Mentally stimulating tasks you need to do 2x week to prevent dementia

 FYI.  I however do games on my smartphone.

video games (87 posts to March 2012)

Mentally stimulating tasks you need to do 2x week to prevent dementia

What activity has been shown to ward off dementia in a new study? Clue: It's one across and has nine letters.

In a recent study, doing a crossword at least twice a week was found to dramatically slow cognitive decline in older Americans compared to those who did this less often.

Other 'mentally stimulating' activities like reading a book, playing Sudoku or journaling also appeared to protect against the decline.

It's thought that these activities can help form new brain cells and boost connections in the brain responsible for memory. 

Researchers in Mississippi, Texas, and Illinois found that older Americans who did 'mentally stimulating' activities more than twice a week had a lower risk of cognitive decline than those who did so less often (stock image)

Researchers in three states followed nearly 6,000 adults over 50 for almost a decade and divided them into groups based on how often they participated in 'cognitively simulating' activities.  

Though all participants suffered memory decline with age, those who regularly picked up a book or a puzzle had consistently better memory and slower rates of cognitive decline over an eight-year period.

This lowered their risk of mild cognitive impairment (MCI), which can lead dementia in as many as nine in 10 patients. 

Dementia plagues more than 7million Americans per year, along with almost 1million Brits. And about 10million Americans and one in five Brits over 65 are diagnosed with MCI. 

Dr Jungjoo Lee, lead study author and assistant professor at the University of Southern Mississippi, told PsyPost the findings indicate that 'the cognitive care program needs a comprehensive design that includes physical activities, cognitively stimulating activities, and community engagements.

'Balanced therapeutic strategies incorporating all these healthy behaviors will boost cognitive health benefits rather than focusing on a single domain.' 

The study, published earlier this year in the Journal of Cognitive Enhancement, followed 5,932 adults recruited from the Health and Retirement Study (HRS), a database on aging Americans, from 2012 to 2020.

Participants ranged from 50 to 109 years old, with an average age of 68.

The team measured cognitive function by looking at memory, working memory, and attention and processing speed. 

Working memory is how long someone can hold on to temporary information, such as remembering an address while being given directions. 

Attention and processing speed measure how quickly the brain takes in information, such as letters while reading a book. 

Researchers measured these factors based on how fast they could recall words, basic math skills, and tasks like counting backwards. 

Participants were then divided into groups based on how often they did tasks like crossword puzzles or reading a book.

Though all participants saw memory declines, those who completed these activities more than twice a week 'consistently presented higher memory working memory, and attention than groups that participated less in the activities,' Dr Lee said.   

It's thought that brain games like crossword puzzles help stimulate brain cell growth and connections responsible for memory

It's unclear why exactly these activities slowed cognitive decline, but experts believe they may help stimulate brain cell growth and strengthen connections between brain cells responsible for memory.

There were several limitations to the research, with the main one being that researchers did not account for other factors that could have caused cognitive decline, such as other health issues, medication use, and unforeseen events like accidents. 

Additionally, there was a significant age range among the participants, with the youngest being just 50 and the oldest 109. As the risk of cognitive decline increases with age, this could have led to bias. 

Dr Lee said: 'Futher investigation is required to control internal and external confounders affecting healthy behaviors and each cognitive function.'  

The Surprising Mental Health Benefits of Video Games

 Does your hospital have these for you to play? You'll need to build persistence since your doctor knows nothing about actual stroke recovery and you will have to persist on your own.

The Surprising Mental Health Benefits of Video Games

Benefits are found even across first-person shooter games, which often spark controversy due to their violent content.

By Darren IncorvaiaMay 9, 2022 1:00 PM

(Credit: SolidMaks/Shutterstock)

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Video games tend to get a bad rap.

They’ve been blamed for countless violent crimes, including the 1999 Columbine high school massacre, and video game addiction was listed as an official medical condition by the World Health Organization in the latest revision of the International Classification of Diseases. Concerns about video games turning children into either violent criminals or antisocial outcasts permeate our pop culture now more than ever, but researchers have studied video game addiction and its negative health effects since the 1980s. What does the science say? Is playing video games actually bad for you?

