Wii-hab – applicable to PT, or is more Wii-search needed?

Wii Logo

I read this right before leaving for vacation (not sure I want a surgeon trained on a Wii platform vs. learning in surgery). I borrowed a Wii and Wii Fit for two weeks in May to see how I might possibly use it with a patient at the SNF I was at. Overall, it required a pretty high level of ability on the Wii Fit for balance, and none of the games on the Wii would work on the issues I wanted to address to the extent I wanted to. Many places are getting them, SNF’s, hospital rehab units, and outpatient clinics. I understand how it can be used as a tool in rehab, but I told my friend at Nintendo I would want to be able to modify the system so the PT would have more control (see below for an interesting article about that idea).

Potential pitfalls I noticed:
1. The patient can be lazy – my wife and I played it while laying down, just to see if we could – and we did great. There is the potential to be more focused on the activity and not in the technique or mechanics you are working for.

2. Increased time for the same exercise outside of the system (therefore less repetitions, and a potential waste of therapist and patient time).

3. Lack of research: In a search of Pubmed, I only turned up 2 articles for Wii and rehabilitation (a PTJ case study in 2008 with a child with CP, and an interesting article “Monitoring 3D movements for the rehabilitation of joints in physiotherapy” by Martin-Moreno J, Ruiz-Fernandez D, Soriano-Paya A, Jesus Berenguer-Miralles V. in Conf Proc IEEE Eng Med Biol Soc. 2008;2008:4836-9 –

“This article tackles several problems faced by professionals in physiotherapy: the performance of the rehabilitation exercises by the patients, the control of the course of the illness and the patient’s ignorance about whether or not he is properly performing the exercises. We propose a solution based on the use of the Wii Controller to control the exercise movements, along with software that provides the patient with an easy, intuitive and interactive control system. Finally, web services are used to allow the remote monitoring of the treatment by physiotherapy professionals.”)

So would I use it? Possibly – if they would make a rehab version where you could fine-tune the program; if there is more research; and if I’m convinced it is the best bang for the buck both for a specific patient and for our time together. I would be interested in hearing from anyone who has used the software mentioned in the article (pretty cool – it is basically a video game version of a HEP for “joint exercises of the upper limb”, complete with a repetition and time tracker, changes in ROM, and the ability to tell if the patient is doing it correctly or not), or who has modified the programming on a Wii – a quick google search turned up nothing.

Photo credit: Wii Logo, originally uploaded by Ian Muttoo.

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