Study supports using video games for Parkinson’s physical therapy

Study compared Nintendo Wii system with motor imagery, PT-only approaches

Marisa Wexler, MS avatar

by Marisa Wexler, MS |

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Playing rehabilitative video games along with physical therapy is more effective than conventional physical therapy only for managing symptoms of Parkinson’s disease, a study suggests.

Video game-based therapy is also a better add-on to traditional physical therapy than motor imagery where a patient visualizes the steps needed for complex movements, according to “Effects of virtual reality versus motor imagery versus routine physical therapy in patients with parkinson’s disease: a randomized controlled trial,” which was published in BMC Geriatrics.

Physical therapy is an important part of care for many people with Parkinson’s and involves exercises and routines designed to maximize mobility and physical function.

Some studies have explored using video games and virtual reality exercises along with traditional physical therapy, with the goal being to help patients better engage with exercise. The Nintendo Wii Fit system, where players interact with a game by standing on a board that tracks how their weight shifts as they move, has been a popular choice.

Motor imagery, where a patient visualizes the steps needed for movements (without actually moving) in order to strengthen the neurological signals that control movement, has also been explored as an add-on to traditional physical therapy. Here, scientists in Pakistan enrolled 60 people with Parkinson’s in a small clinical trial to test whether adding video games or motor imagery to physical therapy yields better results in Parkinson’s.

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Functional gains with video games

The participants were randomly divided into three groups. One group received traditional physical therapy only, a second group got traditional physical therapy with rehabilitative games on the Wii, and the third group received physical therapy along with motor imagery therapy.

“No study has yet examined these three groups in one study to obtain a candid picture of which therapeutic regime is actually effective or creates sustained effects,” the scientists said.

The study lasted 16 weeks, or about four months, during which all participants received at least 33 40-minute sessions and were assessed at the study’s beginning and end, as well as a few times during it.

Motor symptom severity was measured with Part 3 of the Unified Parkinson’s Disease Rating Scale (UPDRS). Patients given the video game-based therapy saw their average scores decrease from 33.95 to 18.15 points, indicating less severe motor symptoms.

Motor symptom severity scores also decreased in patients given motor imagery or given only physical therapy, but not as much. In the motor imagery group the score fell from 32.7 to 19.9 and in the PT-only group it fell from 33.05 to 24.85.

Similar trends were seen for scores in Part 2 of the UPDRS, which measures the ability to independently carry out day-to-day activities. Measures of balance also generally showed greater improvement with the video game intervention.

“The current study found that the [Wii video game] group showed greater improvements in functional outcomes than the motor imagery group and routine [physical therapy] alone,” said the scientists, who noted more research was needed to validate the results. The findings support incorporating rehabilitative video games into routine physical therapy practice, they said.