The short answer: Not only is playing video games not inherently bad for you, but there are many mental health benefits that can come from gaming. “The vast majority of the research around video games is on the negative impact,” says Isabela Granic, a psychologist at McMaster University in Canada and director of the Games for Emotional and Mental Health Lab. “After a couple of meta-analyses, it’s pretty clear that there is no causation [between video games and real-world violence].” In fact, research by Granic and others has instead found consistent evidence for cognitive, motivational, emotional and social benefits.

Even first-person shooter games — like the Doom series that received a large share of the blame for the Columbine massacre — can give players “increases in abilities for spatial reasoning and spatial cognition in general, hand-eye coordination, multi-level problem solving, and so on,” explains Granic. “For the cognitive domain there’s probably at least two decades of good, solid research showing the benefits.” These benefits are found across shooter games like Halo, Call of Duty and Grand Theft Auto, despite these games often sparking the most controversy due to their violent content.

Try, Try, Try Again

From a motivational standpoint, many video games reward persistence and effort when it comes to solving puzzles or defeating bosses. These traits also have benefits outside of games. The “try, try and try again” mindset that video games reinforce can lead to academic benefits, and also promotes a view of intelligence that values effort over innate ability.

One example is the video game Cuphead, which received praise for its high level of difficulty that rewards patience, persistence and effort. This well-earned fun provides emotional benefits to gamers that are ultimately the point. As philosopher Bernard Suits put it in his 1978 book The Grasshopper, “playing a game is the voluntary attempt to overcome unnecessary obstacles.” It feels good to win, especially when you must work for it.

Community Over Content

On the other hand, many have written about online harassment in video games, and researchers recognize it as a problem. “There are plenty of people who play [massive multiplayer games like] League of Legends and hate the toxicity that goes along with it,” says Granic. “And they either stop playing or play with that in the background.” However, there are social benefits to playing games with others too: team-building, leadership skills and civic mindsets.

Playing games cooperatively has been shown to increase subsequent real-world cooperation, even when the game itself involves violent acts like shooting aliens. Even the most controversial games like Grand Theft Auto don’t seem to lead to more antisocial behavior. When it comes to playing these multiplayer games, the community is more important than the content. And some games, like Granic’s favorite, Journey, completely remove any direct communication between cooperating players. “I love that game, it was this great experience … it’s a social game, but you don’t have any talking,” she says.

Playful Experimentation

Beyond helping us work with others, video games can also help us look inward to learn more about ourselves. The games serve as escapist fantasies, in which we can play with aspects of ourselves that we might not be comfortable playing with in the real world.

A 2016 study, for example, looked at four individuals struggling with gender dysphoria and showed how gaming can help people come to terms with their gender identities in a safe way — such as by playing as a character with a gender expression different from their own. “That kind of playful experimentation and fantasy serves a real purpose in people’s lives when they can’t do it in their otherwise daily lives,” explains Granic.

Video games have been surrounded by stigma since Pong debuted in 1972 and launched them into the cultural mainstream. But negative press is not the same as evidence of negative effects. “Something like 97 percent of kids by the time they reach 18 are playing them daily, or certainly regularly,” says Granic. “It’s basically ubiquitous. Everybody is playing video games.”

Rather than serve as harbingers of the end of society, video games have blossomed into an art form that challenges us to play, fail, learn, work together and become more comfortable with ourselves. Just don’t listen too closely to what those people in the Call of Duty lobby are saying!

 

Stroke Therapy Video Game Just As Effective As In-Person Rehab

 So it is just as ineffective? Since no one ever factually discusses recovery percentages, this is not reassuring.

Stroke Therapy Video Game Just As Effective As In-Person Rehab

 

---

Mar 23, 2022

Photo: Getty Images

Here's today's feel-good story:

Having a stroke can inhibit a person's ability to have feeling in their arm, or have unexpected weakness and reduced movement.

While traditional rehab can be time-consuming, expensive, and tough to travel to, a team of researchers at the University of Missouri have utilized motion-sensing technology to develop Recovery Rapids, a video game that helps stroke victims recover.

“As an occupational therapist, I have seen patients from rural areas drive more than an hour to come to an in-person clinic three to four days a week, where the rehab is very intensive, taking three to four hours per session, and the therapist must be there the whole time,” said assistant professor in the MU School of Health Professions, Rachel Proffitt.

“With this new at-home gaming approach, we are cutting costs for the patient and reducing time for the therapist while still improving convenience and overall health outcomes, so it’s a win-win. By saving time for the therapists, we can also now serve more patients and make a broader impact on our communities.”

