Choosing between games for rehab: the prequel

Subject Review: Facilitating clinical decision-making about the use of virtual reality within paediatric motor rehabilitation: Describing and classifying virtual reality systems
Galvin, J., & Levac, D.
Developmental Rehabilitation,, April 2011; 14(2): 112-122

Link to abstract: informahealthcare.com/doi/abs/10.3109/17518423.2010.535805

Objective: to describe and categorize VR game systems using characteristics relevant to paediatric rehabilitation.

Method: Literature search followed by paper review. Descriptive process to develop classification framework. Based on articles on seven virtual reality game systems: Dance Dance Revolution, EyeToy, IREX by Gesturetek, Pediatric Intensive Therapy System (PITS), PlayStation 3 sensor glove and WiiFit.

Findings: All VR systems possessed three features: they require the player to move in space, they offer an exactly reproduced environment for repeated practice and provide augmented feedback.

A descriptive table is provided to identify the characteristics of each game. The classification system identifies five game characteristics and two variables in user ability that the games should accommodate.

• Game should have properties that are relevant to therapists and that can be both manipulated and measured.
  
  
• Games should target various body movements; it’s best if these can be assessed for quality of movement.
  
  
• Motor demands of the games should change independently from cognitive demands.
  
  
• Users should be able to play without fine motor control, and VR games accommodate both sitting or standing positions.

Experimenting with Kinect

This Peter Wayner article from the New York Times of July 20th details how the hacker-friendly Kinect is being adapted for artistic uses and as a unique home amusement. Kinect’s cameras collect body movements in three dimensions. This could create an opportunity for adapted game playing. Various software helps non-programmers easily create visual or sound feedback environments operated by gestures and movements. It is also possible to do keyboard activities using gestures instead.

Link to this article: nytimes.com/2011/07/21/technology/personaltech/kinect-hacking-finds-a-wider-crowd.html?_r=1&ref=technology

Related New York Times article:
nytimes.com/2010/11/22/technology/22hack.html

Kinect hacks
kinecthacks.net
kinecthacks.com
hackaday.com

Blog
kinecteducation.com/

Minigames offer adapted ‘slow fun’

Digital games for physical therapy: fulfilling the need for calibration and adaptation

Guerts, L., Vanden Abeele, V., Husson, J., Windey, F., Van Overveldt, M., Annema, J-H. & Desmet, S. Proceedings of the fifth international conference on Tangible, embedded, and embodied interaction, 117-124 doi>10.1145/1935701.1935725

Link to abstract and references portal.acm.org/citation.cfm?id=1935725

There has been a move from joystick game controllers to a variety of controllers; from fine motor control to whole body movements, creating an opportunity for people with limited fine motor control to play video games. This paper looks at mapping controllers (calibration) and altering game settings (adaptation) to make games available to people with spasticity. Video games used as therapy tools should be adaptable to the capabilities (and potential) of the player and responsive to the goals defined by the therapist. The authors define calibration: “the fit of the game to the patient”, and adaptability: “game mechanics such as speed and accuracy should be easily adjustable and designed to accommodate [for] a wide range skills”.

After evaluating currently available video games, they discover that the relationship between game actions and ‘correct’ therapy movements (mapping) is insufficient to accommodate their test sample of game players with spasticity.

The authors develop four minigames that offer ‘slow fun’ for people with limited motor control to maintain range, increase strength, and increase coordination. The games variably use arm movement, standing balance, head movements and seated weight shifting to activate webcam, Wii remote, and balance board controllers. The sensitivity of the input devices were sufficient both for these players and for these applications. “It is important however that the game parameters can be adjusted to the players skills and development goals”.

Link to conference TEI '11

Advances in Game Accessibility

Paper review: Advances in Game Accessibility from 2005 to 2010
Westin, T., Bierre, K., Grammenos, D. & Hinn, M.

Published in: C. Stephanidis (Ed.): Universal Access in HCI, Part II, HCII 2011, LNCS 6766, pp. 400–409, 2011. © Springer-Verlag Berlin Heidelberg 2011

Link to abstract: www.springerlink.com/content/v5231nn67304275m/

The references in the text below can be found at www.citeulike.org/group/8459

This document summarizes published research literature between 2005 and 2010 on game accessibility. The review organizes accessibility research by the type of disability and alternate feedback modality.

Reduced vision is accommodated using auditory or tactile (haptic) inputs (Savadis et al., 2007; Atkinson et al., 2006; Archambault & Olivier, 2005; White et al., 2008; Gutschmidt et al., 2010; Sepchat et al., 2006; Archambault, Guady & Meisenberger, (nd); Roden & Parberry, 2005; Sanchez & Saenz, 2005; Morelli et al., 2010; Oren et al., 2008; Sanchez & Elias, 2007; Folmer et al., 2009; Pascale et al., 2008; Glinert & Wyse, 2007; Miller et al., 2007; Allman et al., 2009; Yuan & Folmer, 2008; Sanchez et al., 2009).

