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Nintendo Wii as OT - March 2009

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Nintendo's Wii as OT?, One Occupational Therapist sees what the fuss is all

By: Britt Collins M.S. OTR/L

Many of us have heard of a new innovative entertainment system from Nintendo called the Wii (TM and copyright Nintendo Corporation). The motion sensored system allows players to virtually ski down mountains, box in a ring and drive on a race track, amongst many other exciting activities. You may have read how physical therapists are using the Wii for therapeutic activities during their rehabilitation with adults and some occupational therapist are using the Wii during therapy for patients with Parkinson’s to work on their balance and coordination skills. Various articles have been written about Wii-hab, but not much actual research has been done yet on this product and how it can help people with disabilities. For this assignment, I gladly strapped on my Wii wrist remote and dove into my research.

I could easily see how the Wii would be beneficial in a pediatric hospital for patients with mental and physical disabilities. When children are weak, tired and sick they are not motivated to participate in therapy, but playing a video game is appealing and while playing they don’t feel like they’re doing work. In this case, they may be working many systems at once. Wii Sports is a great game to play with kids because most of them already understand the basic rules of bowling, tennis and baseball. Boxing is also a fun way to get kids up and moving and golf teaches patience and coordination. These games can be slightly adapted to each child’s specific needs and if a child is unable to stand up or they are in a wheelchair, they can bowl sitting down, or swing the baseball bat using one arm. Ultimately you want a child actually getting up and moving using both sides of their bodies which uses both sides of the brain to work on coordination, eye-hand skills, timing ability, balance and more.

A few co-workers at the hospital participated in my Wii study. One OT working with a child in rehabilitation that has a diagnosis of Guillain Barre brought in her Wii Guitar Hero World Fusion and set it up for him to play. His muscle tone is weak and most of the time he is too tired to participate in therapy, but he was able to play the various instruments, drums and guitar and really enjoyed it. For therapeutic purposes, he worked on bilateral hand coordination by listening to the beat of the music and hitting the guitar strings or the drum pads when appropriate. He also was able to work on his active range of motion and functional hand use. It was refreshing to see a smile on his face after suffering from sickness all of the time. Another child that I see on a regular basis told me about a Wii game she enjoys playing called Cooking Mama. She really likes being able to make certain foods to obtain high scores. What she doesn’t realize is that she is working on visual motor skills, eye-hand coordination skills, timing abilities and fine motor skills to hit certain buttons.

A game that has a lot of character and is exciting for slightly older children is Raving Rabbids. A variety of games are offered to play and many of them work on visual perceptual skills by finding objects hidden amongst a busy background. Kids have to coordinate both sides of their body to maneuver their character around a course or to flip burgers and toss them into the mouth of a walrus. Another activity may have you racing to copy shapes with your Wii remote before your time is up. When aiming the remote at the T.V. to pick up an object or knock something out you are using eye-hand coordination, and many different visual skills including figure ground, visual perceptual skills, and discrimination between which object you are supposed to be knocking out.

In a clinical setting, you can pair two children of similar skill level together as part of your therapy plan. The competition is another motivator and makes the “therapy” fly by. Bowling, tennis and baseball are usually a big hit with the kids as they thrive off of the competition. Bowling can take some practice to maneuver the button underneath your thumb, swing the controller behind you in a sweeping motion and then release at the right time. It is also fun trying to twist your hand while bringing your controller forward to make your bowling ball spin. With baseball, you can play a regular game, or you can select a homerun derby and try to hit as many balls as you can out of the park! Be careful, your arm can get quite sore after swinging so many times!

The Wii Play has many options for simple games that most of us enjoy, like pool, air hockey and table tennis. One game in particular you have to have a steady hand and quick visual discrimination skills to decide which position your Wii character is in and then pop the bubbles before they hit the ground. Once you get up to the higher levels, you have the change your position of your Mii character really fast and be quick at the draw. Air hockey is one of my favorite pastimes and you can play with a partner to see who can score the most points.

The Wii balance board is used in many different games and challenges children’s balance and coordination as well as improving core strength like the We Ski game. When playing We Ski you can use the balance board, or for kids in a wheelchair, you can still ski just using the controllers. On the slopes, you can pick various courses and activities that enhance coordination. In one hand you have the Wii remote and in the other you are holding a Wii Nunchuck. While standing on the balance board, you use your poles as though you are skiing down the mountain. Leaning left and right on the board makes your character turn and if you push down on your controls, you go faster down the hill. You can talk to different characters in the game to practice jumps and tricks. You have to watch out though; another skier might run into you knocking you over!

Wii Fit and Let’s Yoga are great for working on a child’s ability to use their motor skills in a fun way, but also to strengthen and increase focus. When standing on the balance board on one leg, I found myself having to try so hard to not fall off and could feel myself engaging my stomach (abdominal) muscles and leg muscles. Children who are weak or have low endurance can do some of the slower less impact games to work on these muscle groups and breathing techniques.

Wii Music helps kids understand music and teaches them how to listen to a beat and interpret the sounds. Parts of the game challenge you to work on your timing to hit the right note at the right time and even be able to tell which instrument is out of pitch. The program encourages auditory processing and the ability to discriminate sounds. This type of game is a wonderful esteem builder to children who may not have the best coordination because they do not focus as much on motor skills, but more on listening and following directions.

The Wii could also be beneficial in the home environment. As Occupational Therapists, we know how important it is to have kids practice skills at home that we work on in the clinic. The Wii allows kids to play while they strengthen those skills. Perhaps, if a child is working on tasks such as eye-hand coordination, like catching a ball, or figuring out how to walk around their environment without knocking into anything, the Wii Fit balancing games or a game of tennis would be conducive to their therapy plan.

Overall, I’m a big fan of the Wii and its potential for therapeutic activities. My understanding is that the Wii is for entertainment only and it not designed for therapy use. That being said, as an occupational therapist I like to use the game as a tool to move and motivate my kids under my supervision and I tell their parents to please do the same. So, have fun, be safe, and do some Wii research yourself – you’ll enjoy every minute of it.

The Nintendo Wii Gaming Console, Wii Balance Board, Wii Nunchuk, Wii Remote, Wii Sports, Wii Play, Wii Fit, Let's Yoga, Guitar Hero World Fusion and Wii Music are all trademarks and copyright of Nintendo Corporation. Cooking Mama is trademarked and copyright of Majesco. Raving Rabbids is trademark and copyright of Ubisoft. We Ski and Snowboard is copyright of Namco Products. PediaStaff and TRP Wellness do not profit or benefit by the sale or use of the above products. The Wii and games mentioned above are designed solely for entertainment purposes. PediaStaff and TRP Wellness is not liable for injuries or damages during the use of the Wii or games mentioned.

This Month's Featured Organization: TRP Wellness

Special Thanks to Britt Collins M.S., OTR/L for her article "Nintendo Wii as OT?" Together Britt Collins, M.S., OTR/L and Jackie Olson created their OT DVD series; "OT in the Home," "OT in the School," "OT for Children with Autism, Special Needs and Typical," and "Yoga for Children with Special Needs," which won an outstanding product award 2008 from iParenting, a division of Disney. She has practiced in many settings including sensory integration clinics, schools, homes and rehab and skilled nursing facilities.

Britt may be heard monthly on her radio show about the benefits of occupational therapy on Autism One Radio.

Tags: March 2009 Newsletter Vestibular Balance & Coordination Issues Fine Motor Skills Gross Motor Skills Yoga Article OT