Video Game Testing and Rehab


Using the video game platform from Nintendo, the Wii, is not novel as much as it may be possibly underused.  One of the first posts on this blog dealt with the usage of the Wii at two different universities, on a trial basis.  What brings me back to this topic; a search earlier this month revealed an article from February of last year and the usage of the Wii at a high school in Pennsylvania;

Testing high school athletes for concussion symptoms is a serious business, but one way the Haverford School athletic training staff is accomplishing this is through a game – Nintendo Wii Fit Plus.

The Wii Fit Plus module contains several games that require balance and coordination – some even require thinking, processing and then quick decisions translated into body movements.

This is what some people are now calling “Wii-hab” from a concussion.

“There are only a few colleges that I know of who are using the Wii as part of a concussion protocol, and I am not aware of any high schools in our area that are using it [for that purpose] yet,” said Haverford School athletic trainer Bill Wardle.

I have always thought that this could be used not only as an objective platform for balance, as described in the article, but I also though that the cognitive, reaction time, and balance that is needed to be successful on this game would be helpful in some cases of concussion rehabilitation.

I decided to reach out to Wardle and see if he wanted to add anything since it has been a year.

My first question: Why are you using the Wii?

Bill Wardle: As for the Wii-hab, for me, it was a pretty easy process to start and get my administration/IT people to buy into it as I had been ramping up our concussion management procedures.  I was inspired to get the Wii after hearing Dr. Kevin Guskiewicz at the NATA meeting in Philly in 2010.  They were doing some pretty cool stuff at UNC with virtual reality simulators to help with concussion “rehab” and generally re-wiring the brain to help athletes get back on the field.  He acknowledged that the majority of schools can’t afford VR equipment, but what about Wii?

DF: How are you using the Wii?

BW: I use the Wii in 2 ways:  first, I am trying to incorporate Wii in our baseline testing protocol.  After the athlete finishes his ImPACT test in the computer lab, they come back to the AT room where we do their balance baseline. This consists of doing 2 of the yoga poses: “single leg stance” and “chair”.  I feel that these 2 are easy enough that anyone can do them without requiring any great skill.  I think this gives a pretty good, accurate, objective measure of balance. These numbers are then monitored after a concussion to check for any decline, or to monitor recovery.

In addition, I use the Wii for those 25% or so of kids whose symptoms just linger on past 2-3 weeks.  In addition to possibly having them do VERY LIGHT aerobic activity, I will have them play some of the balance games – and some of them also have a component of reaction time as well.  I have no objective data to say if this really works or not, but it doesn’t seem to be hurting or setting anyone back, and I DO notice improvement over time.  Plus, the local doctors who I communicate with about this all seem to be on board with the idea.

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It was extremely refreshing to talk to another professional that is independent from all the rigmarole in this issue.  Here stands an athletic trainer, using intuition and resources available to him to create helpful processes.  Wardle didn’t invent this, rather he has gone out and explored what its potential is, which can be often overlooked in anything.

If you have time visit his site as well “Body Active Inc.” and if you are in PA, perhaps Wardle may be of assistance to you.

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2 thoughts on “Video Game Testing and Rehab

  1. Joshua Staples February 17, 2012 / 11:54

    I’m not entirely entirely familiar with the Wii research as it pertains to concussion assessment and rehabilitation, but I hope there is some established reliability/validity for its use. I am always excited to see new (and especially cost effective) means of treatment, but it could be dangerous for clinical practice to get too far ahead of the research.

    If I’m not mistaken, the current research supports a graduated RTP, wherein athletes never advance to higher levels of exertion with symptoms present. The use of the Wii (i.e. Wii-hab) while cognitive and balance symptoms are still present seems contrary to this concept of graduated RTP and should be established empirically before it is put into practice.

  2. brokenbrilliant February 19, 2012 / 20:09

    This sounds like a great idea. It’s similar to the approach I take with my own recovery, though I don’t have a WII (and may never get one). After I incorporated regular exercise into my daily routine, the turnaround was dramatic. I increased my endurance and overall fitness, and I also work in some balance/coordination work. Everyone is different, so different things may have different results for people, but this seems like an excellent option for folks who have a WII, or access to one, who are looking for an extra boost.

    I agree that it would be useful for clinicians and professionals to vet this approach prior to using it, however for individuals (who are not under restrictions for licensure and liability), it could do a lot of good.

    If I had a WII, I’d do it. We have so few real resources available to us – this could be the ticket for some folks to get their skills — and their life — back.

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