Posts Tagged gaming

[WEB SITE] TherapWii – game suggestions

Why TherapWii

Gaming activates and is fun to do! In a playful and often unnoticed way skills are trained. Adolescents grow up in a digital world; they enjoy gaming and do it frequently. For adults and elderly gaming has been shown to be a useful type of therapy.

In a virtual environment moving, executing, learning and enjoying are appealing; if circumstances or limitations keep you from going to the bowling alley or playing an instrument, gaming can broaden your boundaries.

Gaming with the Wii can complement therapy, can make therapy more attractive, intenser and more provocative.

TherapWii has been developed to support therapists in an effective and specific way while using the Nintendo Wii and offer options to game in the home environment.

TherapWii is the product of an exploratory research project done by the Special Lectorship Rehabilitation at the Hague University. The results of this project can be found by clicking on the header ‘research’ at the end of the page.

How does TherapWii work?

Per therapy goal there are three colored tabs to help find the most suitable games. Each game lists specific information in text and symbols. There is also a level of difficulty; by moving the cursor over this button you see more information.

User information is saved in ‘explanation and tips’. To enhance this section you can email recommendations and suggestions to the email address listed below.

TherapWii has been developed, also for home use, so that experience lead to personal growth.

Advice for game adjustments

It is important that the therapist stays close to the patient’s goals and abilities and adjusts the game program appropriately. If you, as therapist, want to make the game easier, more difficult or more daring, you can change the instruction, implementation or setting.

A few examples:

Physical: strength (add weights to the arms or legs or change the starting position); balance/stability (play while standing on an instable foundation (ball, mat). Or play the games while sitting on a stationary bicycle!

Cognition: create double tasks (ask mathematics, questions or riddles); spatial orientation or visual adjustments (play with one eye covered or in front of a mirror).

Social-emotional: stimulate cooperation or competition (create bets or role-playing).

Let us know if you have other ideas to make the games more provoking.

How are the games rated?

The games were tested by several professionals (physical therapists, occupational therapists and sport therapists). Differences in opinion or scores were discussed and voted on.

Give us feedback, corrections and advice, we will adjust the TherapWii program monthly and will use your suggestions.

Which ability do you choose?

Social-Emotional

Physical

Cognitive

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[Abstract] The Present and Future of Robotic Technology in Rehabilitation – SpringerLink

Abstract

Robotic technology designed to assist rehabilitation can potentially increase the efficiency of, and accessibility to, therapy by assisting therapists to provide consistent training for extended periods of time, and collecting data to assess progress. Automatization of therapy may enable many patients to be treated simultaneously and possibly even remotely, in the comfort of their own homes, through telerehabilitation. The data collected can be used to objectively assess performance and document compliance as well as progress. All of these characteristics can make therapists more efficient in treating larger numbers of patients. Most importantly for the patient, it can increase access to therapy which is often in high demand and rationed severely in today’s fiscal climate. In recent years, many consumer-grade low-cost and off-the-shelf devices have been adopted for use in therapy sessions and methods for increasing motivation and engagement have been integrated with them. This review paper outlines the effort devoted to the development and integration of robotic technology for rehabilitation.

Source: The Present and Future of Robotic Technology in Rehabilitation | SpringerLink

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[Abstract] Survivors of chronic stroke – participant evaluations of commercial gaming for rehabilitation

Abstract

Purpose: There has been an increase in research on the effect that virtual reality (VR) can have on physical rehabilitation following stroke. However, research exploring participant perceptions of VR for post-stroke rehabilitation has been limited.
Method: Semi-structured interviews were conducted with 10 chronic stroke participants (10 males, mean age = 72.1, mean time since injury = 38.6 mos.) who had recently completed an upper extremity VR stroke rehabilitation programme.
Results: Four main themes emerged: ‘the VR experience,’ ‘functional outcomes,’ ‘instruction,’ and the ‘future of VR in stroke rehabilitation,’ along with nine sub-themes. Participants illustrated the positive impact that VR training had on their functional abilities as well as their confidence towards completing activities of daily living (ADL). Participants also expressed the need for increased rehabilitation opportunities within the community.
Conclusion: Overall, participants were optimistic about their experience with VR training and all reported that they had perceived functional gain. VR is an enjoyable rehabilitation tool that can increase a stroke survivor’s confidence towards completing ADL.