Impaired hearing receives feedback through haptics (Brashear et al., 2006).

Motor disabilities feedback comes through adapted controls (Lepicard et al., 2007), speech (Sporka et al., 2006), or both modalities (Norte & Lobo, 2008).

The authors highlight game interaction models: (Archambault et al., 2008; Grammenos et al., 2007; Grammenos et al., 2009; Ossmann et al., 2008; Yuan et al., 2010; Torrente et al., 2009).

Game accessibility guidelines are identified: (Archambault et al., 2008; Ossmann et al., 2008; Tollefsen & Flyen, 2006).

Results of selected user surveys (Trewin et al., 2008; Trewin et al., 2008) are included.

Virtual table tennis – alternate access

‘Hyper Ping-Pong’ is a virtual table tennis game, played with a bat containing motion sensors and a speaker. The game provides sound feedback to the motion of swinging at the ball to guide game play. A player hears the other (virtual) player hit the ball, and responds to sustain a rhythm, or to keep the rally going.

The game was developed by Happinet, a Japanese game company, and demonstrated at the International Tokyo Toy Show, June 16 – 19, 2011. It will not be available till October of this year and is estimated to cost $25.

Read more: www.dailymail.co.uk/sciencetech/article-2007785/Ping-pong-partner--ball-Japanese-develop-table-tennis-game-play-ear.html#ixzz1QalvnkAF

View: www.youtube.com/watch?v=H5xdj3s7uXc

Choosing Between Games for Rehab

Subject Review:
Facilitating clinical decision-making about the use of virtual reality within paediatric motor rehabilitation: Application of a classification framework

Levac, D. C. & Galvin, J., Developmental Rehabilitation, June 2011; 14(3): 177-184. Link to the abstract: www.ncbi.nlm.nih.gov/pubmed/21410403

The authors create a clinical tool to enable therapists to choose when they would use different virtual reality game systems. Game systems covered include: Nintendo Wii, Sony EyeToy, Dance Dance Revolution (DDR), GestureTek IREX, Pediatric Intensive Therapy System (PITS) glove and Sony PlayStation 3 (PS3) glove. The decision tool is applied to three case studies of children with motor impairments.

Levac and Galvin identify (but don’t define) their therapist-friendly criteria for sorting out the video games. The criteria include the following. Is it possible to manipulate game levels to grade activity difficulty, or track the variables to evaluate activity performance? Can the therapist choose games that focus separately on upper extremity or lower extremity activities? Are the cognitive requirements to follow the game separate from increasing motor demands as the game progresses? What is the type of motor input and user capabilities, such as fine motor control, required to operate the game? And what seated or standing position is required to play the various games? These criteria are assembled into a table that sorts the game systems.

Then, by way of example, the criteria are applied to three case studies to choose game systems. The authors also provide a comparison of game systems, based on the criteria. This has value in clinical settings where only one system can be purchased. Generally, commercial systems (Wii, EyeToy, DDR) are seen to have fewer motor rehabilitation qualities than the game systems specifically developed for rehabilitation (IREX, PITS, PS3 glove).

The classification system is continuing to be studied to establish validity and clinical utility.

Alternate Access: Speech used as a form of input to mediate video games

Prototype development paper

Audition, the Game: Assessing the possibilities of speech as a non-trivial gameplay element in video games, Lavender, T. J., (2011)

Contact Terry Lavender: tjl.sfu@gmail.com

Link to the article: www.terrylavender.ca/wordpress/wp-content/uploads/2010/06/lavender_finalprojectIAT881.pdf

Speech as a motor-free way of driving video games is not common yet, but Terry Lavender at Simon Fraser University’s School of Interactive Arts and Technology has developed a prototype game that uses speech to change the outcome of a game. The game requires the player to say a certain speech in a given amount of time in order to advance the game.

Players in this prototype game are also hooked up to sensors which make a physiological measure of galvanic skin response (GSR) or hand sweatiness. This is a common way to detect stress or emotion, and may also be a way to indirectly measure speech difficulty. Currently, there is little evidence of the link between speech difficulty and stress. As a possible connection is explored, there could be opportunity to develop therapeutic applications. Physiological measures like GSR, heart rate or temperature are expected to be available in commercial hand held game controllers in the future as effective ways to mediate game play.

Further in the future, speech-mediated qualities like verbal memory and vocal clarity could be more direct game controllers and make motor-free game play a realistic avenue for participation of children with motor difficulties or a way to engage children in speech rehabilitation.