Wiihabilitation

Technology within therapy - Biometrics E-Link vs Nintendo Wii

2011-12-15T11:15:00.000-08:00

For those who recognise the value of computers within therapy, they probably won't need to be told about the Nintendo Wii but its not the only use of computer gaming within rehabilitation, nor will it be the last. One criticism of the Nintendo Wii is its lack of specificity, in that there isn't a piece of software that fully meets the needs of therapy. It doesn't allow you to easily record progress in a manner that is in keeping with therapeutic need and it doesn't let you configure the software that you are using to allow the patient to work at a level and pace which is both suitable and comfortable alongside being therapeutically beneficial.

There are other alternatives on the market though and, unlike the Wii, The E-Link may not be as well known but similarly to the Wii it uses games to support therapeutic activities. Produced by Biometrics, the E-Link is far more robust tool and treatment for therapists and does all that the Nintendo Wii currently does not. It records progression, prints charts, allows the therapist to set goals, targets, offers feedback, saves patient information securely, can be used as an outcome measure in its own right and significantly doesn't allow the patient to 'cheat' or not fully complete the required task/movement.

Its control mechanisms, used by the patient/client are interchangeable and are controlled by several devices. The first measures angles (angle-x) produced by joint movements, the second measures EMG muscle activity (myo-x device), the third is mechanical (upper limb kit) requiring patients to physically control a rotating wheel with a choice of handles or grips for hand function and finally a set of pressure plates that measure forces. It is incredibly versatile and has few limitations, meaning that any joint can be exercised and worked in the way that is therapeutically beneficial.

On the downside the E-Link has two weaknesses - the graphics and the price. Through discussion with colleagues, and use of the E-Link, the graphics are an obvious comment to make. They don't come close to the detail or fluency that many have become accustomed to when playing mainstream console games - but developing console style games requires a phenomenal amount of financing which would only ever serve to increase the over all cost of the E-Link system. From experience its worth mentioning that it shouldn't matter what the game looks and feels like - its the function and the achievements that count. I still have very fond memories of ZX Spectrum games and would still happily play 'Colin the Cleaner' or 'Dizzy - Treasure Island' purely because I enjoyed the game despite the graphics being grittier than a bucket of course sand. With the release of E-Links software - version 12 in the New Year the graphics are said to be one focus of improvement within the system and whilst the current graphic could be considered a weakness they certainly are not a flaw.

The price is the second contentious point. With the Nintendo Wii now at an off the shelf affordable price of around £120 the E-Link, in contrast, costs considerably more. The difference comes from the two systems being made for very different reasons. The Wii is a gaming console that has, as an unintended offshoot, been commandeered by therapists and patients alike to enhance their physical well being and abilities. The E-Link is a purposely designed piece of kit that demands high standards of precision in order to be reliably and specifically used within rehabilitation.

It is easy to comment and state that the Nintendo Wii does all that the E-Link doesn't, it justs costs less and has better graphics - but when the 'rose coloured Nintendo Wii glasses' are removed the Wii isn't so perfect. The graphics may be exceptional but the games are never specifically designed for rehabilitation, you can't adjust the game play time or the level of difficulty to meet your patients needs. The movements that are required are too forgiving, in that they don't need to be exact, creating the opportunity for imperfections in the control, and a reduction in the quality, of active movements. It won't allow you to save specific achievements made by specific patients, or chart their progress and allow you to print out reports.

Often (especially in the early stages of rehabilitation) the games are too 'busy', colourful and so graphically interesting that they distract the patient from the therapeutic purpose of using the game. Because the games are not designed for the use within therapy they are often quite difficult, setting up for failure, disappointment and potential disinterest from the patient.

Currently the Nintendo Wii can/should only be considered as a therapeutic tool, but those willing to pay the premium and purchase an E-Link system will find themselves offering computer gaming as an assessment tool and/or treatment.

For more information on the E-Link please visit the following website.

UK - Nintendo Wii use in Therapy - Workshop interest poll

2011-12-11T07:34:00.000-08:00

This poll is intended to gauge whether there is any interest in organising a workshop to share ideas as to how the Nintendo Wii is being used within therapy and to create a forum through which best practice and research can be shared.

There are no dates, locations or venues decided yet, but if you have ideas or comments please use the comments box below.

Online Surveys & Market Research

Thanks!

Will Wii-U become WiihabU?

