Games in Healthcare

FWD News: Rehabilitation Assisted by Video Game Technology

A Stroke Patient Playing Wii Sports BoxingResearchers from the School of Computing and Information Engineering at the University of Ulster have launched the Games for Rehabilitation project which focuses on video games for the rehabilitation of upper limbs in patients recovering from strokes.

The research project looks at players using their hands and arms to touch targets which move around a screen, tracking their movements with a webcam. Responding to this interaction, the games provide positive feedback on the patients' performance with the system. Designed to be accessible to inexperienced videogame players, the games will also include some the best practices of the medium to be as engaging as possible. Read More...

“The team is working on realising this potential for engagement and applying it to stroke rehabilitation where patients often struggle to engage with therapy due to its mundane and repetitive nature,” said James Burk, Ph.D. student and project researcher.

“We have had several people with varying levels of impairment playing the games, some with very restricted movement, and all have been able to play the games well. Participants expressed enjoyment from playing the games and some were keen to get a copy of the games to play at home,” said Dr. Michael McNeill.

A second research project led by Dr. Dido Green of the Department of Occupational Therapy in the School of Health Professionals at Tel Aviv University is studying the use of virtual tabletop systems to analyze movement patterns in children living with partial paralysis and motor dysfunction.

Called the Elements System, the virtual tabletop was developed by researchers at the Australia's Royal Melbourne Institute of Technology and is being used in addition to new technology producing 3D movement analysis. The system combines 3D exercises with 2D graphic movement games, which arouse enthusiasm from young patients while giving real results.

"The virtual tabletop appealed to children as young as three and as old as 15," said Green. "The movement-oriented games allowed them to 'make music' and reach targets in ways that are normally neither comfortable nor fun in the therapeutic setting."

The Virtual Reality TabletopBuilding off previous research, Green finds that virtual reality applications truly enhance the skill sets learned by her patients. She hopes virtual tabletop-type games will eventually become a recognized and effective therapy treatment method.

"Our research aims to create a complete system for therapist, parent and child. It could bring daily treatments into the home and provides therapists with a complete solution to track and analyze improvements or setbacks in the most accurate way to date," said Green.

Until such technology becomes the norm, others are looking at the Wii to assist rehabilitation efforts. Researchers at the University of Toronto have studied the use of the Wii for stroke rehabilitation. They found that playing eight hours of Wii Sports tennis and Cooking Mama led to significant motor skills improvement and better recovery in stroke patients.

The study observed patients having experienced a mild to moderate stroke within the past two months, receiving physical and occupational therapy. The study group spent eight one-hour sessions playing Wii Sports tennis and Cooking Mama, both games requiring speed and motor skills. The reference group played cards, bingo and Jenga. Following a variety of tests, the Wii group was found to have more strength and speed. While this preliminary study was limited to only 20 participants, a larger-scale study is being developed.

"This is the first randomized clinical study showing that virtual reality using Wii gaming technology is feasible and safe and is potentially effective in enhancing motor function following a stroke, but our study results need to be confirmed in a major clinical trial," said Dr. Gustavo Saposnik, director of the stroke outcomes research unit at St. Michael's Hospital in Toronto and the project's lead researcher.

Another project from researchers at the Toronto Rehabilitation Institute and game designers at Algoma University in Sault Ste. Marie, Ontario is exploring the use of videogames to introduce stroke rehabilitation exercises to the digital world.

The therapeutic exercises consist of paper cards with images presented to stroke patients to help exercise their brains. By moving to videogames, and the digital format in general, the researchers not only expect therapists to be better tooled to see how a patient responds to the treatment but also hope it will allow them to conduct these exercises remotely.

"People can stay home, which means therapists - who currently spend a significant amount of their work day on the road travelling between patients - could potentially stay in their office and they would be able to spend much more of their time serving their clients, or other clients," said Dwayne Hammond, a strategic advisor at Algoma University.

The interactive quality of videogames is also expected to help patients stay committed to their therapy. "The idea that we could take some of the therapies that we do that often have a repetitive component to them but make it fun and alluring and keep people engaged was very attractive," added Elizabeth Rochon, a Toronto Rehab specialist and speech-language pathology associate professor at the University of Toronto.