Magician’s Apprentice

Created by: Grendel Games/ Motek Medical

Nominatie: Games for Health Europe Award

Introduction

Patients walk on an instrumented treadmill and explore a virtual environment consisting of multiple rooms and corridors separated by different types of doors. They have to perform specific arm movements in order to open the doors and proceed through the doorway. The challenge is to train both balance and walking impairments simultaneously with arm function in a functional task.
Goal

To study motor learning and recovery in a dynamic condition, such as walking, opening a door, and proceeding through the doorway and to investigate how balance control constraints influence the re-learning of upper-extremity movements. Subjects explore a virtual environment by walking on a treadmill and opening multiple types of doors. This is a first feasibility study in a series of experiments in which we plan to investigate the use of complex virtual environments to simultaneously train walking and arm function.
Population

The initial study is intended for stroke patients with hemiparesis. However, the task of walking, opening a door and proceeding through a doorway is something of interest for any patient that has both balance and upper extremity impairments. We would like the application to be extendable to other patient populations and not targeted for one type of patient in particular.
Game play

The virtual environment represents the interior of a building with corridors and rooms separated with doors that open either with a “simple reach”, “reach and pull” or “reach and push” movement of the arm. Sliding doors, revolving doors and usual hinge doors with different types of handles in three different sizes, large, medium and small are included and separated by a 10 m distance one from another. The location of door handles can be adjusted (left/ right and up/down) in a manner that requires each individual patient to use the involved upper limb with specified joint kinematics in order to open the doors. The ground surface of the corridors can be set up to be either flat or with a positive or negative slope and this can be synchronized with treadmill motion. In this environment, subjects view an avatar or a computer representation of their own arm interacting with the environment in a first person view. Extrinsic feedback (knowledge of results) is delivered in the form of a sound when the reach is both as fast and as accurate as specified, and the door opens. Knowledge of performance feedback about the quality of the upper limb movement patterns is delivered as an annoying sound when compensatory movements occur during reach.
Unique opportunities

* Controlled environment training for walk and reach
* Objectively monitor reaching
* Encouraging
* Scalable gait training with reaching as double task

Motivatie: Grendel Games and Motek Medical have been pioneering in creating seriously entertaining games since 2005. Games that are on the cutting edge of combining entertainment mechanics and production value with serious goals and well-thought through rehab exercises. This combination instills intrinsical motivation amongst patients, making for more effective and, importantly, more fun rehabillitation. Magician's Apprentice sees players (patients) tidying up a castle and saving other apprentices after having cast the wrong magical spell and changing all his or her classmates into frogs! Magician's Apprentice works at every level, and is testament to years of joint production between the medical- and technical experts at Motek Medical and the game designers of Grendel Games. This game deserves an award because it marks a next step towards a better understanding of how virtual words can assist stroke victims in getting better. It deserves an award because it is Dutch pioneering in the field of medical games fused with entertainment principles at its finest.

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