• Trip and fall lately Tell your doctor

• Minn. Web site creates health market

• FDA links antiwrinkle drugs to deaths

• Doctors use Wii games for rehab therapy

Trip and fall lately Tell your doctor

Mon, 11 Feb 2008 21:41:27 GMT

WASHINGTON - Trip and fall lately? Seniors often won't mention it unless they're hurt, but new guidelines say that first tumble is a good predictor of who's at risk for another, more serious fall. With deaths from falls increasing, the guidelines urge doctors to ask patients to 'fess up.
Better would be to prevent even that first fall. Now scientists are testing simple wrist monitors that may one day be used to predict who is most likely to topple, by tracking how stable they are with each step on any given day.

"Even the frail elderly individuals, some days they have good days and some days they have bad days," says lead researcher Thurmon Lockhart, who in his Virginia Tech laboratory literally forces volunteers to trip in the name of science to determine what makes one person fall while another stays upright.

It's a question of growing urgency, as fatal falls have spiked in the last decade. The government recorded more than 19,000 deaths from fall-caused injuries in 2005, the latest data available. Three-fourths were among people 65 and older.

Nonfatal falls trigger another half-million hospitalizations and almost 2 million emergency room visits.

Anybody can fall, especially during ice-slick winters or while playing sports. Lockhart even worked with UPS, the brown-truck delivery company, to help train their new drivers to avoid falls while hoisting packages.

But aging brings physical changes that make a fall more likely. Still, falls are something of the Rodney Dangerfield of injury prevention, so commonplace — one in three seniors falls each year — that they receive little attention until someone is seriously harmed, such as breaking a hip or suffering a brain injury.

Hence the emphasis on revealing earlier falls in guidelines published by the American Academy of Neurology last week. Someone who's fallen in the past year without a logical reason, such as a sports injury, has about a 55 percent chance of falling again — and thus may need special attention to prevent injury.

At highest risk of falling, the guidelines found, are people with gait or balance problems, dementia, Parkinson's disease or a history of stroke, weakness or nerve disorders in legs, impaired vision or who use certain medications.

The guidelines are aimed at neurologists, but a specialist in falls says asking about earlier tumbles makes good sense for any physician.

Don't "pass it off as a natural part of the aging process, but see it as a symptom with many possible underlying causes, some of which are highly treatable," says Dr. David Riley of University Hospitals Case Medical Center in Cleveland.

But before that first fall, the specific physical changes that determine why one senior can recover from a slip while another won't are poorly understood. Enter the Virginia Tech research.

First Lockhart tripped up several dozen people, a mix of young and old. Don't worry: Safety harnesses kept fallers dangling harmlessly in the air, instead of crashing. Videotape and sensors captured each movement, to map the physiology of falling.

Younger people recovered balance better so that a slip seldom turned into a fall, although some seniors recovered, too.

Why were others fall-prone? As you age, your gait becomes more variable. Seniors tend to compensate with shorter steps. But if one step varies in speed, length or direction from the next, it wobbles the up-and-down torso motion that is a key to balance while walking, Lockhart found.

So when seniors with an unstable gait encounter an obstacle — a bump in the sidewalk or a slick floor — they're already off-kilter and thus less able to recover, he explains.

Lockhart found that it's possible to measure that gait instability with some small, cheap devices, accelerometers and gyroscopes. Now, with funding from the National Institutes of Health, he has begun experiments to see if a wireless wrist monitor containing the gadgets, made by a company called AFrame Digital Inc., can truly predict who is fall-prone.

