March 12, 2010

The Wii way


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Jack Milton/Staff Photographer: Physical therapist Shelley Coull helps Bruce Milne, of Saco, use a Wii video game skiing program as part of his physical therapy Thursday, January 15, 2009, at New England Rehabilitation Hospital, Portland.

Jack Milton

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Jack Milton/Staff Photographer: Physical therapist Alissa Towle celebrates as Cameron Kimball wins a round in a Wii video game boxing program as part of his physical therapy Thursday, January 15, 2009, at New England Rehabilitation Hospital, Portland.

Jack Milton

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Staff Writer

The animated announcer yelled ''Fight!'' Cameron Kimball, an 18-year-old from North Waterboro, began moving his hands left and right to make his boxer on the TV screen bob and weave.

This was a virtual boxing match using Nintendo's Wii Sports video game system, but Kimball was doing more than just trying to knock out a make-believe opponent. He was building his upper-body strength and endurance, and working on his fine motor skills.

It's just a game, but the stakes are high: Kimball boxes from a wheelchair.

Welcome to the world of ''Wii-habilitation.''

With some video games on the Wii console, players mimic the actions of athletes in real-life sports, from swinging a tennis racket to skiing down a virtual snow-covered mountain. Yes, it's fun. But physical therapists and other health-care providers are also finding that playing games using Wii Fit or Wii Sports can help their patients get better faster.

Rehab centers, hospitals, nursing homes and assisted-living facilities in Maine and across the nation are increasingly making Wii a part of their rehabilitation programs. At the New England Rehabilitation Hospital of Portland, where Kimball comes twice a week for physical therapy, the staff has been using Wii since September.

Kimball has been using Wii Sports for just a matter of weeks, and has improved so much in that short time that he's moved from a motorized wheelchair to a manual chair. That's something his mother, Sandy Hutchins, says she never thought she'd see: ''If they had told me a year ago when the accident happened that he would be out of his (motorized) wheelchair, I would have said, 'No way.' ''

Kimball suffered a spinal-cord injury in a trampoline accident on Oct. 20, 2007. He has no movement below the chest. But since he began using the Wii, he's developed the upper-body strength to open doors and cupboards, attempt transfers from his chair to his bed or the shower without any help, and do other tasks he wouldn't have even tried before, his mother said.

Kimball could have developed more independence with traditional therapies alone, says Alissa Towle, his physical therapist, ''but the more fun way to get there is Wii.''

Towle said Kimball has never missed therapy since starting the sessions with Wii. He even comes to the hospital when it snows.

''He's gotten really good at this,'' Towle said. ''He used to need more help to support his trunk. I used to have to hold him, but he's gotten better and better at doing it himself.''

Kimball has tried tennis, baseball, bowling and golf on the Wii, but his favorite activity is boxing. ''It's easier than having people stretch my arms for me,'' he said. ''With the boxing on the Wii, you're constantly moving.''

New England Rehabilitation Hospital of Portland has two Wii consoles -- one purchased by the hospital and another donated by Bryce Milne, a patient from Saco who turned 66 this week. In November 2007, Milne developed a severe case of Guillain-Barré syndrome that paralyzed him from the neck down. One day last January, while he was watching television from his room during a seven-month stay at Maine Medical Center, Milne saw a news story about using Wii for rehab.


''He came to us in May still in a wheelchair,'' said Shelley Coull, Milne's physical therapist with New England Rehabilitation Hospital. ''He had just started walking with overhead lift support and a big frame walker and two people. He wasn't functional walking yet.''

By September, Milne had graduated from a walker to crutches. He had never forgotten about the Wii, and he decided to buy one for New England Rehab. ''When he started with the Wii Fit, we had to start him on parallel bars with two of us holding onto him and making sure he was safe,'' Coull said.

Today, Milne likes strapping on the Wii ski boots and doing the downhill slalom. He holds onto a pole, and Coull braces him when he needs it while he moves from side to side and listens to the swooshing sound of his virtual skis slicing through the snow.

