Do You Do Health 2.0?


EconomixGraphUve
In this time of increasing health costs, falling numbers of paying patients, and overall health-related economic strain, one portion of the health sector seems to be on the move.

An estimated 60 million Americans are can be found partaking in some sort of Health 2.0 activities. This is defined as:

"Health 2.0 consumers are defined as consumers who have conducted one of the following activities in the past 12 months: read health-related blogs, message boards or participated in health-related chatrooms; contributed or posted health content online such as: writing or commenting on a health-related blog, adding or responding to a topic in a forum or group, or creating health related web pages, videos or audio content; used online patient support groups, message boards, chatrooms, or blogs."

Seems like a bit of a loose definition to me.  This would make any reader of my blog a Health 2.0 consumer…so…congratulations?  I'm thinking the definition might be better off including some sort of active intent with respect to one's health condition.  For example, reading my blog with the intent to learn more about selecting a physical therapist for your treatment.

Either way, Health 2.0 is the wave. It's time to get yourself up to speed on Al Gore's new internet. May I suggest starting by tracking the Flu Bug at Google!

ERIC

Image Source: Uwe Reinhardt via NYT

Can the Wii Replace Regular Exercise?

ResearchBlogging.org

With Wii becoming all the rage lately, not to mention finding its way into physical therapy clinics everywhere, it’s important to realize that not much is know about the effects of using the Wii.  Some argue that it can be a replacement for traditional exercise, while others (me) argue it is not.  Well, the researchers are off and running, and some early data is already starting to come back.

A group of researchers in the UK measured energy expenditure while playing the Wii and compared it to similar sedentary video games, in this case, the XBOX 360.  Energy expenditure was measured using a system that estimates energy costs using sensors called the IDEEA (intelligent device for energy expenditure and activity).  The group studied was boys and girls aged 13-15 years.  They played Project Gotham racing on the XBOX, and Wii Tennis, Bowling, and Boxing.

Not surprisingly, the Wii resulted in greater energy expenditure than traditional sedentary video games.  The average increase in energy used during Wii-play was about 51% greater than when playing the "old-fashioned" video games.

But, when researched compared the increased energy expenditure when using the Wii to actually performing the activity the Wii came up short.Wiienergycosts_2
 

The researchers conclude: 

"Active gaming used less energy than authentic bowling, tennis, and boxing, and the exercise was not intense enough to contribute towards the recommended amount of daily physical activity for children"

A couple of caveats are that the IDEEA is not the best way to measure arm activity, which is what the Wii entails, and that the children were standing up and playing, which is always a good thing for breathing, bones, joints, posture, etc.  Also, in terms of Wiihab, perhaps the use of the Wii as a graded activity is warranted.  Finally, the Wii Fit seems the most likely aspect of the Wii to serve as an alternative to traditional exercise, but that was not evaluated in this study.

So, exercise, Wii is not.  Fun, active video game…Wii is.  One more interesting fact from the study…boys used more energy than girls while playing the Wii. 

Link to Abstract.

Graves, L., Stratton, G., Ridgers, N.D., Cable, N.T. (2007). Comparison of energy expenditure in adolescents when playing new generation and sedentary computer games: cross sectional study. BMJ, 335(7633), 1282-1284. DOI: 10.1136/bmj.39415.632951.80

Wihab on CNN

Stacyfritz_wiiresearcher_3
A couple months back, Stacy Fritz was nice enough to pen a guest post for NPA Think Tank providing her thoughts on Wiihab.  You may remember she was in the process of submitting a grant application to study the use of the Wii in rehab.

Last week, Dr. Fritz was awarded a grant from the Robert Wood Johnson Foundation to go ahead and study the effect that Wii can produce.  She will be studying its effects on stroke victims specifically.

“The use of video games is a little controversial so it’s important
to say up front that what we’re doing is not designed to replace
conventional therapy. We’re testing to see if this is one modality that
may help,” said Fritz, a clinical assistant professor in the Department
of Exercise Science.

Now, Stacy Fritz and her grant were featured on CNN Headline News!  Click here to see the video. 

I have one issue with her CNN interview:  As you can see above, they incorrectly labeled Stacy a "Stroke Rehab Researcher".  We all know that they should have labeled her a "Stroke Rehab Wii-searcher!!!"

Good job on the grant, Stacy!  We will be eagerly awaiting your results.

New Blog, PT on Forbes, and Grassroots Political Efforts

There’s a new PT blog to mention, with two very interesting posts which need to be highlighted. 

