Physiotherapy intensity has been known as a measure of stroke recovery for years.However, questions about the methods, timing, and scheduling still raise a few questions among researchers.Video games, in particular, have risen to the occasion when it comes to increasing therapy intensity.They enable access to exercises at any time of the day, and they are not subject to professional supervision while incentivizing through stimulating feedback.
Exercise games which are also known as "exergames" can mimic aspects of conventional physiotherapy like repetitive joint stretches, functional manipulation, and difficulties in adaption while manipulating motivational and cognitive variables.The incorporation of all these factors could increase therapy efficiency and enable a person to transfer those video games skills into the real world.
In recent years, virtual therapy that involves two or more players has been proposed as a method of further improving intrinsic motivation, engagement, and social inclusion.The appeal of gaming as a means of social interaction as well as entertainment can mean a bigger audience who would have been put off maybe due to age, impairment and cognitive or experiential issues.Also, the lure of playing with another patient or a relative at the hospital can aid in preventing patient isolation.Multiplayer training games are also more engaging than single player games, and the impact of the game on the patient does not entirely depend on the personality of the person.
Researchers from Imperial College in London took on the challenge and designed a video game known as Balloon Buddies.The game acts as a tool that enables those recovering from severe conditions such as a stroke to engage together and play with healthy volunteers who range from therapists to family members as a form of rehabilitation.
The game is designed in a way to make it fair by enabling the healthy participants to support the less able player.The researchers were able to show that the collaboration has made it more rewarding for the less able partner and at the same time more challenging for the healthy partner.The pair has to work together to score points, making it fun for the participating players.
The team of researchers undertook a trial for Balloon Buddies by making patients play it in single mode.They were then partnered with healthy players during dual gameplay.The pilot study was conducted on 16 patients and 32 healthy participants playing in 16 pairs.The 16 patients had arm weaknesses following a stroke and were paired to play with a healthy volunteer for over three months at Charing Cross Hospital which is part of the Imperial College Healthcare NHS trust.The game had also been tested on 16 healthy pairs albeit with different baseline abilities.
The game uses animation, sounds, and haptic feedback which is the same as in conventional games.Balloon Buddies requires the users to balance a ball on a beam supported at each of its ends by balloons controlled by the players.Points are scored when players vary the height of the beam, making the ball collide with moving targets.The players should also work together so that they keep the beam horizontal by making the ball stay on the platform which could otherwise roll off the platform.Balloon Buddies is played with a handless grip known as GripAble which enables people with arm weaknesses to control video games on any conventional tablet device.
The study gave promising results.For instance, the team found out that the performance of a patient increased significantly when they played with a healthy volunteer compared to when they played the game on their own.Furthermore, they found out that no matter how poor a patient's single performance was, they had a big improvement when they played with another during the dual-player mode.
Dr.Michael Mace, the lead author from the Department of Bioengineering at Imperial College London, said: "Video games are a great way of providing repetitive exercise to help patients recover from debilitating illnesses.However, most games are designed for users to play on their own which can actually discourage and isolate many patients.We developed the Balloon Buddy game to enable patients to train with their friends, family or caregivers collaboratively and playfully.The technology is still being developed, but we have shown that playing jointly with another individual may lead to increased engagement and better outcomes for patients."
The study has paved the way for the team to now carry out a more extensive study to find out whether Balloon Buddies results to more efficient learning and whether it motivates the patients to train for longer periods.The team will also attempt to unearth the social implications of interaction such as the effects of playing with a relative versus a stranger.
The study has also presented a framework to develop collaborative multiplayer gaming enabling two players to train together.The framework allows for the development of games that are simple, dynamic, and interactive.