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The Nintendo Wii Presentation For Canada Professionals 2
1. Dr. Na n “ n” rz
tha Be He
Me ic l C lle eo Ge rg
d a o g f o ia
Oc up tio l The p
c a na ra y
2. Wii
Thec ns lew sc nc ive in 2 0 a theNinte o
o o a o e d 0 1, s nd
Ga eC ewasfirst se ingre ase. Itsm jor conce t
m ub e le a p
invo d fo us o ane fo o p ye inte c n
lve c ing n w rm f la r ra tio
4. Why is it good for rehabilitation
Allows the therapist to have a virtual
reality/environment in which to work .
Motivation/Fun
Meaningful and purposeful to both the
therapist and the client
Goal directed activities
Can be modified for use across the lifespan
Social Interaction
5. Other reasons for use in
rehabilitation
Adaptable: In Be , Sitting Sta ing a in
d , nd , nd
m tio
o n
Variety: o a tivity/g m stha c uld s ula
f c a e t o tim te
a ne sinte s
nyo ’ re t
Ad re s sa c lla o te w goal
d s e nd o b ra s ith
accomplishment.
C n d va usa tivitie s h a a ro ic
a o rio c s uc s e b ,
s ng ning e ura ee …
tre the , nd nc tc
6. The Wii
Ad re s sthem ve e is ue b a o the
d se o m nt s s ut ls
cg
o nitivep rc p l, vis l p rc p l,
e e tua ua e e tua
e ura e a b la eis ue .
nd nc , nd a nc s s
Thefa t tha the ise -ha c o ina n,
c t re ye nd o rd tio
fo c ns nc fig g und s q nc d
rm o ta y, ure ro , e ue e
m ve e (m to p nning tim , a d p
o m nt o r la ), ing nd e th
p rc p n a d to thea p c a s c te w
e e tio d s s e ts s o ia d ith
theW s te .
ii ys m
And a o thea tivitie a c m le d in as fe
ll f c s re o p te a
a s e e e
nd up rvis d nviro e
nm nt.
7. Other aspects to consider
Eyeha c o ina n
nd o rd tio End nc
ura e
Fig g und
ure ro Finem to c o ina n
o r o rd tio
De th p rc p n
p e e tio Mo r P nning
to la
Bila ra m tio
te l o ns De re s n
p s io
Ba nc
la e Stre the
ng ning
Tim ing Se ue ing
q nc
P p cp n
ro rio e tio Re c n tim
a tio e
8. Creating a Mii Character
Go to Mii Siteo theW m nu
n ii e
C a b s do c
re te a e n hild o c nt
r lie
Allo sfo p rs na tio a tra kingo
w r e o liza n nd c f
p g s
ro re s
Als c
o hild a c nt c n re teto g m b tte
nd lie a la a e e r
9. How does it work?
Us sinte c n to c m le theg m ss c s fully in a
e ra tio o p te a e uc e s
virtua e
l nviro e
nm nt
Sp rts
o
Bo ling
w
Tennis
Golf
Boxing Functional Motion
Ba e a
s b ll and everything
10.
11.
12.
13.
14.
15.
16. Integration
Ones nd ut a p c isthefunc na Mo m nt invo d
ta o s e t tio l ve e lve
in theinte ra n o theg m s
g tio f a e
22. Implications
TheW re uire func na m ve e
ii q s tio l o m nt
C nb m a
a e e ning a p o e
ful nd urp s ful
Thea a tha ne dre b a a d s e in m ny o the
re s t e ha re d re s d a f
“ o ” a e a o rsin s e ia
Sp rts g m s nd the p c lity g m s
a e
The eg m sp vid “ c a n” r thec ntsa
s a e ro e Oc up tio fo lie nd
s m thingtha the d no ne e s rily re lizea
o e t y o t c sa a s
im ro
p vingthe func na s tus
ir tio l ta
24. EVIDIENCE
It isw e re o nize tha up n d g s o P tha d p m
id ly c g d t o ia no is f D t o a ine
le lsa d c a e b 70 0
ve re e re s d y -8 %.
Ones y (Ko p e a 19 8 s w tha p ic l a m nta
tud e p t l., 9 ) ho s t hys a nd e l
a tivity, p rtic rly tha o p yingavid og m , c n inc a ethe
c a ula t f la e a e a re s
a o o d p m re a e a c m a d to b s linele ls
m unt f o a ine le s d s o p re ae ve .
