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International Clinic of Rehabilitation. Web-Based Home Rehabilitation Gaming System. International Clinic of Rehabilitation. Research and Development Team. Prof. Volodymyr Kozyavkin , MD, Director of International Clinic of Rehabilitation,
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International Clinic of Rehabilitation Web-Based Home Rehabilitation Gaming System
International Clinic of Rehabilitation Research and Development Team • Prof. VolodymyrKozyavkin, MD, Director of International Clinic of Rehabilitation, • Dr. OlehKachmar, MD, Head of Innovative Technologies Department, • Dr. TarasVoloshyn, MD, child neurologist, • Mr. VadymMarkelov, software developer, • Mrs. IrynaAblikova, Physical Therapist, • Mr. BohdanKachmar, software developer • Provides Intensive treatment for patients with Cerebral Palsy and other neurological diseases • More than 4.000 patients came for treatment each year
Background • Virtual reality (VR) have great potential in the neurological rehabilitation of patients with movement disorders • Most VR systems for motor training are quite expensive and could be used only in clinical setting • Low-cost, commercially available gaming systems are widely used, but: • typical games are too difficult for disabled children • no means for distant supervision by therapists
Our Experience • Using Computer Games in Motor Rehabilitation for more than 12 years • Now gaming rehabilitation is used on regular daily basis • Custom Made Gaming Hardware • Hand training device • Training chair • Universal gaming device Special Rehabilitation Gaming Software
Objective • Develop a low-cost rehabilitation game training system • for patients with movement disorders, • suitable for home use, • with supervision of a therapist • Preliminary assessment of its benefits for training balance in patients with Cerebral Palsy
System Description Game Device Controller VR Game Server application installed on a home computer Tasks: • connect gaming hardware through USB or Bluetooth: • convert data from different hardware to one format, • send the game controlling data to the games and receive feedback Hosted in the Internet Tasks: • user management • repository for rehabilitation games with training guidelines • usage statistics • messaging
Rehabilitation Gaming Hardware Nintendo Balance Board Nintendo Wii Remote MS Kinect Universal Gaming Device
Rehabilitation Games • Could be played with different gaming hardware • Appropriate for people with movement disorders • Calibrated according to patient’s possibilities • 5 difficulty levels • Unified scoring system (max score 100) • Multilingual – game messages are separate
with Rehabilitation Gaming System Balance Training 9
Training Positions Standing, left-right bending Standing, front- back bending Standing with support Standing one foot in front Kneeling on the board Sitting on the board
Supervision by physical therapist • Physicaltherapist evaluates the patient and draws up a training program, indicating recommended games, training positions, frequency and duration of sessions. • Duration, timing and score of gaming sessions are stored on the server • Using this information therapist may adjust the program, if necessary
Stabilometry, a diagnostic game • Child stands still on the balance board for 15 sec • Meanvelocityof center of pressure (CoP) displacement and areaof CoP displacement are calculated • Higher velocities and larger areas indicate poor balance
Patients Two weeks Daily home training sessions (30 min duration)
Evaluation tools Gross Motor Function Classification System - a five level classification system that describes the gross motor function of children with Cerebral Palsy (Level I can walk without limitations, Level V – transported in wheelchair) Pediatric Balance Scale a scale with proven reliability and validity, designed to evaluate the child’s balance function. (14 tasks, each from 0 to 4 points, 56 max) Stabilometry a specials diagnostic game measuring Velocity and Area of Center of Pressure (CoP) displacement while staying still on the board
Results Balance scale Center of Pressure (CoP) Velocity CoP Area
Conclusions • A Home Rehabilitation Gaming System was developed in order to transfer the virtual rehabilitation of patients with motor disorders from clinical to home settings. • Preliminary results suggest that home gaming training is beneficial for improving balance function in patients with Cerebral Palsy Limitations of the study • a small number of patients • without control group • evaluation performed by a therapist working with them, so his assessments may have been biased • important to determine how balancing skills, obtained during training sessions, can be adapted to everyday life
Acknowledgements • The authors express their gratitude to the administration of the International Clinic of Rehabilitation for their support in developing the system, • as well as to doctors and therapists for testing the system and offering critical and constructive suggestions Home Rehabilitation Gaming System is available free-of-charge to both therapists and patients at http://game.reha.lviv.ua.
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