Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Use of Commercial Gaming Systems in Rehabilitation
Kristy L. Yoskey, MOT, OTR/L
Area Director
Genesis Rehab Services
Technology Symposium 2013
Innovations in Rehabilitation Technology Session Objectives
• Recognize clinical applications for the use of commercial gaming systems in rehabilitation.
• Identify, through clinical reasoning and activity analysis, the technological applications of the commercial gaming systems that may be used in interdisciplinary rehabilitation.
2
Wii Gaming System
• Nintendo Wii
– Interactive gaming system that allows players to physically interact in real time with images on the TV screen
• Wii FIT
– Balance board reacting to leg and feet motions in real time to control the avatar or Mii on the TV screen
3
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
1
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
OmniVR
Acelerated Care Plus
• Virtual rehabilitation
– Uses 3D camera; no hand controllers, mats, etc.
– Software to track patient’s precise movements
• 6 skilled exercise categories
–
–
–
–
–
–
Multiple difficulty levels for balance
Gait training
w/c mobility
Seated exercise
UE exercise
Cognitive activities
OmniVR
• Targets large motor movements
• Allows to match exercise difficulty to patient’s specific abilities
• Printable performance summary for documentation/progress
OmniVR
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
2
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Kinect Xbox 360 Gaming System
•
•
•
•
Your body is the controller
Responds to movement
More physical in nature
Similar cost as Wii and Wii FIT
Kinect Xbox 360 Gaming System
Using Wii as a Clinical Tool
• Clinical Demonstration #1
9
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
3
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Contraindications
•
•
•
•
•
•
Pacemakers
Seizures
Pain
Numbness/tingling
Motion sickness
Frustration
10
Benefits of Commercial Gaming in Rehab
• Improved functional level/outcomes
• Improved socialization/competitiveness
• Willingness to participate in treatment/ high level of motivation
• Puts the FUN back in FUNdamentals
11
Grading the Activity
•
•
•
•
•
•
•
Compensatory strategies
Hand over hand assistance
Verbal cues
Visual cues
Tactile cues
Seated versus standing
UE support (leaning/balance support)
12
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
4
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Gaming for Rehab: Nintendo Wii
Wii
•
•
•
•
•
Wii FIT
Bowling
Tennis
Boxing
Golf
Baseball
•
•
•
•
•
•
•
Hula Hooping
Heading Soccer
Table Tilt
Tight Rope
Ski Slalom
Ski Jump
Yoga
13
Gaming for Rehab: Omni VR
•
•
•
•
•
•
Balance
Gait
UE Exercise
W/C Mobility
Cognitive Activities
Seated Exercise
Gaming for Rehab: Kinect Xbox 360
• Workouts
– Biggest Loser Ultimate Workout
• Kinect Sports
• Kinect Adventures
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
5
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Deficits/Activity Analysis
•
•
•
•
•
•
•
•
•
•
Balance/unsteadiness
Coordination
Contractures/ROM
Edema
Cognition Muscle tone changes (flaccidity/spasticity)
Motor planning/motor control
Visual/perceptual deficits
Gait dysfunction
Weakness
16
Clinical Reasoning
• s/p CVA with inability to bear weight to (R) LE due to fear of falling
– What is the focus of the treatment/deficits?
– What modality will best suit this individual?
– How will this modality affect the outcome of the treatment?
17
Clinical Reasoning
• s/p CVA with inability to bear weight to (R) LE due to fear of falling
– Does the patient have the ability to utilize this modality, cognitively and physically?
– What are the contraindications of this modality, support required to complete this modality, etc.?
– Was the modality effective?
What next?
18
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
6
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Supporting Evidence‐based Practice
Wii gaming technology represents a safe, feasible, and potentially effective alternative to facilitate rehabilitation therapy and promote motor recovery after stroke. Saposnik, G et al. Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation. Stroke; 2010 41(7) 1477‐84.
Occupation‐based performance vs. simulated tasks
19
Additional Resources
• www.newswise.com
• www.webmd.com
• www.businessweek.com
• www.physorg.com
• www.pcmag.com • www.ncbi.nlm.nih.gov
• http://www.youtube.com/watch?v=fPtnI3mr6hU&feature=related
• http://www.youtube.com/watch?v=g4YvC‐Ya874
• http://www.acplus.com/omnivr/Pages/default.aspx
20
References
Deutsch, JE et al. Use of Low‐Cost Commercially Available Gaming Console (Wii) for Rehabilitation of an Adolescent with Cerebral Palsy. Phys Ther.; 2008; 88 (10) 1196‐1207.
Fitzpatrick, M. & Harding,L. Using the Wii for Vestibular Rehabilitation. Vestibular Disorders Association. http://www.vestibular.org/
Saposnik, G et al. Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation. Stroke; 2010 41(7) 1477‐
84.
21
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
7
Grand Rounds Presentation
Use of the Nintendo Wii in Rehabilitation
Any
questions?
22
This presentation may not be duplicated or distributed without written permission.
Please contact [email protected] for additional information.
8