| Many patients begin a painful physical therapy process | | | | The answer may lie with modern video game |
| following shoulder surgery. Following the invasive | | | | systems, specifically the Nintendo Wii. The Wii uses |
| process of implanting bone anchors or the cutting and | | | | motion sensitive controllers to control the characters in |
| replacement of tendons the arm is further inhibited by | | | | the game. Instead of sitting on the couch exercising the |
| weeks of immobilization caused by wearing a sling. | | | | thumbs, as is the case with other systems, users of |
| Once the sling is removed, typically after two to six | | | | the Nintendo Wii are up and active. Simulating the |
| weeks, the arm is stiff, weak, and painful to move. | | | | movements needed to swing a tennis racquet or box |
| The physical therapy process starts with passive | | | | with an opponent. The game gives the patient |
| stretching to try to regain the range of motion the | | | | something other than the pain to focus on which in turn |
| shoulder joint is capable of. Lack of movement has | | | | removes the mental anguish from physical therapy. |
| caused a buildup of scar tissue and a lack of sinovial | | | | The Wii is starting to find a home in hospitals around |
| fluid to "grease" the joint. Initial range of motion | | | | the country. Herrin hospital in southern Illinois has |
| exercises are painful and take a great deal of effort. | | | | started to use the video game system and reports |
| Range of motion returns slowly. Passive, or assisted, | | | | that patients refocus their energies into beating the |
| movement returns much quicker than active, or patient | | | | opponent instead of focusing on the pain. This pushes |
| directed, motion. | | | | them further into rehab than they would normally. The |
| After about four weeks the patient begins | | | | patients often do much better. |
| strengthening exercises. These are also tedious, painful | | | | Having spent time competing with friends to see who |
| and take a lot of time. The mental focus needed to | | | | is the better boxer, I can say that my shoulders were |
| perform these exercises leave the patient mentally | | | | heavily fatigued following play. Whether prolonged use |
| and physically exhausted. The slow pace of recovery | | | | will turn into stronger shoulders or not, I'm not sure. Play |
| often takes its toll on the emotional health of the | | | | definitely got the blood flowing and the muscles |
| patient. Around week six or seven, many patients | | | | working. |
| report to onset of mild depression. While sounding | | | | For liability purposes Nintendo does not market the Wii |
| extreme, the pattern has repeated itself among | | | | has a physical therapy device, although clearly the |
| members of sports medicine community web forums. | | | | potential is there. It's only a matter of time before we |
| The majority of patients find out that real recovery, the | | | | see systems that use this technology geared primarily |
| gain of strength and flexibility, occur when the shoulder | | | | for physical therapy. I would not recommend that |
| is used on a day to day basis to do real tasks. A | | | | patients fresh from the sling start swinging virtual |
| return to exercise is difficult but the activity builds | | | | racquets and don virtual boxing gloves right away. It's |
| active range of motion very effectively. | | | | clear that the potential is there for a faster recovery. |
| The big question is, how can a patient build active | | | | Definitely talk to your doctor before starting any |
| range of motion and strength without the pain of | | | | physical therapy and perhaps the Nintendo Wii is in |
| physical torture? I mean therapy. | | | | your future. |