Video games are usually considered as a waste of
time. However, a study has found that Nintendo Wii can actually benefit
patients with Parkinson's disease.
non-reversible and progressive disorder of the nervous system that affects an
individual's movement. It develops gradually, sometimes starting with a barely
noticeable tremor in just one hand, and then progressing further to cause
muscle stiffness, slowing of movement, and impaired posture and balance. The main
concerns in Parkinson's disease patients are
postural control, fear of falls and balance disorders. Therefore, patients have
alterations in their daily life activities, increasing healthcare costs and
causing a high risk of mortality. Several factors such as functional limitations
and dependency on others, low self-esteem, social restriction and reduction of
leisure time can negatively influence the quality of life in Parkinson's
At present, there is no cure for Parkinson's
disease, and treatment is focused on symptom management via dopamine replacement therapy
While medication has been found to work remarkably well in improving some of
the symptoms of Parkinson's disease such as slowing of movement, rigidity, and
tremor, it has been found to be only partially effective in the treatment of
symptoms like balance and posture.
Previous research has suggested that physical
therapies are generally effective in alleviating symptoms of Parkinson's disease.
Improvements have been demonstrated in strength, physical functioning, quality
of life, balance, and gait speed with physical therapies.
In the area of new technologies, systems based on virtual reality are
promising tools for rehabilitation of Parkinson's disease patients. They increase the
performance of the rehabilitation process against traditional rehabilitation,
which can be sometimes boring, tedious and repetitive. The main
objective in rehabilitation by virtual reality is to increase the functional
ability and raise the participation of a patient in daily life. Among the more
recent resources available for virtual reality are virtual games such as
games can help in the recovery of motor skills, working on one's coordination
skills, strength and reasoning. Virtual
games also require users to perform cognitive tasks related to attention and
executive functions that are affected in Parkinson's disease patients.
Nintendo Wii is a
less expensive and portable home video game with several exercises that allow
training on strength, balance and aerobics. The players are stimulated to
defeat their adversaries in specific trainings such as boxing or tennis, and
they can track their progress over time, enhancing adhesion and concentration
in their physical activity.
Researchers conducted a trial
to evaluate the effects of Nintendo Wii training in improving quality of life
of Parkinson's disease
patients, when compared to traditional physical therapy.
For the study, the
researchers followed 44 patients, aged between 45 and 80 years, who were
diagnosed of Parkinson's disease
with mild-to-moderate motor impairment, by a certified neurologist. Half the
study subjects were assigned to the Nintendo Wii group while the other half
underwent traditional physical therapy. Subjects in both the study groups underwent a warm up session for 10-minutes. This
was followed by a 40-minute physical therapy program that consisted of physical
therapy or Nintendo Wii virtual game.
The traditional physical therapy group performed exercises that involved
mobilization of trunk and limbs. The exercises focused
on improving the patient's balance, muscle strength, rhythmic movement, posture
alignment and double-task execution. This group also received
cardio-respiratory and gait training. Patients in the Nintendo Wii group executed a sequence of tasks according to a
previously established protocol. Both the groups underwent the exercise
sessions for three days per week for
At the beginning
of the study, the 39-item Parkinson's
disease quality of life scale (PDQ-39) scores suggested an impaired the
quality of life among all the Parkinson's disease patients enrolled for the study. After the
intervention, all patients assigned to physical therapy strategies based on
Nintendo Wii training program showed an improvement of more than 10% in their
total quality of life scores especially with regards to social support,
communication, ability to deal with stigma and perform daily living activities.
noted an improvement in the cognitive functions among the study subjects. They
reported a high degree of participant interactivity and satisfaction during
Nintendo Wii games execution.
On the other hand,
no significant difference in the quality of life was observed in the group
assigned to traditional physical therapy.
The main limitation of this study was the
impossibility to blind patients to the program being assigned to them. If the
patient is not aware of which group he/she is assigned to, there is less
likeliness of a bias in the results. However, this was not possible in this
A review of previously published literature
suggests that the type of exercise is relatively unimportant for individuals
with Parkinson's disease, and the key to the effectiveness of physical activity
intervention is likely to be found within the ability of a program to create
and sustain user interest. After completion of the four-week study period, all patients
(except for four) in the traditional physical therapy group migrated to
Nintendo Wii group. This indicates the preference of the patients for
rehabilitation with Nintendo Wii as compared to traditional physical therapy.
The research team
concluded that rehabilitation using Nintendo Wii is superior to traditional
physical therapy to improve the quality of life in Parkinson's disease patients. Further larger randomized controlled trials
are necessary to reassure the results of this study.