If that sounds complicated, there is a simple test anyone can do today to check if their leg muscles are weakening enough to worry about a fall.
It's called the "get up and go" test: Sit in a hard, straight-backed chair. Fold your arms across your chest. Try to stand. If you can't on the first try, tell a doctor so you can be checked for possible problems, says Cleveland's Riley.
For people already known to be fall-prone, specialists advise some commonsense precautions: Ask a doctor about exercises to improve balance and strength. Taper off fall-inducing medications whenever possible. Minimize slipping risks, such as by removing rugs and adding stair rails and hand-grabs in bathrooms.
But fatigue and stress can overcome any precaution, says Riley's patient, Dolly Thomas of Timberlake, Ohio. Her Parkinson's disease makes Thomas, 75, fall so often that she wears knee pads to cushion the blow. Last week, tired from caring for an ill husband, Thomas fell twice in one day.
"It just makes me so mad. I'll get up and darned if it doesn't happen again," says Thomas, who just got a scooter in hopes of falling less. "When you feel good and ... you're an independent person like I've been, it's really hard to sit and take it easy."
___
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Trip and fall lately Tell your doctor

Mon, 11 Feb 2008 21:41:27 GMT

WASHINGTON - Trip and fall lately? Seniors often won't mention it unless they're hurt, but new guidelines say that first tumble is a good predictor of who's at risk for another, more serious fall. With deaths from falls increasing, the guidelines urge doctors to ask patients to 'fess up.
Better would be to prevent even that first fall. Now scientists are testing simple wrist monitors that may one day be used to predict who is most likely to topple, by tracking how stable they are with each step on any given day.

"Even the frail elderly individuals, some days they have good days and some days they have bad days," says lead researcher Thurmon Lockhart, who in his Virginia Tech laboratory literally forces volunteers to trip in the name of science to determine what makes one person fall while another stays upright.

It's a question of growing urgency, as fatal falls have spiked in the last decade. The government recorded more than 19,000 deaths from fall-caused injuries in 2005, the latest data available. Three-fourths were among people 65 and older.

Nonfatal falls trigger another half-million hospitalizations and almost 2 million emergency room visits.

Anybody can fall, especially during ice-slick winters or while playing sports. Lockhart even worked with UPS, the brown-truck delivery company, to help train their new drivers to avoid falls while hoisting packages.

But aging brings physical changes that make a fall more likely. Still, falls are something of the Rodney Dangerfield of injury prevention, so commonplace — one in three seniors falls each year — that they receive little attention until someone is seriously harmed, such as breaking a hip or suffering a brain injury.

Hence the emphasis on revealing earlier falls in guidelines published by the American Academy of Neurology last week. Someone who's fallen in the past year without a logical reason, such as a sports injury, has about a 55 percent chance of falling again — and thus may need special attention to prevent injury.

At highest risk of falling, the guidelines found, are people with gait or balance problems, dementia, Parkinson's disease or a history of stroke, weakness or nerve disorders in legs, impaired vision or who use certain medications.

The guidelines are aimed at neurologists, but a specialist in falls says asking about earlier tumbles makes good sense for any physician.

Don't "pass it off as a natural part of the aging process, but see it as a symptom with many possible underlying causes, some of which are highly treatable," says Dr. David Riley of University Hospitals Case Medical Center in Cleveland.

But before that first fall, the specific physical changes that determine why one senior can recover from a slip while another won't are poorly understood. Enter the Virginia Tech research.

First Lockhart tripped up several dozen people, a mix of young and old. Don't worry: Safety harnesses kept fallers dangling harmlessly in the air, instead of crashing. Videotape and sensors captured each movement, to map the physiology of falling.

Younger people recovered balance better so that a slip seldom turned into a fall, although some seniors recovered, too.

Why were others fall-prone? As you age, your gait becomes more variable. Seniors tend to compensate with shorter steps. But if one step varies in speed, length or direction from the next, it wobbles the up-and-down torso motion that is a key to balance while walking, Lockhart found.

So when seniors with an unstable gait encounter an obstacle — a bump in the sidewalk or a slick floor — they're already off-kilter and thus less able to recover, he explains.

Lockhart found that it's possible to measure that gait instability with some small, cheap devices, accelerometers and gyroscopes. Now, with funding from the National Institutes of Health, he has begun experiments to see if a wireless wrist monitor containing the gadgets, made by a company called AFrame Digital Inc., can truly predict who is fall-prone.