Read more here.

Video-Game-Based Stroke Therapy is as Effective as In-Person Rehab

So in other more truthful words it is also a complete failure at getting to 100% recovery. Tell the truth when you write titles. 

Video-Game-Based Stroke Therapy is as Effective as In-Person Rehab

After a stroke, patients may lose feeling in an arm or experience weakness and reduced movement that limits their ability to complete basic daily activities.

Traditional rehabilitation therapy is very intensive, time-consuming, and can be both expensive and inconvenient, especially for rural patients travelling long distances to in-person therapy appointments.

That’s why a team of researchers, including one at the University of Missouri, utilized a motion-sensor video game, Recovery Rapids, to allow patients recovering from a stroke to improve their motor skills and affected arm movements at home while checking in periodically with a therapist via telehealth.

The researchers found the game-based therapy led to improved outcomes similar to a highly regarded form of in-person therapy, known as constraint-induced therapy, while only requiring one-fifth of the therapist hours. This approach saves time and money while increasing convenience and safety as telehealth has boomed in popularity during the COVID-19 pandemic.

“As an occupational therapist, I have seen patients from rural areas drive more than an hour to come to an in-person clinic three to four days a week, where the rehab is very intensive, taking three to four hours per session, and the therapist must be there the whole time,” said Rachel Proffitt, assistant professor in the MU School of Health Professions.

“With this new at-home gaming approach, we are cutting costs for the patient and reducing time for the therapist while still improving convenience and overall health outcomes, so it’s a win-win. By saving time for the therapists, we can also now serve more patients and make a broader impact on our communities.”

MORE: Coffee and Tea Drinking May be Associated With Reduced Rates of Stroke and Dementia

Traditional rehab home exercises tend to be very repetitive and monotonous, and patients rarely adhere to them. The Recovery Rapids game helps patients look forward to rehabilitation by completing various challenges in a fun, interactive environment, and the researchers found that the patients adhered well to their prescribed exercises.

“The patient is virtually placed in a kayak, and as they go down the river, they perform arm motions simulating paddling, rowing, scooping up trash, swaying from side to side to steer, and reaching overhead to clear out spider webs and bats, so it’s making the exercises fun,” Proffitt said. “As they progress, the challenges get harder, and we conduct check-ins with the participants via telehealth to adjust goals, provide feedback and discuss the daily activities they want to resume as they improve.”

Nearly 800,000 Americans have a stroke each year according to the CDC, and two-thirds of stroke survivors report they cannot use their affected limbs to do normal daily activities, including making a cup of coffee, cooking a meal or playing with one’s grandchildren.

RELATED: In Learning to Use Her Left Hand Following a Stroke 60-Year Old Chen Lie Discovers She’s an Expert Painter

“I am passionate about helping patients get back to all the activities they love to do in their daily life,” Proffitt said. “Anything we can do as therapists to help in a creative way while saving time and money is the ultimate goal.”

This research was recently published in eClinicalMedicine, an open-access journal from The Lancet.

Source: University of Missouri

 

Mapping the human brain

 Since your doctor hasn't gotten you 100% recovered maybe you want to play this game to help other neuroscientists figure out the brain.

Mapping the human brain

 

Comparison of neuromuscular and cardiovascular exercise intensity and enjoyment between standard of care, off-the-shelf and custom active video games for promotion of physical activity of persons post-stroke

 I see no specific recommendations or protocols on what should occur post stroke to get recovered, so useless.

Comparison of neuromuscular and cardiovascular exercise intensity and enjoyment between standard of care, off-the-shelf and custom active video games for promotion of physical activity of persons post-stroke

• Judith E. Deutsch,
• Aurora James-Palmer,
• Harish Damodaran &
• Urska Puh 

Journal of NeuroEngineering and Rehabilitation volume 18, Article number: 63 (2021) Cite this article

• Metrics details

Abstract

Background

Active video games have been embraced for the rehabilitation of mobility and promotion of physical activity for persons post-stroke. This study seeks to compare carefully matched standard of care stepping activities, off-the-shelf (non-custom) active video games and custom active video games that are either self-paced or game-paced for promoting neuromuscular intensity and accuracy, cardiovascular intensity, enjoyment and perceived effort.

