Wii-hab may enhance Parkinson's treatment

AUGUSTA, Ga., 14 june 2009-– The Nintendo Wii may help treat symptoms of Parkinson's disease, including depression, a Medical College of Georgia researcher says.

Parkinson's disease is a degenerative disease that impairs motor skills. Dr. Herz theorized that the popular computer game console, which simulates various sports and activities, could improve coordination, reflexes and other movement-related skills, but he found additional benefits as well.

"The Wii allows patients to work in a virtual environment that's safe, fun and motivational," says Dr. Ben Herz, program director and assistant professor in the School of Allied Health Sciences Department of Occupational Therapy. "The games require visual perception, eye-hand coordination, figure-ground relationships and sequenced movement, so it's a huge treatment tool from an occupational therapy perspective."

In an eight-week pilot study, 20 Parkinson's patients spent an hour playing the Wii three times a week for four weeks. The patients, all in a stage of the disease in which both body sides are affected but with no significant gait disturbance yet, played two games each of tennis and bowling and one game of boxing—games entailing exercise, bilateral movement, balance and fast pace.

"By the middle of the study, we actually had a number of people who could [defeat] their opponent out in the first round, which amazed us," says Dr. Herz, who presented his preliminary findings at the fifth annual Games for Health Conference today in Boston.

The victories weren't the biggest surprise, however. Participants showed significant improvements in rigidity, movement, fine motor skills and energy levels. Perhaps most impressively, most participants' depression levels decreased to zero.

An estimated 45 percent of Parkinson's patients are reported to suffer from depression, though Dr. Herz suspects the actual figure is much higher.

Studies have shown that exercise and video games independently can increase the production of dopamine, a neurotransmitter deficient in Parkinson's patients. He suspects that's the case with the Wii's exercise effect. Dopamine also helps improve voluntary, functional movements, which Parkinson's patients "use or lose," Dr. Herz says.

Wii, which features simulated movements such as cracking an egg, swinging a tennis racket and throwing a bowling ball, responds to a player's movements rather than cues from a controller, so players can do full body movements and see their progress on a screen.

"I think we're going to be using virtual reality and games a lot more because it provides a controlled physical environment that allows patients to participate in the activities they need or want to do. A patient doesn't have to go to a bowling alley and worry about environmental problems or distractions," Dr. Herz says.

Dr. Herz's research was funded by a $45,000 grant from the National Parkinson's Foundation. Next he plans to test the Wii Fit balance board with Parkinson's patients and expand his studies to multiple sites.

"Game systems are the future of rehab," Dr. Herz says. "About 60 percent of the study participants decided to buy a Wii for themselves. That speaks volumes for how this made them feel."

Wii Fit a promising tool for all ages

Game's health measurements flawed

MANHATTAN, KAN., 08 jan 2009 -- While some emerging technologies can create environments that require very little physical effort, one Kansas State University researcher thinks games like Nintendo's Wii Fit can help promote physical rather than sedentary activities for people of all ages.

"I think there is a great potential to develop ways to promote physical activity through technology," said David Dzewaltowski, professor and head of the department of kinesiology at K-State and director of the university's Community Health Institute. "Kids innately like to move, so I believe that there is a big future in games that use emerging technologies and require movement because the games will be enjoyed by children and also be more healthy than existing games."

In a commentary published in the October 2008 Exercise and Sport Sciences Reviews, Dzewaltowski discussed how technology is changing our everyday life and affecting our health.

Wii Fit has games that incorporate yoga, strength training, balance and aerobics. The games are interactive and require the player to physically move, which is better than nothing, Dzewaltowski said. It uses a balance board and allows gamers to simulate challenges like snowboarding down a mountain.

"Anything that gets people to move more than they have in the past is positive, but if people are trying to replace physical activity that demands more movement with the Wii, then that will be negative," Dzewaltowski said.

He said it is difficult in a small indoor space to replicate the intensity of some real-life physical activities, though dance video games are effective at demanding physical movements that require caloric expenditure.

"The caloric expenditure demanded by an activity depends on the energy necessary to move the body's weight to complete the task and how long you perform the task," Dzewaltowski said.

He added that different activities demand different amounts of caloric expenditure, like playing a game of soccer, which demands much more energy expenditure than bowling or playing the outfield in baseball.

Dzewaltowski said Wii Fit can be an effective tool to create or maintain a healthy lifestyle for some people because it follows the basic principles for adhering to an exercise program, like having physical activity goals, tracking those goals and evaluating the progress.

Wii Fit measures players' body mass index, or BMI, which is a weight evaluation based on height and weight. Dzewaltowski said this a good screening tool for adults, meaning if the game categorizes them as being overweight or obese, they should seek more information from a health professional who can better evaluate the level of body fat. However, he said the calculation is unsuitable for children.

"For children, the BMI calculation has to be expressed based on age and gender growth charts, and it doesn't do that," Dzewaltowski said. "Due to children's age and gender differences in growth, the adult BMI calculators don't work. My use of the Wii BMI calculator showed that it was inappropriate for children and would categorize children incorrectly."

The game also gives players a Wii Fit Age, which is measured by the player's BMI and their center of gravity and balance testing. However, Dzewaltowski doesn't think the measurement is credible.

For personal goals, he said it is more important to focus on behaviors such as physical activity and fruit and vegetable consumption rather than the game's BMI and fitness age measurements.

Dzewaltowski said it could be healthy for gamers to solely rely on Wii Fit for exercise if they are meeting the guidelines for physical activity set by the U.S. Department of Health and Human Services.

He said future technologies should continue to promote physical activity if they make exercise enjoyable, especially for adults.

"I also believe that adults enjoy movement if they are at a fitness level where they can perform the activity comfortably," Dzewaltowski said. "The problem is most adults have very poor fitness levels. So, I believe there is a future in developing games that include movement and demand caloric expenditure at the level of the participant."

'Wii warm-up' good for surgeons

Playing computer games such as the Nintendo Wii can improve a surgeon's performance in the operating theatre, a US study shows.
Only certain games are effective - those requiring delicate movements.
The fine hand control required to play these games acts as a warm up and hones scalpel skills the Banner Good Samaritan Medical Centre team claim.
Now they are designing Wii software that will accurately simulate surgical procedures, New Scientist reports.
They asked eight trainee surgeons to spend an hour playing the games on a console before performing "virtual reality" surgery on a computer system.
Wii warm-up
Game players scored nearly 50% higher on tool control and overall performance than other trainees.
Marble Mania, in which a ball is guided through a 3D obstacle course - was particularly effective in the study.
Researcher Kanav Kohel explained that the type of game play was crucial.
"You don't gain a lot from swinging an imaginary tennis racket.
"The whole point about surgery is to execute small finely controlled movements with your hands, and that is exactly what you get with the Wii."
The fine control needed to move a virtual marble around a 3D maze is similar to the skills needed to perform keyhole surgery, for example.
Colleague Mark Marshall said the games consoles were cheap enough to be used to train surgeons in poorer countries where cutting-edge virtual reality systems were not available.
The researchers will present their work at the Medicine Meets Virtual Reality conference in California later in January.