  • Implications for Rehabilitation

  • Although there is an increase in rehabilitation programmes geared towards those with chronic stroke, we must also consider the participants’ perception of those programmes.

  • Incorporating participant feedback may increase enjoyment and adherence to the rehabilitation programmes.

  • The VR experience, as well as provision of feedback and instruction, are important aspects to consider when developing a VR programme for stroke survivors.

  • VR for rehabilitation may be a feasible tool for increasing the survivors’ confidence in completing ADL post-stroke.

Related articles

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Source: Taylor & Francis Online

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[ARTICLE] Coaching or gaming? Implications of strategy choice for home based stroke rehabilitation – Full Text HTML/PDF

Abstract

Background

The enduring aging of the world population and prospective increase of age-related chronic diseases urge the implementation of new models for healthcare delivery. One strategy relies on ICT (Information and Communications Technology) home-based solutions allowing clients to pursue their treatments without institutionalization. Stroke survivors are a particular population that could strongly benefit from such solutions, but is not yet clear what the best approach is for bringing forth an adequate and sustainable usage of home-based rehabilitation systems. Here we explore two possible approaches: coaching and gaming.

Methods

We performed trials with 20 healthy participants and 5 chronic stroke survivors to study and compare execution of an elbow flexion and extension task when performed within a coaching mode that provides encouragement or within a gaming mode. For each mode we analyzed compliance, arm movement kinematics and task scores. In addition, we assessed the usability and acceptance of the proposed modes through a customized self-report questionnaire.

Results

In the healthy participants sample, 13/20 preferred the gaming mode and rated it as being significantly more fun (p < .05), but the feedback delivered by the coaching mode was subjectively perceived as being more useful (p < .01). In addition, the activity level (number of repetitions and total movement of the end effector) was significantly higher (p < .001) during coaching. However, the quality of movements was superior in gaming with a trend towards shorter movement duration (p = .074), significantly shorter travel distance (p < .001), higher movement efficiency (p < .001) and higher performance scores (p < .001). Stroke survivors also showed a trend towards higher activity levels in coaching, but with more movement quality during gaming. Finally, both training modes showed overall high acceptance.

Conclusions

Gaming led to higher enjoyment and increased quality in movement execution in healthy participants. However, we observed that game mechanics strongly determined user behavior and limited activity levels. In contrast, coaching generated higher activity levels. Hence, the purpose of treatment and profile of end-users has to be considered when deciding on the most adequate approach for home based stroke rehabilitation.

Background

Dealing with the social and economical burden resulting from the high number of stroke survivors with permanent disability represents a major challenge for modern societies. The challenge becomes yet higher taking into account the enduring aging of the population worldwide [1] that will consequently result in the increase of the number of individuals with age related diseases such as stroke. For the particular case of the USA, estimates indicate that by 2030, ~4 % of the population will have experienced a stroke, with related costs expected to rise from $71.55 billion to $183.13 billion between 2012 and 2030 [2]. New strategies have to be found to face this upcoming scenario, otherwise it will represent a large burden on healthcare systems and caregivers.

One approach relies on home-based rehabilitation, so that stroke survivors can continue their rehabilitation program after hospital discharge with minimal supervision. Home-based stroke rehabilitation has been increasingly addressed during the last years, and while showing promising results in terms of feasibility and impact on recovery [3, 4] it also poses a number of technical and human challenges. In the concrete case of computer-based rehabilitation, current technology allows offering training scenarios adjusted to the characteristics of users, with detailed progress reports and remote monitorization. Moreover, one of the main advantages relies on the fact that most of these applications have protocols that promote hundreds of task-specific movement repetitions. There is evidence that the conjunction of these two factors, increased number of repetitions and task-specificity, is an important ingredient to achieve reorganization of cortical maps after stroke [5, 6]. Here, technology based solutions can play an important role to increase functional movement practice and impact recovery. There are however challenges when deploying such technologies in the home. One challenge relates to the definition of rehabilitation approaches that are adequate for a home environment. What is the most effective strategy to support users when they have to use these systems on their own or with minimum supervision? Self-managed computerized rehabilitation should be straightforward to use, tailor exercises to the profile of users, address function, set goals, improve self-efficacy, provide instantaneous feedback on performance and be engaging [79]. A second challenge in home-based approaches in general is long-term treatment adherence. It has been observed that compliance tends to decrease over time below recommended levels for reasons such as insufficient familiarity with technology, competing commitments, or simply lack of motivation [1012]. Hence, it is important to investigate what characteristics should be included in such systems so that stroke survivors feel more engaged and motivated to use these tools in a systematic way over long periods of time.