Methods

Fifteen persons (ages 38–72) with mild to moderate severity in the chronic phase post-stroke (average 8 years) participated in a single group counter balanced repeated measures study. Participants were included if they were greater than 6 months post-stroke, who could walk 100 feet without assistance and stand unsupported for three continuous minutes. They were excluded if they had cardiac, musculoskeletal or neurologic conditions that could interfere with repeated stepping and follow instructions. In a single session located in a laboratory setting, participants executed for 8.5 min each: repeated stepping, the Kinect-light race game, two custom stepping games for the Kinect, one was repeated and self-paced and the other was random and game paced. Custom video games were adjusted to the participants stepping volume. Ten-minute rest periods followed the exercise during which time participants rested and completed the PACES an enjoyment questionnaire. Participants were instrumented with a metabolic cart and heart rate sensor for collection of cardiovascular intensity (METs and % of max HR) data. Stepping frequency, accuracy and pattern were acquired via video. Data were analyzed using a RMANOVA and post-hoc comparison with a Holm's/Sidak correction.

Results

Neuromuscular intensity (repetitions) was significantly greater for the off-the-shelf and self-paced custom game, however accuracy was greater for the custom games. Cardiovascular intensity for all activities took place in the moderate intensity exercise band. Enjoyment (measured with a questionnaire and rankings) was greater for the custom active video games and rate of perceived exertion was lower for the custom active video games.

Conclusions

Custom active video games provided comparable intensity but better accuracy, greater enjoyment and less perceived exertion than standard of care stepping activities and a carefully matched off-the-shelf (non-custom) video game. There were no differences between the game-paced and self-paced custom active video games.

Trial registration: NCT04538326.

Background

Activity and participation are often limited for persons-post stroke. Mobility problems are reported by 58% of people in chronic stage after stroke, fatigue in 52%, and falls in 44% [1]. Low cardiorespiratory fitness and other impairments, such as decreased balance and muscle strength interact to drive post-stroke activity limitations and participation restriction [2]. People post-stroke may only manage to walk short distances, walk slowly, fatigue more often during everyday activities and are at greater risk for falls. Their sedentary lifestyle is related not only to decreased walking ability, but it also increases risk for another stroke and other cardio-vascular diseases, depression, psychosocial disfunctions and decreased quality of life [3]. Physical exercise programmes may serve to increase physical fitness and mobility of people post-stroke [2, 4].

Active video games (AVGs) became available for movement focused rehabilitation when gaming consoles such as the Play Station II (PS2) with the Eye Toy camera, the Nintendo Wii and the Microsoft Xbox with the Kinect camera were trialed by clinicians and tested by researchers [5,6,7]. Analyses of the non-custom AVGs associated with the consoles identified elements of motor learning and therapeutic exercise in order to guide the application of AVGs into physical therapy practice, as well as rehabilitation research [8,9,10,11]. Recent surveys of virtual reality and AVGs confirm that AVGs have become part of the repertoire of rehabilitation tools used for persons post-stroke. Physical and occupational therapists, surveyed about virtual reality and video games in both in Canada and the United States, report primarily using non-custom AVGs for commercial consoles such as the Nintendo Wii and the Microsoft Kinect to treat balance and fitness for persons post-stroke. [12] Boyne and colleagues [13] reported AVGs were used to promote aerobic exercise for persons post-stroke in a variety of clinical settings. AVGs appear to meet the need for rehabilitation of mobility and fitness deficits experienced by persons post-stroke.

Evidence to support these non-custom AVGs has been increasing with their potential application for rehabilitation of upper limb use, [14] balance and mobility [15] as well as promotion of physical activity (PA) [16, 17] for persons post-stroke. There has also been an interest in developing active custom games for upper limb use [18] and balance [19,20,21]. A rationale often proposed for incorporating AVGs into stroke rehabilitation is their potential to increase participant motivation. Several elements of AVGs may account for increasing or be associated with motivation; these include game mechanics (such as scoring), performance feedback, “the right level of challenge” and enjoyment [22]. In persons post-stroke in an inpatient setting who played upper limb games using a manipulandum to control a game displayed on a tv, the use of feedback was shown to be superior in improving movement speed and smoothness to games that did not provide performance feedback. Importantly, they also had greater motivation (measured with the interest and enjoyment subscale of the Intrinsic Motivation Inventory) with the game play [23]. Game mechanics that involved scoring and “operant conditioning” both yielded higher performance metrics when playing an upper limb labyrinth game with those features [24].

