Together with therapists, patients and gaming companies, we are developing games for rehabilitation technology or e-health applications to improve treatment outcomes in healthcare. Under supervision or independently, patients can train with a schedule of exercises that gradually become more difficult. Games motivate and facilitate therapy compliance. Via the game, therapists can receive feedback about progress and adjust the game settings where necessary.
To help determine how to provide each target group with an appropriate game, we itemised which groups of people prefer specific types of games and translated this information into guidelines for the design. For example, elderly people prefer quieter games in which they can discover new worlds and that do not have a clear final goal.
Various applications
We deploy games in various manners. In the first place, we use games in combination with other technology, such as robotics, to train the gait function, for example. In these cases, we mainly use the game to motivate people to keep doing these exercises.
Another option is using the game itself for rehabilitation therapy. For example, we have used mixed reality in an application to train arm/hand function. A video projector projects a game onto a table and the rehabilitants control the game by picking up, moving (reaching out for), manipulating and letting go of real objects.
In a third approach, we use games in e-health solutions to motivate people in their daily lives to do exercises or to change their lifestyle. For example, we are working on a HealthNavigator that uses tourist information to persuade people with heart conditions to go for a walk. During the walk, we measure the heart rate and activity and coach the patient based on this information. For example, if the user becomes tired, he or she will receive a tip on how to shorten the route.
Working method
Together with end users, care professionals and patients, we itemise which requirements and wishes a game should satisfy. We translate the user requirements into technical specifications, design targets and boundary conditions for the game. We always develop the content of the game in several iterative stages in which each design cycle ends with a test phase performed by end users. Within these play tests, we examine whether the game elicits the right behaviour. We also assess whether end users find the game attractive. Based on the outcomes of these tests, we refine the design to realise a new prototype. This cycle is repeated until a well working prototype has been designed. We subsequently deploy the game in everyday care and investigate the use, motivation and clinical effects.
Projects
VIREP – Virtual Reality to support chronic pain rehabilitation
VIREP is a Virtual Reality application with biofeedback to support chronic pain rehabilitation. VIREP offers a motivating and safe virtual environment where clients can repeatedly practise daily activities and train their body awareness.
AIRplay – Gaming for children with asthma
AIRplay is an innovative gaming concept to support self-management of children with asthma. AIRplay consists of a personalised, gamified app for monitoring and coaching in daily life and an interactive playground where children can play together, e.g. in the hospital.
HandsOn – Mixed-reality game for arm and hand function training
By linking reaching, grasping and releasing of a physical object to the control of a game, an intensive, motivating and meaningful training is accomplished. Moreover, this hybrid approach also results in a very natural form of sensory feedback, e.g. touch, proprioception and eye-hand coordination.
Gryphon Rider – Balance game
Gryphon Rider is an applied exergame for balance training. The game is controlled by the player’s movements. By making adjustments, the challenge of the game can be matched with the skills of the individual rehabilitant. Different difficulty levels are available, with progressing balance exercises.
Other projects within this expertise
Please contact
Monique Tabak is associate professor at the University of Twente and Roessingh Research and Development, with a background in Biomedical Engineering. She focuses her research on Personalized eHealth Technology for Rehabilitation, including self-management programmes for COPD and comorbidities, cardiac rehabilitation or asthma, but also interactive eHealth technologies like Virtual Reality for chronic pain. She specifically investigates the shared-decision making triangle between healthcare provider, patient and technology. She has vast experience in eHealth research for patients with chronic conditions and within rehabilitation by participating in >20 (inter)national research projects (e.g. BIONIC (H2020), IS-ACTIVE (AAL), InLife (H2020), VIREP (Interreg), TOPFIT CitizenLab (Regiodeal) and in close collaboration with local care centres and patients. In addition, Monique is part of the management team of the cross-faculty, transdisciplinary research programme at the University of Twente. She is also programme coordinator ‘Health and Well-being’ in the Digital Society programme from the Association of Universities in the Netherlands (VSNU).
