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The Nintendo Wii As Therapy For Parkinson’s Disease

Two studies have now demonstrated that a targeted amount of activity-based video game play helps patients improve their motor skills.

It looks like seniors may now have a way of getting treated for symptoms of Parkinson’s disease and have some fun in the process, as indicated by ongoing research at the Medical College of Georgia.

Dr. Ben Herz, OTD, MBA, OTR, program director and assistant professor in the Department of Occupational Therapy, School of Allied Health Sciences, found that an 8-week study that using the popular game console, Nintendo Wii, helped patients with Parkinson’s disease improve their coordination, reflexes and other motor skills.

The 20 patients participating in the study spent 45 to 60 minutes, three times a week, playing games on the Wii. During each session, the participants played one game of boxing and two games each of tennis and bowling. These games were chosen because they required bilateral movements, challenged balance, involved playing at a fast pace and induced some exercise.

"The more significant results were not the number of games won, but the huge gains the patients made in movement, flexibility, the more complicated motor skills and energy levels."

At the beginning of the study, “there was a learning curve associated with the games,” according to Dr. Herz, who also conducted a study on the use of occupational therapy on patients with Parkinson’s disease in 2008. Over the course of the study, the participants “eventually finished within 20 to 30 minutes.”

The study participants were all affected by Parkinson’s disease on both sides of the body, although they had not yet had any significant disturbance in gait.  By the midpoint of the study period, several of them could already win the boxing game in the first round.

The patients were allowed to continue playing any game of their choice—“The goal being the 45 minutes to 1 hour of playing time,” says Dr. Herz—and they showed a preference for bowling and tennis.

The more significant results were not the number of games won, but the huge gains the patients made in movement, flexibility, the more complicated motor skills and energy levels. Very significantly, the depression levels in most of the participants went down to zero. Depression affects at least 45 percent of Parkinson’s disease patients.

Dr. Herz believes there are many other games to play that could benefit someone with Parkinson’s disease. These include games “that increase the cardio and exercise such as the personal trainer, EA Sports Active and the Wii FIT, to name a few,” he says.

"Dr. Herz believes virtual reality game systems are the future of rehab."

By the time most patients are diagnosed with Parkinson’s disease, their level of dopamine, an important neurotransmitter, is already 70 to 80 percent depleted, according to Dr. Herz. Previous studies have shown that exercise and video games induce an increase in dopamine production, and Dr. Herz believes the “combination works well with the Parkinson population.” Not only that, there is greater motivation for patients to improve their skill since this is not strictly exercise, but rather a game they want to win.

In April 2008, Dr. Herz was one of the principal investigators in a study designed to determine if occupational therapy enhances treatment of Parkinson’s disease. For that research, they tried to teach patients do more functional activities in order to slow the progression of the disease and reduce the amount of medication needed for treatment. At that time, the study team first began using the Wii because the interactive nature of the game required the player to do certain functional movements in order to play successfully.

Both studies have now established that there are beneficial short-term effects from playing Wii. “The question remains how long do the benefits remain effective,” says Dr. Herz. He retested the patients after one month of not playing and found that 18 of the 20 showed some decline in their motor abilities.

Conversely, is it possible to play too much? Dr. Herz says that, without his knowledge, one of his patients bought a Wii set for use at home. One day, the patient called to say he was experiencing some pain. Dr. Herz found out he had played the Wii for three hours straight. His routine called only for 45 to 60 minutes of playing time three times weekly.

Dr. Herz believes virtual reality game systems are the future of rehab. “The Wii may be the next cost effective way to assist therapists and others in the medical field to assist individuals to regain their independence.” And, although studies will have to be conducted, it is possible that EA Sports Active and other sports type games can benefit those with multiple sclerosis, particularly in decreasing rigidity and slowness of movement.