Rachel Halter

An interactive video game that has been a sensation among teens and adults alike has moved into the realm of rehabilitation.

The Nintendo Wii craze has caught on at a number of local rehab hospitals and elderly services centers, where physical therapists now are saying “Wii-habilitation” is improving outcomes for patients with a wide range of cognitive or physical conditions.

By playing games using the Wii’s handheld motion-sensitive controller, patients can work their way to recovery without even realizing it, said James Stacey, occupational therapy assistant at Alexian Brothers Community Services PACE program. The adult day care program’s rehabilitation department got a Wii game console in the fall.

“It’s kind of a sneaky approach” to rehab, he said. “We can sometimes see improved results because they’re not thinking about how humdrum this activity is. They’re totally engrossed in something and focused on a goal that they’re unaware of.”

The Nintendo Wii craze has caught on at a number of local rehab hospitals and elderly services centers, where physical therapists now say “Wii-habilitation” is improving outcomes for patients with a wide range of cognitive or physical conditions.

Using a cordless device that detects motion, a Wii player can direct the movements of on-screen players competing in games such as tennis, boxing and bowling.

The movements and skills required by the Wii (pronounced “we”) are similar to exercises in physical therapy, and the Wii can be used with a yoga ball, balance mat or arm weights to add difficulty or emphasize different skills, local therapists said.

“Each game offers a different set of strategies and movements,” said Rachel Halter, occupational therapist at Siskin Hospital for Physical Rehabilitation, where about 10 patients have used the Wii.

Ms. Halter recently worked on the Wii with Siskin patient Larry Kyle, who has brain damage after having a tumor removed. Halfway through his workout, she added a foam mat under his feet so that Mr. Kyle would have to work a little harder to maintain his balance while virtual bowling.

“You can make it more challenging depending on what you want to do,” Ms. Halter said. “I think this is a tool that anybody that provides therapy could use.”

After sustaining a traumatic brain injury in an October car wreck, 25-year-old Dennis Cleek worked with the Wii at Siskin. The therapy was so effective that his family bought their own Wii a few months ago so he could use it at home.

Mr. Cleek, a Monteagle, Tenn., resident, said he prefers the Wii, particularly the bowling game, to his other exercise-based therapies.

“You have to actually get into it,” he said. “You really have to bowl.”

Yet physical therapists note that using the Wii as a rehabilitation device still is a relatively new concept, and uncertainty exists about the “transferability” of skills learned on the Wii to everyday life.

For brain-injured patients, transferability is “being able to learn a skill in one environment and take it and use it in another environment,” said Mark Heydt, community re-entry specialist at Siskin. “There hasn’t been a lot of research on that.”

In some cases a Wii game almost seems designed for occupational therapy and the adjustment back to independent living, therapists here said.

A Wii cooking simulation game allows patients to get used to being in a “virtual” kitchen, said Eric Lyons, rehab services manger at Life Care Center of East Ridge, where dozens of rehabilitation patients have used the Wii over the past year.

“You gotta follow a recipe and use the remote to get (the) proper pan, pour proper ounces. It challenges them mentally,” he said.

All of the Life Care Centers in the area now have Wiis, Mr. Lyons said.

The Health Center at Standifer Place is constructing a room that will be entirely devoted to Wii-hab, said Kent Silvey, director of therapy and rehabilitation for the center. HealthSouth rehabilitation hospital in Chattanooga is planning on getting a Wii in the next couple months, though patients there have been using a computer-based medical program for a couple of years, said Scott Rowe, administrator at HealthSouth.

Some PACE program participants are even going home to play on their grandchildren’s Wiis, Mr. Stacey said.

“It really spans the generations,” he said.

“VIRTUAL REHABILITATION”

Use of the Wii is part of a trend in “virtual rehabilitation,” or physical or cognitive rehabilitation entirely based on or augmented by virtual reality, such as robotics or video games, said Grigore C. Burdea, a professor at Rutgers University in New Jersey. Dr. Burdea helped launch a yearly international conference on virtual rehabilitation in 2002 and pioneered research on its use for hand rehabilitation.

Thousands of rehabilitation hospitals across the nation now are using the Wii, including Walter Reed Army Medical Center, he said.

“I predict in five years it’s going to be all over the place,” he said.

Computerized therapies can be a cost-effective way to expand access to care for patients in remote parts of the country, such as Alaska and Montana, where it can be a struggle to reach a physical therapist, Dr. Burdea said.

The Wii does raise some safety concerns, however, Dr. Burdea said.

“The Wii is not designed as a rehabilitation system, and it’s designed for the very young and energetic,” he said. “It does require the careful monitoring of the therapist, who has to stop the patient from having too much fun.”

Local practitioners agree that therapists have to be sure patients don’t overextend themselves.

“You can get carried away, so you have to notice if your patient is getting tired and say, ‘Let’s rest a while,’” Mr. Stacey said.

 Lower Lights