An e rlie unp lis d 2 0 MC s y o the“
a r, ub he 0 7 G tud n Effic c o
ay f
Oc up tio l The p in C ntsw P d m ns te inc a e in
c a na ra y lie ith D” e o tra d re s s
a tivitie o d ily living(ADL) a c g
c s f a nd o nitio fro b s line
n m ae
p rfo a eus theNinte o W g m s te .
e rm nc ing nd ii a ing ys m
25. EVIDIENCE
P va nc e tim te va b d p s e m o isc m o in
re le e s a s ry, ut e re s d o d o m n
p tie w P (up to 4 %) (Ric rd , 2 0 )
a nts ith D 5 ka s 0 5
Ac o ingto Zha e a virtua re lity isaus ful to l fo g d
c rd ng t l. l a e o r ra ing
le urea tivitie s tha c ntsw P m y p uea tivitie in a
is c s o t lie ith D a urs c s
s fee
a nviro e nm nt.
Ba e o theKo p e a s y ind a
sd n e p t l. tud ic tingtha d p m inc a e
t o a ine re s s
w p rtic a n in vid o g m sa the2 0 MC s y, it w s
ith a ip tio e a e nd 07 G tud a
ne e s ry tois la theW s te a atre tm nt m tho to
c sa o te ii ys m s a e e d
d te ineit’ e c ne sin im ro
e rm s ffe tive s p vingp rfo a ein ADL,
e rm nc
le ure p d tivity, IADL, a p yc s c l a p c .
is , ro uc nd s ho o ia s e ts
26. EVIDIENCE
Virtua re lity e
l a nviro e d m ns tes a q itio
nm nts e o tra kill c uis n
c m a b to re l w rld e
o p ra le a o nviro e (Ro e Attre , & Bro ks
nm nts s , e o ,
19 7)
9
Virtua re lity e
l a nviro e a c s ffe tive c ns te
nm nts re o t-e c , o is nt,
s nd rd d s fe a c ntro d (Zha e a 2 0 )
ta a ize , a , nd o lle ng t l., 0 3
27. Why is it good for PD
Do a ineDe le n isa p xim te 70 a tim o
pm p tio p ro a ly % t e f
d g s
ia no is
Exe is inc a e thep d tio o Do a ine
rc e re s s ro uc n f p m
“
USE IT OR LOSE IT”
28. Questions
Tho etha d e rc eha b tte p rfo a ew
s t o xe is ve e r e rm nc ith
a tivitie a m y s wtheP p c s , s w tha in
c s nd a lo D ro e s o ith t
m w ta o
ind ha b ut…
Func na Ac
tio l tivity vsExe is ?
rc e
29. In PD the Wii
It a d s e them ve e is ue b a othe
d re s s o m nt s s ut ls
cg
o nitivep rc p l, vis l p rc p l, e ura e
e e tua ua e e tua nd nc ,
a b la eis ue .
nd a nc s s
Thefa t tha the ise -ha c o ina n, fo
c t re ye nd o rd tio rm
c ns nc fig g und s q nc dm ve e
o ta y, ure ro , e ue e o m nt
(m to p nning tim , a d p p rc p n a d
o r la ), ing nd e th e e tio d s
tothea p c a s c te w theW s te .
s e ts s o ia d ith ii ys m
All o thea tivitie a c m le din as fea
f c s re o p te a nd
s e e e
up rvis d nviro enm nt.
30. Theim le e tio o theW s te ha d m ns te
p m nta n f ii ys m s e o tra d
inc a e in p rtic a a it re te to m ve e
re s s a ip nts s la s o m nt,
a p
m litud o m ve e e ura e a ility, b la e
e f o m nt, nd nc , g a nc ,
s c l p rtic a n, a fine ro sc o ina n a w ll a
o ia a ip tio nd /g s o rd tio s e
in thevis l/c g
ua o nitivep rc p l a a m ntio d a o .
e e tua re s e ne b ve
31. Study Overview
Our p p s d re e rc s y a m te tod te inethee c o
ro o e s a h tud tte p d e rm ffe t f
theNinte o W s te a atre tm nt m d lity in c ntsw
nd ® ii ys m s a e oa lie ith
P rkins n’ d e s (P a it re te tofunc na a tivitie .
a o s is a e D) s la s tio l c s
W hyp the ize tha theW w im ro thea ility o c nts
e o s d t ii ill p ve b f lie
w P top rfo ADL ta ks a w ll a func na m ve e
ith D e rm s , s e s tio l o m nt,
a d c a ed p s io in thes rt-te (a r 4w e o
nd e re s e re s n ho rm fte e ks f
inte ntio a o r o m nth fo w tre tm nt.
rve n) nd ve ne o llo ing a e
W ho etheW c n b va a d a a ine e iveinte ntio
e p ii a e lid te s n xp ns rve n
s te y tha e c ly inc a e thefunc na ind p nd nc a
tra g t ffe tive re s s tio l e e e e nd
q lity o lifeo c ntsw P
ua f f lie ith D.
32. Background and Need
It isw e re o nize tha up n d g s o P tha d p m
id ly c g d t o ia no is f D t o a ine
le lsa d c a e b 70 0
ve re e re s d y -8 %.
