Using the Wii for Vestibular Rehabilitation Clinical Observations

PO BOX 13305 · PORTLAND, OR 97213 · FAX: (503) 229-8064 · (800) 837-8428 · [email protected] · WWW.VESTIBULAR.ORG

By Margaret Fitzpatrick, PT, DPT, OCS, and Lynne Harding, PT, (Willow Grove Physical Therapy) and the Vestibular Disorders Association

The Nintendo Wii is a popular video game program. Before introducing the Wii into console that permits users to be more therapy, we typically start patients with physically active during what has clinically proven exercises to improve traditionally been a sedentary activity. gaze stabilization and balance. Once Wiis include a hand controller that senses patients are able to perform vestibulo- players’ movements; for instance, players ocular reflex exercises that involve head- may see an image of a bowling lane with shaking while in front of a busy visual a group of pins, and a hand that background, the Wii can be introduced as corresponds to their own hand’s position a progression into more demanding holding a ball. To knock the pins down, activities. players will use the same physical motions required during an actual bowling Using the Wii for vestibular therapy game: drawing an arm back and then requires a balance board called the WiiFit. moving forward in order to “throw” the When patients stand on the WiiFit, the virtual ball. This element of real-life board’s sensors record their foot and leg movement has inspired people of all ages movements. Before starting a program, to use the Wii as a tool for physical patients create personal profiles with fitness. their individual statistics, including height, weight, age, and basic balance A recent case study noted that the use skills. A physical therapist can then work of the Wii for physical rehabilitation together with each patient to create a produced improvements in visual- treatment plan of activities. perceptual processing, postural control, and functional mobility (Deutsch et al, Program choices that have been 2008). Now physical therapists are using successfully used at our clinic include the console to help patients recover “Tightrope Walk,” an activity where balance. At our clinic, the integration patients have to stay balanced when of dynamic balance, visual stimulation, walking and jumping over obstacles while and realistic arm motions in a controlled experiencing visual distractions, such as environment has made the Wii a valuable birds flying by. “Soccer Heading” involves component of our vestibular rehabilitation patients shifting weight © Vestibular Disorders Association ◦ www.vestibular.org ◦ Page 1 of 3

to hit soccer balls while avoiding shoes four-week period and with only eight and other flying objects that are racing sessions of therapy. Overall, we have toward them. “Table Tilt” requires found the Wii to be an exciting option in very refined weight shifts which move the treatment of vestibular disorders. marbles across a board and into holes without losing them over the side of the board. These games are effective at providing visual stimulation while simultaneously challenging balance. Another activity, the Wii Sports game, includes everything from the previously mentioned bowling to boxing. The game can be used as an adjunct to traditional static and dynamic balance exercises to help prepare patients for resuming their regular activities.

The relatively inexpensive Wii provides patients with visual and balance chal- lenges in a safe and fun environment. After using the Wii in our clinic for the A patient improves her balance while playing the WiiFit game “Soccer Heading.” past six months, our experience has been that many patients have enjoyed it so Reference much that they purchase a unit for their Deutsch JE et al. Use of a low-cost, home, and their compliance with therapy commercially available gaming console (Wii) and resulting outcomes are improved. for rehabilitation of an adolescent with One particular patient, who had a left- cerebral palsy. Phys Ther. 2008; 88(10):1196–1207. side vestibular weakness and was using the Wii in conjunction with traditional © Vestibular Disorders Association balance and visual exercises, improved her balance in one leg stance from 8–14 VEDA’s publications are protected under seconds to 30 seconds. Her ability to walk copyright. For more information, see our permissions guide at www.vestibular.org. tandem with eyes closed improved from 3–5 steps to 15 steps, and her Dizziness This document is not intended as a substitute Handicap Inventory score decreased to for professional health care. 16% from 56%. This all occurred over a

PO BOX 13305 · PORTLAND, OR 97213 · FAX: (503) 229-8064 · (800) 837-8428 · [email protected] · WWW.VESTIBULAR.ORG

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