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

3. So how does it work
with different
Diagnoses?

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

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

17. Functional aspects (Cooking Mama
Cook- off
Co
o kingisno o func na b s fe
t nly tio l ut a …

19. Buttering a pan

20. Filling a pot

21. Cracking an egg

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

23. Duncan: Columbia
Area PD Support
Group Mascot

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