CONNECT & COMBINE GAMES AND REHAB/EXCERCISE DEVICES!

"Gabarello v.1.3r" & "Gabarello v.2.0"

The third-person side-scrolling RehabGames “Gabarello v.1.3r” and “Gabarello v.2.0” (short for “Game Based Rehabilitation for Lokomat“) are designed for the pediatric robot assisted gait-therapy [1]. From the patient’s point of view, “Gabarello v.1.3r” turns the Lokomat® from a physiotherapeutic tool into a full-body game controller. Patients influence both walking speed and abilities of a game avatar by the level of their active participation in the Lokomat® [2]. “Gabarello v.2.0” uses the “RehabConnex” for the connection of Lokomat® and “PITS” with the RehabGame. The dual task “Gabarello v.2.0” aims to shift the patient’s focus of attention from the gait locomotion to the upper extremities in order to further automate and improve gait training. In “Gabarello v.1.3r” the patient actively controls the walking speed of a game avatar through the detected biofeedback level of the Lokomat®. The avatar is a little astronaut named “Nicolo”, whose rocket has landed on a foreign planet. “Nicolo” walks around a rocky, dark planet, trying to set free as many lighting flowers as possible by colliding with these score-items. The flowers are distributed across the avatar’s path. “Gabarello v.2.0” is located on a different planet with obvious differences in vegetation, landscape design and atmosphere. The character encounters rose hips (score-items) and aims at red clouds (score-items) with an extra feature, a rocket-enhanced backpack, which is triggered by the patient’s opening and closing of the “PITS” glove. A hit at a red cloud results in rain, which leads to the growth of more rose hips. Each time “Nicolo” collides with a rose hip and sets it free, it will turn into a blue cloud. After one circumvention of the planet, these blue clouds will have become red clouds, again providing targets for “Nicolo’s” rockets.

Both games react to the biofeedback of the patient’s walk through thresholds, which can be adjusted by the therapist. Depending on the patient’s effort (resulting in the “PlayerWalkState” of the avatar) the points awarded by each score-item will vary between 1, 4 and 8. Initially each score item (flower or rose hip) has 3 points, which will be subtracted on collision with “Nicolo”, according to the current “PlayerWalkState”. For “Gabarello v.1.3r” the number of possible scoring items is finite and results in a maximal highscore; the scoring items are reduced over the elapsed training time. In “Gabarello v.2.0” the number of possible scoring items is infinite and is rebuilt over the course of the gameplay. The final score depends on the overall training time elapsed. Both games offer only positive incentives, even at minimal exertion. In addition to the scoring feedback, “Nicolo’s” shape and abilities vary according to the current level of exertion of the patient. The visual feedback of the patient’s effort is displayed through changes of the lengths of “Nicolo’s” legs and of a particle trail from his backpack. The level of exertion is also directly linked to three different walking speeds of the avatar, affecting Nicolo’s ability to jump over obstacles. The games take into account the trauma experienced by the patients and places balanced demands upon physical and cognitive abilities during the gameplay. For this reason, both rehabilitation games offer “active” and “resting” phases. During “active” phases the patient has to concentrate on the in-game events and react in time to be able to score points. The “resting” phases require less physical and cognitive effort.

In “Gabarello v.1.3r” the player strategically plans the avatar’s paths to collect as many flowers as possible. In “Gabarello v.2.0” the described mechanism of a constant transformation of clouds into rose hips and vice versa guarantees a continuous supply of score-items – the highscore depends on the overall gaming time. Both games use a side-scrolling camera to prevent the patient from typical coordination problems resulting from steering an avatar in the depth of perspective. Besides the therapist’s option to manually set the biofeedback thresholds, she/he can synchronize the movement of “Nicolo’s” legs to the walking rhythm of the Lokomat® and manually change the screen-zoom according to the demands of the patient.

References

[1] U. Götz, K. Brütsch, R. Bauer, F. Faller, R. Spoerri, A. Meyer-Heim et al. “A Virtual Reality System for Robot-Assisted Gait Training Based on Game Design Principles,” Poster presented at the Int Conf on Virtual Rehabilitation (ICVR) IEEE, 2011, pp. 1-2.

[2] A.L. Martin, U. Götz, C. Müller and Bauer, R., “Gabarello v.1.0 and Gabarello v.2.0: Development of motivating rehabilitation games for robot-assisted locomotion therapy in childhood,” in Proceedings of the 4th Conf on Gaming and Playful Interaction in Healthcare, B. Schouten, S. Fedtke, M. Schijven, M. Vosmeer, A. Gekker, Eds., Springer Fachmedien: Wiesbaden, 2014, pp. 101-104.

[3] A.L. Martin, U. Götz and R. Bauer, “Development of Task-specific RehabGame Settings for Robot-assisted Pediatric Movement Therapies,” In Proceedings of the 7th IEEE Consumer Electronics Society Games Media Entertainment Conference (GEM), IEEE Xplore Digital Library, 2014, pp. 1-4.

[4] A.L. Martin, U. Götz and R. Bauer, “IMIC – Innovative Movement Therapies in Childhood”, Neurol Rehabil, C., Dettmers, P.W. Schönle, C. Weiller, Eds., 20th ed., vol. 4, Hippocampus: Bad Honnef, 2014, pp. 215-225.