Publications:
Tabak M, Dekker-van Weering MGH, van Dijk H, Vollenbroek-Hutten MMR (2015). Promoting daily physical activity by means of mobile gaming: a review of the state of the art. Games for Health Journal, 4(6), 460-469. https://doi.org/10.1089/g4h.2015.0010
de Vette A, Tabak M, Dekker MGH, Vollenbroek-Hutten MMR(2015). Engaging elderly people in telemedicine through gamification. JMIR Serious Games, 3(2), e9. https://doi.org/10.2196/games.4561
Tabak M, Brusse-Keizer M, van der Valk PDLPM, Hermens HJ, Vollenbroek-Hutten MMR (2014). A telehealth programme for self-management of COPD exacerbations and promotion of an active lifestyle: a pilot randomized controlled trial. International Journal of Chronic Obstructive Pulmonary Disease, 9(1), 935-944. https://doi.org/10.2147/COPD.S60179
Tabak M, Vollenbroek-Hutten MMR, van der Valk PDLPM, van der Palen JAM, Hermens HJ (2014). A telerehabilitation intervention for patients with Chronic Obstructive Pulmonary Disease: a randomized controlled pilot trial. Clinical Rehabilitation, 28(6), 582-591, https://doi.org/10.1177/0269215513512495
Tabak M, op den Akker H, Hermens HJ (2014). Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD. Patient Education & Counseling, 94(3), 372-378. https://doi.org/10.1016/j.pec.2013.10.014
Link to publication list on personal website: http://eprints.eemcs.utwente.nl/view/author/Tabak,_M.html
Anke is a human movement scientist working at Roessingh Research and Development since 2001. She got her PhD at the University of Twente in 2010 on a randomized controlled trial, in which the effect of an implantable two-channel peroneal nerve stimulation was examined in comparison with usual care, consisting of a splint or orthopedic shoe, in chronic stroke survivors with a drop foot.
Currently she is involved in several (inter)national research projects concerning stimulation of motor relearning in neurological disorders using rehabilitation technology (including (soft)robotics and applied gaming), mainly for the upper extremity.
Publications:
Radder B, Prange-Lasonder GB, Kottink AIR, Holmberg J, Sletta K, van Dijk M, Meyer T, Buurke JH, Rietman JS (2018). The effect of a wearable soft-robotic glove on motor function and functional performance of older adults. Assistive Technology, 30, 1-7. https://doi.org/10.1080/10400435.2018.1453888
Prange GB, Kottink AIR, Buurke JH, Eckhardt MM, Rouweler BJ, Ribbers GM, Rietman JS (2015). The effect of arm support combined with rehabilitation games on upper extremity function in sub-acute stroke: a randomized controlled trial. Neurorehabilitation and Neural Repair, 29(2), 174-182. https://doi.org/10.1177/1545968314535985
Kottink AIR, Prange GB, Krabben T, Rietman JS, Buurke JH (2014). Gaming and conventional exercises for improvement of arm function after stroke: a randomized controlled pilot study. Games for Health Journal, 3(3), 184-191. https://doi.org/10.1089/g4h.2014.0026
Kottink AIR, Tenniglo MJ, de Vries WHK, Hermens HJ, Buurke JH (2012). Effects of an implantable two-channel peroneal nerve stimulator versus conventional walking device on spatiotemporal parameters and kinematics of hemiparetic gait. Journal of Rehabilitation Medicine, 44(1), 51-57. https://doi.org/10.2340/16501977-0909
Ellis MD, Kottink AIR, Prange GB, Rietman JS, Buurke JH, Dewald JPA (2011). Quantifying loss of independent joint control in acute stroke with a robotic evaluation of reaching workspace. 2011 Annual International Conference of the IEEE, Engineering in Medicine and Biology Society, EMBC, 8231-8234. https://doi.org/10.1109/IEMBS.2011.6091940