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    Wii Makes For The Most Fun Parkinson's Occupational Therapy Ever
    By News Staff | April 6th 2008 02:00 AM | 3 comments | Print | E-mail | Track Comments
    Parkinson’s disease affects daily tasks that people take for granted. Brushing teeth, getting out of bed and walking become a problem for these patients because of dopamine depletion, which results in stiffness or slowing of movement and fine motor dysfunction.

    While occupational therapy is frequently used in the comprehensive care of Parkinson’s patients, evidence is needed to support its short- or long-term effectiveness, says says Dr. Ben Herz, assistant professor of occupational therapy in the School of Allied Health Sciences at Medical College of Georgia.

    Toward that end, 30 Parkinson’s disease patients have been participating in a study to determine if occupational therapy enhances the treatment of the disease - and they are using a Nintendo Wii to do it.

    Ingrid Bell, left, uses the Nintendo Wii with guidance from her occupational therapist, Jessica Westmeier-Shuh. The Wii is part of an MCG study examining the efficacy of occupational therapy in treating Parkinson's disease. Credit: Medical College of Georgia


    “Occupational therapy looks at how the illness affects the patient’s whole life, from the psychological, cognitive and sensory motor standpoints,” says Herz, a study principal investigator along with Dr. John Morgan, neurologist. “Our therapists are responsible for helping someone maintain or gain their independence with functional activities.”

    “We’re hoping to show a slowing of the progression of the disease and a decrease in medication while increasing function. If we can teach patients to exercise and do functional activities, maybe we can have them take less medications,” he says.

    Study participants are divided into an experimental group receiving therapy or a control group that does not. Each participant meets individually with an occupational therapist for one hour a week for eight weeks. Participants in both groups are given functional and standardized tests and evaluated on a quality-of-life scale before and after therapy begins, then four months later. The control group has the option to receive therapy after the second evaluation.

    “None of the participants have had occupational therapy before because we wanted no preconceived notions of what therapists would do or how they would do it,” Dr. Herz says. “A few participants were probably taken aback when they heard they’d be playing video games.”

    But the Wii has been popular with both participants and therapists.

    “Because the Wii is interactive and you have to do certain functional movements to be successful, it’s an effective modality for working with Parkinson’s patients,” says Dr. Herz. “One of the therapists uses the Wii for timing and loosening up, and the other uses it for coordination and balance issues.”

    Participants also perform functional activities, such as dressing and rolling over in bed; fine motor skills, like circling in word searches and carefully moving blocks in the game Jenga; and stretching.

    “These therapists are thinking way out of the box. They’re doing activities that will make a difference in these participants’ lives based on what we know about Parkinson’s,” Dr. Herz says.

    Early results show at least short-term gains. Therapists set goals for each participant prior to treatment. These goals range from independence with daily living activities, such as cooking, dressing or bathing, to functional activities such as sports and leisure without any adaptation. About 98 percent of those goals have been met or surpassed, Dr. Herz says.

    When Mrs. Bell started therapy in January, she was dependent on her husband to walk, dress and get out of bed. She could climb only one step on her own.

    “Now she’s doing 24 steps without any difficulty,” says Dr. Herz.

    “I may need help putting my shirt and shoes on, but I’m trying as hard as I can to do it myself,” Mrs. Bell says.

    The study, funded by a $30,000 grant from the National Parkinson’s Foundation, is a collaboration between the Department of Occupational Therapy and MCG’s Movement Disorders Program.

    Comments

    IM A patient of PD 10 years. stalevo and requip no longer work. At present for the most part of waking its either
    dyskinisia or tremor. quality of comcious or awakinng hours is gone.

    The major component of a dedicated rehabilitation software is the functionality to allow the therapist to customize the games to the patients disability or handicap. All aspects of the exercise task have to be customizable to the patients motor, sensory and cogntive ability. therefore parameters such as the difficulty of the exercise task relative to the patients movement ability and the maximum time to play for the game needs to be under the therapists control. This flexibility will prevent for example overuse injuries as well as the patient developing a compensatory movement pattern.

    However as the article points out, the software has to motivate and challenge the patient to perform repetitive practice. The MediTouch HandTutor is a rehabilitation glove and software which offers impairment oriented training and augmented feedback. The HandTutor provides repetitive customized isolated or inter joint coordinated finger and wrist hand exercises and rehabilitates fine movements of the hand and wrist. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and Orthopedic conditions.

    Research with the HandTutor confirms that Task oriented training should be combined with Impairment oriented (IOT) training to achieve enhanced functional recovery. The HandTutor is used in hospitals and community hand therapy clinics as well as through tele rehabilitation. Examples of patients that are treated include Stroke, TBI, spinal cord injury CP, Orthopedic hand and arm surgery, development co-ordination disorders in children etc. At the same time the dedicated rehabilitation software motivates the patient to continue intensive repetitive exercises by providing challenging games that have been designed around both neurological and orthopedic conditions.

    Experience of Occupational Therapy is such good experience in everyone's life because it changes the very living style, increase performance to do activities and improve abilities. I also tried it once when I was suffering from back problems. In this therapy person doesn't really feel like he's getting a treatment because the method is very different but yet very effective.