The Journal of mHealth Vol 2 Issue 4 (August) - Page 45

Gaming for Health Reported Benefits Scott describes the benefits to patients and clinicians, “Gaming Software utilising the Kinect technology, such as MIRA, offer advantages to both patients and clinicians. Patients report that they find the activities achievable and enjoyable and particularly like the flexibility of the software allowing activities to be tailored to their individual needs, with the ability to ramp up the exercises and programme as they improve.” “Individual activities are specifically designed to encourage different physical skills, from upper limb range of movement, balance skills in sitting or standing, stamina, concentration, control of movement during activity, promote posture and body spatial awareness through visual feedback. For the patient this provides objective evidence of improvement in physical ability.” “For the clinician, the software records data from which they can compare previous sessions and enables adjustment to activities to further tailor the software to the patients’ needs and current ability. Where patients present physical progress the evidence is tangible from the recorded data. (Examples of performance data include points scored in each game, distance the wrist travels, average speed of upper limb movement throughout the game etc.). By adapting the physical requirements of the activities accordingly the therapist can therefore also have a measurable influence on the patients’ improvement’. Case Studies Example 1: Jack is a teenager with cerebral palsy, weak core muscles and com- promised postural control. As part of his routine physiotherapy programme he uses a standing frame to promote weight bearing, aid circulation, offer a prolonged lower limb stretch and also to work on his upper body control and core stability through upper limb activities. Normally, upper limb activities would be of a traditional nature and include throwing and catching or general exercises. Using MIRA, Jack has been able to continue to use the standing frame and work on both his upper limb movement and core through activities set up specifically for him using the software. In one exercise Jack plays CATCH, which is a game where he has to move his arm to catch objects that appear in several areas of the screen before they disappear, this requires Jack to use wide gross movements on the frontal plane such as stretching. Because Jack’s core stability is compromised he tends to fall to his left side, so the activity has to be set up so all the activity occurs on his right to encourage more prolonged control of his posture – he has to maintain an upright posture to be able to access the game. Not only does Jack find the therapy more fun than traditional activities, the MIRA software records an array of relevant data from which to compare to previous sessions. Example 2: Stephen is a young man with an acquired brain injury who has poor upper limb range of movement and poor control of movement. Stephen’s limitations are due to increased tone distally and whilst his range is not significantly compromised, the patterns of his movements are. The main aim of using MIRA with Stephen has been to help develop control of movement as well as encouraging him to maintain, if not improve, his range of movement in both left and right upper limbs. Several activities have been added to his programme, of which two have been most beneficial. The first, Follow, requires the patient to hover their hand over a box as it moves around the screen. The muscles have to work with a fine balance of control in order to achieve this, taking much concentration from the patient. The incentive of the game is to keep the hand within the box, if the arm doesn’t stay in the box due to fatigue, poor control or otherwise the soundtrack which is playing fades until the hand returns to the box. For patients motivated by music this game is particularly appealing. Continued on page 44 The Journal of mHealth 43