As the proud possessor of a brand new Wii and WiiFit, I’m a convert to the addictive powers of the Wii. I’m not the only, and certainly not the first person to think of the rehabilitative potential of the Wii – in fact it’s been one of the most successful ‘cross-over’ toys that the computer geeks have come up with.
I am planning to use the Wii and WiiFit to study whether it can help develop balance, activity tolerance and especially increase proprioceptive awareness in people experiencing persistent pain and complex regional pain syndrome. There are clinical guidelines I’ve just discovered here at RehabCare who have produced a podcast covering clinical practice guidelines for using the Nintendo Wii. And I’ve just found an occupational therapist’s site called WiiHab!
I’ve had mine for two days now, I don’t want to admit to the number of hours I’ve spent on it (sad but true!), and there are a few quibbles about it for my purposes: the main problem with the WiiFit component is that it’s not modifiable so as a therapist I can’t select the exercises I want to prescribe for the people I work with; and I haven’t yet worked out how to transfer the cumulative graphical information into another format. But I do like the English (UK) instructors accent, and that it’s possible to view how to do the exercises from front or back. I also love the portability of it, and the relative lack of bits and pieces apart from the controller and WiiFit platform.
With a bit of tweaking from some geeky types, I’m sure it will be possible to modify the bits I’m less than happy with, or perhaps Nintendo will work out that this is a feature that it could provide in a ‘therapy-specific’ version of the programme. From the search I completed on Google just using the term ‘Wiihabilitation’ which came up with 9,920 hits, it seems clear that there is a demand for it within health and rehabilitation settings.
For pain management? Well apart from my specific study, I think the Wii has further application as an alternative to the many gym-based exercise programmes that are funded by major rehabilitation funders such as ACC or WorkCover.
To date there is no conclusive evidence that any specific fitness programme is superior to any other for the management of chronic pain (particularly low back pain), so it seems reasonable to think that any activity that is engaging, motivating and appeals to families might be able to be purchased or loaned as part of a pain management programme. Under the supervision of a therapist (occupational therapist or physiotherapist) a person with chronic pain can be guided through the process of gradually regulating their engagement in activity while at the same time learning how to integrate pain management skills.
It would be even more appropriate if the therapist can select and grade the level and type of activities the person uses. Hey, adding in a couple of biofeedback elements (like a heart rate monitor or skin conductance monitor) would make it even more useful!
The main concern I have with any exercise-focused pain management is that in the enthusiasm to engage in ‘fitness’ it becomes the goal rather than a means to develop activity tolerance, reduce avoidance, and a method for developing appropriately paced activity.
I think a time-limited loan or rental of something like the WiiFit could be a great way for someone to develop the skills until they move into the next phase of learning to live with chronic pain – returning to ‘normal’ activities. And if fitness or exercise becomes part of the person’s general pain management regime, and a Wii is something they use, it might be helpful. Of course, if they prefer to salsa dance, go rock climbing, trot around the shopping mall at full tilt, or perhaps go to a local tai chi class – then that might be a better option!
The main thing is that here is a gadget that is fun, well-accepted, and emininently modifiable. Oh, and it makes for team-building as well as family fun while the therapist/s are learning to use it!!