Enjoyment is proposed as an important construct to recommend AVG play [25]. It has been measured by the same group of investigators while persons post-stroke: (1) interacted with the PS2 Eye Toy, [5] (2) compared enjoyment while playing the PS2 and the Wii [26] and (3) played Kinect Sports and Adventure games [11]. Across all three studies, enjoyment was reported by persons post-stroke. Enjoyment was also identified as an important construct linking engagement for motor learning in virtual environments [27]. It is speculated that enjoyment is a factor that also promotes motivation and may lead to sustained and intense activity required for neural, musculoskeletal and cardiovascular plasticity required for stroke rehabilitation. In fact, several groups have shown that persons post-stroke exercising in virtual environments and AVGs achieve high levels of repetitions [28] and a higher number of repetitions (a measure of intensity) compared to standard therapy [29].

While the non-custom AVGs have shown promise and they are appealing because of their low-cost, high quality graphics and variety, they have several important limitations for incorporating them into therapy. Often, they are not user-centered, do not meet therapeutic goals, nor provide performance metrics, nor promote desirable movement patterns [30, 31]. One of the consistent limitations, of these off-the-shelf consoles and their games, reported by both clinicians and persons post-stroke, is the lack of control in adjusting exercise parameters such as speed or difficulty [32]. The lack of game control is especially true for game-paced, rather than player or self-paced games. AVGs and virtual environments may also not reliably promote optimal movement patterns [33,34,35]. This is particularly important for persons post-stroke who exhibit asymmetrical movements. The promise that some of these limitations could be addressed with games that were specifically designed for rehabilitation was heralded with the open development kit of the Kinect (STK). The combination of markerless motion capture with customized software could overcome some of the limitations of non-custom off-the shelf games as well the cost of more specialized systems. Several groups have developed custom games with the Kinect primarily for balance that allow customization and clinician control and have been shown to efficacious in rehabilitation post stroke [19] or superior to off -the-shelf analogs in older adults [36]. There are however, to our knowledge no studies that carefully compare movement performance, energetics and enjoyment of off-the-shelf video games with custom games as well as standard of care activities for persons with stroke.

Therefore, in this study we sought to compare if carefully matched standard of care activities and off-the-shelf AVG with customized AVGs produced a desirable exercise intensity and player experience for persons post-stroke. The specific purpose of this study was to determine if: (1) Movement outcomes of neuromuscular intensity (repetitions) and movement accuracy were superior when playing an off-the-shelf AVG, compared to custom AVGs or standard of care therapy, (2) Cardiovascular intensity outcomes of (METs and % of HR_max) were superior when playing an off-the-shelf AVGs, compared to custom AVGs or standard of care therapy, (3) enjoyment, game preference and perceived effort differed when playing an off-the-shelf AVG, compared to custom AVGs or standard of care therapy and (4) there was a difference in neuromuscular and cardiovascular intensity as well as enjoyment and game preference between the two customized AVGs that are self-paced compared to game-paced. We hypothesized that neuromuscular and cardiovascular intensity, would differ between custom AVGs, off-the shelf AVGs and standard of care; and that enjoyment would be greater and perceived effort lower for the custom AVGs compared to the off-the-shelf AVG and standard of care.

More at link.

 

Videogames to help rehabilitate stroke patients

 We don't need you to tell us the obvious, it's been known for over a decade.  

WE NEED YOU TO CREATE EXACT STROKE REHAB PROTOCOLS.

• video games (81 posts to March 2012 and I had video games 14 years ago)

But nothing like that will occur until we get survivors in charge.

Videogames to help rehabilitate stroke patients

A game controller helping stroke patients get back hand and arm movement by playing on the computer is set to start tests in a stroke unit. 

Expand

The NeuroBall is shown to help people regain strength and movement in their arms and hands after a stroke by making dull daily rehab exercises more fun.

1.5 million Brits have a stroke and 70% of them get weakness in their hands and arms, leaving many unable to even make a cup of tea or get dressed. 

Developers at Brunel University London and UK firm Neurofenix have won £60,000 from The Stoke Association and MedCity to take development to the next level.

