#biogaming

BioGaming, the leading developer of virtual reality physiotherapy solutions, has taken computer aided patient recovery to the next level.

For the first time, exercise routines can be created by licensed physiotherapists for patient use at home, using ‘motion capture technology’ to ensure correct rehabilitation, and low cost hardware and mobile apps automatically to connect the physiotherapist…

By Roy Tzemah, PT Head of Clinical Affairs

Adherence, defined as “the extent to which a person’s behavior corresponds with agreed recommendations from a healthcare provider”, is considered to be a very important pre-requisite for the success of exercise programs for musculoskeletal disorders.  Adhering to an exercise program enhances its effectiveness, and patients who undertake regular physical activity may be less likely to progress to recurrent, persistent, or disabling problems (Melanie A Holden, 2014).

Adherence has implications on treatment cost and effectiveness. Despite its importance, adherence to clinic-based exercise protocols is often around 50% or less and is usually worse for unsupervised home exercise programs (Melanie A Holden, 2014). Some studies even suggest that non adherence with treatment and exercise performance could be as high as 70% of patients (Kirsten Jack, 2010 Jun). Non-adherence to exercise recommendations may negatively affect treatment effectiveness, treatment duration, efficiency of use of personnel and equipment, therapeutic relationship, waiting times, and cost of care (Melanie A Holden, 2014) (Kirsten Jack, 2010 Jun).

Computer-oriented exercise programs and training has been found to improve compliance in musculoskeletal patients exercising at home (Dhurjaty, 2001). Exergaming may also result in an increase of daily physical activity and over-all motivation to actually train more. (Leonie Klompstra, 2014)

BioGaming innovative line of rehabilitation games (www.yugonow.com) provide state of the art, Kinect based, games that aim to increase adherence to training programs both in the physiotherapist clinic and at home.

Works Cited

Dhurjaty, S. (2001). Challenges of Telerehabilitation in the Home Environment. Telerehabilitation and Applications of Virtual Reality, (pp. 89-93). Washington DC.

Foster, N. E. (2014). A multicentre, pragmatic, parallel group, randomised controlled trial to compare the clinical and cost-effectiveness of three physiotherapy-led exercise interventions for knee osteoarthritis in older adults: the BEEP trial protocol. Foster et al. BMC Musculoskeletal Disorders, 15:254.

Kirsten Jack, S. M. (2010 Jun). Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review. MANUAL THERAPY, 15(32):220-228.

Leonie Klompstra, T. J. (2014). Exergaming to increase the exercise capacity and daily physical activity in heart failure patients: a pilot study. Klompstra et al. BMC Geriatrics, 14:119.

Melanie A. Holden, K. L. (2014). Recommendations for exercise adherence measures. Holden et al. Systematic Reviews, 3:10.

OUT – boring exercises, IN – 3D virtual reality computer games!

Developed by PTs for PTs, BioGaming’s new solution – YuGo – is the first fun, user-friendly, cost-effective, and professional tool that motivates patients to actually perform their exercises, and to do so correctly. YuGo creates a motivational environment in which tedious, repetitive exercises are “disguised” within exciting personalized video games that direct the patient’s attention towards a fun activity and away from boring technical execution. BioGaming has created entertaining, interactive therapy sessions that look and feel like some of the best video games you’ve ever played.

"YuGo makes you forget about your injury! It makes you think about getting to the next level" says 35 year old Nadav Zelber who is recovering from a hip fracture.

BioGaming recognizes that doing an exercise the wrong way can sometimes prove worse than not exercising at all. Unprecedented research and development efforts have been invested in an innovative gesture recognition technology, which analyses the quality of exercise execution. Using data collected by a Kinect camera, our algorithms analyze the performance input in real time so that auditory and visual feedback is provided to patients as they exercise. Therapists use an intuitive dashboard to build patient-specific training programs, and to access detailed qualitative and quantitative reports on patient compliance and status. BioGaming's technology takes into account the subtle differences between patients in terms of ability, strength, body size, and progress in performance.

Come meet us at booth 1242

Noa Russo Ayash, B.Sc.PT – Physical Therapy Field Expert

BioGaming Ltd.

 A well-fitting exercise program is developed by the PT for each patient who enters a physiotherapy clinic.

