Posts Tagged ‘stroke’

Kata Project logo

Kata Project logo

Stroke. The word is enough to drive fear deep into the stoutest of hearts. They strike with little or no warning, and without rapid and adept medical attention, they can be fatal. For survivors, recovery is by no means certain: about half come through the experience permanently disabled—debilitated and dependent, cutoff from bodies they can no longer control. Every year, nearly 800,000 people in the United States fall victim to stroke’s crushing hammer, their lives often irreparably altered.

Sadly, the standard approach to stroke therapy offers little hope. It’s rooted in the science of centuries past, is driven by economics, and at best is often too little, too late. The current model—an hour each of speech, physical, and occupational therapies per session—is 150 years old, says Justin McArthur, director of the Department of Neurology at Johns Hopkins University, and “not adequate or up to today’s scientific knowledge.”

Dr. John Krakauer, professor of neurology and neuroscience at Hopkins, is less diplomatic. He has only one word for the contemporary state of stroke rehabilitation therapy: medieval.

If you have a stroke in the United States,” he says, “you’re better off if you’re a rodent than if you’re a human being.”

In his eyes, it’s high time for a revolution. And he knows just the dolphin to lead it.

Dr. Krakauer has a reputation for challenging the status quo—and ruffling not a few feathers in the process. He came to Johns Hopkins in 2010, and immediately began recruiting for a bleeding-edge stroke recovery research center, taking a wrecking ball to the traditional staffing model. Krakauer’s BLAM lab (brain, learning, animation, and movement) includes robotics and software engineers, an animator, a computer scientist, and, as consultants, an animal intelligence expert and the director of animal programs at the National Aquarium in Baltimore. Together, they form the brain powering BLAM lab’s Kata Project, whose mission is to create computer games for post-stroke rehab and neurological research. But the heart and soul of the project is a dolphin named Bandit.

Bandit’s no ordinary marine mammal: he’s a digital amalgam of three of the National Aquarium’s bottlenose dolphins, with a pinch of spinner dolphin for spice. The team spent countless hours studying the animals, distilled their research into the essence of dolphin-ness, translated that into digital form, and gave virtual birth to Bandit—a cybernetic dolphin that moves with the grace and fluidity of the real thing. A user (ideally, a post-stroke patient) controls Bandit on a screen, via movement of his or her arm placed in a robotic sling. For all intents and purposes, the player becomes Bandit. Omar Ahmad, director of the Kata Project, describes the effect as being “jacked into the creature.”

It’s visceral feedback; every subtle movement you do is reflected in the dolphin.”

But why go to all this trouble? Why create such a hyper-realistic, detailed virtual creature in the first place? Because movement—early and often—is key to recovering from a stroke, and taking on the role of a beautiful aquatic mammal is far more engaging and fun than anything conventional physical therapy has to offer. According to Krakauer, there’s no reason why the PT environment has to be bleak and depressing.

Why shouldn’t a hospital be more like a gaming arcade? Why can’t it be a place where you want to explore and play?”

He makes a valid point, but the idea of using games for therapy is not exactly groundbreaking. Physicians and therapists have turned to the Nintendo Wii to aid in stroke recovery for years. Others, like Yale University’s Dr. Adam Noah, have noted the ability of Dance Dance Revolution and other so-called exergames to reduce symptoms of Parkinson’s disease (and they may even help repair damaged areas of the brain). And senior centers and assisted living facilities often have the Wii on hand so that residents can get up and moving, and stay active with something that’s both enjoyable and accessible (I’ve covered this in previous blog posts, as well as in my book, Virtual Ascendance: Video Games and the Remaking of Reality).

What’s new with Krakauer’s team is their intent, their focus. Bandit is the first virtual creature designed to help stroke patients get better (of course, he’ll have many other uses, but that’s his original purpose). And the BLAM lab is the first medical research facility dedicated to the idea of creating computer and video games specifically for physical therapy (as opposed to adapting off-the-shelf games to the task).

But more than that, it’s Bandit himself. He is delightful and engaging, and he responds so intuitively to the motions of the person controlling him that it effectively erases the line between player and object: you become him, and you can’t help but get caught up in his gracefulness, his antics, and his sheer joy at simply being alive. Stroke rehabilitation can be a lonely and forbidding process. For those setting out on this journey, slipping into Bandit’s skin and moving through his watery world—creating a deeply emotional connection to a creature whose every movement is the paragon of grace—may be the beacon guiding them down the long, hard road to recovery.

