Video games used for physical therapy: Serious games – or serious games – using virtual reality or not, are tested on patients suffering from multiple sclerosis and on others suffering from a stroke.
Video games used for physical therapy
We are in front of a giant screen. The background represents a virtual character pedaling on a bicycle hanging from a balloon and flying over a rough sea. Suddenly, colored circles carrying a bar pointing in a specific direction appear in the landscape. The reds must be ignored, but watch for the green pointing downwards, upwards, to the right or to the left, and direct his hands as quickly as possible in the direction indicated.
Change of scenery. This time, we are equipped with a mask giving a three-dimensional vision and we hold two controllers. We are suddenly transported to a football field and transformed into a goalkeeper. Virtually equipped with gloves that appear on the screen, we must stop the balloons that players (virtual too) send us from various sides.
The experience may be fun, we are not in a playground, but in a laboratory of the Vaud University Hospital Center (CHUV). The screen and the associated computer are part of the Neuroscape @ NeuroTech platform, and the technologies involved will be validated on patients.
The game of red and green circles – an example of a “serious” video game – was designed by American neuroscientists at the Neuroscape Center at the University of California, San Francisco. It is intended for cognitive neurorehabilitation, especially for people with multiple sclerosis. This neurological disorder is due to destruction of myelin. When this envelope which isolates and protects the nerve fibers is damaged, the nerve impulse is slowed down. For patients, most of them young adults, this translates “mainly by a loss of information processing speed, associated with short-term working memory problems and attention”, explains Arseny Sokolov, doctor at the Department of Clinical Neuroscience at CHUV and director of Neuroscape @ NeuroTech.
The three video games available on the platform aim to exercise these different cognitive functions. Some of them also require a physical effort, not only because it motivates, but also “because many studies have demonstrated a beneficial effect of physical activity on cognitive functions,” says Pietr Grivaz, neuroscientist and coordinator of the platform. In addition, explains the neuroscientist, “an algorithm can adapt, in real time, the difficulty of the game depending on the performance of the player.” This is important, says Arseny Sokolov, because “it allows personalizing the rehabilitation. The game pushes the patient to increase his performances, without exhausting him “.
The CHUV team began “to adapt this game to patients with multiple sclerosis with mild cognitive impairment,” notes the doctor. It has also launched the recruitment of patients – there will be twenty in Lausanne and as many in San Francisco – who will have to play, on screen or tablet, three times a week for a month. After a few months, these will be re-evaluated “to know if the effects persist or not, over time”.
Immersion in a virtual world
More than video games, virtual reality immerses the patient in another world. By discovering on the screen his own body, “he is teleported”, according to Professor Andrea Serino, director of the MySpace Laboratory and the Immersion NeuroTech platform of the CHUV. By watching his avatar performs a task he can no longer do in real life (such as moving his arm to grab an object), he lures his brain.
Classical rehabilitation uses different methods to deceive the brain to stimulate it to reorganize and compensate for the injured area. Especially for people with sequel of a stroke. Some may have one side of their body, arm or leg paralyzed. Others suffer from negligence: their brain “neglects” then to inform them of everything that happens on their left (if the lesion is in the right brain, and vice versa).
Virtual reality has the advantage of complete movements. It can even give him the illusion that he is doing more than he actually does, which avoids frustration, “says the CHUV professor. In addition, the “player” receives a return – he can visualize his progress or earn points when he reaches the set goal -, which further increases his desire to continue the effort.
Virtual reality in the service of neurorehabilitation has already been the subject of some concrete achievements. The company MindMaze in Lausanne, which was initially a spin-off from EPFL, marketed the MindMotion system, which allows the patient, after doing exercises with his therapist, to continue to train alone. Andrea Serino and her colleagues have just launched a study to test the value of this tool to help re-educate people with heminegligence.
Get inspired by marketed games
The game of the goalkeeper mentioned above is intended to increase attention and mental flexibility. It was created by the Italian company Orwell with a purely playful intention, since it is intended for fans of football clubs. The CHUV team has therefore undertaken to adapt it to the rehabilitation of people who have suffered a traumatic brain injury. As part of the European Eurostars project, it has partnered with the University of Applied Sciences of Western Switzerland (HES-SO) of Valais, MindMaze and Orwell. The idea, explains Arseny Sokolov, is to “preserve the concept and the graphics of the commercial game, but to modify it in order to put exercises, designed by neuropsychologists, intended to make work the defective cognitive functions”. Once developed with the participation of patients, the sport game will be tested and its interest evaluated. There is no doubt that it will seduce young patients, who will be more inclined to continue the effort required by neurorehabilitation.