Fitness

'Wiihabilitation' is Fast Becoming an Accepted Form of Therapy at Physical Therapy Clinics Statewide

SACRAMENTO, Calif., Oct 14, 2008 /PRNewswire via COMTEX/ -- With October being National Physical Therapy Awareness Month, expect Nintendo Wiis to be flying off the shelves. Among the first in line will be members of the California Physical Therapy Association (CPTA), who stand by the video game console and its accompanying sports and fitness games as one of the best therapeutic technology inventions to roll out in a long time.
"As physical therapists, we are movement specialists engaged in the CPTA-sponsored MoveCalifornia campaign to get people active and fit again. In the midst of this, we're seeing a therapeutic phenomenon of sorts with kids, grown-ups and geriatric patients getting off the couch and learning how to properly use the Wii for core strength and balancing exercises," said CPTA member Amy Calhoun Sanchez, PT, DPT, CSCS, NSCA-CPT.
Sanchez is a doctor of physical therapy working in the outpatient rehabilitation department at a local Los Angeles hospital and provides pediatric home health care for developmentally delayed children.
"In the clinic setting, we treat patients with acute and chronic pain, those recovering from surgery or stroke and many other conditions with specific balance and strengthening exercises and manual therapy, and they respond to that," added Sanchez. "But the Wii sports games are interactive, fun and entertaining, and patients become more engaged playing with them. By teaching patients how to use the Wii in a clinic setting, we empower them to continue their exercise, fitness and training with the Wii Fitness in the comfort of their own homes."
While Sanchez emphasized Wii is helpful in preventing injuries and falls and increasing functionality, she cautions that anyone with undiagnosed pain or untreated injuries should refrain from using the Wii without professional guidance.
"Playing a Wii game too soon after an injury can be extremely harmful to a person's health and even set back recovery or lead to re-injury if he or she is not properly evaluated by a physical therapist first," said Sanchez. "A therapist will help to decrease pain and improve posture before recommending or advancing a Wii regimen tailored to the individual's specific needs."
Sanchez noted most physical therapy includes core stability training, but often it is difficult to teach people how to engage their core. "They tend to arch their backs and put too much weight on their heels in a way that causes further pain with movement."
"What's so great about the Wii is it allows a patient to know where the body is in space by showing real-time movements on a screen in simulated yoga, aerobics, strength training and balance exercises," stated Sanchez. "The Wii is the next best thing to simulating an environment on the golf course or tennis court, so we can see first hand what a person is doing wrong and correct that movement. The Wii makes for simple and fun therapy and, right now, is the coolest, new therapy around."
MoveCalifornia is a CPTA-sponsored statewide public education campaign designed to call attention to the importance of wellness and daily physical exercise and the unique role physical therapists play in these areas. For more information about MoveCalifornia, visit the MoveCalifornia Web site at http://www.movecalifornia.org.
SOURCE California Physical Therapy Association