MCG Physical Therapy student, Ben Seagraves’ most recent post sends us to this blog from Rich Karlgaard on Forbes, who outlines how it cost $14,000, 3 specialists and 2 MRI’s before his son was able to access the services of a physical therapist.  Defensive medicine at it’s best! 

Most interestingly, Ben’s blog, "Views from a Georgia Boy" was welcomed to the scene with an interesting commentor on only his third post.  Ben’s post about GA bill HB 1055 provoked a very lengthy diatribe from GATA president Paul Higgs

I found it curious that such a comment would show up on what is very obviously a brand new, student-penned blog (not to take away from the blog, but traditionally, it takes at least a week or two to even tell your friends about your blog).  In order to find the post Higgs must have created a blog alert for the bill number, right?  This type of grassroots effort with collaborative technology is some solid stuff.  I would bet that Ben could comment on several hundred PT bills and issues and never get a direct comment from any APTA-ish entity. 

Reaching out and connecting through blogs and social networking is how relationships are being made.  Higg’s actions remind me of the Obama campaign, which has infiltrated almost every social networking site on the planet promoting his campaign.

There is a lesson to be learned here…maybe several, in fact.
ERIC

Wii Fun vs. Wii Funded

Hwdwii
Readers of this blog know that I think of Wii as fun, not therapy.  In the spirit of fairness, I must acknowledge that there might be a patient population which could benefit from gaming in rehabilitation. 

Checking in with a GUEST POST(the first ever guest post on NPA Think Tank!) is Stacy Fritz, PT, PHD, Clinical Assistant Professor of Physical Therapy at the University of South Carolina, who explains her research interest in Wiihab:

"Recent research has focused on identifying innovative and cost effective rehabilitative strategies to enhance function and quality of life in aging and/or neurologically compromised adults.  Virtual reality (VR) gaming may provide an ideal opportunity for motor learning and the recovery of lost function.1 First, the system allows for repetitive practice of activities, sometimes without the assistance of a rehabilitation specialist. Second, it has built-in augmented feedback, and the interactive interface helps to maintains participant interest and motivation. Third, the system may be an affordable option for many individuals.2

Research suggests that people with disabilities are capable of learning movement skills in virtual environments. Specifically, movements learned in a virtual environment transfer to real-world equivalent motor tasks; in some instances, evidence suggests that learning in a virtual environment has some advantages over real environment rehabilitation.1 Such findings paint an optimistic portrait for the future of VR in the treatment of balance and mobility deficits. To date, however, there is limited research that supports the use of VR in the treatment of balance and mobility deficits.3

The popularity of commercially-available gaming systems, such as Nintendo’s Wii, is extending beyond the teen gaming set. The systems are fast becoming an integral part of rehabilitation. Numerous news reports suggest that usual physical therapy such as stretching and/or lifting exercises can be “painful, repetitive and downright boring.” To avoid the “boring” therapy, therapists have been using gaming systems that involve interaction between the person and the video system through body actions that are similar to traditional therapy exercises. While there is considerable anecdotal evidence, as well as high utilization of gaming systems by hospitals, there has been limited research to indicate whether or not using virtual reality is effective for improving balance.

Supporters of the use of VR in a physical rehabilitation environment argue that it provides a non-threatening, fun, and motivating experience. However, there are concerns regarding the use of VR in individuals with physical limitations, including patient attitudes toward technology, equipment safety, feasibility of use, and lack of individualization of therapy. Despite these concerns, VR has been shown to be beneficial for a variety of populations.2,4,5

Anyone who has ever played the Wii, can not deny that it is fun, engaging, and many games are physically active. But is it appropriate for rehabilitation? The research needs to be done, this includes feasibility, efficacy, and determination if there is a need for a skilled therapist? Maybe it will be a good complement or adjunct to other falls prevention programs. Most important, it needs to be investigated before Wii Rehab centers start turning virtual reality into reality."

Thanks, Stacy!

Click on for references.

 

Continue reading “Wii Fun vs. Wii Funded”

MCG Tech Fair Features Wiihab!

I found this tucked away in the schedule for the Medical College of Georgia Tech Fair planned for tomorrow (3/12): 

12:15 p.m.

· Windows on my Mac?

· Getting the Word Out – Internal Communications at MCG 

 

1:00 p.m.

· Adobe Dreamweaver

·     Rehabilitation and the Nintendo Wii

 

1:45 p.m. 