Continue HTML —>  Coaching or gaming? Implications of strategy choice for home based stroke rehabilitation | Journal of NeuroEngineering and Rehabilitation | Full Text

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[ARTICLE] Therapists’ Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation – Full Text HTML

ABSTRACT

Background: The application of technologies, such as video gaming and social media for rehabilitation, is garnering interest in the medical field. However, little research has examined clinicians’ perspectives regarding technology adoption by their clients.

Objective: The objective of our study was to explore therapists’ perceptions of how young people and adults with hemiplegia use gaming and social media technologies in daily life and in rehabilitation, and to identify barriers to using these technologies in rehabilitation.

Methods: We conducted two focus groups comprised of ten occupational therapists/physiotherapists who provide neurorehabilitation to individuals with hemiplegia secondary to stroke or cerebral palsy. Data was analyzed using inductive thematic analysis. The diffusion of innovations theory provided a framework to interpret emerging themes.

Results: Therapists were using technology in a limited capacity. They identified barriers to using social media and gaming technology with their clients, including a lack of age appropriateness, privacy issues with social media, limited transfer of training, and a lack of accessibility of current systems. Therapists also questioned their role in the context of technology-based interventions. The opportunity for social interaction was perceived as a major benefit of integrated gaming and social media.

Conclusions: This study reveals the complexities associated with adopting new technologies in clinical practice, including the need to consider both client and clinician factors. Despite reporting several challenges with applying gaming and social media technology with clinical populations, therapists identified opportunities for increased social interactions and were willing to help shape the development of an upper limb training system that could more readily meet the needs of clients with hemiplegia. By considering the needs of both therapists and clients, technology developers may increase the likelihood that clinicians will adopt innovative technologies.

Full Text HTML –>  JSG-Therapists’ Perceptions of Social Media and Video Game Technologies in Upper Limb Rehabilitation | Tatla | JMIR Serious Games.

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[ARTICLE] Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice

Abstract

Purpose: Stroke upper limb impairment is associated with disability in activities of daily living. Gaming (Nintendo Wii) is being introduced to rehabilitation despite limited evidence regarding effectiveness. Little data exists on how gaming is implemented resulting in a lack of clinical information. We aimed to gather therapists’ opinions on gaming.

Methods: A survey was posted to therapists, identified from stroke services across Scotland. A second survey was posted to non-responders. Survey data were analysed using descriptive statistics and thematic coding.

Results: Surveys were sent to 127 therapists (70 stroke services) and returned by 88% (112/127). Gaming was used by 18% of therapists, 61% (68/112) stated they would use this intervention should equipment be available. The most commonly used device was Nintendo Wii (83% of therapists using gaming) for 30 min or less once or twice per week. Half of therapists (51%) reported observing at least one adverse event, such as fatigue, stiffness or pain. Gaming was reported to be enjoyable but therapists described barriers, which relate to time, space and cost.

Conclusions: Gaming is used by almost a fifth of therapists. Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage.

Implications for Rehabilitation  – Commercial gaming devices are reported to be used by 1/5th of therapists for stroke upper limb rehabilitation, 3/5ths would use gaming if available.  – Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage.  – Current use of gaming in practice may not be achieving intense and repetitive upper limb task-specific practice.

via STORRE: Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice (Forthcoming/Available Online).

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[RESEARCH] Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice

Abstract

Purpose: Stroke upper limb impairment is associated with disability in activities of daily living. Gaming (Nintendo Wii) is being introduced to rehabilitation despite limited evidence regarding effectiveness. Little data exists on how gaming is implemented resulting in a lack of clinical information. We aimed to gather therapists’ opinions on gaming.

