Gamification of therapeutic effort
More than half of those with progressive multiple sclerosis (MS) experience motor impairment in their upper extremities, and typically one arm will be noticeably weaker than the other. This limited motor function not only prevents people from performing many daily tasks, but it can also impact their interactions in the community and negatively affect their quality of life.
Constraint-induced movement therapy (CI therapy) has been used successfully to improve range of motion in the weaker arm and also promote brain neuroplasticity, helping to strengthen the neural networks that facilitate arm movement. For some people, the positive effects from a single treatment of CI can last for years. But unfortunately, access to CI can be challenging due to the limited availability of qualified CI practitioners, the cost of the therapy and the several hours it takes for each treatment session.
To address challenges to CI access and promote upper extremity recovery, the research team for the Gamification of therapeutic effort project designed an immersive computer gaming rehabilitation platform. The platform is based upon the principles of CI therapy, and includes practices and strategies that promote increased use of the more affected arm. Clients play the computer game in their homes between consultations with a therapist, and a Microsoft Kinect camera tracks their hand and arm movements. This Kinect-based platform allows for continuous quantification of movement data, enabling real-time objective assessment of motor fatigue and subsequent motor recovery. Our initial findings indicate that this game-based intervention has the potential to partially reverse motor decline in progressive MS.In addition, people with MS commonly experience debilitating fatigue which has been linked to less efficient neural processing. We will examine objective markers of fatigue over the course of treatment as a person regains motor function, eventually providing a model for examining the fluctuations in neurocapacity that correspond with fatigue.