Dr Richard Francis, head of research awards at the Stroke Association, said: “Neurofenix and Brunel University London will explore how this new hand-held console and app could improve the recovery of hand and arm movement at vital, earlier stages of recovery.

“They will also look at whether the new technology can be cost-effective for the NHS.” 

Stroke survivors can play nine themed video games holding the Neuroball console, which uses AI to track arm and hand movements and send feedback to an app. Developed by the team at Brunel along with Neurofenix and stroke survivors, it’s designed to motivate users to do hundreds of physio reps from home without even realising it.

"Our vision is to enable stroke survivors and patients suffering neurological conditions to regain their independence. Brunel University London helped us validate how our technology can aid stroke survivors,” said Neurofenix’s Dimitris Athanasiou.

Hospital stroke rehab patients move their arm and hand an average 32 times in a session. But survivors who played videogames with the Neuroball practiced an average 17 hours a week, notching up 15,000 reps over seven weeks, an earlier study showed.

Starting in January, the new study will track stroke patients who are in an earlier stage of recovery, first at Hillingdon stroke unit and then their first weeks at home. 

 

 

Boy, 15, has stroke after 22 hours a day playing computer games

Be careful out there, specially if you are trying to rehab using Fruit Ninja, although that one requires full arm movements.

Choice of Human–Computer Interaction Mode in Stroke Rehabilitation - Fruit Ninja

The latest here:

Boy, 15, has stroke after 22 hours a day playing computer games

A teenager in China has been unable to move his left arm and hand after binge-playing computer games for a month.

The 15-year-old, nicknamed Xiaobin, indulged in video games for about 22 hours a day while staying at home during the coronavirus lockdown, his mother said.

He was rushed to a hospital in southern Chinese city Nanning after he suddenly passed out at home.

The event was recently brought to light by Nanning Television after Xiaobin had been receiving treatment at the Jiangbin Hospital in Guangxi province since the incident.

The Year 9 student had been staying at home since February after schools across China were closed due to the coronavirus outbreak.

Xiaobin’s mother said that her son spent most of his time in his bedroom during the school closure.

When his parents asked what he was doing, Xiaobin replied that he was taking classes online.

The parent told reporters: ‘He shut the windows and locked the door. We had no idea what he was doing in there.’ 

The mother later discovered that Xiaobin had been playing computer games non-stop for some 22 hours a day.

She said: ‘I saw his online conversation with friends. He said he wasn’t well rested and was sleeping for at most two hours a day.’ 

The teenager was rushed to the Nanning hospital in March after he had suddenly collapsed at home.

Xiaobin was diagnosed with a cerebral stroke after undergoing a CT scan. He also lost sensation in his left arm and hand.

Dr Li, a brain specialist at the hospital, said that the boy’s condition was caused by his unhealthy lifestyle of binge-playing computer games and staying up late.

She told the local media: ‘The main reason is that he had irregular sleeping and eating patterns because he wasn’t at school. The parents also tolerated his behaviours too much.

‘A lack of nutrition and rest had led to a reduced amount of blood and oxygen in his brain and caused a cerebral stroke,’ said Dr Li. 

The young gamer has since been receiving rehabilitation treatment at the Nanning hospital. 

Dr Jin, a chief therapist at the facility, said that it was difficult to determine whether Xiaobin could ever fully recover.

Video game addiction has become a prominent societal issue among the young people in China, with an increasing number of young people choosing to ignore their studies, social lives and family to play online games.

Many parents use the so-called ‘digital detox’ rehab camps as a last resort to curbing their children’s fixation on the digital world.

Internet addiction is considered a clinical disorder in the nation.

12 emerging technologies that could revolutionize medicine - one for stroke

I only show the one we are really interested in. But it shows you the complete incompetence of the stroke medical world and our fucking failures of stroke associations. These video games should have been rolled out years ago. Even today I'm sure there are no protocols on how they should be used. You are just going to get lazy guidelines and hope like hell YOU can figure out to recover because your doctor knows nothing and does nothing.

• Kinect (34 posts to June 2012)

• video (115 posts to February 2012)

• video games (79 posts to March 2012)

• Wii (10 posts to March 2012)

• Wii-based Movement Therapy (3 posts to December 2016)

 

12 emerging technologies that could revolutionize medicine

What happens when you gather dozens of healthcare experts from Massachusetts General, Brigham and Women’s Hospital, and Harvard Medical School and ask them to predict what will change medicine in the next year or so? What you’ll get is the “Disruptive Dozen”—an authoritative list of the 12 innovations mostly likely to have a significant impact on healthcare by the end of 2021.

