Virtual rehab by gaming

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A novel, collaborative study between Rutgers University engineers and Indiana University School of Medicine clinicians found gaming a therapeutic tool improving hand use in those suffering from cerebral palsy.

The 10-month study was published on March 15 in IEEE Transactions on Information Technology in Biomedicine, a technology and biomedical journal published bimonthly by The Institute of Electrical and Electronics Engineers (IEEE). 

Meredith R. Golomb, M.D., M.Sc., associate professor of neurology at Indiana University School of Medicine and neurologist at the Riley Hospital for Children, explained to Relaxnews, "To our knowledge, this is one of the only studies to provide in-home access to telerehabilitation with virtual reality videogames, and one of the longest studies with this technology. This approach made rehabilitation more accessible. Our subjects all lived in small towns, were in school full-time and had working parents- they would not have been able to access daily rehab  in other ways. Also, this technology rewards even minimal movements, unlike off-the shelf games, so subjects are motivated to keep going."

Grigore Burdea, PhD, director of Rutgers Tele-Rehabilitation Institute and founder and CEO of the International Society of Virtual Rehabilitation, modified the Sony PlayStation 3 (PS3) and gaming glove to use specifically designed software that encouraged gaming hand exercises for maximizing finger motion and speed. Burdea told Relaxnews, "It was not easy to modify since the architecture is 'closed' by Sony." However the hard work definitely paid off. After 10 months of 'virtual rehabilitation', a term coined in 2002 by Burdea and colleague Daniel Thalmann, the "teenagers who had not used their hand essentially since birth responded so well to the games, and could now carry heavy objects and open doors."

Golomb was also impressed with their findings, adding "we got significant improvements in hand use in teenagers with chronic disability, who had been told by others that further improvement was not possible; and we got improvements in forearm bone health even though the exercise was not weight-bearing."

This cutting-edge research will provide relief to many who thought there was none. Golomb believes this virtual rehab is for "All ages - Absolutely!  We think that eventually this technology could work for patients ranging from toddler age to the elderly."

Nonethless both Golomb and Burdea agree the role of the physical therapists will "be augmented by technology" and "able to serve more people."

"I think that subjects who were told that further improvement was impossible may qualify for therapy like this in the future," said Golomb. 

The research teams do not "know yet if the benefits are long-term or if functions revert. We will try to bring the original subjects back for further studies, and we are applying for grants for larger studies," she said.

 Similarly, a small study presented in February at an American Stroke Association's conference, demonstrated gaming can be an effective rehab tool for stroke survivors.

The researchers utilized two Wii games: Wii tennis and Cooking Mama and found "significant motor improvement in speed and extent of recovery" with the study participants.

Saposnik, director of the Stroke Outcomes Research Unit at St Michael's Hospital in Toronto, led the study and explained, "patients in the Wii group achieved a better motor function, both fine and gross, manifested by improvement in speed and grip strength".

The future looks bright for virtual rehab, it will be readily accessible for anyone with chronic health challenges in the comfort of their own homes. Burdea said, "The path to a commercial product is a logical followup. The development of such depends on interested investors."

Presently research is ongoing to evaluate the benefits of widely using Wii as a rehab tool for stroke victims.  

Here is a video that documents the progress of the teens' hand function before and after gaming: http://www.ti.rutgers.edu/ps3hemi.php
Full study, "Feasibility of Modi?ed Remotely Monitored In-Home Gaming Technology for Improving Hand Function in Adolescents With Cerebral Palsy" : http://ti.rutgers.edu/publications/papers/2010_TITB_Huber.pdf

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