· Collaboration Within an Online Course 

I guess Wiihab is everywhere!  At least I get to go see a presentation on it.  I’ll be sure to have some pertinent questions ready for the presenters!  Anyone wish to join me?

ERIC

Continue reading “MCG Tech Fair Features Wiihab!”

Connecting PT's

A month or so back, I wrote a post urging Physical Therapists to become more active in the blogosphere.  I highlighted a few blogs that were new to the scene, but was very pleased when my comments became a buzz of activity with PT’s reaching out to let me know of their existence in the world of blogs.

Here is a list of the sites I’ve had time to check out.  You will notice that this list has some active blogs, and some less frequently updated sites.  You will also notice that the content of these blogs is very diverse, with a large portion of them related to pain science.  Finally, yes, there are women PT bloggers!!  I’m sure there are some more blogs out there, but I got a little dizzy trying to determine which blogs were active, which were proposed blogs, and which were abandoned.  If I left you off the list, do not be offended, just send a note and I’ll update it.

Check em Out! (in no particular order)

Student PT Blog

Orthopaedic Physical Therapy Blog

Humanantigravitysuit (which includes a very interesting tag line: From the Vantage Point of a Professional Human Primate Social Groomer, or "Neuroplastician")

TherExtras The "truth about healthcare and therapy for children with disabilities"

Gaston Rehab Associates Blog

Neurotonics: a PT Team Blog

The Neurotopian

Strengthen your Health

Soma Simple Forums

Rehab Edge

Apparently, I’m not the only one who wonders about PT’s uptake of Internet technology.  One blogger wrote regarding PT’s web use:

"The resistance to any use of the web is beyond your imagining" Barrett Dorko

 

As a side note, several of the comments referred to John Duffy’s PT Update site as a precursor to current blogging efforts.  Perhaps, although the paid subscription model keeps him firmly on the Web 1.0 side of the web universe.

ERIC

Oh Brother! Still the Wii?

Angry_man
My fear of having non-fitness personnel take up the profession of Wiihab is coming closer to fruition as Nintendo has announced a Fitness package which will include a balance board.  Nintendo itself is spearheading the effort into the fitness industry.

The APTA is very typically all excited about this gimmick and announced their new love affair in this week’s news:

"Look
for an upcoming article in the May issue of
PT Magazine about PTs who have used the Wii as part of
patient care."

How many people in the world can do Wiihab without having to spend time getting a doctoral degree?  Exactly!  So should this be something physical therapists do?  This is very similar to going to see a physical therapist and getting put on an exercise bike for a half hour.  Yes, within our scope of practice, but not good practice.  If I was a patient and hurt my shoulder only to be put on a Wii-regimen…well, I’m not coming back.

I’ve got a bad feeling about this. 
ERIC

The National Wiihab Crisis

Dunce
Most news articles on physical therapists can be found in newspapers by the following categorization:

"Newspaper name / world news / national news / health news / local news / physical therapy news"

No longer, as I found this headline under the "world news" category in the  Atlanta Journal Constitution:

"Forget rehab, try Nintendo Wiihab"

Yikes!!! World news?  Forget Rehab?  Yes, Wiihab is surely helping our professional branding now, isn’t it?

Let’s put a hypothetical example forward.  I’m a random guy with a business background, perhaps a personal trainer, and a half-dozen Nintendo Wii systems.  I’m not a licensed physical therapist, but still I decide to open a Wiihab Center.  I’m not doing physical therapy, I’m not billing for physical therapy…I’m doing "Wiihab."  Wiihab is exercising with a Wii, surely not the intellectual or professional property of the physical therapy profession.  I’m now free to invite all those injured patients who have read about Wiihab in to exercise at my singlularly branded Wii-clinic.

Is this was all those clinics getting press about Wiihab are hoping for?  Obviously, not.  But as Wiihab gets a national branding and enterprising individuals realize that anyone can open a fitness center, how can they stop it?  Won’t they feel like a dunce when a Wiihab shop opens up next door and bills cash at a higher rate than physical therapy reimbursement for therapeutic exercise!

Will the APTA and state chapters spend thousands of legislative dollars trying to get Wiihab added to practice acts, to prevent chiropractors and athletic trainers from performing Wiihab?  I sure hope not.   

The Wiihab crisis…it could be just the beginning.
ERIC

p.s.  I’ve added a Wiihab category to the blog to track my posts about this next big thing in rehab!