Will The Nintendo Wii Change Physical Therapy?

Many patients begin a painful physical therapy process following shoulder surgery. Following the invasive process of implanting bone anchors or the cutting and replacement of tendons the arm is further inhibited by weeks of immobilization caused by wearing a sling. Once the sling is removed, typically after two to six weeks, the arm is stiff, weak, and painful to move.

The physical therapy process starts with passive stretching to try to regain the range of motion the shoulder joint is capable of. Lack of movement has caused a buildup of scar tissue and a lack of sinovial fluid to "grease" the joint. Initial range of motion exercises are painful and take a great deal of effort. Range of motion returns slowly. Passive, or assisted, movement returns much quicker than active, or patient directed, motion.

After about four weeks the patient begins strengthening exercises. These are also tedious, painful and take a lot of time. The mental focus needed to perform these exercises leave the patient mentally and physically exhausted. The slow pace of recovery often takes its toll on the emotional health of the patient. Around week six or seven, many patients report to onset of mild depression. While sounding extreme, the pattern has repeated itself among members of sports medicine community web forums.

The majority of patients find out that real recovery, the gain of strength and flexibility, occur when the shoulder is used on a day to day basis to do real tasks. A return to exercise is difficult but the activity builds active range of motion very effectively.

The big question is, how can a patient build active range of motion and strength without the pain of physical torture? I mean therapy.

The answer may lie with modern video game systems, specifically the Nintendo Wii. The Wii uses motion sensitive controllers to control the characters in the game. Instead of sitting on the couch exercising the thumbs, as is the case with other systems, users of the Nintendo Wii are up and active. Simulating the movements needed to swing a tennis racquet or box with an opponent. The game gives the patient something other than the pain to focus on which in turn removes the mental anguish from physical therapy.

The Wii is starting to find a home in hospitals around the country. Herrin hospital in southern Illinois has started to use the video game system and reports that patients refocus their energies into beating the opponent instead of focusing on the pain. This pushes them further into rehab than they would normally. The patients often do much better.

Having spent time competing with friends to see who is the better boxer, I can say that my shoulders were heavily fatigued following play. Whether prolonged use will turn into stronger shoulders or not, I'm not sure. Play definitely got the blood flowing and the muscles working.

For liability purposes Nintendo does not market the Wii has a physical therapy device, although clearly the potential is there. It's only a matter of time before we see systems that use this technology geared primarily for physical therapy. I would not recommend that patients fresh from the sling start swinging virtual racquets and don virtual boxing gloves right away. It's clear that the potential is there for a faster recovery. Definitely talk to your doctor before starting any physical therapy and perhaps the Nintendo Wii is in your future.

Andy Calver is the owner of http://slaptear.com where pre op patients can learn all the little details that frequently are not discussed during their doctors appointments. Post op patients can compare their recovery patterns and determine if they are on the right track.

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