TBI G4H An Experimental Game for Traumatic Brain Injury

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This presentation is a post-mortem of a grant investigating games for use in traumatic brain injury patient rehabilitation.

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  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • Slide 1:  Title / Funded by/ Date of Availability of Prototype
  • TBI G4H An Experimental Game for Traumatic Brain Injury

    1. 1. Games for Health<br />Cognitive & Emotional Health Track<br />An Experimental Game for Traumatic Brain Injury<br />Post-mortem<br />Bob Waddington, COO<br />SimQuest LLC<br />Supported by the US Army Medical Research and Materiel Command under Contract No. W81XWH-09-C-0122.<br />
    2. 2. What I’m <br />Playing…<br />
    3. 3.
    4. 4. Although many TBI patients may return to normal lives, many are circumscribed with disability, unmet care needs, or inability (sometimes temporarily, sometimes permanently) to successfully re-enter home, military, vocational, and/or community life.<br />Bob Woodruff<br /> Gabby Gifford<br />
    5. 5. The effectiveness of rehabilitation in TBI patients has been demonstrated repeatedly in the literature, with results that include changes in cortical organization, improved test scores, faster recovery, increased level of function, and increased functional independence<br />
    6. 6. Cognitive/Motor Therapy Application Using Console-Based Video Game Platform<br />SimQuest, LLC<br />Novint Technologies, Inc.<br />The Institute for Rehabilitation and Research (TIRR) at Memorial Hermann Hospital<br />
    7. 7. Project Objectives<br />Analyze effective TBI rehabilitationprotocols<br />Establish TBI rehabilitative training goals and define strategies/performance metrics<br />Investigate technology options for TBI rehabilitation<br />Develop technology-based TBI rehabilitation game-goal structure<br />Select candidate game/goal therapy topic for development<br />Develop game presentation strategies<br />Demonstrate sample scenario for prototype<br />
    8. 8. Therapeutic Challenge<br />Although a continuum of care is in place, many veterans do not get the<br />rehabilitative services they require. <br /><ul><li>Lack of local support services
    9. 9. Limited inpatient coverage – visit caps
    10. 10. Difficult to track at home exercise compliance </li></li></ul><li>Consultation<br />Met with therapists from TIRR’s Challenge Program and Project Victory.<br /><ul><li>Physical
    11. 11. Speech
    12. 12. Occupational
    13. 13. Vocational</li></li></ul><li>Consultation<br />Reviewed<br /><ul><li>Therapy goals
    14. 14. Assessment tools
    15. 15. Therapy protocols
    16. 16. Patient demographics
    17. 17. Use of games in therapy</li></li></ul><li>Consultation<br />Findings<br /><ul><li>Multi-modal requirement
    18. 18. Stimulation of multiple areas of brain leads to more rapid return to function
    19. 19. Link to function
    20. 20. Games designed specifically for TBI offer potential over off-the-shelf games. </li></li></ul><li>Mapping<br />Conceived game organization and complexity scale that acknowledges that game play and interaction <br /><ul><li>are blended processes requiring multimodal brain functionality,
    21. 21. can support therapists’ desire for multimodal stimulation, and
    22. 22. allows leveling from very basic games to increasingly complex games.</li></li></ul><li>Proposed solution<br />Support TBI rehabilitation goals in an intuitive, entertaining fashion and extend the reach of rehabilitation services to underserved service members<br />Series of games with multimodal stimulation<br />
    23. 23. Proposed solution<br /><ul><li>Develop on XBOX 360 (console required)
    24. 24. XNA offered portability to PC</li></ul> (key segment of target population did not have game consoles)<br /><ul><li>Investigate use of haptics technology
    25. 25. Phase I proof of concept</li></ul>PC Mouse/Keyboard<br />Xbox 360 Gamepad<br />Novint Falcon<br />
    26. 26. Phase I Effort<br /><ul><li>Determine the severity level of TBI (mild, moderate, or severe)
    27. 27. Area of function (cognitive, motor, sensory, behavioral)
    28. 28. ID segment of the continuum of care of most pressing need
    29. 29. Develop prototype game using a sophisticated haptics device connectable to a videogame console or PC. </li></li></ul><li>Game options<br /><ul><li>Mini-game collections
    30. 30. Conducive to brain training
    31. 31. Faster development
    32. 32. Bridge to real-world function
    33. 33. Difficult to create something truly novel
    34. 34. Traditional adventure style game
    35. 35. Increased engagement
    36. 36. Difficult if too challenging
    37. 37. Games embedded in storyline</li></li></ul><li>Prototype Evaluation Criteria<br />• demonstrate multiple, increasingly challenging, levels;<br />• demonstrate that the levels address multiple brain functions;<br />• be able to be demonstrated on the Xbox 360;<br />• be targeted toward patients with mid- to high-range FIM scores;<br />• integrate with haptics on a PC;<br />• integrate with haptics (Falcon) on the Xbox 360;<br />• be able to demonstrate different haptic effects;<br />• have short-turnaround development time; and<br />• be low in cost.<br />
    38. 38. Prototype Evaluation Criteria<br />• Vision<br /><ul><li>Fine motor skills
    39. 39. Memory</li></ul>Abstract game selected for prototype proof-of-concept<br />
    40. 40. Sample Ideas<br />
    41. 41. Sample Ideas<br />
    42. 42. Sample Ideas<br />
    43. 43. Sample Ideas<br />
    44. 44.
    45. 45.
    46. 46. Results<br />TBI rehabilitation games should not focus on single brain functions but should be multimodal to reflect the fact that in TBI therapy, stimulation of multiple areas of the brain leads to a more rapid return of functionality<br />Established TBI rehabilitative training goals and defined strategies/performance metrics, subsequently determining that the game would focus on identification of target areas of function (cognitive, motor, sensory, behavioral) and would target Challenge Program and Project Victory patients <br />
    47. 47. Results<br /><ul><li>Demonstrated the feasibility of interfacing the Novint Falcon to the Xbox 360 platform,
    48. 48. Successfully demonstrated the Novint Falcon manipulating an object running on the Xbox,
    49. 49. Implemented an XNA puzzle game for the Xbox that is controllable through the gamepad or the Falcon</li></ul>Critical points that aided game structure and provided guidance for game complexity and type, i.e., <br /><ul><li>A certain level of function is required for a patient to interact with a computer and comprehend a game’s goal and mechanism of play,
    50. 50. Inherent to the process of computer interaction is stimulation of multiples areas of brain function</li></li></ul><li>Results<br />Selected a collection of mini-games as the candidate approach, established a design framework to provide a contextual mechanism for the mini-games, and developed sample mini-game concepts.<br />Chose a prototype mini-game targeted at the less complex end of the functional independence scale that would focus on vision, fine motor movement, and memory.<br />
    51. 51. Conclusions<br />Games have the potential to increase the reach of rehabilitative services to currently underserved individuals and would improve performance, thus reducing costs of care and other dependent services.<br />

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