Fun and Games

“I wish they had used this when I was in therapy. It is such a fun way to improve balance, instead of the boring games we had” – Douglas Coetzee (C6 quad) after playing the skiing game on the Wii Balance Board

The development of interactive gaming has opened up a whole new world of great gaming fun, whilst providing a surprising amount of exercise.

Numerous tiny little buttons, that only exercised your thumbs, are no longer the only way to interact and have loads of gaming fun; and being a gaming fanatic no longer means that you have to be a ‘couch potato’!

It has also changed rehabilitation by allowing patients to get caught up in the world of fun and fantasy while they retrain their movements. They get so involved in the game that they forget how hard they are working and therapists are obtaining excellent results. Research projects around the world have also proven that certain interactive games, requiring a physical response, can improve fitness levels and reduce weight if used regularly.

A gaming console is a standalone computer system that can be displayed on a TV or monitor. They are designed for playing games and do not have all the features of personal computers. Instead of a keyboard or a mouse they have input devices which pass information between the gamer and the console enabling interaction with the game on the screen. It is the variety of input devices now available that has made gaming accessible to people without hand function or limited coordination. Modern gaming consoles are easy to set up, have better graphics, smaller consoles, and a huge variety of games. South Africa’s most popular gaming consoles are PlayStation, Nintendo Wii and Xbox 360.

Nintendo Wii

With worldwide sales of over 13,5 million in 2009, Wii’s unique interactive gaming style has made its mark in the gaming market. A variety of games and exercises are enjoyed by all ages, with different motion-sensitive input devices that the gamer controls as if they were playing the real sport. The developers thought up amazing ways of getting the gamer to get a full body work out while having heaps of fun. Games can be played individually or as a group, which enables families to share the fun together.

Jacques Pienaar, an incomplete quadriplegic values the time he spends playing these games with his children.

Joné and Anje Dreyer suffer from cerebral ataxia, which is a condition which impairs their coordination and negatively affects their ability to execute controlled movements.

The Wii Remote was observed to respond to the slightest of movements and, to their delight, they were able to participate in tennis and boxing games for the first time in their lives.

Rehabilitation centres all over the world have started to use this device in therapy. In the USA therapists call Wii therapy “Wii-hab”.

The shape of the standard remote makes it very easy to hold in a basic grip with minimal hand function. It has a few buttons that may need to be pushed during some games but boxing, tennis and baseball can be played without buttons.
The variety of games provides an opportunity for people to play with one hand or both, thus suitable for both spinal injury and brain injury rehabilitation.

The Wii Fit balance board is pressure sensitive and normally controlled from a standing position. We had great success sitting on it, an excellent excuse to get someone out of their wheelchair and working on their trunk muscles, as demonstrated by Nico Bilankulu, an in-patient at the Eugene Marais Life Rehabilitation Hospital.

Therapists at the Just @ Muelmed Rehabilitation Centre uses Wii brain training games in the rehabilitation of their patients who have suffered cognitive impairments. These are played using the standard Wii Remote.

Basic Wii units start at R2,499 including a console, remote, nunchuk, sensor bar and usually comes with Wii Sports. Wii Fit Plus (game plus balance board) costs about R1,099 and additional games cost between R300 and R600.

Sony PlayStation

Sony have refined and improved on the original Playstation with the PS2 and PS3s both of which are available in stores and online.

PS3 improvements over the PS2 include wireless controls, improved picture quality through the use of Blue Ray technology, a hard drive and WiFi for wireless internet access. Both have built-in modems for online gaming.

As the PS2 has no hard drive game scores are stored on memory cards which can be removed and swapped. The PS2 will play most games from the PS1 but not many PS2 games will play on the PS3.

The original PlayStation 1 games were designed to be played via the PS control and were of the action, shooting, racing, fighting and role playing variety. Sports, strategy, party and music games have since crept in with the advent of new input devices such as cameras, dance mats, microphones, turn-tables, drum kits and guitars.

Sony will be launching their answer to the Wii remote later this year, the PlayStation Move motion controller. The Move will apparently work with the Pla yStation Eye camera to track movements such as punches, the swinging of swords and workouts.

PS2 base units are still much in demand and start off at around R1,399. PS3 units cost about R3,799 but you can often find them bundled. Microsoft Xbox 360

Xbox is a wireless console which is very simple to set-up and use. The Arcade option has large controls and is available with either 256MB or 512MB of memory whereas the Elite Edition has 120GB to 250GB hard drives.

Xbox games are mainly action/ adventure with the focus on hardcore shooting games. They also have some great racing games as well as movie interaction games. Excellent online facilities for multiplayer gaming.

