I remember when I was a young kid and my mom would yell at me to get off the video games, but times have changed. Recently, many video game creators have incorporated physical activity into video games. This is most easily noted with the advancements Nintendo has made with the Wii gaming console. Progress has not stopped here either. Video games are now being used to provide low cost alternative to costly physical therapy sessions. The idea is that if a patient will benefit from a lot of physical training, but cannot afford to attend physical therapy for all of the recommended time, then they could use smart video games to help bridge the gap.
Summary:
In "Reducing Compensatory Motions in Video Games for Stroke Rehabilitation," two researchers attempt to push the bar even further. Gazihan Alankus and Caitlin Kelleher use video games to help stroke victims perform physical therapeutic shoulder exercises and detect compensatory movements such as patients leaning to a side or backwards to falsely increase range of motion. They accomplish this feat by first observing stroke rehabilitation patients and noting the most common compensatory motions. Then, they designed a wearable, physical sensor network that consists of a series of Wii remotes place on patient's arms and torso. Next, they designed a video game that would use simple strategic exercises to provide physical therapy to the stroke patients.
Finally, they incorporate the spine angle sensors as compensatory sensors and modify the video game to reward and punish the patient based on the compensation levels. The game that they had the most success with is a hot air balloon that is steadily traveling towards the right hand side of the screen. The patients can alter the height of the hot air balloon by raising one of their arms. Parachuters are suspended across the screen and the patient must attempt to rescue the parachuters by picking them up. Obstacles are introduced to encourage sustained holds and to prevent jerking motions. If a patient compensates by leaning their torso to one side or backwards, then the hot air balloon tilts. If the hot air balloon tilts past a certain amount or if they crash the hot air balloon, then their score goes down.
Related Work:
One piece of related work, which discusses video game based therapy, is "Virtual rehabilitation after stroke." Then, "Optimizing engagement for stroke rehabilitation using serious games," also discusses video games used for therapy. For a slightly different approach, one team of researchers investigate motivational factors in video game based therapy in "Design strategies to improve patient motivation during robot-aided rehabilitation. However, I think that Gazihan and Caitlin did a pretty good job considering and mentioning motivational factors. Another piece of research that is related is "Use of low-cost, commercially available gaming console (Wii) for rehabilitation of an adolescent with cerebral palsy." I thought that this article seemed interesting because I have a family member with cerebral palsy and she has mentioned her physical training exercises that she is instructed to do and a video game version would be great. Similar to the cerebral palsy focused research paper, "Improving patient motivation in game development for motor deficit rehabilitation" investigates video game based therapy methods for motor disability patients. One group attempts to use an older gaming system to improve the economic availability factors in "Feasibility of using the Sony PlayStation 2 gaming platform for an individual poststroke: a case report." More related papers are "Game design in virtual reality systems for stroke rehabilitation," "PlayStation 3 based tele-rehabilitation for children," "Tailoring virtual reality technology for stroke rehabilitation: a human factors design," and " Effects of intensity of rehabilitation after stroke: a research synthesis."
Evaluation:
For the evaluation portion of this paper, the research team used a combination of objective and subjective, qualitative and quantitative analysis. For the accuracy of the Wii remote sensors, they used an objective, quantitative analysis. This was done because objective, quantitative analysis tends to best represent the accuracy of physical sensors. Then, when the researchers conducted a case study, they performed subjective, qualitative analysis on the research patients. This subjective feedback, combined with direct observation, allowed the researchers to modify and tailor the game to most efficiently and effectively prevent compensatory movements in poststroke rehabilitation therapy.
Discussion:
The main thing that I like about this article is that it attempts to address a very powerful problem. My granddad had multiple strokes before he passed away, and I wish that they had something like this to help him maximize his recovery therapy. The main difference between this research project and the ones mentioned in the related work section is its focus on compensatory movements. Some of the research papers listed focus on the possibility of tele-presence physical therapy, but this still requires a physician on the other end of the connection, which is still costly to use at high frequencies. The other research papers focus on using video games for rehabilitation, but do not adequately address compensatory movements. This paper definitely is novel because it actually shapes the video game around the idea of rewarding good form and attempting to prevent compensation.
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