Tuesday, December 21, 2010

Adapted Wii Games for Students with Orthopedic Impairments

Wii games can be adapted for exercise and play for those with severe orthopedic impairments. As we have been developing Wii therapy for students, our work has been more limited in the area of severe orthopedic impairment but we have developed the use of a game mat with a game called Outdoor Challenge and we have set the accompanying game pad on a rocker board and have folded it around triple thick cardboard custom cut to fit the width of the mat and support a student. We fold it so the middle row with the right and left arrows (like on a dance pad) are across the cardboard and rocker board. We then carefully set the student on the pad and have one person support from behind while others do the hand over hand assist to steer and press. It involves three people so to release 3 para-pros to work with one student is a luxury many teachers don't have. Because of this it is harder to get class time at school when it can be done as a daily therapy tool. We have also set the cardboard and pad on a laptray on a wheelchair and supported the student to use arms and hands to press the arrows down while arms rest on the tray.
The Outdoor Challenge game has a pipe slider activity that allows the player to sit on a sled and slide down a large tube. By patting with the left or right hand on the pad, the player can steer down the pipe slide to run over target arrows lit up in blue that shoot them down the tube faster.

Pipe Slide:

We have used hand over hand assist to work with students that have poor muscle tone and are stiff. We have found that the activity is exciting for the students and allows their mind to be entertained. The distraction helps relax the hand/wrist/arm during the manipulation/assist. We have seen the rocker board help in creating the leaning motion and assist in balance goals.
The game is getting harder to find but can still be found online if you do a search. It is Active Life Outdoor Challenge for Wii.
I have seen recently a switch controller for Guitar Hero. It would be a fun adaption for those with limited hand movement or with a head array. You can see one at Enabling Devices.
Another game a nurse colleague uses with her son who is in a wheelchair is Let's Tap. See the You tube video below:

There are some great games that help strengthen and work on muscle tone as well as have fun, all at the same time. Check them out, but remember to use care and caution when moving and working with children who have orthopedic impairments. If you have any doubts about what you can do or limitations, consult a doctor, specialist, OT or PT before starting any of these on your own.

All the best to you!

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Monday, December 6, 2010

The Wii, Kinect and Gaming Technique for Therapy and Disabilities

The Wii has been a great tool for us to use in therapy with students in our school districts. Now we see the new sensor controller-less systems hitting the market and they are all over the TV and their sales are hot this Christmastime. What are the differences in these two kind of systems when looking at therpeutic uses?
An occupational therapist team member and I have been busy at work on building and expanding trials for our therapeutic model for using the Wii with students with disabilities. We have broken it down into 3 domains, physical, cognitive and social/communication. As we have done trials with students, we have found that the game play/strategy that is involved in correcting upper body movements and body/eye coordination, build balance and strengthen cognitive abilities for problem solving and strategizing on even basic levels. We are excited as we further develop our data collection and break down the skills and objectives that the active Wii games can strengthen.

Kinect in the mix - some initial thoughts:
The other day as we were going over some of our notes and findings, we got on the topic of the new Kinect add-on to the X Box for controller-less game play while moving the body like with the Wii. I can see the new sensor systems that bypass hardware you hold as being the new frontier, but the handheld Wii controllers give you the opportunity to still develop the hand and wrist movements in a way that these new systems cannot. It is also more fun than stringing beads and other conventional activities that can get mundane for kids. I am sure that the new Kinect games work areas of upper and lower body awareness, space, coordination, balance and build on cognitive process for problem solving and stragy building. They also require hand movements, but don't have something you hold for grip and movement stregthening. There is also something important about the tangible stepping up on a fit board and balancing that is lost just standing in place on the floor.

Ablegamers has put out a 2 part series on the Kinect and have reviewed the system's strengths and weaknesses for those in the disabled community. It doesn't address the ramifications of the new controller-less sensor systems on therapeutic applications, but is a great review of the system and how Microsoft to them into consideration in the research and development.

We are in our second year of trials at 2 new schools and hopefully we will have a manual, data collection forms and an objective/skill-based grid that spans the three domains sometime next year. This is taking time but we want to do it right. Check back now and then and we will keep you posted and let you know when something is ready. Hopefully our model it will be general enough so that it can apply across multiple game systems - we will keep the Kinect in mind as we press on.

All the best to you!