Video Games for Rehab

From the Footlevelers Website...

You’ve probably heard of the Wii and Kinect video games. Maybe they’re even sitting in your living room.

Gaming software isn’t just for kids. Some of the most innovative advances in physical therapy and rehabilitation are due in part to gaming devices—the key being how these devices actually work.

Ever hear of Exergaming?

Exergaming requires a system that responds to body movement or reaction—a player, using only the movements of his body can play a video game. No control, no joystick, just a flourish of the wrist or a swivel of the hips. We’re not talking about playing Pong, either—the video games supported by these systems can be incredibly complex and labor intensive. Exergaming has completely revolutionized the cultural stigma of gaming as a sedentary activity. Technology like the Nintendo Wii and the Microsoft Kinect are getting everyone off the couch and into the game.

The Kinect uses light to map the body with points of reference and stores it—being able to identify and remember players by facial structure, hairstyle, height and weight. This method of identification also enables the Kinect to observe a patient’s posture, and in the case of rehabilitation, whether or not the patient is performing the exercise correctly. On the other hand, the Wii is equipped with the Balance Board, a device that uses pressure as points of reference (as opposed to light). The Balance Board uses a player’s balance, alignment, and weight to determine progress and performance of exercises.

Patient doesn’t want to leave the house? No problem.

Microsoft’s Kinect can link you to your patients without ever having to leave their home. Where once patients had to come to a doctor’s office for supervised rehabilitation exercises, the Kinect enables the patient to perform exercises at home.

The Xbox Live (the Xbox internet) enables the doctor to review a patient’s progress, and check in face-to-face with Video Chat.

Both the Kinect and the Wii are affordable tools that perform just as well as costly medical equipment and can do everything from virtual doctors’ visits to injury rehabilitation. While gaming software is not a replacement for care (no machine can adjust, prescribe, or advise patients), it can be a valuable fitness and rehabilitation apparatus. Gaming tools such as The Kinect and the Wii Fit have "great potential for core strengthening and rehabilitation and may boost compliance exercises,” said Sue Stanley-Green, a professor of athletic training at Florida Southern College in Lakeland.

According to the National Athletic Trainers’ Association (NATA), these new gaming systems can assist with strength training, balance and aerobics, and show potential for increased exercise motivation.

As healthcare professionals know, one of the hardest parts of physical therapy is keeping patients motivated through tedious, repetitive, and sometimes painful exercises. Chances are, your patients have complained on more than one occasion about the banality of the exercises. Gaming software turns the dull into the dynamic, increasing compliance and potentially, your results. The game also serves as a distraction to patients who must suffer through more painful rehabilitation exercises.

“Acute pain is shown to be noticeably reduced in children and adult sufferers once engaged in video game activity,” said Charles Friedman, D.O. of the Pain Relief Centers in Pinellas Park, FL. “These video games do certainly play a role in relieving some pain through both distraction and movement.” The interactive aspect of this software creates a fun distraction, allowing the patient to go through rehab without even realizing it.

In addition to rehabilitation, gaming software is also a valuable fitness resource. Games that require extensive movement, such as dancing games like Just Dance 2 and Dance Dance Revolution (DDR), offer players the chance to work out, lose weight, and maintain a healthy lifestyle—without even knowing it. A study featuring 22 overweight and normal weight children between the ages of 11-17 found that DDR increases players’ heart rates so that they obtain an aerobic workout, even at the easiest levels of the game

Another study observed the physical intensity of playing DDR at an intermediate level of difficulty and found that it met official standards for developing and maintaining cardio-respiratory fitness in an active and aerobically fit population . Games such as Your Shape:
Fitness Evolved, EA Sports Active and New U Fitness are just a sample of the wealth of fitness games available. Check with your game dealer before you purchase game titles—most game consoles are “region locked”, meaning “an Xbox 360 console in North America cannot play game discs that are sold in Europe or in Asia on that console. An Xbox 360 console that is sold in Europe can only play game discs that are sold in Europe. And an Xbox 360 console that is sold in Asia can only play game discs that are sold in Asia.”

Systems that support these kinds of software are relatively inexpensive and the potential applications for the product in your office are virtually limitless.

1 Loftus, Jack. "In Early Tests, $99 Wii Balance Board Outperforms $17,885 Medical Rig." Gizmodo. N.p., 17 Jan. 2010. Web. 20 Dec. 2010.2 Rauscher, Megan. "Wii Fit Finding Its Way Into Rehab." Reuters. N.p., 12 June 2008. Web. 9 Dec. 2010.3 "NATA Offers Tips for Fitness Video Game Users." National Athletic Trainer's Association. N.p., 29 May 2008. Web. 20 Dec. 2010.4 Taylor, Owen. "Wii Fit, The Balance Board and Its Role in Physical Therapy." Ezine Articles. N.p., n.d. Web. 3 Dec. 2010.5 Unnithan, V. B.; Houser, W.; Fernhall, B. (2005). Evaluation of the energy cost of playing a dance simulation video game in overweight and non-overweight children and adolescents. International Journal of Sports Medicine, 26. 1-11.6 Tan, B., Aziz, A.R., Chua, K., & The, K.C. (2002). Aerobic demands of the dance simulation game. International Journal of Sports Medicine, 23, 125-129.7 Manners, Tom. "Are international games compatible with local consoles?" MyGaming. N.p., n.d. Web. 3 Oct. 2009.

Dr. Joshua Brooks,
Chiropractor, Fairfax VA