Straight to video

Pam Russell doesn’t worry when her husband, Alan, takes to the skies in driving rain, bursts of lightning, or thick fog. “He likes to fly in bad weather, to give himself more of a challenge,” she explains.

A severe stroke in 2005 grounded Alan Russell, a nuclear engineer who flew Cessna aircraft for fun. But Microsoft’s flight simulator video program allows him to pursue his longtime passion while giving both his weakened right hand and his brain a workout. “This has been a little bit of a lifesaver,” says Pam Russell, governor of District 5340 (California, USA).

Like the Russells, many people are using video technology as a tool to maintain or help restore good health, while bringing a sense of fun and enjoyment to the process. In Chicago, Marbles: The Brain Store sells software and games designed to boost brain power. Company president Lindsay Gaskins says two popular sellers are the Brain Fitness Program and InSight, computer games that challenge visual and audio processing abilities to help improve memory and increase learning capacity. Marbles’ customers are “people who want to outsmart their age,” Gaskins says.

Health experts are trying to tap into this enthusiasm for games. “Video games are a popular and widespread medium, so we looked at this and said, How can we use them to impact health?” says Paul Puopolo, director of consumer innovation at health insurer Humana. A handful of insurers like Humana are promoting video games as a way to stay physically and mentally fit.

After a 2003 study in the New England Journal of Medicine showed that brain-flexing leisure activities such as playing board games and reading could reduce the risk of developing dementia, a raft of games aimed at boosting cognitive fitness hit the shelves. One of the most popular is Nintendo’s Brain Age, which challenges players with tasks such as solving math problems, making change, and reciting song lyrics. It’s meant to be played regularly, much as a person would have a physical workout routine.

With an obesity epidemic circling the globe, game makers are tackling the physical side of fitness, too. “The genre has been kicked off by the Nintendo Wii games,” says Stephen Yang, assistant professor of physical education at the State University of New York (SUNY), Cortland.

Indeed, Wii games are designed to take the couch out of the passive, couch potato image of video games. Nintendo makes hundreds of Wii games, including Wii Sports and Wii Fit, that register movements mimicking a sport or exercise and then translate them to a computer or television screen. Bowling, boxing, tennis, golf, yoga, balance games, and strength training are on Wii’s extensive list of interactive games.

Another popular game is Dance Dance Revolution (DDR) by Konami Digital Entertainment, which has the added cachet of being perhaps the first video game to have inspired a stage musical (it played New York in December). The game uses a floor mat emblazoned with arrows; commands on the video screen direct the player to step on various arrows in time to music and in increasingly complex patterns. A 2007 study in the journal Pediatrics showed that children burned more calories by playing DDR than by walking on a treadmill, and the New York Times reports that the game is showing up in hundreds of school gyms across the United States.

At SUNY Cortland, Yang studies this new trend of “exergaming” – getting a workout with the help of a video game. In one study, he monitored nearly three dozen teenagers as they played DDR for 45 minutes. He found that the game helped raise their heart rates to a training target level, just as moderate-to-vigorous exercise does.

Still, research shows that Wii games won’t provide as much cardiovascular or musculoskeletal benefit as actually playing a sport or going for a run. But experts say activity-oriented video games are a far better choice than no activity at all. “In the right environment and with the right task, you can receive strong benefits” with video games, says Yang.

The entertainment that video games provide makes them an ideal tool to help patients recovering from strokes, spinal cord injuries, and other conditions that involve rehabilitative therapy. “What I love about these games is that they require patients to use the actual movements that are used in playing the sport,” says Jillian Beemer, manager of recreational therapy at the Rehabilitation Institute of Chicago (RIC).

Therapists at RIC and other rehabilitation hospitals are using Wii games to motivate patients undergoing often difficult or painful therapy. “It’s a positive diversion,” says Beemer.  For patients with severe burns, a virtual reality game called Snow World is being used at some rehabilitation centers as a distraction during wound care. The game, which allows players to pelt penguins and snowmen with snowballs in an icy environment, is now being studied at the U.S. Army Institute of Surgical Research.

The physical and cognitive benefits of many games are what attract headlines and consumer dollars, but video games also can pay emotional dividends. “I see a difference in the patients’ mood,” says Beemer.

Pam Russell knows that well. Using the flight simulator gives Alan a topic for conversation with his pilot friends. “They come over, help him with the flying part of it, and it’s another reason for him to talk with people,” she says. The flight simulator often brightens her husband’s mood and provides an activity he finds truly absorbing. “He gets out his old flight bag and his flight maps,” she says. “He takes this as seriously as if he were really flying an airplane.”

Rebecca Voelker is a contributing news editor for JAMA, the journal of the American Medical Association.