Ones y (Ko p e a 19 8 s w tha p ic l a m nta
tud e p t l., 9 ) ho s t hys a nd e l
a tivity, p rtic rly tha o p yingavid og m , c n inc a ethe
c a ula t f la e a e a re s
a o o d p m re a e a c m a d to b s linele ls
m unt f o a ine le s d s o p re ae ve .
An e rlie unp lis d 2 0 MC s y o the“
a r, ub he 0 7 G tud n Effic c o
ay f
Oc up tio l The p in C ntsw P d m ns te inc a e in
c a na ra y lie ith D” e o tra d re s s
a tivitie o d ily living(ADL) a c g
c s f a nd o nitio fro b s line
n m ae
p rfo a eus theNinte o W g m s te .
e rm nc ing nd ii a ing ys m
33. Methods/ Subjects
C ntsw rere ruite fo p rtic a n fro theC
lie e c d r a ip tio m SRA a nd
C lum iaP rkins n’ Sup o Gro , a w ll a Dr. Se Dr.
o b a o s p rt up s e s thi,
Mo a a Dr. Me ’ C
rg n, nd hta s linic s
5 c ntsw reinvite to p rtic a
0 lie e d a ip te
2 c ntsd c d invita n fo p rtic a n
7 lie e line tio r a ip tio
2p rtic a d no m e inc io c ria
a ip nts id t e t lus n rite
A to l o 2 c ntsw P w res le te
ta f 1 lie ith D e e c d
34. Methods/ Subjects Cont’d
7 ha W e e nc (us o W g a r
d ii xp rie e e f ii re te
tha e ht tim s 14ha
n ig e ), vingno W ii
e e nc (ind ua ha
xp rie e ivid ls vingp ye la d
theW Sys mle stha e ht tim s
ii te s n ig e
p vio ly a no o ningaW s te )
re us nd t w ii ys m
2w re s c nd ry to m d a re s ns
ithd w e o a e ic l a o
(1 w re p r to b g
ithd w rio e inningthes y; tud
1 w re d
ithd w uringthes y)
tud
2g up ; o g up c ns tingo 14
ro s ne ro o is f
p rtic a a thes c nd g up
a ip nts nd eo ro
c ns tingo 7 p rtic a
o is f a ip nts
35. Methods/ Design
Op n La e Stud (Le l III, Inte ntio
e bl y ve rve n)
A typ o s y in w h b th thehe lth p vid rsa thep tie a
e f tud hic o a ro e nd a nts re
a a o thetre tm nt b ingg n.
w re f a e e ive
36. Inclusion Criteria
Id p thicP
io a D
Me a w m n o a a e
n nd o e f ny g
Ho hn a Ya Sta e2in the“ n” ta
e nd hr g o s te
Antic a ds b
ip te ta ility o P m d a nsfo 8w e
f D e ic tio r e ks
Me tingo o thefo w c ria
e ne f llo ing rite :
P vio e e nc w theW Sys m–d fine a p vio
re us xp rie e ith ii te e d s re us
us o thes te g a r tha e ht tim s
e f ys m re te n ig e
No p vio e e nc w theW Sys m–d fine a
re us xp rie e ith ii te e d s
p vio us o thes te le stha e ht tim s
re us e f ys m s n ig e.
37. Exclusion Criteria
De e
m ntia(MMSE < 2 , a jus d fo e uc tio le l)
4 d te r d a n ve
Kno n no o p nc w m d a o o r the p s
w n-C m lia e ith e ic l r the ra ie
Any o r c -m rb c nd n tha c uld le its lf to unila ra o b te l
the o o id o itio t o nd e te l r ila ra
s ta dd func n (s ke tra a b in injury, fro n s uld r, p rip ra
us ine ys tio tro , um tic ra ze ho e e he l
ne p ls s m s niag vis e )
rve a ie , ya the ra , tc
Unc ntro d d p s io a d te ine b theInve tig to
o lle e re s n s e rm d y s a r
P s nc o p yc s /d lus ns
re e e f s ho is e io
Se rele d p -ind e d kine ia a d te ine b theInve tig to
ve vo o a uc d ys s s s e rm d y s a r
De p Bra Stim tio The p
e in ula n ra y
Sub c w ut p r e e nc w theNinte o W w b e lud d if
je ts itho rio xp rie e ith nd ii ill e xc e
the p ha ea us thes te thro ho thed tio o s y p rtic a n
y urc s nd e ys m ug ut ura n f tud a ip tio
38. Project/Research Questions
To d te ineif tre tm nt w theNinte o W s te p vid s
e rm a e ith nd ii ys m ro e
im ro m nt in ADLs tim d ta ks a func na m ve e in
p ve e , e s , nd tio l o m nt
c ntsw P
lie ith D.
