Does playing video games benefit people with Parkinson’s?

Beth Holloway, St. John’s Newfoundland
Beth Holloway, St. John’s Newfoundland

Beth Holloway held a Wii bowling tournament in her St. John’s, Newfoundland home, recently, with six friends who, like Beth, have Parkinson’s disease. She also performs a tightrope walk, regularly, using her Wii Fit balance board. She says, “I can’t say these video games help my balance because I just don’t know. But I like the fun of it. Anything that gets a person moving, as far as I’m concerned, is a good thing.”

She is possibly on the right track, judging from current research into the usefulness of Wii games in helping people with Parkinson’s.

• Canadian research
• US research

Canadian research

In a small study at the University of Ottawa, Dr. Louis E. Tremblay, associate professor, in the School of Rehabilitation Sciences, and four of his physiotherapy undergraduate students* designed a 45-minute activity program that they asked people to do at home, three times a week, for six weeks.
• 30 minutes of Wii Fit, starting with simple yoga postures, then progressing to balance games such as ski slalom, ski jump and table tilt
• 15 minutes of Wii Sports – bowling or golf

“The goal of the project was to determine if the use of the Wii console and the Wii Fit game with its balance board could help in the rehabilitation of people with Parkinson’s disease,” says Jean-François Esculier, a newly graduated physiotherapy student who was on the research team.

“People with Parkinson’s are usually taken care of by the healthcare system in the late stages of the disease. The goal of the study was to establish a program to help people take care of themselves and slow down the decline of functional disabilities, such as balance problems, from the very beginning.”

The 20 people in the study were tested before and after the six-week program.
• 11 had Parkinson’s: 5 women, 6 men; average age – 62 years; with an average Unified Parkinson’s Disease Rating Scale (UPDRS) motor score of 2.2. (The range is 0 to 5.)
• 9 were healthy subjects: 4 women, 5 men; average age – 63.5 years; some were partners of the participants with Parkinson’s

Here is a sampling of the results for the participants with Parkinson’s:

Test Description Result after Wii training
Static balance Standing on one leg. 53% improvement on left leg

58% improvement on right leg

Sit-to-stand Sit on a chair. Stand, sit and repeat as many times as possible in 30 seconds. 45% improvement
Timed up-and-go Stand from a seated position. Walk three metres. Turn. Return to the chair and sit. 23% improvement
Community balance and mobility assessment A series of 13 tasks that evaluate a wide range of balance and mobility skills. 21% improvement
Gait speed Measurement of walking speed over 10 metres. 16% improvement
Force platform Stand on a platform device while a computer measures the movement of the person’s centre of gravity. no statistically significant improvement

Esculier notes, “An overall 55% improvement in the one-leg stance is great because, in one phase of walking, you have to stand on one leg; so, if you can improve that, you have more stability. The 45% change on the sit-to-stand test indicates improvements to both balance and leg strength.”

Interestingly, when participants rated their own performance, they did not think their balance had improved, although the objective tests showed that it had. Esculier suggests the subjects’ under-estimation could be a good thing because it could guard against taking unnecessary risks and increasing the likelihood of falls. Participants did report that they were walking a bit more easily than they did before.

The fun factor was undisputed: 83% of participants enjoyed the activity program much or very much; the remaining 17% were moderate in their praise; no one reported disliking the program. In conversations with participants after the study had ended, the researchers found that people have continued using the Wii because they like it, they find it helpful and they enjoy playing the video games with their grandchildren.

Esculier recommends that, before powering up the Wii for exercise, people with Parkinson’s should see a physiotherapist for a balance and mobility assessment. The balance exercises on Wii Fit require standing on a balance board but the Wii Sports can be done sitting or standing.

(* The student researchers were Patrick Bériault, Jean-François Esculier, Karine Gagnon and Joanie Vaudrin.)

US research

At the Medical College of Georgia, Dr. Nathan (Ben) Herz, assistant professor of occupational therapy and his colleague, Dr. John Morgan, assistant professor of neurology and director of the Movement Disorders Program’s National Parkinson Foundation Center of Excellence are also doing groundbreaking research on the use of Wii in Parkinson’s.

Dr. Herz visited Canada, in May, to address conferences hosted by Parkinson’s Society of Southern Alberta and PSC Southwestern Ontario Region.

Here are few of the points Dr. Herz shared with his Canadian audiences:

• The Wii promotes exercise that can be meaningful and purposeful.
• Some games can even be used for rehabilitation therapy to improve functional abilities in activities of daily living, such as, filling a pot with water or cracking an egg.
• Wii Sports, in particular, address many of the areas that need rehabilitation.
• The games keep people occupied without them realizing its therapeutic benefits.
• Success in Wii activities is closely tied to people’s ability to integrate their movements.
• The physical, cognitive, psychological and social aspects of playing with the Wii can have positive impacts on the health and wellness of participants.

Contact your regional Parkinson Society, to see Dr. Herz’ research presentation and Wii demonstration on DVD.