If that sounds complicated, there is a simple test anyone can do today to check if their leg muscles are weakening enough to worry about a fall.
It's called the "get up and go" test: Sit in a hard, straight-backed chair. Fold your arms across your chest. Try to stand. If you can't on the first try, tell a doctor so you can be checked for possible problems, says Cleveland's Riley.
For people already known to be fall-prone, specialists advise some commonsense precautions: Ask a doctor about exercises to improve balance and strength. Taper off fall-inducing medications whenever possible. Minimize slipping risks, such as by removing rugs and adding stair rails and hand-grabs in bathrooms.
But fatigue and stress can overcome any precaution, says Riley's patient, Dolly Thomas of Timberlake, Ohio. Her Parkinson's disease makes Thomas, 75, fall so often that she wears knee pads to cushion the blow. Last week, tired from caring for an ill husband, Thomas fell twice in one day.
"It just makes me so mad. I'll get up and darned if it doesn't happen again," says Thomas, who just got a scooter in hopes of falling less. "When you feel good and ... you're an independent person like I've been, it's really hard to sit and take it easy."
___
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.

Minn. Web site creates health market

Mon, 11 Feb 2008 23:01:10 GMT
By ELIZABETH DUNBAR, Associated Press Writer

PLYMOUTH, Minn. - You can buy almost anything online these days, but try shopping the Internet for an MRI, strep throat test or even an annual physical exam and you'll run into roadblocks.
A new Twin Cities company called Carol is trying to change that with a Web site that gives consumers a "care marketplace" to search for medical services, compare quality and price and make appointments.

Carol joins an effort to transform the U.S. health care system by putting consumers in charge and letting the market do its work.

"We want to let consumers define value," said Tony Miller, Carol's founder and chief executive officer. "We don't have care competition in the marketplace today."

The free site, which went live in January, generates revenue from health care providers who become "tenants" on the site. When a consumer sets up an appointment with a clinic or doctor on Carol.com, the provider pays the site a fee.

While limited to about 30 providers in the Twin Cities area at its launch, the company is adding others and plans to serve a second U.S. market sometime this year, Miller said.

Health care experts said Carol will face challenges in getting enough doctors and health plans to participate. But they said it goes farther than previous efforts to use the Web to enhance medical choice, and they praised its ease of use.

Instead of going through a list of doctors or clinics, users tell the site what they're looking for by clicking on parts of the body.

For instance, if a consumer clicked on "entire body," then "annual exam," and chose a routine physical for women age 40-64, the results page would show six different options ranging from $207 to $335. After selecting a number of options, consumers can click "compare" and see exactly what each exam would entail. They can also read a description of the doctor or clinic's philosophy and link to ratings by MN Community Measurement, a nonprofit that measures health care performance in Minnesota.

Consumers who have insurance can type in plan information to have Carol.com estimate their out-of-pocket cost.

Miller said Carol is sensitive to consumer privacy, allowing people to search the site without registering, and it won't market to individual consumers even if they do register.

"The fact that they have a basic set of providers and prices and care packages is very impressive," said Greg Scandlen, president of the advocacy group Consumers for Health Care Choices, which lobbies against government regulation of the health care market.

But Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, said the site is nothing more than advertising, and he hoped it wouldn't catch on.

"Among physicians, there's a belief that health care is too critical ... to be left to the usual marketplace," he said.

If the site becomes more comprehensive, Carol.com would be most useful to people with high-deductible plans, health savings accounts or those without health insurance, said Elizabeth Boehm, an analyst with Forrester Research who studies the health care customer's experience.

She was skeptical of the site's prospects because many people's choices are limited by their HMO.

" just not what drives people to make their health care choices," Boehm said. "The challenge for a site like this is that while conceptually it's good ... the reality is there are only a small group of customers looking for that."

