Hemiplegia and hemiparesis are conditions that affect one side of the body, causing it to present with weakness often with reduced movement and limited active control in the limbs and trunk. Hemiplegia can affect people at any age and is caused by an injury or an illness that affects the brain, such conditions leading to hemiplegia can be stroke/CVA, acquired brain injury or an injury/illness at birth.
More information about Hemiplegia for young adults and children can be found at HemiHelp a charity supporting youngsters with the condition.
Physiotherapy aims to promote normal range and control of movement, maximising the available active control and strength in the affected limbs. This may include core stability and balance work in either a sitting or standing posture, or both, work on range of movement in upper and lower limbs and it might include fine motor control in hands and fingers (dexterity).
During therapy by encouraging symmetry of the bodies movement it will prevent muscle imbalance problems, where the muscles on the dominant side are significantly better developed and more powerful, which can cause postural changes.
Core stability and balance work will contribute towards improved postural control in sitting and standing. Such work to improve standing balance will also aid the development of a symmetrical gait pattern and movement control during walking.
The Wii has proven to be very popular within the rehabilitation. It is very flexible and forgiving with regard to the movements that are needed to play the game, offering the opportunity for a patient to work an affected upper limb with reasonable success (depending upon the severity of the hemiplegia), benefiting from the visual feedback that the console and controllers offer.
The console itself is popular amongst the general population and is therefore a great motivational and interesting tool to use, with those playing the games generally wanted to have another go, rather than becoming bored of repetitive exercises. The console offers a variety of opportunities to work on physical abilities, depending upon which game is selected.
The physical skills that can be worked on include dexterity, balance, hand function, fine and gross control of movement, general fitness, upper limb range of movement, reaction speed, cognition and lower limb movement.
Finally the Wii could be considered by some to be more interesting that some more traditional exercises (although the traditional exercises should not be completely replaced by the new technology – all things in moderation). Because of its popularity there is a good chance that family members or the patient themselves own a console, offering the opportunity to continue practicing certain skills at home.
Some ideas for use: click the words to follow the links
Standing balance and Sitting balance for which you may need to recalibrate the balance board
Upper limb exercise
Lower limb exercise
Adaptations – to enable use weak upper limb with poor dexterity and co-ordination.
Associated reactions or compensations can influence the quality of the movements being produced, if this is the case easier games should be played that allow for more concentration of movement. Because of the forgiving nature of the controllers (e.g. it will let you play the game even if you don’t do exactly the right move) it is easy to ‘cheat’ and therefore decrease the benefit of the active movement that is being encouraged.
Elements of using the Wii Console maybe frustrating to those with limited movement or physical ability, therefore it is important to choose games that are accessible and flexible enough to offer success during gameplay.
Fatigue levels need to be Elements of using the Wii Console maybe frustrating to those with limited movement or physical ability, therefore it is important to choose games that are accessible and flexible enough to offer success during gameplay.