Next level in therapeutic gaming

VIRTUAL REALITY: Ryan Hebert, 5, works with physical therapist Megan Wilkins at Meeting Street in Providence. Ryan uses head movements to operate his chair. / PBN PHOTO/MICHAEL SALERNO
VIRTUAL REALITY: Ryan Hebert, 5, works with physical therapist Megan Wilkins at Meeting Street in Providence. Ryan uses head movements to operate his chair. / PBN PHOTO/MICHAEL SALERNO

Any parent can tell you that if you don’t keep a child interested, they quickly become disengaged, no matter the activity.
It’s the same challenge for those involved in physical therapy, when working with children with physical disorders. So Rhode Island medical professionals have partnered with an Israeli gaming company that is developing a Web and mobile therapeutic-gaming platform that aims to keep children engaged through play.
Dr. Trey Crisco, professor of orthopedics at Brown University, heads a bioengineering laboratory affiliated with the university and Rhode Island Hospital where he’s been working since 2007 to develop devices that allow disabled children to exercise arm and hand muscles while playing with remote-controlled toys. He and his staff at the laboratory have teamed up with Timocco, a virtual motion therapeutic-gaming company, which heard about Crisco’s work before reaching out and creating a new partnership.
The two groups are now working to develop gaming technology that will “enable [physical therapists], clinicians and parents to better control and improve children’s body movements,” Crisco said.
“If children are not engaged, they’re not going to play, so keeping them engaged is key,” he continued. “Timocco’s ability to come up with so many different types of games is a real strength to keep the children engaged.”
The gaming company already produces the technology – especially within the field of occupational therapy – in markets outside the United States, but is trying to further develop its systems within the market of child physical therapy here in the United States.
Timocco currently offers about 50 games created for children coping with cognitive, motor and learning disabilities.
The gaming concept on the surface is relatively simple, which is part of why Crisco was attracted to the idea. Children are given different-colored balls – red, green and blue – and face different challenges that require moving the balls to different corners of a screen.
The gaming platform will introduce new state-of-the-art computer vision and machine learning algorithms that will allow “highly accurate tracking of both gross and fine motor skills, and measuring the correctness of joint movements,” according to the project’s funding proposal. Megan Wilkins, a Meeting Street physical therapist at 1000 Eddy St., Providence, works with a team of therapists who collectively aim to improve the lives of children of all abilities. Wilkins agrees with Crisco and says the biggest challenge when working with a child, regardless of ability, is keeping them engaged.
“If we’re not able to make the task fun and interesting, the child is likely not going to want to participate,” Wilkins wrote in an email. “Technology seems to be a big motivator for many children – computers, iPads, gaming systems, interactive toys, etc.”
Wilkins has used some Timocco technology in the past and says it works well for improving reach, strength and making children use both sides of their bodies together.
But there are other challenges in her field, Wilkins said. Therapy could happen two or three times a week for about 30 minutes, but for many people it stops there. In order to continually progress in physical therapy, Wilkins said, children need to continue practicing what they learn at therapy and repeat it at home. This can be a challenge, especially if parents don’t feel confident on their own or can’t find enough extra time in the day.
Timocco’s gaming platform is trying to address some of these issues. The idea is to create a fully featured Web and mobile therapeutic game platform that is relatively cheap, easy to install and has the capacity to track progress in different locations.
The games can be set up anywhere with third-party controllers like Kinect, which is used with the popular game system Xbox. Movements are seen through 2-D Webcams, which track the children’s movements and log trials into the software’s system, calibrating progress.
Crisco, whose role in the partnership will largely involve helping test the technology with disabled children, says development is in its early stages, but the plan has an 18-month window. Timocco and Crisco’s team secured $800,000 through the U.S.-Israel Binational Industrial Research and Development Foundation, and their efforts will be scaled to match budget, Crisco said. The funding group, referred to as the Bird Foundation, approved $8.3 million in 2014 to fund 11 new projects between U.S. and Israeli companies.
“In the next two or three months we’ll start to work [on] evaluating the technology itself, and recruiting and bringing together therapists and technicians,” Crisco said. “Groups of people will then be playing the games and receiving the treatments, to see if this improves their daily ability to function.” Meeting Street is not currently involved, but is a likely candidate, he said.
Children will likely start testing the technology within a year, Crisco said, but at first it will be just to collect feedback to see what children like and dislike.
The new technology falls under a category of therapy equipment that both Wilkins and Crisco say is lacking in the field.
Therapeutic equipment – specifically developed for children – is scarce.
“Typically equipment is designed for adults, and then ‘scaled down’ for children,” Wilkins said. “It is only recently that a true pediatric power wheelchair has been designed for young children. Children interact with their environment differently than adults. What works for an adult does not always work for a child.”
Medical-technology companies shy away from the medical market for children, Crisco said, because it’s smaller and comes with higher risk.
“It’s a challenging business market,” Crisco said. “The numbers are smaller, the market is smaller, and there is a lot of development and challenging regulations.”
Crisco, however, thinks this new technology, which is currently just focused on physical therapy for children, has great potential – if successful – to expand into the adult stroke-rehab market.
“I think this [technology] will work, but proving that it works is going to be challenging. But, as costs rise in health care, the ability to get a cost-effective therapy that is Web-based has great potential,” Crisco said. •

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