But Miller said consumers are starting to realize that choosing cheap health care might come back to haunt them in the form of higher premiums or other increased costs. And he thinks there are plenty of people like him who might want different options for care and are willing to pay more out-of-pocket to get what they want.
He said his idea for Carol came in part from his own experience with a heart condition for which he was told he needed surgery. A second professional recommended medication, which Miller, 41, said worked.
"I had the wherewithal and some of the contacts to help me navigate and find answers in the health care system. Most consumers don't have that," said Miller, a partner in the venture capital firm Lemhi Ventures, which has invested $25 million in Carol.
Park Nicollet Clinic, one of the bigger providers in the Twin Cities with nearly 700 doctors, was one of the first to embrace the Carol idea. Chief executive David Wessner said the clinic was already looking at ways to deliver value to patients and wasn't afraid to reveal prices.
"We just think there really is a crisis in value in health care. One of the things that helps us address that crisis is to package high value services and start to be willing to compete on that," Wessner said.
Psychiatrist Ronald Groat said Carol is important because it makes health care "more visible and transparent to someone who's looking for help."
___
On the Net:
http://www.carol.com

FDA links antiwrinkle drugs to deaths

Mon, 11 Feb 2008 23:01:28 GMT
By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON - The popular anti-wrinkle drug Botox and a competitor have been linked to dangerous botulism symptoms in some users, cases so bad that a few children given the drugs for muscle spasms have died, the government warned Friday.
The Food and Drug Administration's warning includes both Botox, a wrinkle-specific version called Botox Cosmetic, and its competitor, Myobloc, drugs that all use botulinum toxin to block nerve impulses, causing them to relax.

In rare cases, the toxin can spread beyond the injection site to other parts of the body, paralyzing or weakening the muscles used for breathing and swallowing, a potentially fatal side effect, the FDA said.

Botox is best known for minimizing wrinkles by paralyzing facial muscles — but botulinum toxin also is widely used for a variety of muscle-spasm conditions, such as cervical dystonia or severe neck spasms.

The FDA said the deaths it is investigating so far all involve children, mostly cerebral palsy patients being treated for spasticity in their legs. The FDA has never formally approved that use for the drugs, but some other countries have.

However, the FDA warned that it also is probing reports of illnesses in people of all ages who used the drugs for a variety of conditions, including at least one hospitalization of a woman given Botox for forehead wrinkles.

The FDA wouldn't say exactly how many reports it is probing.

"We're not talking hundreds. It's a relative handful," said Dr. Russell Katz, FDA's neurology chief.

But the agency warned that patients receiving a botulinum toxin injection for any reason — cosmetic or medical — should be told to seek immediate care if they suffer symptoms of botulism, including: difficulty swallowing or breathing, slurred speech, muscle weakness, or difficulty holding up their head.

"I think people should be aware there's a potential for this to happen," Katz said. "People should be on the lookout for it."

Friday's warning came two weeks after the consumer advocacy group Public Citizen petitioned the FDA to strengthen warnings to users of Botox and Myobloc — citing 180 reports of U.S. patients suffering fluid in the lungs, difficulty swallowing or pneumonia, including 16 deaths.

Nor is it the first warning. The drugs' labels do warn about the potential for botulinum toxin to spread beyond the injection site and occasionally kill, but the warnings link that side effect to patients with certain neuromuscular diseases, such as myasthenia gravis.

That's what's different about these latest cases, said FDA's Katz: The botulism toxin seems to be harming people who don't have that particular risk factor.

Still, the FDA cautioned that its investigation is in the early stages. It has asked Botox maker Allergan Inc. and Myobloc maker Solstice Neurosciences Inc. to provide additional safety records.

Allergan spokeswoman Caroline Van Hove said children with cerebral palsy receive far larger doses injected into their leg muscles than the doses given adults seeking wrinkle care.

In a statement, Solstice said it supports FDA's probe but stressed that the agency hasn't concluded the drug poses any new risk.

While the FDA said the problems may be related to overdoses, it also has reports of side effects with a variety of doses.

