Technology: Playing a Key Role in Rehab Programs
From: Veterans' Health Matters - Volume 2, 2008

It made its worldwide debut in September 2006, five years after Nintendo
designers and engineers began work on the Japanese company's fifth home video
game console. Given the unusual name of Wii (pronounced "we"), it was an
instant success, being swept off store shelves as soon as it became
available.  

Aimed primarily at video game fans, the Wii gaming system has taken on a
different and evolving therapeutic role. Today, the Wii has become a fun part
of the rehabilitation process and a form of "therapy" for veterans and
returning service members at the VA Palo Alto Health Care System (VAPAHCS)
Polytrauma program. 

VA's Mission
The Polytrauma Unit, which cares for severely injured service members with
Traumatic Brain Injury (TBI) and other serious and often life-threatening
injuries, has introduced the Wii system during Recreation Therapy treatment
sessions.  

Polytrauma refers to the complex patterns of injury commonly seen in
personnel injured during Iraq and Afghanistan deployments. Polytrauma
typically results from blast injury caused by improvised explosive devices or
rocket-propelled grenades. The combination of high-pressure waves, explosive
fragments, and falling debris produce multiple injuries, including brain
injury, amputations, burns, wounds, fractures, blindness, and hearing loss. 

The magnitude of these injuries, and the circumstances in which they occur,
can cause additional psychological stress to patients and their families.
Consequently, reports Richard K. Smith, Certified Therapeutic Recreation
Specialist and Recreation Therapy Supervisor, their care requires a full
complement of medical, surgical, rehabilitation, and mental health personnel
and services. 

"From a recreation therapist perspective," Smith reports, "the emphasis and
treatment goal of using the Wii may include increasing the patient's handeye
coordination, improving balance, strength and movement, and overall safety in
their environment. The activities are something patients enjoy and benefit
from and continue using when they go home. From the patient perspective, it's
all about "having fun." While bowling, a patient mentioned that he never knew
"therapy" could be such fun."  

"The beauty of the Wii and adaptive technology," Smith adds, "involves other
applications, such as social networking sites on the Internet. It helps
patients get back into communicating and socializing with their families,
friends and comrades in other locations. The virtual togetherness is a great
way to help them in their recovery and rehabilitation process."  

The inpatient Polytrauma program currently has three recreational therapists,
who meet with patients during individual and groups sessions. "Using the Wii
system and gaming can enhance part of the treatment session," Smith says,
"Arm movements during boxing and recreation therapy sessions can also address
issues brought up in other areas, such as physical therapy."  

Bed-bound patients are also involved in recreation therapy during bedside
treatments sessions; a computer or gaming system can be rolled directly to
patients' rooms. 

Outpatient and Transitional Programs
Much of the responsibility for the transitional outpatient Recreation Therapy
programs is in the hands of Susan Feighery, Lead Recreational Therapist.
"Much of our work," she says, "involves applying current technology to meet
the clinical needs of our recently wounded combat service personnel."  

For example, the program uses the Wii Brain Academy game to increase
cognition, memory, mathematical and visual scanning skills with head-injured
patients. In addition, the Wii Sports program allows patients, families, and
friends to compete athletically, while the recreation therapist measures and
monitors the physical recovery process. 

The recently released Wii Fitness program teaches other mind/body fitness
skills through innovative activities, such as yoga and hula hoop contests. 

Additionally, all Wii programs, when clinically utilized, can address
specific patient deficits via interventions involving behavioral, social,
physical and cognitive applications, which can then be directly transferred
to the patients’ home environment when they return to their local communities. 

"Keeping up with rapidly changing technology can be quite a challenge," says
Feighery. "There's a huge learning curve, but tools such as Wii and the
XBox360 make treatment sessions enjoyable for both patients and clinicians.
In using gaming technologies, we're breaking new clinical grounds, as we
develop new treatment strategies."  

"With clinicians, patients and families working as a team, we certainly put
the ‘WE’ in adaptive WII technology," stated Feighery and Smith. 

"We're constantly learning from our patients and their families," Feighery
says. "But there may be veterans out there with strong gaming skills who can
assist us in the development of future adaptive technology and gaming
programs."  

Source:
http://www.visn21.va.gov/docs/VHM/VHM_2008_Vol2.pdf