As we already know, the exercises are used as a tool for recovery as they increase the patient's body strength, elasticity, balanced and endurance resulting with recovery in a shorter time span and with higher success.

Giving a tailor-made exercise program, taking into account a patient's problems and his physical situation, is one of the underpinning stones of the physical therapy field.

When giving an exercise program, the physical therapist has to provide two types of programs, one to be performed at the clinic and one for home practice.

For home practice, the PT has to choose exercises that will fit the practice space, will not include practice instruments and will be safe for the patient. Another thing to be consider is objects that every house contains, and can interfere or become a risk for the patient while practicing. A good example is a carpet.

A home exercise program is very important to the rehabilitation program! Because Average patients come to physical therapy treatments twice a week or less.  It is already known that for the improvement of body physical functionality, it is necessary to practice at list 4-5 times a week.  Home practice is the only available solution. There are many researches that documented the effectiveness of home exercise.

McKenzie, one of the manual therapy founders, based most of his treatment methods on home training. His rational was that every one of us, repeats the same movements thousands of times a day and in order to fix a problem, we need to do the opposite movement in a significant way. This is where home training is the solution.

But, there are some difficulties when using home based exercise programs. For start, the patient has to remember the exercises and how to do them correctly and accurately. Otherwise he may harm himself. Second, he has to actually perform it, even if he is busy or in pain (this is the main reason why home exercises are not very effective today). Third, the PT does not get accurate feedback on how the patient actually exercised and what was his real progress.

Here, in BioGaming, we thought about how to make home exercises safe, actually performed and with real and accurate feedback to the PT.

Yugo, BioGamings’ game based exercise platform enables patients to execute PT defined exercise programs in a Kinect based game which is safe, fun and provides accurate feedback to the PT. In addition, the patient receives real time feedback on his accomplishments and enjoys his exercises.

Noa Russo Ayash, B.Sc.PT – Physical Therapy Field Expert

BioGaming Ltd.

The world of physical therapy is unique and interesting; in most cases, a PT works closely with his patience and has significant professional pride as his patents get better.

Rehabilitation is similar to a journey that a patient passes through, in order to get well. Some patients have to take a very long journey towards complete recovery while others are lucky enough to endure a short one. It all depends on the injury.

In most cases, the medical individual who escorts the patient in this journey is the physical therapist. The therapist considers the patient’s problems with all the medical training and knowledge in his possession. He plans treatments and builds a gradual program fitting the patient’s physical situation and capabilities supporting him throughout the entire rehabilitation process.

A key part of the rehabilitation process is the physical exercises program. It consists of exercises the patient performs daily - encouraging improvement to his/her initially limited performance. Part of the program is implemented at the clinic (using training aids) and some of it is self-administered at home. It is well known in the literature that in order to improve a certain physical skill, one must train and repeat the related physical exercise many times. If the minimal amount of training was not achieved, the purpose of the training will never be achieved (remember that phrase? No pain – no gain). Performing the program at home, is therefore, critical to a successful rehabilitation.

A good example is a patient that broke his ankle so bad that he required a fixation surgery.  In the first two month after the surgery, the doctor’s orders were to avoid any weight bearing on the injured foot. Of course, even though the patient is not walking normally yet, after those two months it becomes something essential. In order to do so, the muscles on the specific leg needs to be strong enough to carry the body weight.

Therefore, initially, the rehabilitation program will not include exercises that require stepping on the injured leg but will advance gradually to exercises encouraging and promoting muscle strength in the muscles participating in walking to allow the usage of the injured leg resulting in safe walking as soon as possible. The program, will later on, address more advance functions, such as exercises to promote running and jumping.

The process of rehabilitation is very demanding, patients are asked to make a huge effort with daily training, repeatedly, while enduring pain and getting bored. It all results in long hours of training and usually significant less compliance resulting in longer rehabilitation time.

Having a fun tool to make that rigorous training less boring and more challenging is a dream to many therapist and patients. It may change the entire exercise routine, make it better, both emotionally and physically and increase compliance significantly. Enjoying a rehabilitation journey, not just going through it. This is exactly were rehabilitation games take place. Gamification of physical therapy exercise routines is coming of age. Perform the same exercises while enjoy the excitement and joy of playing a game is what Yugo is all about.

www.biogaming.com