Published in NY Times

In the world of health care, Nintendo Wii golf is more than a high-tech toy. The video game has become a tool in physical, occupational and neurological rehabilitation.
“It really is helpful as an adjunct to what we do in physical therapy,” said Dean Beasley, the director of inpatient rehabilitation at Doctors Hospital in Augusta, Ga. “It allows the patient to put into practical application what they’ve done in therapy and, in some cases, it helps them know if they could still play golf.”


Balance and movement are common concerns for those recovering from brain injuries or strokes. Others may be working to improve range of motion or gross motor coordination, like walking and lifting.
Although the treatment for each patient is different, Wii golf brings an element of pleasure into physical therapy, which is often abbreviated as P.T. and sometimes referred to by patients as “pain and torture.”
“If it’s something like golf that they previously enjoyed, the patients are more motivated to do it,” said Michaela St. Onge, an occupational therapist at Aroostook Medical Center in Presque Isle, Me. “They like it because it’s a change of pace from the normal exercises we give them in therapy.”
To play the game, a patient swings the Wii’s wireless hand-held motion-sensitive wand in front of animated screens that simulate holes on a course. Physical therapists have marveled at the ease in coaxing patients into movements that could have taken more time to achieve in the traditional manner. Patients may gain the ability to coordinate by pressing buttons on the wand and maintain balance while looking at the screen.
Two years ago, Aroostook’s inpatient and outpatient units added Wii Sports, which includes golf, baseball, bowling, boxing and tennis games.
“I have to give some credit to this Wii game,” said Mike Pelletier, who had a stroke in June and spent four weeks at Aroostook. “It helped me work on my balance.”
Pelletier, who struggles with balance and double vision, played Wii golf from his wheelchair during occupational therapy sessions. Now he returns to Aroostook twice a week for outpatient physical therapy.
Pelletier said he also played Wii golf at home and competed with his granddaughter. He said that the game helped him become less dependent on the physical therapists in improving his balance and also motivated him to stay active.
“I made it my own challenge to try to beat my previous score,” Pelletier said. “The game is fun, but it’s also constructive.”
Scoring provides immediate feedback to patients as their motor skills, range of motion, balance and coordination improve with activity, said Renee Guerette, program manager for Aroostook’s neurological rehabilitation unit.
“We used to use board games with patients, but it didn’t have the same feedback as the Wii,” Guerette said. “It’s nice to offer something that has a positive, fun approach that can be shared with family members at home.”
Guerette observed that when recuperating patients played Wii golf at home, they did not regard it as exercise

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. Still, the repetition of movement and the practice of balance have had a positive effect.
“We have seen it actually speed up their recovery time when patients elected to come to the rehab center in their free time to play Wii golf,” St. Onge said. “Every little bit helps with recovery.”

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. Arlene McCarthy, the director of the neurological physical therapy residency program at Kaiser Permanente in Redwood City, Calif., was convinced of the therapeutic value of Wii golf after observing a class for stroke patients there. She said she saw them “cheering each other on as they watched each other use the Wii.”
McCarthy also witnessed a sense of competition among the patients.
“In using Wii golf as therapy, you are asking a patient to practice a skill in something they might already be interested in doing,” she said. “As they watch their score, they get feedback right away if they’ve done it correctly.”
In her experience, McCarthy said, the Wii game has attracted golfers and nongolfers.
But, she said, “The weight shifting that is used in Wii golf may come more naturally to someone who has actually played golf.”
She added, “If you think about sports, it’s about skills that you are learning coupled with practice and repetition. Patients are more willing to do the practice and repetition we’re asking them to do in therapy if they are having fun.”
McCarthy acknowledged that she could design patients’ workouts using more traditional therapy and achieve the same results.
“The difference is that by using the Wii, it’s more fun for the patient,” she said. “I believe therapy should be fun and meaningful for the individual, and if they are having a good time while getting better, it’s another tool in our toolbox that we can use.”
Kaiser Permanente’s neurological physical therapy program added Wii golf more than two years ago. Since then, McCarthy has seen patients use the game to move beyond medically supervised rehabilitation — often buying the units for personal entertainment at home. She has also seen Wii golf used as a regular activity to keep seniors engaged and exercising.
“It’s so important to keep people moving, and this game achieves that,” McCarthy added. “It helps with balance and provides another way for individuals to stay active.”