New Technology in
Physical Therapy:
Nintendo Wii
Northeastern University
Overview
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Introduction
Treatment Objectives
Physical, occupational, neurological rehab
Which health care professionals use WiiFit?
Which patients use WiiFit?
Wii Golf
Wii Balance Board
Arthritis
Total Knee Replacement Case Study
How is WiiFit helpful?
Introduction
• When it comes to technology in physical therapy, there have
been some exciting new advances in the field. Innovations in
physical therapy technology serve to shorten patients healing
times, increase comfort levels, and improve the overall level of
care. Some of the newest technology devices used by physical
therapists includes the Nintendo Wii. The Wii aids patients in
recovery and is used by therapists in physical, neurological,
and occupational rehabilitation.
Source: http://www.ducksters.com/games/wii-sports-golf.php
Treatment
Objectives
Visual-perceptual
processing
Postural control
Functional
mobility
Physical, occupational,
neurological rehab
• Balance/movement:
• common concerns for those recovering from brain injuries/strokes
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Range of motion
Motor skills
Gross motor coordination: walking/lifting
Endurance
Strength
Source: http://blog.chron.com/armedsources/2010/04/veterans-use-nintendo-wii-as-physical-therapy-tool/
Wii is used by…
• Physical Therapists:
• Physical Therapists can tailor
patient sessions to avoid
overuse common with Wii’s
simulated sports. They can
also better explain center of
gravity through the use of
Nintendo Wii and help
patients use that knowledge,
as the Wii Fit allows patients
to see how they affect the
game when they change their
balance.
• Occupational Therapists:
• Occupational therapists use
the Wii to help patients
relearn daily living skills such
as getting dressed
Source:
http://blog.cleveland.com/lifestyles/2008/06/wii_fit_n
intendo_game_makes_ph.html
Wii-hab for what type
of patients?
Stroke
Arthritis
Combat injuries
Broken Bones
Lower
extremeties
Upper
extremeties
Surgery
Burn injuries
Nintendo Wii Golf
• Patient swings wireless hand-held motion-sensitive
wand
• Animated screens stimulate holes on a course
• Ease in coaxing patients into movements that could
have taken more time to achieve in the traditional
manner
• Scoring provides immediate feedback to patients
• Hula hooping, boxing, ring toss, and bowling are
other commonly played games in wiihabilitation
Source: https://resnet.gatech.edu/GAMINGSYSTEMS/Pages/wii.aspx
WiiFit Balance Board
• Vestibular therapy
• Board’s sensors record foot and leg movements
• Provide visual stimulation while simultaneously
challenging balance
• Program choices include lateral weight shifting games,
static/dynamic postural control, and multidirectional
balance games
Source: http://www.engadget.com/2010/01/19/wii-balance-board-decent-for-measuring-equilibrium-medical-stu/
WiiFit Balance Board
• Lateral Weight Shifting
• Tightrope walk- Patients stay balanced when walking and jumping over
obstacles while experiencing visual distractions such as birds flying by.
The sharp turns necessitate increased pressure on the side towards the
side which the user wishes the character to turn.
• Multidirectional balance
• Table Tilt- This requires refined weight shifts in which the user is
required to apply pressure to the balance board which move marbles
across a board and into holes.
• Static/Dynamic Postural Control
• Deep breathing- The user stands still on the balance board and takes
slow deep breaths while a tracking dot is displayed showing the user’s
center of gravity and weight distribution. The user is encouraged to
guide the tracking dot into the center of a given target to achieve
optimal postural alignment and even weight distribution between the
right and left sides
Helps With Arthritis
• Physical activity maintains a healthy and active life
• Helps bone structure: movement of joints promotes strength
by stretching tendons and muscles
Source: http://www.knowabouthealth.com/play-nintendo-wii-to-stay-fit/1260/
Case Study: Total Knee Replacement
• Setting: Outpatient department of a rehabilitation hospital
• Participants: Adult outpatients following total knee
replacement
• Interventions: The study group receieved a physiotherapy
session followed by 15 minutes of Wii Fit activities. The games
encouraged lateral and multidirectional weight shifting, and
provided visual feedback regarding postural balance. The
control group received a physiotherapy session followed by 15
minutes of lower extremity strengthening and balance training
exercises
• Main outcome measures: 2-minute walk test, knee range of
motion, timed standing, activity-specific balance confidence
scale
Case Study: Total Knee Replacement
• Conclusions: Wii fit is potentially acceptable as an adjunct to
physiotherapy intervention for outpatients following total
knee replacement, provided that the games chosen challenge
balance and postural control and use the lower extremities.
However further research is needed to establish whether
video games as therapy adjunct increase patient motivation
and compliance with rehabilitation goals.
How is WiiFit helpful?
• The WiiFit is helpful in rehablitation because it is an engaging
and fun way for patients to do exercises, and allows them to
stay active.
• Sometimes, normal physical therapy exercises can be boring
for patients to do repetitively. Patients are more willing to
practice and maintain repetition if an activity is entertaining.
• The Wii connects learning, practice, and repetition.
• If patients have the Wii at home, it makes it easy for them to
do their exercises on their own. Games may also be shared
with family members to add to the enjoyment level.
• The Wii speeds up recovery time, and patients may be able to
walk longer and increase their standing time.
• It may reduce risk of falls in elderly patients.
Sources
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4 Physical Therapy Technologies Improving Patient Care. (n.d.). Health Care Staffing. Retrieved February 19, 2014, from
http://www.supplementalhealthcare.com/blog/2013/4-physical-therapy-technologies-improving-patient-care
Chen, B. (2012, September 11). New Breed of Robotics Aims to Help People Walk Again. The New York Times. Retrieved
February 19, 2014, from http://www.nytimes.com/2012/09/12/technology/wearable-robots-that-can-help-peoplewalk-again.html?_r=1&
He's Got Game. (n.d.). He's Got Game. Retrieved February 19, 2014, from http://www.apta.org/PTCareers/Profiles/He
Nintendo Wii’s Niche Market: ‘Wii-hab’ for Physical Therapy Patients. (n.d.). Promotional Products Blog Quality Logo
Products Inc. Retrieved February 19, 2014, from http://www.qualitylogoproducts.com/blog/nintendo-wii-niche-marketwiihab/
Physical Therapists Turn to Wii Golf. (2012, September 8). The New York Times. Retrieved February 19, 2014, from
http://www.nytimes.com/2012/09/09/health/physical-therapists-use-wii-golf-to-treat-patients.html?_r=0
Result Filters. (n.d.). National Center for Biotechnology Information. Retrieved February 19, 2014, from
http://www.ncbi.nlm.nih.gov/pubmed/2046
Use of Nintendo Wii FitTM in the rehabilitation of outpatients following total knee replacement: a preliminary
randomised controlled trial. (n.d.).Science Direct. Retrieved February 18, 2014, from
http://www.udel.edu/PT/PT%20Clinical%20Services/journalclub/noajc/12-13/Oct/NOA%20JC%20Wii%20TKA.pdf
Using the Wii for Vestibular Rehabilitation . (n.d.). Vestibular Disorders Association. Retrieved February 19, 2014, from
http://vestibular.org/sites/default/files/pag
Wii Fit Nintendo game makes physical therapy fun - Cleveland Lifestyles – Living, Food, Health & Fitness News from The
Plain Dealer. (n.d.). Wii Fit Nintendo game makes physical therapy fun - Cleveland Lifestyles – Living, Food, Health &
Fitness News from The Plain Dealer. Retrieved February 19, 2014, from http://blog.cleveland.com/lifestyles/2008/0