Technology: more than just a game

BALTIMORE - For most people, video games are strictly for entertainment.

For therapists and patients who use these gaming systems as tools, however, the technology is important to improving quality of life.

Rebecca Martin, manager of clinical education and training at Kennedy Krieger Institute, works with patients in the spinal cord unit who have varying levels of paralysis. For them, a range of technology from standard video games to more specialized virtual reality systems are important tools for rehabilitation.

“We have a range of technology that sort of fits with the range of patients,” Martin said.

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At the grand end of the spectrum are pieces of equipment such as the ArmeoSpring, a spring-loaded exo-skeletal arm that works in tandem with a computer. Sensors in the arm register small amounts of movement and translate that into motion on the screen, creating a virtual reality type of experience.

The system uses programs that simulate practical activities like cleaning a stove or washing windows, to more recreational activities like fishing or driving a chicken in a go-cart.

The programs make small movements feel like big accomplishments by translating a small motion into a broad sweep across the screen.

“The great part of using this computer-driven technology is that we can get patients to do a lot of repetition,” Martin said.

Martin, a licensed occupational therapist with a doctorate in the field, explained research shows repetition is important in helping the nervous system heal, but it comes with its own set of challenges.

“It’s hard to get somebody to do high levels of repetition and to do it accurately without getting bored,” Martin said.

Technology like the exo-skeletal arm helps eliminate the element of boredom and makes consistent repetition easier to accomplish.

“It allows us to get in that high level of repetition we know is needed in helping the brain reorganize,” Martin said.

But the virtual reality system is just one of many ways technology aids therapists and patients at Kennedy Krieger.

The institute also has special harnessing systems accompanied by treadmills to simulate walking and special bicycles that help even those who are wheelchair-bound go for a ride.

On the bike, electrodes are attached to a patient’s leg as they sit on the bike and a computer determines how much of a charge is needed to make the leg muscle contract. The appropriate charge is then released into the patient’s leg. The process is repeated over and over again, making the legs pedal.

“The patient is able to cycle on their own muscle power even though the brain is not able to tell the muscles what to do,” Martin said.

For someone who doesn’t have the use of their legs, this experience means exercise, stimulation of the nervous system and, perhaps most importantly, hope.

“Patients find things like the treadmill and the Armeo really motivating,” Martin said. “It gives them faith and hope in the recovery process.”

On the more familiar end of the spectrum are iPads and video gaming systems like the Nintendo Wii or Xbox Kinect.

The Wii and Kinect function in much the same way as some of the other technology available at the institute. They allow for repeated movement and muscle building.

“I think the nice thing about the Wii versus the Arameo is that it is very normalizing,” Martin said. “Our patients so often don’t get to participate, it’s hard to blend in in a wheel chair, but if everyone is sitting at the table playing their game on the iPad then that’s a very normalizing experience.”

The iPad, which can help with development of fine motor skills and cognitive motor skills, can also help some patients interact and access their environments.

Martin explained some of her patients are non-verbal and the iPad makes picture communication easy.

The accessibility of the iPad is also a help because it allows Martin’s patients to incorporate that crucial repeated motion into daily life, not just the hour they are in therapy.

“It’s even better if we don’t call it homework, it’s even better if the patient wants to do it,” Martin said.

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