Then Monday moved into several talks on tech assisted treatment, beginning with Judith Deutsch and Virtual Reality (VR) and Serious Games for Persons with Neurological Conditions: Plasticity, Prevention, Participation and Prediction (aka P^4).
Since VR and serious games are a relatively new treatment strategy, Judith thankfully started very basic. Virtual reality is defined as a computer generated interactive environment drawing on the three primary senses: visual, auditory, haptic (touch). There are 3 main types: head sets that block the peripheral vision, fully body immersion and semi-immersive in which the user wears 3D glasses to view 3D images. The strengths of VR are: the enriched environment, the systematic delivery and control of stimuli (precise prescription), real time performance feedback, self-guided exploration and independent practice, safe environment for testing purposes and games increase motivation. Serious games are those found in the Nintendo Wii and Xbox Kinect. The benefits of utilizing serious games include: in game goals provide motivation, in game feedback, can adjust the difficulty level for multiple patient types, narrative structures can provide a story to follow. Virtual reality is mostly limited to investigatory studies right now. Mostly because these systems can be very expensive and require large spaces. The benefit of VR over serious games though, is that you can make a game for whatever your heart desires. This does require some serious technical know-how or serious networking skills to find someone who will write a program for you. However, serious games on the other hand, many households have these game systems already in place. Maybe you have one. Maybe your patient has one. That’s participation right there!
For serious games, the Wii system 5 games that are available on the basic system for $209; however, if you purchase the additional Wii Fit Balance Board Plus you’ll get 15 more games and the ability to customize a workout (a la telehealth!) and will cost about $318. The Kinect is an add-on to the Xbox, but can be purchased as a bundle with the console. It comes with 3 games and you can buy several more. The bundle is $289. (All prices come from Amazon at time of posting.) Another benefit of the Kinect, is that it’s an open system, meaning again if you’re tech savvy you can write your own games for it. There is also more research out there with Kinect, rather than Wii.
VR and serious games are more for wellness (chronic disease prevention) rather than fitness for sport. So don’t think or sell your patients on the idea of getting a six pack out of these games. It won’t happen.
The jury is still out on whether these can create plasticity or no.
Judith made a quick reference to maybe using VR in combo with treadmill training…. Which I think is a fabulous idea. She also briefly mentioned a smart phone app called Wellpepper that is being investigated together with shoe sensors to track home exercise program success. I really like the idea of this! Wish I could see a live demo of this!
Now if you’re like me, you’re going, “That’s all well and good, but I could never figure this stuff out!” I think I hide it fairly well, but truly I’m technologically challenged. Just ask my husband. Never fear! KWIC is here! Kinecting WIth Clinicians is a website that will help you select the most appropriate games for your patients and their individual goals on the Kinect.
Or maybe you’re on the opposite side of the tech spectrum and ready to dive in and design your own games. Judith provided a resource for you too! The Open Rehab Initiative has VR and open games for download and is community driven, meaning you give some game and you can take some game. Some of the games are even FREE. I like free. It is also an interactive community, so you can chat with other clinicians, game developers, etc.
Or if you’re somewhere in between, game development for dummies takes form in EnvironSim. It looks like a blog platform (plug in the bits you want and ‘play’), but for virtual environments. Looks promising, but isn’t available yet. Keep your eyes peeled though. There’s lots of big names involved in this project, so I’m sure it will turn out well.
There. Now no one has an excuse to not utilize virtual reality and serious games in treating patients.
Even though VR and serious games are the shiny new penny of treatment options, there are some draw backs. The technology is running away so quickly, it is outpacing research efforts by a lot. The cheaper commercial products like the Wii and Kinect may not be designed specifically enough to meet rehab goals. Will this tech even get into the clinic? That’s up to you and me. Collaboration is always difficult amongst clinicians, industry leaders and patients.
That’s all for this round. We do have a couple more presentations on VR, serious games and rehab robots. I will also have a special presentation of some virtual reality devices from Bertec at the completion of this series, so stay tuned! This is so exciting! *squeals like a little girl*