Saturday, November 09, 2013

Wiihab Revolution

Pamela Hsieh
Rehab Revolution
15 June 2010

I originally wanted to post about the yogic principle of mudita today, but since things often don't go as planned (at least in my reality), I thought I should speak a bit about something that came up today: an alternative, and usually a supplement, to the daily workout: the (in?)famous Wii. I'm beefing it up today with plenty of info, feedback, and suggestions, so get out your reading glasses and preferably your excitement.

Now, surely you have heard of the Wii. Revolutionary both to video games and rehabilitation, Wii's innovative adaptations to the gaming world has swept the world over, if not only out of curiosity.

But it doesn't come without its complaints. Gamers used to the solitary quality of previous and alternative consoles, like the Xbox360, often prefer the old-school solitude in single-user games (i.e., the stereotypical blow-everyone's-head-off war games like Call of Duty) or in any case, traditional multiplayer blow-everyone's-head-off games (Halo).

Perhaps, though, that wasn't the objective of Nintendo when they designed the Wii. Wii is ideally suited for mass multiplayer (read: party) games, like Mario Party or Super Smash Bros Brawl (PS I once pulled an all-nighter with friends as a freshman in undergrad playing Smash on N64, and yes, this was pre-stroke). And let's not forget that as a set, all of Nintendo's preceding consoles have embraced a more lighthearted approach to video games, with the greatest worries stemming from oversized turtle-dragon hybrids whose opposition took form in the world's most lovable Italian plumber, who talks of spaghetti, ravioli, and his mamma in his sleep. And to acknowledge all the guys out there scratching their heads at why a girl like me would play video games, this cartoonish, innocent quality of the Nintendo lineup is my explanation for my lifelong devotion to their games.

Nintendo has always been a more cartoon-like, sympathetic console that embraced a more innocent form of video game enjoyment, and in so doing, their creation of the Wii unwittingly also entered the arena of therapy for those in need of a new outlet for rehab -- and even those looking for a fun way to get fit. It's a fun way of strength training, relearning coordination and balance, and weaving in cardio while you're at it, too.

So if you've never tried or seen a Wii before, let me quickly explain. There is a sensor placed either on top or below your television screen that senses the movements of your hands which hold two things, a "Wiimote" (cutesy Nintendo-speak for remote) with arrow, A, plus and minus, and Z buttons. The Wiimote is the principal controller of the Wii and if you have an affected side, will be the piece you become most intimate with. The Wiimote is used by your dominant hand, and in certain games for dual-handed movement (hint: this is ideal stimulation for neuro reprogramming of that hand and arm!) can be connected to another little controller called the nunchuck, a curved handle that houses a joystick (the nemesis of my affected left hand, as this is exactly one of the toughest things to relearn to use).

I'm not sure if Wii still comes standard with the game Wii Sports, a game which in my opinion was created solely to show off the console's ability to sense arm motions, allowing you to play tennis, golf, baseball, bowl, and box. But if you're a "Wii bit" competitive or you feel like you've been missing out on these sports in real life, trying out Wii Sports is a nice way to get back in the game, so to speak, because it removes the elements of running around and carrying significant weight -- things that perhaps in this condition you're not yet ready to get back to.

(As an aside, I tried to bowl with friends semi-recently and came out in the first game with a score of twenty-five. The next round, I quadrupled my score by learning to bowl the ball quasi-properly and following the release by lying on the floor. Clearly, not alley ready, this one. Although the push-ups to get off the floor were certainly good for the triceps. . . .)

It also offers you varying levels of competition, based on how many games you win and how well you won, awarding you points for clear victories over your computer-based opponent and docking points for losses. (I'm not sure of the logistics, as I won against my adversary the other day in Wii Boxing, by beating her in two of three rounds, and lost four ranking points. I quickly thereafter "pwned" her more clearly and knocked her out by round two.) The only frustration here is when you reach your maximum level of expertise and are stuck in a standstill with the same opponent that you simply are not beating. Talk about plateauing. I find, in this case, the best solution is to not take it too far and take a break from that particular game for a while until you think you can take them on again and beat them.

(On an aside, Wii Boxing is an excellent way to get out some pent-up steam in you. If you're in a bad mood or mad at someone, you can symbolically whup them to the boxing ring floor and feel much better about it without actually inflicting any damage. It's also great for cardio -- but you'll definitely feel it the next day!)

So apparently many hospitals have incorporated what is known as "Wiihabilitation" into their therapy programs. I personally have worked with two practitioners (one personal therapist and the other a physical therapist) on the Wii, and I have very few complaints.