Public Citizen's Dr. Sidney Wolfe criticized FDA's warning as falling short. He asked that the agency order a black-box warning, the FDA's strongest type, be put on the drugs' labels and require that every patient receive a pamphlet outlining the risk before each injection.
"Every doctor needs to notified about this, every patient needs to be notified," Wolfe said. "Children are showing the way, unfortunately some dead children."
He said drug regulators in Britain and Germany last year required that sterner warnings be sent to every doctor in those countries.
___
On the Net:
FDA: http://www.fda.gov/cder/drug/early_comm/botulinium_toxins.htm

Minn. Web site creates health market

Mon, 11 Feb 2008 23:01:10 GMT
By ELIZABETH DUNBAR, Associated Press Writer

PLYMOUTH, Minn. - You can buy almost anything online these days, but try shopping the Internet for an MRI, strep throat test or even an annual physical exam and you'll run into roadblocks.
A new Twin Cities company called Carol is trying to change that with a Web site that gives consumers a "care marketplace" to search for medical services, compare quality and price and make appointments.

Carol joins an effort to transform the U.S. health care system by putting consumers in charge and letting the market do its work.

"We want to let consumers define value," said Tony Miller, Carol's founder and chief executive officer. "We don't have care competition in the marketplace today."

The free site, which went live in January, generates revenue from health care providers who become "tenants" on the site. When a consumer sets up an appointment with a clinic or doctor on Carol.com, the provider pays the site a fee.

While limited to about 30 providers in the Twin Cities area at its launch, the company is adding others and plans to serve a second U.S. market sometime this year, Miller said.

Health care experts said Carol will face challenges in getting enough doctors and health plans to participate. But they said it goes farther than previous efforts to use the Web to enhance medical choice, and they praised its ease of use.

Instead of going through a list of doctors or clinics, users tell the site what they're looking for by clicking on parts of the body.

For instance, if a consumer clicked on "entire body," then "annual exam," and chose a routine physical for women age 40-64, the results page would show six different options ranging from $207 to $335. After selecting a number of options, consumers can click "compare" and see exactly what each exam would entail. They can also read a description of the doctor or clinic's philosophy and link to ratings by MN Community Measurement, a nonprofit that measures health care performance in Minnesota.

Consumers who have insurance can type in plan information to have Carol.com estimate their out-of-pocket cost.

Miller said Carol is sensitive to consumer privacy, allowing people to search the site without registering, and it won't market to individual consumers even if they do register.

"The fact that they have a basic set of providers and prices and care packages is very impressive," said Greg Scandlen, president of the advocacy group Consumers for Health Care Choices, which lobbies against government regulation of the health care market.

But Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, said the site is nothing more than advertising, and he hoped it wouldn't catch on.

"Among physicians, there's a belief that health care is too critical ... to be left to the usual marketplace," he said.

If the site becomes more comprehensive, Carol.com would be most useful to people with high-deductible plans, health savings accounts or those without health insurance, said Elizabeth Boehm, an analyst with Forrester Research who studies the health care customer's experience.

She was skeptical of the site's prospects because many people's choices are limited by their HMO.

" just not what drives people to make their health care choices," Boehm said. "The challenge for a site like this is that while conceptually it's good ... the reality is there are only a small group of customers looking for that."

But Miller said consumers are starting to realize that choosing cheap health care might come back to haunt them in the form of higher premiums or other increased costs. And he thinks there are plenty of people like him who might want different options for care and are willing to pay more out-of-pocket to get what they want.
He said his idea for Carol came in part from his own experience with a heart condition for which he was told he needed surgery. A second professional recommended medication, which Miller, 41, said worked.
"I had the wherewithal and some of the contacts to help me navigate and find answers in the health care system. Most consumers don't have that," said Miller, a partner in the venture capital firm Lemhi Ventures, which has invested $25 million in Carol.
Park Nicollet Clinic, one of the bigger providers in the Twin Cities with nearly 700 doctors, was one of the first to embrace the Carol idea. Chief executive David Wessner said the clinic was already looking at ways to deliver value to patients and wasn't afraid to reveal prices.
"We just think there really is a crisis in value in health care. One of the things that helps us address that crisis is to package high value services and start to be willing to compete on that," Wessner said.
Psychiatrist Ronald Groat said Carol is important because it makes health care "more visible and transparent to someone who's looking for help."
___
On the Net:
http://www.carol.com

FDA links antiwrinkle drugs to deaths

Mon, 11 Feb 2008 23:01:28 GMT
By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON - The popular anti-wrinkle drug Botox and a competitor have been linked to dangerous botulism symptoms in some users, cases so bad that a few children given the drugs for muscle spasms have died, the government warned Friday.
The Food and Drug Administration's warning includes both Botox, a wrinkle-specific version called Botox Cosmetic, and its competitor, Myobloc, drugs that all use botulinum toxin to block nerve impulses, causing them to relax.

