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Winter 2012

Fun and Games in the ICU

Critically ill patients find benefit from Wii time.

Date: February 1, 2012

Fun and Games in the ICU

Interactive video games, already known to improve motor function in recovering stroke patients, appear to safely enhance physical therapy for patients in intensive care units, according to Michelle E. Kho, an assistant professor of physical medicine and rehabilitation.

In a report published online in the Journal of Critical Care, she and her colleagues studied the safety and feasibility of using video games to complement regular physical therapy in the ICU.

“Patients admitted to our medical intensive care unit are very sick and, despite early physical therapy, still experience problems with muscle weakness, balance, and coordination as they recover,” says Kho. “We are always looking for creative ways to improve rehabilitation care for critically ill patients, and our study suggests that interactive video games may be a helpful addition.”

For the study, the Hopkins researchers identified a group of 22 critically ill adult patients who, over a one-year period, received video games as part of routine physical therapy. These patients were part of a group of 410 patients who received standard early physical therapy in the medical ICU during the same time frame from Johns Hopkins physical therapists. The study patients, mostly males ranging from 32 to 64 years of age, were admitted to the medical ICU as a result of health problems such as respiratory failure, sepsis, and cardiovascular issues.

These 22 patients participated in 42 physical therapy sessions that included use of Nintendo Wii and Wii Fit video game consoles. Almost half of the 20-minute sessions, all provided under the direct supervision of a physical therapist, were for patients who were mechanically ventilated. The most common video game activities were boxing, bowling, and use of the balance board. The physical therapists chose these activities primarily to improve patients’ stamina and balance.

“As always, patient safety was a top priority, given that healthy people playing video games may be injured during routine gaming, but when properly selected and supervised by experienced ICU physical therapists, patients enjoyed the challenge of the video games and welcomed the change from their physical therapy routines,” says Dale M. Needham medical director of Hopkins’ Critical Care Physical Medicine and Rehabilitation Program.

He and Kho caution that more research is needed to determine whether the games improve patients’ abilities to do the tasks that are the most important to them.

“Our study had limitations because the patients were not randomly selected, the video game sessions were infrequent, and the number of patients was small,” Kho notes. “Our next step is to study what physical therapy goals best benefit from video games.”

John Lazarou

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