Enter Wii Fit, a game on its own built for fitness. The game utilizes a balance board that measures weight, balance, and foot/leg movement. For people with no disabling condition, the Wii Fit is sometimes a bit too severe, something many of us find disconcerting but vaguely entertaining.

Wii Fit addresses various areas of fitness, including cardio, strength training, yoga, and your overall shape. Admittedly, it does overemphasize the significance of BMI (body-mass index), which can be frustrating for someone like me, with a dancer's build that is made of more muscle than the norm and therefore can be deceptively dense, and during times of even more muscle gain, I tend to drift towards the dangerously named "overweight" area of the BMI scale -- and God forbid you actually tip over that mark! The Wii will take your little Nintendo avatar, the cutely named Mii, and give her a spare tire.

It happens. Read New York Times bestselling and self-proclaimed "prettily fat" author Jen Lancaster's Chicago Tribune article on it above where I wrote the word "severe."

So a word of warning to those of you interested in trying a bit of Wiihab: the game is a tad on the strict side. Unfortunately, I believe all Wii fitness games made as of now are all catered to the not-disabled lot, in which case they are not written to sense movements and positions of neurologically wobbly, imperfect form. (I intend to write to Wii and bring this to their attention, even if they do retort that they were not created with the intention of bringing people back to their physical integrity, so let's hope they have a heart and put us into consideration.)

So after Wii Fit came out, so did Wii Active, a more intense, personalized game for fitness complete with lifestyle analysis and a trainer who works with you. Both games keep track of your consistency in playing and give you a computer-generated trainer (Fit uses the actual balance board who gives you immediate feedback and tips) who encourages you, but unlike Wii Fit, Active does not give you an inferiority complex when you do not achieve the barest of minimums (i.e., one star of five) in certain activities. For the toughest of love, I'd turn to Fit, but for an organized, more regimented feel, try Active, which involves a Wiimote, the nunchuck, a resistance band, and a leg strap that will sometimes hold the nunchuck (depending on the exercise). If you so choose, they also capitalize on the option to incorporate also the balance board.

And if you love Wii Fit and Active both, the two games later released "extensions," the Wii Fit Plus and the Wii Active: More Workouts. Personally, I'm sort of obsessed with the Kung Fu Rhythm game on Fit Plus, but I haven't tried More Workouts as of yet.

Of course, don't go on a buying frenzy, and don't expect these games to be your only stimuli for working out. It's an excellent tool, but can't be your only one.

Getting a real trainer, therapist, or even just going out for a walk or doing some exercises at the gym or at home are all invaluable to your continued improvement. Let the Wii be a supplement to your workouts. You wouldn't just eat vitamins, would you? Of course not; you still need real food to cover your bases. I'm actually still reeling from a hardcore "pilates sculpt" DVD I borrowed from the library, and a following intense session of Wii Boxing.

The nicest part about Wiihabilitation is that you can really use it to focus in on the areas where you struggle most. For example, my toughest challenge lies in coordination, so certain yoga moves in Wii Fit really help me to target that. Balance issues are also well tested on the balance board, so it's a great idea to invest in one of those (but it'll be useless without the game).

Feedback for Wii Sports: As a born righty, it's kind of cheating for me to play Sports with my dominant, non-affected hand. But to make it tougher, I've also created a Mii who represents my left hand, and activities like tennis are feasible options for the time being. Bowling requires a bit too much fine motor (involving pressing down on keys and letting go at the right time) for now, so it'll have to wait.

A great upside to Wii as therapy? It allows you to apply what you can do -- whereas rote exercise sometimes has difficulty translating into your daily activities, with the Wii, application is key, so it's a nice gauge of your progress. Tough part is getting past the occasional blips where the machine can't sense whether you're doing a movement correctly. It's also a great idea to document your progress, because again, you are not competing with anybody but yourself. So a record of your scores is a nice way to track your improvements. Also, for me personally, I have to fill out a score sheet -- incomplete charts and stuff annoy me, so keeping track is also a slightly compulsive ritual that pushes me to keep it up.

Shall we challenge me to another experiment? Should I do a week or two of Wiihab and document my progress? All right, I'm in. (Don't forget I'm also walking around in the Reeinspires -- admittedly sporadically, but I'm definitely in the habit of putting them on when I'm going out to walk around.)

So again, if you have any feedback or questions on Wiihabilitation or anything else about therapy and disability acquisition (or healing in general), please leave me a comment or e-mail me. I welcome your input and would be ecstatic for the blog to become a community, a conversation.

To our healing,

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