Twelve new technological innovations, the Disruptive Dozen, could revolutionize healthcare in 2020, Harvard experts predict.

This list is the result of interviews with 100 medical experts from the facilities noted above (among others), followed by a rigorous selection process, to identify 12 emerging technologies with the potential to “disrupt” healthcare in the next 18 months, one of which could even help us gain some ground against COVID-19. These innovations were presented as part of the World Medical Innovation Forum, held virtually on May 11. 

Video games for stroke patients

For individuals who’ve had a stroke, recovery often requires intensive physical and cognitive therapy to regain impaired or lost functions. This can be a long and difficult struggle that challenges patients’ willpower and their bank accounts. Now, clinicians are increasingly turning to video games—from standard consumer units to sophisticated virtual reality systems—to help increase patient motivation(You can't be motivated if you have no protocol because guidelines have nothing concrete about them,) and compliance, as well as expand access to rehabilitation services. 

“In the area of stroke, gaming technologies and virtual reality technologies have recently been shown to be virtually approximate to therapies for upper extremity stroke. In the area of limb dysfunction, virtual technologies are also enhancing sensory impairment as well as motor impairment. What we can do, then, is deliver ‘mass practice’ to people—delivering more to many and changing the world,” said Ross Zafonte, DO, senior vice president, Research Education and Medical Affairs, Spaulding Rehabilitation Network, and Earle P. and Ida S. Charlton professor and chair, Physical Medicine and Rehabilitation, Harvard Medical School. 

“These kinds of interventions have [both] a near-term and then a long-term benefit,” Dr. Zafonte explained. “And we're just starting to understand who might benefit the most, how we can deliver it, and what are the worldwide implications of delivering mass practice to many.”

Impact of game mode in multi-user serious games for upper limb rehabilitation: a within-person randomized trial on engagement and social involvement

No protocols, so USELESS.  Start guessing what might help you. I expect our stroke medical professionals to know EXACTLY what needs to be done for rehab. This is totally worthless.

Impact of game mode in multi-user serious games for upper limb rehabilitation: a within-person randomized trial on engagement and social involvement

• Fábio Pereira,
• Sergi Bermúdez i Badia,
• Rúben Ornelas &
• Mónica S. Cameirão 

Journal of NeuroEngineering and Rehabilitationvolume 16, Article number: 109 (2019) | Download Citation

Abstract

Background

Serious games have been increasingly used for motor rehabilitation. However, it is not well known how different game features can be used to impact specific skills properly. Here, we study how the mode (competitive, co-active, collaborative) in which a multi-user game is presented impacts engagement and social involvement.

Methods

We collected data from 20 pairs of community-dwelling older adults (71.5 ± 8.7 years) in a study following a within-persons design. The participants performed a two-player upper limb rehabilitation game with three conditions (Competitive, Co-active, and Collaborative modes). Engagement and social involvement were assessed through the Core Module and Social Presence Module, respectively, from the Game Experience Questionnaire. To infer the impact of personality and cognitive function, users answered the International Personality Item Pool (short version) and the Montreal Cognitive Assessment, respectively.

Results

Results show that the Collaborative game mode promotes more social involvement when compared to Competitive and Co-active modes. This result is mostly explained by those participants with higher cognitive skills, and those that are more extrovert. Extrovert participants feel more empathy and are behaviorally more involved when playing the Collaborative mode. Also, the Collaborative mode is shown to be appropriate to promote interaction with participants that previously had a distant relationship, while the Competitive mode seems to be more beneficial to promote empathy between players with a closer relationship.

Conclusions

The Collaborative game mode elicited significantly higher social involvement in terms of Empathy, Positive Affect, and Behavioral Involvement. Hence, this game mode seems to be the most adequate choice to be used in multiplayer rehabilitation settings, where social interaction is intended.