Milne also enjoys bowling and ski jumping. Playing four or five games of virtual tennis helps him work up a sweat.

''This thing is unbelievable,'' Milne said. ''I mean, it will tell you if you're leaning a little bit too much to this side, or too much to that side.''

The Wii Fit uses a balance board that measures the user's weight, center of balance and body mass index. The balance board has been particularly helpful for Milne, who doesn't have any sensation in his feet. It's helped his body re-learn what being centered feels like. ''It's increased my balance, my eye-hand coordination,'' he said.

One of Milne's biggest issues is keeping his balance while standing still, Coull explained. The ski-jump game has helped him with that -- Milne has learned that he doesn't jump as fast or as far if he doesn't remain still on the balance board.

''He could be moving and keep his balance, but once you stopped, he'd be kind of dancing around,'' Coull said. ''But in the ski jump, you can't. In the ski jump, he has to hold it and then come up. He has to hold it statically bent and statically straight, so it's been a good one for him.''

The staff at New England Rehab would like to get an Internet modem so their patients can play with their families at home, or even have competitions with patients from other hospitals.


Tammy Dion, a physical therapist on Maine Medical Center's pediatrics unit, first started using Wii with one of her young cystic fibrosis patients who found the treadmill boring. The 13-year-old patient made a deal with her nurse practitioner: She could use the Wii during her physical therapy appointments as long as she got her heart rate up as high as she would have on the hated treadmill.

The girl booted up a Hannah Montana dance program she brought from home, and Dion monitored her heart rate intermittently throughout the session. It worked.

''After that, I started recommending it to families who were having a hard time with the cystic fibrosis kids at home, trying to get them physically active, because that's an important part of keeping themselves healthy,'' Dion said.

Chronically ill children who are in and out of the hospital a lot don't want to lie in bed all day, but they'd rather do something more fun than just walk up and down the hall.

''Getting them to do things, especially kids, you're not likely to get them to agree to an exercise program,'' Dion said. ''With this, it's something fun, it's something they like. It's something other kids do, too, so it's something that's somewhat normal.''

After her success with the 13-year-old, Dion started reading more about how Wii Sports is being used to improve core strength, visual and perceptual skills, postural control and overall balance. She wants to expand its use to other patients when it's appropriate.

Physical therapists make it clear that other forms of therapy are not going away. The big advantage to Wii is compliance. Skiing down a virtual slope is a lot more fun than, say, doing 10 leg lifts, and when patients are having fun, they're more motivated to complete their exercises.

''It's certainly not all of anyone's rehab, and it shouldn't be,'' said Cathy Bourque, a physical therapist and outpatient rehabilitation manager at MaineGeneral Medical Center in Augusta. ''It should just be a piece.''

MaineGeneral has been using Wii Fit and Wii Sports in its three outpatient rehabilitation clinics as well as its inpatient rehab facility. Patients range from a 22-year-old who suffered a brain injury in a skydiving accident to high school athletes with orthopedic injuries.

Bourque notes that the Wii technology is so new, there's not been any long-term studies of its effectiveness. But with so many therapists finding it useful, word about the games is spreading fast, and such research probably won't be long in coming.

''We even see now that there's a conference for therapists to learn how to use the Wii most effectively,'' Bourque said. ''So just give it a little bit more time, and there will be a lot more rehab-specific features to the Wii with a lot of research behind it.''

As for Kimball, the Wii training has given him a new goal to shoot for.

''I'm trying to get my mom to buy me one,'' he said.

Staff Writer Meredith Goad can be contacted at 791-6332 or at:

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Additional Photos

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Jack Milton/Staff Photographer: Physical therapist Alissa Towle, right, watches as Cameron Kimball uses a Wii video game boxing program as part of his physical therapy Thursday, January 15, 2009, at New England Rehabilitation Hospital, Portland.

Jack Milton


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