2011-10-31T03:59:00.000-07:00

It is anticipated that in 2012 Nintendo will release their new Wii console - the Wii U. With the Wii still growing in popularity amongst healthcare professionals it is interesting to consider whether the Wii U will follow suit.

The Wii U is a new base unit boasting high definition graphics, a large hard drive and a new form of console/controller interactivity. The 'old' Wii controllers will continue to be compatible alongside the Wii U playing Wii games. The Wii U moves away from supporting Gamecube discs but this barely relevant to those interested in Wiihabilitation.

Whilst the new console is set to compete with Sony and Microsofts HD gaming consoles the Wii U dares to be different. The new controller will act as either a stand along screen, so it can be used without a TV or as a second screen, much like the DS. The second screen function goes way beyond the capabilities of the DS which offers a static alternative view to the same game. The Wii U controller offers a dynamic view or a window into the game that previously never existed. An example of this has been demonstrated with a golf game, where the new controller, placed on the floor shows the golf ball which is ready to be hit as the player swings the wii remote. Once the player has swung the wii controller the ball is digitally lauched from the Wii U controller onto the TV in front of the player. The following trailer on YouTube gives a clearer demonstration and is well worth a viewing.

So what does this mean for WiiHab?
It will largely depend on the price of the console. Many rehab specialists who use the Nintendo Wii may not be inclined to spend more until specialist software is released. Finances and specificity aside the Wii U has some interesting features that are worth looking out for.

The potential interaction with the local playing environment and perceptual development that the Wii-U requires may offer an additional dimension to therapy, coupled with the increased precision that will undoubtedly be required to play many of the new games. The need for the control unit of the console to be held by two hands will unfortunately limit its use for those with hemiplegia or one sided weakness. This feature doesn't write it off within therapy as the control unit will also act as a viewing platform, away from a TV, but it will decide whether software is useful within the rehab gym or not. It is reassuring to hear that the current controllers will remain compatible with the new console as this will reassure people that whilst the console it new the fundamental controls will remain familiar.

Even if the Wii-U doesn't capture the imagination of the therapy arena, the Wii will undoubtedly remain for the foreseeable future and continue to be used to motivate fitness recovery, movement control and enjoyment in therapy by a spectrum of therapists and patients.

Read more about the Wii-U here.

Advice and guidance for those using the Wii for rehab especially with Parkinsons Disease

2011-10-30T05:32:00.000-07:00

With the Nintendo Wii being 5 years old (released 19th November 2006) it could be considered surprising that nothing yet has superseded it. Five years in the life of technology is a long time, especially when considering the rate of change and development. Despite both Sony and Microsoft releasing their own 'person controlled consoles' (Move and Kinect respectively) it continues to be the Nintendo Wii that is frequently used, adapted and integrated within therapy and rehabilitative programmes. The Kinect is possibly the Wii's biggest rival, with Microsoft keenly working with a spectrum of potential users - including those engaged with disabled fitness or rehabilitation.

In the mean time it is interesting to see that support groups now recognise the interest regarding the use of the Wii to maintain mobility and fitness levels by publishing guidance on their website. I refer to the Parkinsons UK website. Whilst much of the advice is specifically for those with Parkinsons Disease a considerable amount of the information can be safely applied by others with mobility or movement related disorders. Parkinson's UK should be commended on their interest to offer specific advice for their readers and for producing a comprehensive guide. The link for the website and information is below.

Parkinson's UK - Parkinson's and the Wii - (formerly Parkinson's Disease Society)

The question continues to revolve around whether such interest in the use of the Wii will attract the attention of those at Nintendo to formally acknowledge and support the use within therapy and rehabilitation. The market and interest is still there for them, if they want it, with Nintendo Wii consoles being more commonly, and increasingly, found within therapy units worldwide. The potential to formally link beneficial therapeutic activities with Nintendo Wii software is as promising as it has ever been, but lets hope we're not kept waiting another five years...

Website Updated:

2011-02-21T06:19:00.000-08:00

Easier links to the research, news and games blogs from the website. Visit @ http://www.wiihabilitation.co.uk/home.shtml

Thanks

Does Rehab Kinect?

2011-01-24T12:55:00.000-08:00

Since the release of Microsofts Xbox Kinect in November 2010 a burning question of therapists, interested in using technology, has been - can it be used within rehab?