Methods: A survey was posted to therapists, identified from stroke services across Scotland. A second survey was posted to non-responders. Survey data were analysed using descriptive statistics and thematic coding.

Results: Surveys were sent to 127 therapists (70 stroke services) and returned by 88% (112/127). Gaming was used by 18% of therapists, 61% (68/112) stated they would use this intervention should equipment be available. The most commonly used device was Nintendo Wii (83% of therapists using gaming) for 30 min or less once or twice per week. Half of therapists (51%) reported observing at least one adverse event, such as fatigue, stiffness or pain. Gaming was reported to be enjoyable but therapists described barriers, which relate to time, space and cost.

Conclusions: Gaming is used by almost a fifth of therapists. Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage.

Implications for Rehabilitation

  • Commercial gaming devices are reported to be used by 1/5th of therapists for stroke upper limb rehabilitation, 3/5ths would use gaming if available.
  • Adverse events were reported by 51% of therapists; this should be considered when recommending use and dosage.
  • Current use of gaming in practice may not be achieving intense and repetitive upper limb task-specific practice.

via Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice, Disability and Rehabilitation: Assistive Technology, Informa Healthcare.

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[ARTICLE] Effectiveness of commercial video gaming on fine motor control in chronic stroke within community-level rehabilitation

Abstract

Purpose: The purpose of this study was to investigate the effectiveness of commercial gaming as an intervention for fine motor recovery in chronic stroke.

Methods: Ten chronic phase post-stroke participants (mean time since CVA = 39 mos; mean age = 72 yrs) completed a 16-session program using the Nintendo Wii for 15 min two times per week with their more affected hand (10 right handed). Functional recovery (Jebsen Hand Function Test (JHFT), Box and Block Test (BBT), Nine Hole Peg Test (NHPT)), and quality of life (QOL; Stroke Impact Scale (SIS)) were measured at baseline (pre-testing), after 8 sessions (mid-testing) and after 16 sessions (post-testing).

Results: Significant improvements were found with the JHFT, BBT and NHPT from pre-testing to post-testing (p = 0.03, p = 0.03, p = 0.01, respectively). As well, there was an increase in perceived QOL from pre-testing to post-testing, as determined by the SIS (p = 0.009).

Conclusion: Commercial gaming may be a viable resource for those with chronic stroke. Future research should examine the feasibility of this as a rehabilitation tool for this population.

Implications for Rehabilitation

  • Stroke survivors often live with lasting effects from their injury, however, those with chronic stroke generally receive little to no rehabilitation due to a perceived motor recovery plateau.
  • Virtual reality in the form of commercial gaming is a novel and motivating way for clients to complete rehabilitation.
  • The Nintendo Wii may be a feasible device to improve both functional ability and perceived quality of life in chronic stroke survivors.

via Effectiveness of commercial video gaming on fine motor control in chronic stroke within community-level rehabilitation, Disability and Rehabilitation, Informa Healthcare.

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[WEB SITE] Xbox in the Rehabilitation of Chronic Traumatic Brain Injury

Study currently recruiting participants.

…Traumatic brain injury is an extremely common disease, it counts 50.000 deaths and 235.000 hospitalizations every year. Functional consequences of an acquired brain injury have a considerable impact on quality of lives of patients and care-givers with direct effects on balance, mobility and on psycho-social functions. Attention deficits are one of the most frequent and disabling consequences of severe brain injury. Within the wide spectrum of attentive problems, patients with traumatic brain injury frequently have shown difficulties in divided attention. Patients, care-givers and professionals frequently refer difficulties also in selective attention and vigilance as consequence of the trauma. It has been shown how these difficulties are tightly related with the missed return to work after two years from the injury.

The hypothesis of this study is to investigate the feasibility of a rehabilitative protocol on gaming using the console Xbox and its efficacy in improving balance, mobility, risk of falling, attentive functions (selective and divided attention) in subjects which have had a traumatic brain injury at least 12 months before…

via Xbox in the Rehabilitation of Chronic Traumatic Brain Injury – ClinicalTrials.gov.

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