Why the Nintendo Wii has a future in PT

By Lauren Himiak

I would like to start this article fully admitted that I am biased toward video games. Yes, I play them. Do I enjoy them? Like you wouldn't believe! I blame, or rather credit, my father for instilling my passion for them. I vividly remember Christmas morning, 1986, when my sister and I found a large box under the tree labeled for both of us. With excitement and curiosity we ripped away the red and gold wrapping to discover a Nintendo Game System. Both quite young, we were vastly confused and looked to our father with wide eyes as if to say, "I don't get what this is." Of course, my dad felt it was necessary to postpone other presents and immediately hook up this new game system.

I didn't fully understand how that small, grey rectangular piece of equipment would forever change my childhood. Yet it did, and to this day I enjoy playing Nintendo. But this article is not a history of my passion for Nintendo; it is rather a look at how Nintendo has enormous potential to create a healthier future for children.

Let Me Explain

You may be scratching your head at this point. You have probably read articles stating how video games lead to laziness, weight gain, violence and even attention deficit disorder. But when used in moderation, video games have huge potential.

Going through physical therapy can be a daunting and demanding task. As a child, it is difficult to wrap the brain around the fact that going through pain will actually improve the body. By using virtual reality based therapy, PTs can not only keep children engaged in their therapy, but they can see amazing results.

The latest in Nintendo's impressive portfolio is called the Wii (pronounced "we"). Released in November 2006, the system is comprised of a wireless console and a remote that acts like a handheld pointing device. Using digital sensors, the Wii can detect motion and rotation allowing the player to literally play the game. When a player physically simulates the act of throwing a baseball, the game mimics the same movement. The system forces players to get out of their seats and physically exert themselves in the games.

Publications such as PC Magazine, Fortune magazine and Time have written about how Wii has taken over the gaming population, some claiming it is the best of those products. It seems that the largest health gain to come out of using this system is weight loss. People from all over the world have voiced how they have lost weight playing Wii.

In the January issue of Pediatrics, the Mayo Clinic reported that children burn three times as many calories while playing active video games as opposed to traditional hand-held video games.1 In fact, when searching online; one can find hundreds of blogs from people who claim they have lost weight simply by playing Wii every day.

Games Are More Than Just Fun

By using systems that force physical movement, physical therapists can work to improve proximal movement as well as fine motor skills.

"I think a virtual reality therapy approach is a really exciting new avenue to develop in, both in pediatric and adult rehabilitation," stated Darcy Fehlings, PhD, physician director of the child development program at Bloorview Kids Rehab, a teaching hospital of the University of Toronto.

Dr. Fehlings is currently part of a research team at the university working to create a therapeutic video game for children with hemiplegic cerbal palsy. This condition leaves patients partially paralyzed on one side of the body. They must deal with muscle tightness, spasticity and impaired movement. Children with hemiplegia typically use their unaffected side for fine motor skills, leaving the other side to dehabilitate further.

"We came up with an idea of trying to get a virtual reality system into the home with the focus on helping children with hemiplegia to improve their upper arm skills," Dr. Fehlings said. "To date, a lot of the virtual reality programs have been available with really expensive units that are based in institutions. We wanted to come up with a less expensive unit."

Dr. Fehlings worked with her associate, professor Tom Chau, to recruit William Li, 21, a fourth-year engineering student, and Sophie Lam-Damji, an occupational therapist, to work on the project. Trying to come up with ideas, they noticed how beneficial virtual reality game therapy has been with stroke patients and decided to take a similar approach.

"We wanted to make sure it met certain requirements," noted Li. "It had to be a home-based device, and it had to promote certain movements such as elbow and shoulder flexion. Through those efforts we decided a game would be the best approach."

The game incorporates the PlayStation 2 Eye Toy, a USB camera that sits on top of the TV set and is connected to the system, similar to how the Nintendo Wii works. But in order to help children improve motor skills in their weak sides, they made one huge adaptation.

