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Stroke Smart Magazine

September/October 2008

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Video Game-Based Movement Rehab

By Stephen J. Page, PH.D.

My team develops and tests movement therapies for stroke patients. One device that we  recently studied was the Nintendo Wii™ video game system.

In many ways, the Wii™ is similar to traditional video games. The user is equipped with a handheld controller. This device is used to control a character embedded in the game.  Cartridges are inserted into the system’s console. There are many different games. Unlike traditional gaming systems, however, the Wii™ hand controllers have sensors in them that detect where the user’s hand is in space. This feature allows the user to control the character on the screen through his own physical movements. For instance, if the user moves his arm, the character’s arm moves accordingly. With the Wii™ system, the user can virtually bowl, box, and play other games.

The Wii™ has some promise as an interesting tool for rehabilitative purposes. The large movements that patients must perform to play many Wii™ games are a great way to motivate patients to move their weak arms. This movement may help patients perform exercises that would normally be unexciting (e.g., basic range of motion exercises for the arm).

However, there are limitations to Wii-habilitation:

  • New skills are learned by repetitive practice. Since the Wii™ doesn’t have games that  work on skills such as writing or grasping objects, it will probably not be helpful with these types of fine movements.
  • Many Wii™ games require some pressing of controller buttons during movement. Yet only a few stroke survivors have the finger movement necessary to perform such pressing. So, games requiring finger movement could be a challenge for many.
  • Finally, while many have jumped on the Wii™ bandwagon, the system and its components are pricey.

The good news is that there are less expensive alternatives on the horizon. Our lab is testing a video game system that sells for about $30. Using a camera that mounts on top of any television, the game uses immersive virtual reality that places users directly into the game as they play it. This technology allows patients to watch and monitor their movements in real time, while interacting with the game. Patients can pop balloons, catch or deflect soccer balls shot at them, or perform other activities with the system. Other systems, available at local toy stores, come with motion-sensitive balance boards. As patients shift weight on the board, they can adjust the direction of a surfboard, or change other movements in the game to aid balance.

When it comes to improving arm and leg movement, video games are going to be a valuable tool for stroke survivors.

Stephen J. Page, Ph.D. is an Associate Professor of Rehabilitation Sciences, Physical Medicine and Rehabilitation, and Neurosciences, all at The University of Cincinnati Academic Medical Center. He is also Director of the Neuromotor Recovery and Rehabilitation Laboratory (NmRRL) at Drake Rehabilitation Center in Cincinnati, Ohio. You can learn more about Dr. Page, his team, and their ongoing research at http://www.rehablab.org/.



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