With the success of the Nintendo Wii obvious within therapy, there are high hopes for the Xbox Kinect, especially as it is considered the more advanced technology. But does a more complex technology bring with it more constrained usage!? Unfortunately early investigation with its use would suggest so.

It would seem that its strengths might end up being its rehab potentials weakness.

The Kinect seems to have two inconvenient aspects. The first is that it is so very sensitive and knows exactly what body landmarks it is looking for. If the camera cannot see all body points, then it detects nothing. This means for wheelchair users they cannot get passed the calibration stage, least of all play a game. Even using a standing frame will not trick the controller as body parts are blocked and in incomplete picture being received is discarded by the console.

The second inconvenience is that as a therapist you cannot closely support your patient to perform the movements required because, as a second body in the field of view, you are detected and included within the game. This causes confusion and, without meaning to, the second body can influence the playing of the game and render the experience frustrating. The alternative is the let your patient work out the controls and respond to your instructions as you hide out of the cameras view - a long way from the hands on therapy that many patients initially need and benefit from.

Whilst considering the negative aspects of the Kinect there are ways around the issues so that it can be used successfully and to the benefit of rehabilitating patients. Careful selection of patient is the first important decision. Able bodied patients working on refining control of movement or on dynamic balance, fitness or intending to increase basic global activity levels will find benefits from the Kinect.

It's graphics and response to movement are far beyond the feedback from the Nintendo Wii making it difficult to cheat or adapt movements, offering, where accessible, a more rewarding visual feedback experience.

Wii, Move or Kinect?

2010-12-02T14:32:00.001-08:00

Now the ‘big three’ have all released their movement controlled game systems its only time that will reveal the success of each of them within health. With the Nintendo Wii already being used in therapy, is there room for another console to interest the rehabilitation market?

The Nintendo Wii has grabbed the attention of patients and professionals alike, with its engaging variety of active games and its intuitive use – surely it can’t get any better?

Sony released their Move controllers earlier this Autumn to work with Playstation 2 and 3’s alongside Microsofts release of the Kinect in early November. The Move retails its ‘Wand’ like controllers at a reasonable cost and offers a very similar experience to the Nintendo Wii Remotes. The Kinect requires the purchase of a camera and sensor unit, enabling gameplay without the use of hand held controllers. Both new accessories to the existing and popular console have games and graphics which far exceed the quality of the Wii but the better quality of gameplay does only mean one thing – higher cost of the games. Such games for the Move and Kinect are likely to be aimed at different population of the gaming community consisting of complex game play and superior graphics warranting a price that requires value for money.

The question is – what is it that Sony and Microsoft think they can offer or achieve through the Move and Kinect that isn’t already accessible through the Wii? With many Nintendo Wii consoles already being used with in health and rehabilitation, will the other big consoles capture the imagination of the professionals incorporating them with in therapy? If there is an interest in the Move and Kinect, how then is the decision about which console to purchase made and for what reasoning?

Microsofts Kinect has the better potential to offer Nintendo competition, purely because its different and very much at the cutting edge of gaming at the moment. Its voice activated commands and controller free movement control allow for using generalised movements throughout the whole body to play the games. Whilst initially this concept sounds breathtaking the reality of it is that there are constraints and adapting the game play to increase accessibility to the console for disabled users is, currently, much more difficult than it ever was with the Nintendo Wii. With the small (but growing) selection of games available to use with Kinect, assume that the player must have to stand to play some or all of each game, be able to manage dynamic standing balance to play the game and have reasonably good control of both upper limbs. These initial physical requirements immediately restricts usage by many disabled people who are likely to continue to access the games, should they wish to play such games, through the classic controller. There is no hiding or adapting away from a disability whilst using the Kinect, which is a disappointment.

So for now the Nintendo Wii holds its place as the more adaptable and therefore most suitable mainstream console used within therapy. Future developments that may influence this pole position are likely to consist mainly of software developments where it is the software that is adapted for the use within rehab, rather than the therapy professionals adapting the console accessories. Which ever leading gaming brand develops the software needed to be successful in rehabilitation first might just be able to secure popularity and longevity within healthcare.

New Changes to the Wiihab website

2010-08-05T05:18:00.000-07:00

Over the past couple of weeks and months I have gradually restructured the original website so that it contains all of the original information plus opportunities to add more information with ease.

I would welcome any feedback regarding the layout, links, missing links and content, so please email me.

Thanks for visiting the site,

Kind regards,
Rebecca