The use of the Wii Fit in forensic mental health: exercise for people at risk of obesity

Introduction: Side effects of psychotropic medication often lead to rapid weight gain, having detrimental effects on forensic mental health patients' health, wellbeing, occupational performance and quality of life. Virtual reality technology could provide novel environments and motivating forums for exercise, which are otherwise unavailable to patients in such secure settings. This exploratory study aimed to evaluate the use of the Nintendo Wii Fit in changing engagement in physical activity for patients at risk of obesity at a secure hospital. Method: Two participants used a Wii Fit for 8 weeks in individual or group sessions. A mixed methods approach was taken, because participants' use of the Wii Fit was compared with their attitudes towards it (reported during interviews) and their daily physical activity levels (measured using an accelerometer). Researcher field notes were also used to gather contextual data. Findings: Participants played Wii Fit up to four times a week in sessions ranging from 7 to 127 minutes. When using the Wii Fit, participants increased their overall time spent actively moving their bodies in physical activity, as measured by the accelerometer. Using the Wii Fit also changed participants' attitudes towards exercise as they realised that it could be 'fun' and 'challenging', especially if staff members also participated. Conclusion: The Wii Fit encouraged patients to attempt physical activities and to learn about their bodily response to exercise. It provided a meaningful occupational intervention in a secure setting and demonstrated a potential use of the technology in mental health settings.