In order for the game to work, children must sit in a chair and hold down a button that is placed on one side of the chair. If they let go, the screen goes blank. This forces children to occupy their good hand and use their weak hand to play the game. Working with the motion-detecting Web camera, the game controller becomes an extension of the arm, allowing children to reach up, throw, grab and perform other fine motor skills.

"What's unique is this is a one-handed system," added Dr. Fehlings. "For a child with hemiplegia we could use constraint therapy and place a cast on the child's non-hemiplegic hand, forcing him to use his hemiplegic hand. But of course, children do not like constraint therapy. That's why we are so excited about this research project; because the kids are so excited it."

Participants range from 5 to 10 years-old and are asked to play the games for 30 minutes a day for three months. The study is being funded by the Bloorview Research Institute, and the team is hoping they don't stop there. Currently, they are at work to develop another game device from scratch, one that focuses more developing hand skills.

Wii Can Help You

It seems undisputable that virtual reality games, including the Nintendo Wii, have potential for players to lose weight and improve motor skills. In a statement to Time magazine, Perry Kaplan, vice president of marketing for Nintendo, said, "One of our hopes was that people would find a way to enjoy the Wii sitting on the couch or getting up and moving their body around. This huge fitness craze was more than we had anticipated."¹

"I think there's real potential for the Nintendo Wii and with similar systems," Li added. "It really is a way to promote different kinds of movements. It certainly promotes more activity than using a regular game controller."

Physical therapists, especially in pediatrics, will hopefully see the potential of using gaming systems like the Wii to encourage movement and recovery. Obviously all needs to be done in moderation. When kids catch wind that they can play games as a form of therapy, it could lead to some problems. But PTs, physicians and parents can control how long children play.

"Yes, virtual reality therapy has a lot of possibilities because of the fun aspect of it," noted Dr. Fehlings. "But wearing my other hat as a pediatrician and a mother, we have to watch the amount of time our kids are spending on video games and watching TV. We want to make the child has a well-balanced approach to leisure activities."

Lauren Himiak is assistant editor at ADVANCE. She can be reached at lhimiak@merion.com

Reference

1. Schmidt, T. "Is the Wii Really Good for Your Health?" Time. Feb. 1, 2007.

Wii May Have a Problem

Although new technology is paving the way for virtual reality video games, there have been a few downfalls. And majority of them revolve around injury.

In December 2006, more than 3 million controller straps were recalled for the Nintendo Wii. This was due to increasing reports of gamers injuring themselves or others while playing. The strap is worn like a bracelet around the wrist of player's hand holding the controller. It is worn snugly so that if a player gets too excited, the controller won't fly out of their hand. Unfortunately, that happened too.

Many of the early straps snapped, causing controllers to fly across the room, sometimes breaking any object in site. Numerous Web sites posted photos of broken windows, televisions and lamps, all apparently from the Wii controller. Nintendo replaced the controller strap, making it thicker and more durable.1

Other gamers have complained of being sore after playing the Nintendo Wii. In Boston, one physician actually documented a case of "Wiiitis." Dr. Julio Bonis told a patient that his sore shoulder was caused from playing too much Nintendo Wii. The patient was a fan of playing tennis on the game system but was waking up with a constant sore shoulder.2

Nintendo has received complaints since the Wii was released of players being sore after playing for long periods of time. Even before the release of Wii, complaints were made by people whose thumbs were sore from extended video game use.

If you are becoming seriously injured from a video game, there may be two answers: 1) This may not be the game system for you. And 2) Perhaps you may want to increase your daily dose of exercise.

References

1. "Nintendo Wii Recall." Dec. 15, 2006. From the World Wide Web. http://www.wkyc.com/news/news_article.aspx?storyid=60677.

2. "If It's Not Tennis Elbow, It May Be 'Wiiitis." June 6, 2007. From the Word Wide Web. http://www.cnn.com/2007/TECH/fun.games/06/06/wii.elbow.reut/index.html

–Lauren Himiak