Video, computer and virtual reality games continues to be popular, and systems like the Nintendo Wii Sports are rapidly making the transition from home to therapeutic use. Such systems are now commonly seen in both neurorehabilitation and long term care settings. In clinical environments, games like the Nintendo Wii are, for the most part, used to enhance recreational and therapeutic activity programs because they help creating positive motivation and encourage participation and movement that might otherwise be difficult to solicit. For example, the Glenrose Rehabilitation Hospital in Alberta Canada is now using the Wii technology to treat patients with movement and balance issues. There, virtual boxing with Nintendo’s popular Wii video game is helping a boxer who had suffered a brain-injury re-develop his right jab and footwork.
It becomes clearer for some time now that for training or re-training of motor control and coordination to be effective, it must be intensive, speed sensitive and preferably a problem solving process (i.e. using patient-initiated not passive movement). The ‘gaming’ environment generally can provide these key ingredients for motor functional recovery; it is conducive to intense training that is speed-sensitive and asks for the patient’s active involvement. Not surprisingly, techniques that utilize these principles, for example, intensive electromyography (EMG) or virtual reality, have been shown to improve patients balance and motor skills.
Although there is clear benefit for researchers using video and virtual reality games during motor rehabilitation, There are limitations from a clinical perspective. The Nintendo Wii game, for instance, employs a sensor that allows the user to play virtual games of tennis, golf or boxing by swinging the arm while holding a movement-sensor. This type of activity allows the training individuals to engage in intensive, speed sensitive and variable training. While this has benefits from a general movement perspective, the therapist has no control over the actual movement that a patient makes, the musculature and joints involved (e.g. arm versus shoulder) or the numerous other parameters that might be important to control (e.g. weight shift, posture). This has been a major constraint in the effectiveness of this type of biofeedback activity in the clinical setting.
There is a call for new tools or technologies that can provide therapists with a clinical tool that incorporates the motivational aspects of video and virtual reality games with the practical clinical needs of today’s rehabilitation settings. Applicable to the treatment of the full range of motor deficits associated with neurological injuries or conditions, a new tool should be able to do the following:
• Increase active range of joint movement
• Increase weight-bearing ability and balance (static & dynamic)
• Decrease muscle tension
• Improve coordination between agonist/antagonist muscle pairs