To d te ineif theW s te im ro so o e o theUnifie
e rm ii ys m p ve utc m s n d
P rkins n'sDis a eRa
a o es tingSc le(UP
a DRS), am a ureo q lity o
es f ua f
lifein P (P
D DQ-3 ), a theHa ilto Ra
9 nd m n tingSc lefo De re s n
a r p s io
(HAMD).
39. Methods/Instruments Used
P a Outc m s
rim ry o e Se o a Outc m s
c nd ry o e
9 leP gTe t
-Ho e s UP DRS
TheTine Ga a Ba nc
tti it nd la e PDQ-3 9
Te t
s
P ueP g o rd Te t
urd eba s
Tim d Ta p Te t
e p ing s Inte wtod te ineW
rvie e rm ii
No tting mExte e ADL
ha nd d e e nc
xp rie e
Sc le
a
Tim d Up a Go
e , nd
Ha ilto De re s n Ra
m n p s io ting
Sc le(HAMD)
a
40. Measured Variables
De c tiveVa b s(Tim , P rfo a e Ra , Se
s rip ria le e e rm nc , ting lf-Re o
p rt)
Ind p nd nt Va b : W
ee e ria le ii
De e e Va b :
p nd nt ria le
P yc s c l, g it, b la e finem to ADL, a IADL o o e o ins
s ho o ia a a nc , o r, nd utc m s n trum nts
e
us d
e
P , P s a 1 Mo P s Te ting
re o t, nd nth o t s
C nfo ingVa b s
o und ria le :
2g up o te t a m tra rs
ro s f s d inis to
Va usa o
rio m unt o s e io
f up rvis n
41. Operational Definitions
Ninte o W Inte c
nd ii: ra tiveg m s te w h utilize virtua
a ing ys m hic s l
re lity a inc rp ra sfunc na a tivity tob s c s ful
a nd o o te tio l c e uc e s
Ho hn a Ya s g 2 b te l invo m nt w ut d fic in
e nd hr ta e : ila ra lve e itho e its
g it a b la e
a nd a nc
Virtua re lity: c m ute s ula n o are l o im g ry
l a o p r im tio f a r a ina
s te tha e b saus r top rfo o e tio o the
ys m t na le e e rm p ra ns n
s ula ds te
im te ys m
“
On” ta : w n s p m a c ntro d b m d a n
s te he ym to s re o lle y e ic tio
42. Methods/Procedure
P a p s te ting/ 1 m nth fo wup
re nd o t s o llo
Se s ns 3x /w e fo 4w e , 4 –6 m
s io : ek r e ks 5 0 inute p r s s io us
s e e s n ing
theW ii
P to o 2g m so te , 2g m so b w , a 1 g m o
ro c l: a e f nnis a e f o ling nd a e f
b xing
o
Ga es q nc w sa rna d e c vis to d c a ep c ee c
m e ue e a lte te a h it e re s ra tic ffe t
C ntsw rea w dto p y s o g m so the c ic a r
lie e llo e la p rt a e f ir ho e fte
s q nc w sc m le d
e ue e a o p te
43. Statistical Analysis
All s tis a a lys sw rep rfo e b MC Bio ta tic ns
ta tic l na e e e rm d y G s tis ia
us thefo w :
ing llo ing
W o n s ne ra te t
ilc xo ig d nk s
Exa t b m l p p rtio te t
c ino ia ro o n s
44. Results/Findings
HAMD (De re s n)
p s io
P / P s Te t:
re o t s
P s Te t / 1 m nth fo wup
ot s o llo :
NEADL
To l P /P s Te t
ta re o t s
To l P s Te t/ 1 m nth fo wup
ta o t s o llo :
PDQ-3 (Qua o life
9 lity f )
To l P /P s Te t
ta re o t s
UPDRS
Mo r P s m nth fo wup
to o t/1 o llo :
Sta ility P /P s Te t
b re o t s
To l P /P s Te t
ta re o t s
45. Results/Findings: Motor
Tim d Ta R
e p
P /P s Te t:
re o t s
Le P ue
ft urd
P /P s Te t:
re o t s
9Ho P gR:
le e
P /P s Te t:
re o t s
TUG:
P /P s Te t:
re o t s
46. Summary
TheNinte o W ha m ny d re a p a nsfo
nd ii s a iffe nt p lic tio r
Re b tio
ha ilita n
TheSys mre uire inte ra d func na m ve e fo
te q s g te tio l o m nts r
s c s in thea tivitie
uc e s c s
The isap ic l, c g
re hys a o nitive p yc lo ic l, a s c l
, s ho g a nd o ia
a p c to the einflue ingthehe th a w llne so
s et s nc a nd e s f
p rtic a
a ip nts