Stroke/CVA & the Wii

About:
A Stroke or CVA are the terms used to refer to patients who have had a cerebro-vascular accident caused by a circulatory complication in the brain causing either a bleed or a clot. The symptoms last for more than 24 hours and often cause weakness and loss of movement on one side of the body.

Therapy:
Physiotherapy aims to minimise the effects of the bleed or clot by encouraging the restoration of functional movement and control. The degree to which function can be recovered largely depends on the type and severity of the stroke coupled with other influential factors such as fitness levels, ability and general health prior to the stroke.

Wii:
The Wii has proven to be very popular within the rehabilitation of stroke patients during therapy. 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 severity of the CVA), 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 itself 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.

Cautions/Concerns:
Easy to cheat and reduce the quality of the movement produced by focusing more attention on the screen rather than the control of the movement. Because of the level of concentration needed to play some games it maybe that associated reactions or compensations influence the quality of the movements being produced, in which case easier games should be played that allow for more concentration of movement.
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 monitored as overuse is easily reached due to the motivational strengths of the console and games.