Background

Serious games have been widely studied concerning their impact on improving physical and social skills with elderly [1], mostly because of their potential to increase motivation levels compared to conventional therapies [2, 3]. Moreover, the therapeutic potential of games for the elderly is well documented, with results showing a positive impact on their health and well-being [1]. However, while one of the most critical elements of successful aging is to conserve social relationships [4], research on how to appropriately address social experiences with serious games is still scarce [1]. Also, social interaction through multiplayer games has been underlined as an essential aspect of motor rehabilitation because it supports enhanced enjoyment during interaction and an increased sense of self-efficacy [5]. In fact, stroke survivors with low levels of social support have a greater risk of developing depression [6]. A longitudinal study examined the impact of social support in 5643 participants that had experienced a heart attack or stroke, with results indicating that the risk of developing depression is very contingent to the level of social support [6]. Moreover, social support is a modifiable factor that can mitigate the impact of illness on depression, and higher social support could improve the outcomes [6]. In another study, Janssen et al., investigated how social activity of stroke patients undergoing rehabilitation changes over time [7]. After analyzing data from a sample of 14 participants, the authors concluded that the levels of social activity were low even after improvements in the levels of independence and mood. These data highlight the need to explore alternative ways of social stimulation within rehabilitation environments [7].
One way to foster social interaction is through multiplayer modalities, which typically promote more socialization than their single-player counterparts [8]. For rehabilitation purposes, the design and specific characteristics of these games should be carefully analyzed, to identify the features that influence motivation and engagement levels, which in turn could have an impact on recovery. One feature that potentially can have an impact is the playing mode. I.e., inter-player relationships can be of one of the following four kinds of interaction: competitive, co-active, cooperative or collaborative [9, 10]. However, the literature typically addresses competitive, collaborative and cooperative modes only [11]. In addition, most of the studies that addressed game modes focused on competitive vs. cooperative, or competitive vs. collaborative, not establishing a difference between cooperative and collaborative modes [8, 12,13,14,15,16]. The main difference between cooperation and collaboration is that cooperation requires players to work together to complete a task but having different roles, while collaboration implies players to have the same role and still needing to work together to complete the task [9, 17]. Moreover, there is no consistency in nomenclature. Some modes of training identified in previous studies should be named as co-active instead of cooperative, as they imply that players work together to reach the same goal with the same task, but they do not depend on each other to finish it [9, 10]. Considering these different definitions, research on collaborative games is lacking. To our best knowledge, only a minority of studies differentiated the three above mentioned game modes [18], and according to a systematic review on multi-player games, there is no research comparing them [11].
Multiplayer rehabilitation games show good potential for producing greater enjoyment and more intense exercise in comparison to single-player modalities [8]. A study with 12 pairs of unimpaired participants concluded that participants prefer to cooperate than to exercise alone, feeling less pressure in this mode [19]. Another study that linked patients with their spouses in rehabilitation through haptic interaction found that multiplayer modes were more motivating when compared to single-player modes [20]. Nevertheless, the right game mode, when comparing competitive vs. collaborative modes, for a specific person depends on skill and personality, alongside with having an appropriate co-player [8]. A study with 158 healthy adults found that a co-active mode caused higher levels of motivation and effort in comparison with a competitive mode, but motor performance was similar in both [21]. An interesting result of this study was that the level of relationship (friends vs. strangers) also influenced players’ motivation, goal commitment, and performance. Those who played with friends showed greater goal commitment than those who played with strangers [21]. In contrast, several studies indicate that competitive modes motivate players more, resulting in more intense performance, and are associated with more movement repetitions [12, 15, 22, 23].
Here, we aim to understand the impact on engagement and social involvement of different multiplayer settings, specifically aiming to distinguish collaboration and cooperation. For this purpose, we deployed a game in three different modes (Competitive, Co-active and Collaborative) and tested these in a sample of healthy older adults (> 55 years). We decided for a sample of older adults without motor deficits to avoid potential confounds brought by stroke, which is known to impact cognitive, motor, emotional or social domains. We believe that a sample where these domains remain relatively intact represents a good baseline to assess the impact of these game modes on engagement and social involvement. Next, with a stroke population it will be possible to better understand how these results are modulated by the deficits brought by stroke. Our first hypothesis is that engagement will be significantly higher in the Competitive mode when compared to Co-active and Collaborative modes. Our second hypothesis is that social involvement will be significantly higher in the Collaborative game mode compared to Competitive and Co-active modes. Additionally, we want to understand how the results are modulated by the cognitive profile, personality, and previous relationship between co-players.