In rare cases, the toxin can spread beyond the injection site to other parts of the body, paralyzing or weakening the muscles used for breathing and swallowing, a potentially fatal side effect, the FDA said.

Botox is best known for minimizing wrinkles by paralyzing facial muscles — but botulinum toxin also is widely used for a variety of muscle-spasm conditions, such as cervical dystonia or severe neck spasms.

The FDA said the deaths it is investigating so far all involve children, mostly cerebral palsy patients being treated for spasticity in their legs. The FDA has never formally approved that use for the drugs, but some other countries have.

However, the FDA warned that it also is probing reports of illnesses in people of all ages who used the drugs for a variety of conditions, including at least one hospitalization of a woman given Botox for forehead wrinkles.

The FDA wouldn't say exactly how many reports it is probing.

"We're not talking hundreds. It's a relative handful," said Dr. Russell Katz, FDA's neurology chief.

But the agency warned that patients receiving a botulinum toxin injection for any reason — cosmetic or medical — should be told to seek immediate care if they suffer symptoms of botulism, including: difficulty swallowing or breathing, slurred speech, muscle weakness, or difficulty holding up their head.

"I think people should be aware there's a potential for this to happen," Katz said. "People should be on the lookout for it."

Friday's warning came two weeks after the consumer advocacy group Public Citizen petitioned the FDA to strengthen warnings to users of Botox and Myobloc — citing 180 reports of U.S. patients suffering fluid in the lungs, difficulty swallowing or pneumonia, including 16 deaths.

Nor is it the first warning. The drugs' labels do warn about the potential for botulinum toxin to spread beyond the injection site and occasionally kill, but the warnings link that side effect to patients with certain neuromuscular diseases, such as myasthenia gravis.

That's what's different about these latest cases, said FDA's Katz: The botulism toxin seems to be harming people who don't have that particular risk factor.

Still, the FDA cautioned that its investigation is in the early stages. It has asked Botox maker Allergan Inc. and Myobloc maker Solstice Neurosciences Inc. to provide additional safety records.

Allergan spokeswoman Caroline Van Hove said children with cerebral palsy receive far larger doses injected into their leg muscles than the doses given adults seeking wrinkle care.

In a statement, Solstice said it supports FDA's probe but stressed that the agency hasn't concluded the drug poses any new risk.

While the FDA said the problems may be related to overdoses, it also has reports of side effects with a variety of doses.

Public Citizen's Dr. Sidney Wolfe criticized FDA's warning as falling short. He asked that the agency order a black-box warning, the FDA's strongest type, be put on the drugs' labels and require that every patient receive a pamphlet outlining the risk before each injection.
"Every doctor needs to notified about this, every patient needs to be notified," Wolfe said. "Children are showing the way, unfortunately some dead children."
He said drug regulators in Britain and Germany last year required that sterner warnings be sent to every doctor in those countries.
___
On the Net:
FDA: http://www.fda.gov/cder/drug/early_comm/botulinium_toxins.htm

Doctors use Wii games for rehab therapy

Mon, 11 Feb 2008 23:01:41 GMT
By LINDSEY TANNER, AP Medical Writer

CHICAGO - Some call it "Wiihabilitation." Nintendo's Wii video game system, whose popularity already extends beyond the teen gaming set, is fast becoming a craze in rehab therapy for patients recovering from strokes, broken bones, surgery and even combat injuries.
The usual stretching and lifting exercises that help the sick or injured regain strength can be painful, repetitive and downright boring.

In fact, many patients say PT — physical therapy's nickname — really stands for "pain and torture," said James Osborn, who oversees rehabilitation services at Herrin Hospital in southern Illinois.

