Volume 16, No. 2, Spring 2008
RHCI’s Center for NeuroRecovery continues to boggle with the toggle in finding innovative ways to utilize new technology to assist patients recovering from neurological diseases and injuries. The latest therapeutic innovation is the Wii game system, pronounced Wee as in Wee Folk for whom it was developed by Nintendo.
The Wii is emerging as a useful therapeutic tool that can improve balance, coordination and other skills needed in daily life. The device consists of compact wireless hand controls and a computer game console that connects to a television. Software programs simulate tennis, golf, bowling, target practice and other sports. The patient uses the hand controls to mimic the movements associated with the sport and participate in the game’s virtual reality.
“It’s pretty amazing,” says Dawn Lucier, physical therapist and RHCI’s Neuro Education Coordinator. “Decades of research show that practicing specific tasks and repetition are key to recovery in patients with stroke and brain injury. The Wii allows us to engage patients in dynamic activities while providing the repetitive task practice that is key to their recovery. And it’s fun. It’s great for motivation.”
For example, instead of stepping onto and off of a step repeatedly to practice balance and weight shifting, the patient can play tennis. Instead of reaching for cones, the patient can swing a bat or roll a bowling ball. A patient using the tennis game works on a multitude of skills, including hand-eye coordination, visual scanning, control of arms and shoulders, sitting or standing balance and weight shifting.
“It’s a fantastic tool for the right patient,” agrees Matthew Keilty, occupational therapist, who notes that it can be effective even with patients who have never played video games. “It can be an advantage to capture the patient’s full attention with something that’s new. The interactive nature of the game holds the patient’s attention longer, so we can use it to build endurance.”
One recent morning 86-year-old Dorothea (Dot) Luce of Buzzards Bay stood side-by-side with Mary Farnham, physical therapy assistant, and practiced bowling. Hospitalized with an infection that aggravated her chronic pain and left her seriously debilitated, Mrs. Luce was using the Wii to improve standing, balance and walking–and to build endurance.
“I’m trying to get my strength back to do the things I did before I got sick, and that was just about everything,” she explained. “It feels great really, it’s relaxing and it breaks up the routine of the day.”
The Wii also offers therapists a lot of flexibility and can be used standing, seated and even adapted for use at the bedside.
Thus far RHCI therapists have used the Wii during inpatient therapy for stroke and brain injury survivors and amputees.
Hidden away in the Medicare, Medicaid and SCHIP Extension Act signed by President George W. Bush in December was a little-noted provision that enables acute rehabilitation hospitals to provide inpatient rehabilitation to a broader range of patients than previously allowed.
The patients still must meet certain guidelines to show they require hospital-level rehabilitation care, but those requirements are now less stringent.
This change means that facilities such as the Rehabilitation Hospital of the Cape and Islands (RHCI) in Sandwich can admit a larger number of patients needing cardiac and pulmonary rehabilitation as well as qualifying patients scheduled for joint replacement surgery.
Under the new Medicare regulations, patients who qualify to be admitted to RHCI following joint replacement surgery must have:
To facilitate the patient’s transfer from the acute care hospital to rehabilitation, RHCI is reinstituting its Joint Replacement Advance Bed Reservation Program. The program allows qualifying patients to reserve an RHCI bed prior to their surgery.
“This practice relieves the stress of having to make a decision when the patient is in the hospital and often not feeling well. It’s a process that works well for patients and it also assists the clinical teams at both hospitals,” says Myrna Ryan, LICSW, Manager of Patient Care Coordination at RHCI.
For more information, call (508) 833-4008 to receive a Joint Replacement Advance Bed Reservation fact sheet, or visit www.rhci.org. For questions about inpatient referrals, call Admissions at 508-833-4200.