Everything in moderation.
A few weeks in a row, I have come into work my Saturday night shift to find Jane* practically unable to transfer herself from her bed to her wheelchair and onward when she needs to get up to use the bathroom. Jane has arthritis that severely limits the movement in her legs and impairs her upper body motion.
Last year, the ceiling mounted lift snapped while Jane was in the air and she fell from about 3 feet high onto her back and hip. That fall took Jane from requiring almost no assistance throughout the day to needing almost total assistance with bathing, eating and taking her medications. She went from independently transferring and going to the bathroom st night to needing a two person lift at every step.
Since then, she has improved greatly. Jane is doing all of her daily transfers unattended and with supervision at night. She is nearly back to her level of capability before the fall.
So why, on Saturday night, is she unable to do the things that she has worked long and hard to regain the ability to do?
Jane has a Wii. Lately, she has been rolling into the front room and getting hooked in to her Just Dance game and playing for hours. Considering the extent of Jane’s exercise is minimal compliance with her physical therapy exercises, 4-8 hours of vigorous arm waving and chair rocking is really too much.
The knee-jerk reaction is to get rid of the Wii. Jane can’t manage it responsibly–just get rid of it all together. And that is what initially happened. Wii hiatus for a week. She was feeling and moving better, so on the seventh day she spent the entire day playing Wii again. Again, she couldn’t move. And again, there is a week-long moratorium on playing the Wii.
How do we balance her use of the Wii and is it even worth it?
There have been a number of studies examining the benefits of games, such as Wii Fit, on increasing exercise in able-bodied families. The results were mediocre at best. Children used the Wii more than parents, the amount used decreased over time.
However, when looking at the benefits of the Wii in a rehab setting, the results are mixed and tentative. In the literature, there is both an indication for therapeutic use and risk of injury. It would seem the difference between the two is moderation.
For Jane, moderation is the answer to preventing these injuries. If she were to play for 30-45 minutes a day, she would be moving more than she does with her PT exercises and gaining strength and increased range of motion. She has a fair amount of free time that she spends listening to music and reading magazines.
Will it work out? I hope so. It is a low commitment, low effort (on the part of staff members) way to increase strength and mobility. All it takes is for someone to remind Jane that she doesn’t have to only play on the weekends.
For more reading about the Wii and its role in both injury and rehab:
From the Vancouver Sun.
From Injury–Wii-habilitation: Is there a role in trauma? (This link is to the article abstract, you will need a database log in to read the whole article.)