Games matter! Making therapy engaging by promoting neuroplastic - - PowerPoint PPT Presentation

Games matter!

Making therapy engaging by promoting neuroplastic adaptation through movement controlled computer games

H.F. Machiel Van der Loos, Navid Shirzad, Bulmaro Valdés, Leia Shum, Alex Lee

Collaborative Advanced Robotics and Intelligent Systems Lab

What are the costs of f stroke?

1 [AHA Statistics, 2013], 2[Van Peppen et al. Clin Rehab, 2004] 3 [Sathian et al. NNR, 2011], 4[Sawaki et al. NNR, 2008], 5[Lang et al. APMR, 2009]

• Stroke is the most common source of long-term adult

disability in North America.1

• Only 5-20% of people affected regain full upper-

extremity functionality. 2

• The “dose” of movements required for recovery is

estimated to be in the thousands.3,4

• But only ~30 repetitions of a movement are practiced

in a usual therapy session.5

What are the strengths of f games?

• 500 million people have installed Candy
• CrushTM. (That’s about 8% of the

people in the world!)1

• 58% of Americans play video games. 2
• 45% of gamers are female. 2
• Nearly half of adults over 50 play video

games (computers, cellphones, consoles). 2

1[http://www.bbc.com/news/magazine-25334716] 2[2013 Demographic and Usage Data, ESA]

How to help solve this big problem?

1 [Kleim et al. JSLHS, 2008], 2[Boyd et al. Neuro Letters, 2010], 3 [Taub et al. Stroke, 2013]

Volume of movements Total Per week Critical volume Traditional Therapy Gaming Supplement

• Large quantities of practice

lead to neuroplastic change and behavioural recovery.1

• Practice needs to be

challenging, progressive, and specific to the individual.2,3

• Can we use games to increase

specific movements in the affected limb?

Smart controls for engaging therapy

Design Programming Testing

The FEATHERS Project

Functional Engagement in Assisted Therapy through Exercise Robotics

• To develop a new solution for upper-limb rehabilitation in

stroke and CP populations

• 3 years, funded by UBC PWSI, started in 2012 and

continued through KBHN 2013-2018

• 3 UBC Departments (Drs. Van der Loos, Croft, Boyd, Virji-

Babul, Hodges), 3 clinics, 1 company, +30 people

User-centred Approach in in Medical Devic ice Desig ign

• 1. What is the problem that needs to be solved?
• 2. How can we solve the problem?
• 3. Is the proposed solution effective?

Inclusion of the user in the design team

Zenios in BioDesign (2009), Martin in Applied Ergonomics (2012)

Methodology: User-centred Design

Stroke Therapy: Functional Needs

Recovery only through intensive therapy Stroke leads to disability Back to independent life

news.brown.edu Getty Images Getty Images

Stroke: the most common source of long-term adult disability in North America Repetition of therapeutic exercises is the key to induce neuroplasticity and functional reorganization of the motor cortex

Van Peppen in Clin Rehab (2004), Schaechter in Prog Neurobiol (2004), Boyd in Stroke (2014)

Stroke Therapy: Context xtual Needs

User’s Problem: The Paradox of Repetition… Qualitative research through clinical immersion aimed at:

• 1. Establishing a multi-faceted understanding of the problem in its context
• 2. Engaging therapists and therapy clients to co-create technologies

User’s Desire: To Play Games and Interact with Friends… Needs Statement: to develop an exercise system that tracks arm movement to play games and connects the users via a social media platform

Lohse, JNPT (2013), Lam, JMIR Rehabil (2015), Tatla, JMIR Serious Games (2015)

How does FEATHERS Control Cursor Movement?

• Game controllers (PS3 Move, Kinect) for motion tracking
• Unimanual exercise vs bimanual exercise

Valdes in EMBC (2014)

FEATHERS…

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Thank You

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For more information: Email: vdl@mech.ubc.ca Google Search: UBC FEATHERS Web: http://caris.mech.ubc.ca/feathers/project-summary/