Stroke patients' experiences with Wii Sports® during inpatient rehabilitation

Scandinavian Journal of Occupational Therapy
Posted online on February 20, 2012
Authors: Dora Celinder & Hanne Peoples
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Abstract

Introduction: Commercial virtual reality games have been used as adjunct therapy for stroke rehabilitation, mainly after patients have been discharged. The aim of this study was to explore stroke patients' experiences with Wii Sports® as a supplement to conventional occupational therapy in a controlled hospital setting.

Materials and methods: The study had a qualitative triangulation design that included semi-structured interviews and field notes. Nine Danish stroke patients participated, receiving between one and nine interventions with Wii Sports® during a three-week period. Responses were coded by qualitative content analysis.

Results: Analysis revealed one overarching category, “Connecting to past, present, and future occupations”, and three categories that encompassed patients' experiences with Wii: (i) variety, (ii) engagement, and (iii) obstacles and challenges. Interview findings were confirmed by field notes that included observations of engagement and challenges.

Discussion: Stroke patients in hospital settings may experience Wii Sports® as a beneficial and challenging occupation for both rehabilitation and leisure. Incorporation of Wii Sports® into conventional occupational therapy services may benefit patient rehabilitation directly or provide motivation for alternative leisure activities.

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A Kinect-based system for physical rehabilitation: A pilot study for young adults with motor disabilities.

Research in Developmental Disabilities. 2011 Jul 22. Chang YJ, Chen SF, Huang JD. Department of Electronic Engineering, Chung Yuan Christian University, Chung-Li, Taiwan
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Abstract This study assessed the possibility of rehabilitating two young adults with motor impairments using a Kinect-based system in a public school setting. This study was carried out according to an ABAB sequence in which A represented the baseline and B represented intervention phases. Data showed that the two participants significantly increased their motivation for physical rehabilitation, thus improving exercise performance during the intervention phases. Practical and developmental implications of the findings are discussed. Highlights ► To reduce staff intervention and enhance students’ motivation, interest, and perseverance to engage in physical rehabilitation, a Kinect-based system was employed with success. ► Single subject research design was used with two young adults who were diagnosed with motor disability. ► Data showed that the participants improve exercise performance during the intervention phases. Click here for more

Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. May 2011

Journal of Neuroengineering Rehabilitation.

2011 May 23;8(1):30

Gil-Gomez JA, Llorens R, Alcaniz M, Colomer C.

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ABSTRACT:

BACKGROUND:
Acquired brain injury (ABI) is the main cause of death and disability among young adults. In most cases, survivors can experience balance instability, resulting in functional impairments that are associated with diminished health-related quality of life. Traditional rehabilitation therapy may be tedious. This can reduce motivation and adherence to the treatment and thus provide a limited benefit to patients with balance disorders. We present eBaViR (easy Balance Virtual Rehabilitation), a system based on the Nintendo Wii Balance Board (WBB), which has been designed by clinical therapists to improve standing balance in patients with ABI through motivational and adaptative exercises. We hypothesize that eBaViR, is feasible, safe and potentially effective in enhancing standing balance.

METHODS:
In this contribution, we present a randomized and controlled single blinded study to assess the influence of a WBB-based virtual rehabilitation system on balance rehabilitation with ABI hemiparetic patients. This study describes the eBaViR system and evaluates its effectiveness considering 20 one-hour-sessions of virtual reality rehabilitation (n=9) versus standard rehabilitation (n=8). Effectiveness was evaluated by means of traditional static and dynamic balance scales.

RESULTS:
The final sample consisted of 11 men and 6 women. Mean+-SD age was 47.3+-17.8 and mean+-SD chronicity was 570.9+-313.2 days. Patients using eBaViR had a significant improvement in static balance (p=0.011 in Berg Balance Scale and p=0.011 in Anterior Reaches Test) compared to patients who underwent traditional therapy. Regarding dynamic balance, the results showed significant improvement over time in all these measures, but no significant group effect or group-by-time interaction was detected for any of them, which suggests that both groups improved in the same way. There were no serious adverse events during treatment in either group.

CONCLUSIONS:
The results suggest that eBaViR represents a safe and effective alternative to traditional treatment to improve static balance in the ABI population. These results have encouraged us to reinforce the virtual treatment with new exercises, so an evolution of the system is currently being developed.

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Lessons learned: Staff perceptions of the Nintendo Wii as a health promotion tool within an aged-care and disability service.

Health promotion journal of Australia, 2010 Dec;21(3):189-95.

Higgins HC, Horton JK, Hodgkinson BC, Muggleton SB.

Blue Care, Milton, Queensland.

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Abstract
Issue addressed: Enhancing opportunities for all older people to be physically and mentally active is an imperative in our ageing society. Lessons learned from the use of the Nintendo Wii within Queensland agedcare and disability services were assembled through eliciting staff perceptions regarding the usefulness of Wii technology within their centres.

Methods: Telephone interviews were conducted with direct care staff in 53 centres that had been using the Wii technology for at least three months. Content analysis of interview data identified the major response patterns raised by staff.

Results: Staff noted that Wii activities were easy to master for more able clients and that there was minimal risk to clients. Staff reported that these activities provided health promoting physical benefits (mobility, range of motion, dexterity, coordination, distraction from pain) and psychosocial gains (social engagement, self-esteem, mastery, ability to pacify challenging behaviours) and were a useful adjunct to other care practices within these aged-care and disabilities services.

Conclusions: Staff believed that Wii activities provided purposeful and meaningful opportunities to promote wellbeing for aged and disabled clients within an aged-care and disability service. However, Wii activities were less successful with clients who had significant cognitive and/or physical disabilities.

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Motivation and Physiologic Responses of Playing a Physically Interactive Video Game Relative to a Sedentary Alternative in Children

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Penko AL, Barkley JE.

The School of Exercise Leisure and Sport, Kent State University, Kent, OH, 44240, USA,

Abstract

Background While there is emerging research outlining the physiologic cost of the physically interactive Nintendo Wii, there are no evaluations of the relative reinforcing value (RRV) of the Wii versus a sedentary alternative.

Purpose The purpose of this study is to evaluate the physiologic cost, RRV, and liking of playing Wii Sports Boxing (Wii) versus a traditional sedentary video game (SVG) in 11 lean and 13 overweight/obese 8- to 12-year-old children.

Methods Heart rate (HR) and VO2 were assessed during rest, treadmill walking, and playing an SVG and Wii using a counterbalance design. Liking was assessed during treadmill walking and video game play. RRV was assessed for Wii versus SVG.

Results Average HR, VO2, and liking were significantly greater for Nintendo Wii (p ≤ 0.001 for all) than all other conditions. Lean children displayed a greater (p < 0.001) peak responding for access to Wii relative to the SVG while overweight/obese children did not (p ≥ 0.16). Conclusion Wii was a well-liked activity of greater physiologic intensity than both the SVG and treadmill walking. Lean children were more motivated while overweight/obese children were equally as motivated to play Wii relative to the SVG. Keywords Exertainment - Nintendo Wii - Reinforcing value - Liking - Hedonics