Tuesday 12th June 2012
Mandy Trickett, Macmillan Specialist Physiotherapist, finds interactive video games help people in palliative care stay active.
Helping people achieve their goals in an interesting way can be a challenging and rewarding aspect of physiotherapy in palliative care.
At NHS Tayside, the Specialist Palliative Care Services team has found gaming technology, such as Nintendo Wii and Kinect for Xbox, to be particularly beneficial for people in palliative care.
When a patient’s abilities deteriorate, gaming technology can be adapted to allow them to continue with, and complete a physical activity. This enhances their sense of achievement at a time when frailty is increasing and more traditional physiotherapy interventions become too difficult, or remind them of what they can no longer achieve.
One of our patients has rapidly advancing motor neurone disease. They said that using gaming technology has helped them maintain some upper body strength and improved their sitting posture.
They said, ‘Keeping active in a way that I can gives me some control and a little hope.’ Although this person’s physical outcomes are deteriorating weekly, maintaining the best quality of life is a priority, and gaming technology appears to be assisting this because it is flexible and can be adapted throughout various disease trajectories.
When used as a form of exercise, gaming technology can be used to encourage movement, alleviate pressure areas, improve balance and respiratory function, promote social interaction, and enhance the quality of life for those in the palliative care.
NHS Tayside recently established a practice development group for gaming technology. This is attended by physiotherapists, occupational therapists and assistant staff, from areas including brain injury, amputee therapy, mental health, paediatrics and palliative care.
Each area uses its own measures to assess the benefits of gaming technology, and we are currently developing a patient satisfaction questionnaire to assess patients’ views of using gaming technology as part of their treatment.
Gaming technology is selected after a full patient assessment is done. Kinect for Xbox is particularly useful for stimulating normal, active movement and balance reactions. The technology doesn’t require remote controls and balance boards, so it is more suitable for patients who find operating these two pieces of equipment difficult.
Alternatively, if upper limb coordination is the main problem, the Nintendo Wii, which uses a remote, may be a better choice. The gaming equipment and choice of game should always fit the patients’ problems and goals, not the other way round.
Patients who have access to gaming technology at home report high levels of compliance with their home exercise programme, which fits in with the current guidelines of promoting physical activity for all long-term conditions, especially cancer.
Gaming technology provides a fun, interactive method of achieving specific therapeutic goals, and most importantly, patients really seem to enjoy it.
Contact Mandy Trickett, Macmillan Specialist Physiotherapist, Specialist Palliative Care Services at NHS Tayside on 01382 423194 or email Mandy
The gaming equipment was purchased using money from the NHS Endowment Fund
and patient donations.