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Leading Edge

Wii-habilitation

Video games making physical therapy fun and productive at BIDMC

Kolya-Lynne Smith may be suffering from multiple sclerosis and recovering from brain surgery, but she can still beat tennis star Venus Williams on the court. In fact, the 33-year old does it several times a day as part of her physical therapy at Beth Israel Deaconess Medical Center.

There's no clay court at the hospital. Smith is one of the first patients at BIDMC to use the department's new Nintendo Wii video game for rehabilitation.

"Before I had my brain surgery and developed MS I was very athletic. I did everything from swimming and mountain climbing to tennis and boxing," says Smith. "The Wii gives me the opportunity to do those things again. It's a little less real but it still feels like you're doing it."

The Wii created quite a buzz last year thanks to its motion-sensitive wand. When you hold the wand in your hand and make a punching motion, for example, so does the animated boxer on the screen. The Wii offers a variety of sports - tennis, boxing, bowling, baseball, and golf - many which require movements similar to traditional therapy exercises.

"Boxing is especially good for balance because you have to shift your weight back and forth and use both hands," says Kathy Shillue, Director of Physical Therapy at BIDMC. "It actually helps and because you're paying attention to the screen your eyes are engaged and you have to rely on your body senses more to keep your balance."

The department has only been using the Wii for a few weeks, but already they're noticing a difference in patients.

"It's definitely more fun. They can get through a series of exercises without getting bored," notes Shillue. "The Wii takes you out of yourself. You're not really thinking about your problem so much. It doesn't really feel like exercise - you're caught up in the game."

Case in point - the patient with an orthopedic back problem who easily tired doing her lunge exercises. When Shillue had the patient play the Wii bowling game, which required lunging to throw the ball down the alley, she did a whole string - 10 lunges - without blinking an eye. That same patient is now thinking about buying a Wii to use at home.

"When she comes in, the first thing she says is, 'Can I play the Wii?' So where people were reluctant to do exercises before they're not only looking forward to it, they want to do more," says Shillue.

But that level of engagement can come at a cost. If patients are so engrossed with the video game, they may not realize they're even exercising, and may overwork themselves. Kolya-Lynne Smith learned that the hard way.

"I got a little too involved. I was really getting into it and when I finished, my arm was pretty sore," recalls Smith, who is now taking a break from the Wii until her arm gets better.

"People can overdo it really easily," warns Shillue.

She advises users to pay attention to the game's built in timing mechanism that encourages players to take a break after a certain amount of time. Also, wear sneakers to avoid foot injuries, and be sure to use the proper form - not just the one that gets you the most points.

"If you're playing tennis you could get a good score by using your wrist to bend the racquet back and forth instead of using a good swing," notes Shillue. "We try to encourage people to use the proper form because that's really the purpose of the exercise. Just like with any other form of exercise, if you're not using the right form you could really get into trouble and get injured. "

The benefits of using the Wii in rehab are still being studied. The Parkinson's disease program at BIDMC is applying for funding to compare the effect of Wii use for Parkinson's patients with regular exercise and dance classes. For now, the Physical Therapy department will continue to explore how Wii's virtual sports can help its patients get back on track for real.

"So far we're pleased," says Shillue. "We're going to think about more ways to use it."

Patient's like Kolya-Lynne Smith think that's a good idea.

"I won't lie - it's more fun than my regular exercises," notes Smith. "I'm looking forward to continuing my physical therapy."

Posted November 2009

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