Gaming for good
Less than 1 percent of those affected receive constraint-induced movement therapy (CI therapy), which is proven to work better than other interventions and produce long-lasting results. Access to CI therapy is limited due to the treatment’s expense of approximately $9,000 and a lack of trained providers.
By incorporating a Microsoft Xbox Kinect body action sensor, the Recovery Rapids game recreates CI therapy and provides an in-home delivery option that addresses access and affordability limitations. In the immersive, interactive game, patients propel and guide a kayak and manipulate items in the surrounding environment, such as swatting away bats in a cave or grabbing bottles from the water.
“By having rehabilitation at their fingertips, patients will be empowered to drive their own recovery, to maintain their improvements and to continue to progress when clinic-based therapy is no longer accessible to them,” said Roger Crawfis, associate professor of computer science and engineering, who has worked on the project since it began more than three years ago.
In addition to Crawfis, the interdisciplinary research team includes Lynne Gauthier, assistant professor of physical medicine and rehabilitation; David Maung, a CSE graduate student; Alex Borstad and Lise Worthen-Chaudhari, research assistant professors of health and rehabilitation sciences; and Ryan McPherson, an electrical and computer engineering lecturer. Linda Lowes, a physical therapist and researcher at Nationwide Children's Hospital, is also a co-investigator on the research.
Customizable to each patient’s needs, Recovery Rapids includes hundreds of movements designed by therapists for patients with motor deficits of varying severity. Game play is driven by the weaker hand and requires no controller, making it accessible to players of all ages and experience levels.
The video game is already helping patients achieve impressive results. A Phase II clinical trial on 11 participants with long-standing weakness post-stroke showed that the game is as effective as CI therapy in improving motor speed. Many participants also experienced improvements in their range of motion and arm use.
Originally developed as a rehabilitation for stroke survivors, Recovery Rapids also has shown potential as effective therapy for patients with other neurological conditions. Preliminary research suggests that motor decline in progressive MS could be partially reversed by the proposed CI therapy-based gaming intervention.
The team recently received a $44,000 National Multiple Sclerosis Society Pilot Research Grant to fund a controlled-setting clinical trial that will further assess feasibility and initial efficacy of Recovery Rapids among MS patients.
Plus, users say, it’s fun.
“It immediately engages the participants and presents rehab therapy in a fun and convenient way,” said stroke survivor Kevin Parrish.
The team’s next goal is to move Recovery Rapids out of the lab and into living rooms where it can provide therapy to the masses. Through spinout company Games That Move You, the team hopes to raise the $250,000 necessary to make the game available via online download on the Xbox One platform.
Getting the game Xbox-ready will require some additional development, Crawfis explained, including developing a simple user interface that lets patients specify their individual therapy needs and creating a mechanism to provide feedback on their progression.
Crawfis, whose research focuses on game technologies and procedural content for games, was a natural fit for the project.
“I like the games that benefit society and have a purpose,” he said. “There were some interesting challenges from a research standpoint, but it’s also just a very worthy project.
One of those challenges, Crawfis explained, was creating more than 30 hours of rich game play on a relatively low budget. The other technical challenge was being able to customize and personalize the gestures. His team developed technology to automatically shape the gestures, so that as a player’s performance improves, the game mechanics require a much stronger gesture.
David Maung, Recovery Rapids’ chief architect and software developer, received the Ohio State 2014 Student Innovator of the Year Award for his work on the game.
“David was instrumental in taking a concept, working with a disparate group of scientists and developing a working product in a short timeframe,” said Crawfis, who is also Maung’s advisor. “His gesture system allowed for defining complex movements that could be shaped to each individual’s needs.”
The researchers also continue to investigate the potential of extending Recovery Rapids therapy to treat other conditions like Parkinson’s, or even to provide at-home physical therapy.
And if the game becomes widely used, Crawfis said, the team could use data analytics techniques to study the progression of therapy and how different protocols might influence its effectiveness.
“Virtually none of that is able to be done with traditional therapy,” he explained. “It could be used to tweak the game, tweak an individual’s therapy plan or further motivate patients.”