Xbox Arcade costs from R 1,999 and the Elite Edition from R3,199. So, What is the Difference?

The Xbox and PlayStation platforms have many of the same games and input devices available, and are in direct competition with each other.

The Wii’s range of interactive input devices give it the edge at the moment but both Xbox and PlayStation are launching their range of interactive devices later this year and this can only be to the benefit of people with disabilities.

Many of the input devices for the Xbox and PlayStation games have been around for quite some time and tend to be overlooked as devices for persons with disabilities. To our detriment!

I spent a few very enjoyable hours getting to know these products and they are extremely accessible and lots of fun!

The Wii is great but the graphics can be quite half-baked and under-cooked, and where is the fun in “doing excercise”?

Playstation and Xbox games feel like games, act like games and perform like games, and yet, you can get a pretty good work out at the same time.

There are many different companies, such as EA Sports, who produce the games on a number of platforms, for example EA Sport’s FIFA 10 is available for Wii, Xbox, PS3 and PSP. The trick is to find a game that thrills you and has input gizmos suited to your range of motion.


Wii, Xbox and PlayStation all have cameras that can connect to their consoles. Playtation’s PS2 Eye Toy tracks your movements enabling you to interact with the game purely by moving different parts of your body. The Eye Toy sensor is also adapts to the amount of movement that you do, and will automatically compensate for a smaller range of movement (in some games it prefers a smaller range!).

Antigrav is a fantastic skateboarding game which is well suited to being played with the Eye Toy and only needs arm and trunk movements.

The PS2 Eye Toy in combination with the PS Sports Series was used by a group of Occupational Therapy students at Wits University to assess the use of gaming therapy in improving pain and range of motion in burn patients. They found it to be a very successful medium as there was no risk of infection (as the patient was not required to touch any apparatus), and they had wonderful compliance and improvement through the patients getting so involved in the activity and being distracted from their pain.

Dance Mats

PlayStation, Xbox and Wii all have dance mats. This is a mat which is normally laid out on the floor and interacts with the game according to the different blocks that the gamer stands on.

We experimented with the gamer sitting on the mat as well as having the mat on a table and the gamer using the mat like a big game control. This provides a great option for quads with some upper limb function and poor hand function. The dance mat has all the functions of the normal remote except for the lack of analogue joysticks. Its compatibility is therefore limited to games that do not require the analogue joystick. This includes all the games from PlayStation 1.

Steering Wheels

All three gaming platforms have a driving games and it is possible to purchase steering wheels (Wii) and steering wheels with foot pedals (PlayStation and Xbox) to replace the conventional hand controls. Hand controls can be difficult to hold and the buttons are notoriously small even if you stand the control on a table or lap tray in front.

The Wii steering wheel is just a round piece of plastic that the remote slides into and requires quite dextrous agility to use but the PlayStation and Xbox combinations provide a truly realistic experience. All driving games can use these devices and even certain other games, so do experiment and please give us feedback!

As can be seen in this shot of Jacques Pienaar operating his racing wheel, the foot pedals can be placed at the same height as the steering wheel for hand control.

Driving games help to strengthen arms and grip and aid with coordination, reaction speed and some aspects of cognition.

Music Devices

DJ Hero, Guitar Hero, Guitar Hero World Tour Drum Kit and SingStar all enable gamers to interact using “musical input devices” and play, or sing, along to some of the greatest hit songs. DJ Hero uses a turntable with a detachable flat controller (which can be used with certain other games), and imitates a DJ - mixing and scratching the hottest hits. The buttons on the turntable are quite large making it usable for most fingers. You don’t need to be a musical genius to create your own mixes or just to play the game.

Guitar Hero: World Tour takes muso gaming to the next level, transforming the solo genre into a cooperative band experience by enabling multiple interaction from multiple musical devices and players thanks to wireless instruments. The game feature a guitar, electronic drum kit and a microphone. The Music Studio music creator allows you to compose, record, edit and share your own hit songs and online connectivity enables you to create your own online Band Careers and compete in eight-player Battle of the Bands competitions.

Singstar is also available across all three platforms and whereas Karaoke may seem a bit passé, singing into a microphone while following the words on the screen (and trying to keep in time and tune) is excellent brain training.

It does not require a lot of volume for the microphone to pick up the voice, so it can be used as a fun way of improving and training lung function.


An internet connection enables gamers to compete against gamers all over the world, instead of competing against the game and/or kids. People with disabilities can connect with their friends (and in some cases talk and chat) whilst playing against them in a safe and comfortable environment.

The gaming platform removes disability barriers and everyone is equal. Gamers become part of an online social community. The ‘disability factor’ is not visible over the internet and all that counts is the skill level.

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