Science News
Occupational Therapists Use Wii For Parkinson's Study

ScienceDaily (Apr. 7, 2008) - It's Ingrid Bell's turn at bat. She steps up 
to the plate, awaiting the pitch. A 70-mph fastball soars toward her. She 
swings and connects with the ball. Foul ball! Everyone cheers for her 
anyway.

This baseball game's not taking place on a field, and there's no real bat or 
ball to be seen. Mrs. Bell is playing the Nintendo Wii as part of her 
occupational therapy. She is among 30 Parkinson's disease patients 
participating in a Medical College of Georgia study to determine if 
occupational therapy enhances the treatment of the disease.

Parkinson's disease affects daily tasks that people take for granted. 
Brushing teeth, getting out of bed and walking become a problem for these 
patients because of dopamine depletion, which results in stiffness or 
slowing of movement and fine motor dysfunction.

"Occupational therapy looks at how the illness affects the patient's whole 
life, from the psychological, cognitive and sensory motor standpoints," says 
Dr. Ben Herz, assistant professor of occupational therapy in the School of 
Allied Health Sciences and a study principal investigator along with Dr. 
John Morgan, neurologist. "Our therapists are responsible for helping 
someone maintain or gain their independence with functional activities."

While occupational therapy is frequently used in the comprehensive care of 
Parkinson's patients, evidence is needed to support its short- or long-term 
effectiveness, says Dr. Herz.

"We're hoping to show a slowing of the progression of the disease and a 
decrease in medication while increasing function. If we can teach patients 
to exercise and do functional activities, maybe we can have them take less 
medications," he says.

Study participants are divided into an experimental group receiving therapy 
or a control group that does not. Each participant meets individually with 
an occupational therapist for one hour a week for eight weeks. Participants 
in both groups are given functional and standardized tests and evaluated on 
a quality-of-life scale before and after therapy begins, then four months 
later. The control group has the option to receive therapy after the second 
evaluation.

"None of the participants have had occupational therapy before because we 
wanted no preconceived notions of what therapists would do or how they would 
do it," Dr. Herz says. "A few participants were probably taken aback when 
they heard they'd be playing video games."
But the Wii has been popular with both participants and therapists.

"Because the Wii is interactive and you have to do certain functional 
movements to be successful, it's an effective modality for working with 
Parkinson's patients," says Dr. Herz. "One of the therapists uses the Wii 
for timing and loosening up, and the other uses it for coordination and 
balance issues."

Participants also perform functional activities, such as dressing and 
rolling over in bed; fine motor skills, like circling in word searches and 
carefully moving blocks in the game Jenga; and stretching.

"These therapists are thinking way out of the box. They're doing activities 
that will make a difference in these participants' lives based on what we 
know about Parkinson's," Dr. Herz says.

Early results show at least short-term gains. Therapists set goals for each 
participant prior to treatment. These goals range from independence with 
daily living activities, such as cooking, dressing or bathing, to functional 
activities such as sports and leisure without any adaptation. About 98 
percent of those goals have been met or surpassed, Dr. Herz says.

When Mrs. Bell started therapy in January, she was dependent on her husband 
to walk, dress and get out of bed. She could climb only one step on her own.

"Now she's doing 24 steps without any difficulty," says Dr. Herz.

"I may need help putting my shirt and shoes on, but I'm trying as hard as I 
can to do it myself," Mrs. Bell says.
The study, funded by a $30,000 grant from the National Parkinson's 
Foundation, is a collaboration between the Department of Occupational 
Therapy and MCG's Movement Disorders Program.
Adapted from materials provided by Medical College of Georgia.

Rayilyn Brown
Director AZNPF
Arizona Chapter National Parkinson Foundation
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