Using the game console's unique, motion-sensitive controller, Wii games require body movements similar to traditional therapy exercises. But patients become so engrossed mentally they're almost oblivious to the rigor, Osborn said.

"In the Wii system, because it's kind of a game format, it does create this kind of inner competitiveness. Even though you may be boxing or playing tennis against some figure on the screen, it's amazing how many of our patients want to beat their opponent," said Osborn of Southern Illinois Healthcare, which includes the hospital in Herrin. The hospital, about 100 miles southeast of St. Louis, bought a Wii system for rehab patients late last year.

"When people can refocus their attention from the tediousness of the physical task, oftentimes they do much better," Osborn said.

Nintendo Co. doesn't market Wii's potential use in physical therapy, but company representative Anka Dolecki said, "We are happy to see that people are finding added benefit in rehabilitation."

The most popular Wii games in rehab involve sports — baseball, bowling, boxing, golf and tennis. Using the same arm swings required by those sports, players wave a wireless controller that directs the actions of animated athletes on the screen.

The Hines Veterans Affairs Hospital west of Chicago recently bought a Wii system for its spinal cord injury unit.

Pfc. Matthew Turpen, 22, paralyzed from the chest down in a car accident last year while stationed in Germany, plays Wii golf and bowling from his wheelchair at Hines. The Des Moines, Iowa, native says the games help beat the monotony of rehab and seem to be doing his body good, too.

"A lot of guys don't have full finger function so it definitely helps being able to work on using your fingers more and figuring out different ways to use your hands" and arms, Turpen said.

At Walter Reed Army Medical Center, the therapy is well-suited to patients injured during combat in Iraq, who tend to be in the 19 to 25 age range — a group that's "very into" playing video games, said Lt. Col. Stephanie Daugherty, Walter Reed's chief of occupational therapy.

"They think it's for entertainment, but we know it's for therapy," she said.

It's useful in occupational therapy, which helps patients relearn daily living skills including brushing teeth, combing hair and fastening clothes, Daugherty said.

WakeMed Health has been using Wii games at its Raleigh, N.C., hospital for patients as young as 9 "all the way up to people in their 80s," said therapist Elizabeth Penny.

"They're getting improved endurance, strength, coordination. I think it's very entertaining for them," Penny said.

"It really helps the body to loosen up so it can do what it's supposed to do," said Billy Perry, 64, a retired Raleigh police officer. He received Wii therapy at WakeMed after suffering a stroke on Christmas Eve.

Perry said he'd seen his grandchildren play Wii games and was excited when a hospital therapist suggested he try it.
He said Wii tennis and boxing helped him regain strength and feeling in his left arm.
"It's enjoyable. I know I'm going to participate with my grandkids more when I go visit them," Perry said.
While there's plenty of anecdotal evidence that Wii games help in rehab, researcher Lars Oddsson wants to put the games to a real test.
Oddsson is director of the Sister Kenny Research Center at Abbott Northwestern Hospital in Minneapolis. The center bought a Wii system last summer and is working with the University of Minnesota to design a study that will measure patients' function "before and after this 'Wiihab,' as someone called it," Oddsson said.
"You can certainly make a case that some form of endurance related to strength and flexibility and balance and cardio would be challenged when you play the Wii," but hard scientific proof is needed to prove it, Oddsson said.
Meantime, Dr. Julio Bonis of Madrid says he has proof that playing Wii games can have physical effects of another kind.
Bonis calls it acute "Wiiitis" — a condition he says he developed last year after spending several hours playing the Wii tennis game.
Bonis described his ailment in a letter to the New England Journal of Medicine — intense pain in his right shoulder that a colleague diagnosed as acute tendonitis, a not uncommon affliction among players of real-life tennis.
Bonis said he recovered after a week of ibuprofen and no Wii, and urged doctors to be aware of Wii overuse.
Still, as a Wii fan, he said in an e-mail that he could imagine more moderate use would be helpful in physical therapy "because of the motivation that the game can provide to the patient."