Nintendo Scores Points As Unlikely Tool in Rehab

Pittsburgh Tribune-Review

Karen L. Gillary suffered a stroke April 4. She struggles to make her mouth form the words that she can hear perfectly well in her head. Her husband, Robert, speaks for her.

"She knows what to do," says Robert Gillary, of Plum. "Getting it out is the hard part."

He waits as his wife bowls a few virtual frames using a Nintendo Wii, a popular video game that allows the user to mimic the motions of golf, tennis or other sports. But she's not just passing the time. The bowling sessions are part of her physical-therapy regimen at Harmar Village Care Center, a skilled nursing and long-term facility in Cheswick.

In her left hand, Karen, 54, holds a game controller, a wireless device that resembles a television remote. She fixes her gaze on the screen and swings the controller toward the screen, causing the cartoon figure to launch the ball down the lane.

Bam! Down go the pins.

"It's wonderful because it makes them use their motor skills and vision at the same time," Gillary says. "It helps them connect."

Introduced by Nintendo in 2006, the Wii has become an unlikely tool in physical therapy for those recovering from strokes, surgery and traumatic injuries. It also is used by Alzheimer's patients. Visit a rehabilitation clinic, a sports medicine center or veterans care hospital, and you're likely to find patients using a Wii to ski, box or play baseball.

Wii-habilitation, as it's sometimes called, won't replace exercise and stretching for those seeking to regain mobility and motor skills. But it can provide an alternative to the often-monotonous repetition of physical therapy, says Mike Wielobob, an occupational therapist and rehab program manager at Harmar Village.

"They might be doing a little bit of work but not realize it because they're playing a game," he says. "It's a different way to challenge them."

Harmar Village got its Wii in January. While the novelty has worn off somewhat, the game still is popular enough to draw competitors to the facility's weekly Wii bowling tournament. That's another selling point for the game in a patient setting: It can provide a social outlet for patients who might be isolated or depressed.

As one of the more user-friendly video games, the Wii has been embraced by many senior citizens, a group that traditionally is seen as computer-phobic.

Jan Cravener, 64, uses the Wii as part of her physical therapy to recover from recent open-heart surgery. Cravener, of Freeport, bowls or plays golf with the Wii. She has become a regular user, despite being dubious at first.

"It gives you coordination and balance," she says.

At St. Barnabas Health System in Richland, the residents use the Wii in physical and occupational therapy, says Gwenn Whiteford, director of rehabilitative services. Bowling and tennis seem to be the most popular games.

"We use it to work on their coordination, their balance and their range of motion," Whiteford says.

Dr. Michael Boninger, director of the Institute for Rehabilitation and Research at UMPC Mercy, uses the Wii to help rehabilitate patients who have suffered a stroke, traumatic brain injury or spinal-cord injury.

"I can tell a patient who's got a stroke to lift their arm above their head 50 times," he says. "On the 10th time they're bored, and the 20th time they want to kill me. But if they're attached to a video game, everything changes."

At $250, the game system is a bargain in an industry whose costs are skyrocketing. There have been numerous studies on the efficacy of video gaming in aiding stroke victims or those with cerebral palsy, Boninger says.

"The difference is that everything becomes less expensive and more accessible when there's a commercial product that comes out from it. Therein lies the value of the Wii."

Between 60 percent and 74 percent of patients at Tri-State Physical Therapy in Seven Fields utilize the Wii and the Wii Fit, says director of rehabilitation Ben Kivlan, a physical therapist and strength and conditioning coach.

The Wii Fit, a second-generation Wii game, lets the user stand on a balance board that measures her posture and calculates their body-mass index based on her age, weight and other data. Patients can perform yoga poses, do push-ups, even twirl a virtual Hula Hoop.

At Tri-State Physical Therapy, patients often use elastic resistance bands and free weights while using the Wii Fit, Kivlan says.

The balance board also can be used in helping a patient regain her normal gait.

"One of the main things is balance training," Kivlan says. For example, patients recovering from surgery on their anterior cruciate ligament, or ACL, would use the Wii Fit balance board to relearn how to transfer weight from one side to the other.

The Veterans Administration Pittsburgh Health Care System uses Wii in its three Pittsburgh health-care facilities, including the H. John Heinz III Progressive Care Center in O'Hara.

Virginia Dougherty, a creative-arts therapist at the center, says the Wii is used by everyone from World War II veterans to those who fought in Operation Desert Storm.

"If you take a PlayStation 2 or X-Box 360, they rely on these very minute, very fine motor movements," Dougherty says. "All of a sudden, Wii has something that you get to use your gross motor movements. You swing your arm back and you swing it forward, and at the same time you release a button."

It's also fun, she says. And there's nothing wrong with that.

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