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.
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The Journal of mHealth

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