You can read more about Dr. Krakauer’s research in the National Geographic article here.

To watch a video of Bandit in action, check out this link.

You can learn more about the Kata Project here.

Krakauer’s team is also developing an iOS game based on Bandit called I Am Dolphin. You can read about it here.

And there are two more articles about video games and stroke therapy here

… and here.



I’m feeling a bit dishonest about something. Well, maybe that’s too strong a word. Let’s say disingenuous. Careful readers will have noticed that I’ve been engaging in a little linguistic sleight-of-hand with respect to games and health. I’ve argued that videogames can help treat a variety of physical and mental issues, and then gone on to talk about how people are adapting existing technology and developing new games to meet a specific health need. And there’s nothing wrong with that. In fact, it’s part of what makes videogames such a powerful tool.

“But wait,” you say. “These aren’t real videogames. They’re just training tools. Regular people can’t go out and buy them. How can a standard, run-of-the-mill Xbox or Wii game—you know, a real videogame—make people better? What do they have to offer? Where’s the evidence? Wait. Have you been lying to me all this time?”

Okay, okay, take a deep breath and sit down for a second. First of all, I have mentioned some real games in earlier posts, but… okay, mea culpa. You got me. Keep reading, though, ‘cause this is for you.

Playing the Wii can help you recover from a stroke. And I don’t mean some custom-built, made-for-rehab game here. I’m talking about the standard Wii Sports that anyone can go out and buy for 30-40 dollars (less if you’re a smart shopper). How do I know? Because videogame designer and overall genius Kent Quirk—who happens to be a friend of mine—actually did it. Regular sessions playing Wii Tennis and Wii Bowling were part of his post-stroke rehab. Kent summed it up this way:

Being able to stand up for 10 minutes and play a game of Wii Tennis was a real victory for me. And I certainly wasn’t going to go out on a tennis court and play real tennis at that point. So that was motivating and helpful to me.”

Motivating and helpful. Now contrast that with standard physical therapy. PT—or pain and torture, as it’s affectionately known by many who’ve gone through it—is painful, repetitive and downright boring. The problem is, it’s also necessary. So how can you take a treatment modality that’s vital for recovery and make it, well, fun?

Make a game out of it. Dr. Gustavo Saposnik, a neurologist and director of the Stroke Outcomes Research Unit at St. Michael’s Hospital in Toronto, has been studying clinics and hospitals that do just that. Here’s what he found:

Basically, we found that patients in the Wii group achieved a better motor function, both fine and gross, manifested by improvement in speed and grip strength.”

The Wii’s not just for stroke rehab, either. It can be used to help people recover from things like broken bones, surgery, and even combat injuries. Why? Like traditional PT, the Wii uses the same principles of performing repetitive, high-intensity tasks that help repair damage. The difference is that the Wii makes it fun. Says James Osborn, who oversees rehab services at southern Illinois’ Herrin Hospital,

When people can refocus their attention from the tediousness of the physical task, oftentimes they do much better.”

At WakeMed Health’s facility in Raleigh, NC, patients from nine to 89 play Wii games to improve strength, endurance and coordination. According to Bill Perry, a retired police officer and WakeMed patient who used the Wii to help recover from a stroke,

It really helps the body to loosen up so it can do what it’s supposed to do.”

Doctors and therapists at Walter Reed Army Medical Center agree. They find that Wii therapy works very well for patients injured during combat operations in Iraq. Here’s Lt. Col. Stephanie Daugherty, Walter Reed’s chief of occupational therapy:

They think it’s for entertainment, but we know it’s for therapy.”

And what happens when you turn therapy into entertainment? Patients are more motivated to do it, they stick with it longer, and they get better faster. It remains to be seen whether active videogame systems like the Wii, Playstation Move or Xbox Kinect will ever replace traditional PT. But this much is undeniable: they sure as hell make it more fun.

To read more on how doctors use the Wii for therapy, check out this link.

For an overall summary of how the Wii is used for PT, click here.

You can see some videos of the Wii in action here.

For more info on stroke rehab and the Wii, click here

… and here.

And for an ABC news story on how senoirs use the Wii for rehab, click here.