Summary
Background: The functional connectivity and structural proximity of elements of the language
and motor systems result in frequent co-morbidity post brain injury. Although rehabilitation
services are becoming increasingly multidisciplinary and “integrated”, treatment for
language and motor functions often occurs in isolation. Thus, behavioural therapies
which promote neural reorganisation do not reflect the high inter-system connectivity
of the neurologically intact brain. As such, there is a pressing need for rehabilitation
tools which better reflect and target the impaired cognitive networks.
Objectives: The objective of this research is to develop a combined high dosage therapy tool
for language and motor rehabilitation. The rehabilitation therapy tool developed,
MaLT (Motor and Language Therapy), comprises a suite of computer games targeting both
language and motor therapy that use the Kinect sensor as an interaction device. The
games developed are intended for use in the home environment over prolonged periods
of time. In order to track patients’ engagement with the games and their rehabilitation
progress, the game records patient performance data for the therapist to interrogate.
Methods: MaLT incorporates Kinect-based games, a database of objects and language parameters,
and a reporting tool for therapists. Games have been developed that target four major
language therapy tasks involving single word comprehension, initial phoneme identification,
rhyme identification and a naming task. These tasks have 8 levels each increasing
in difficulty. A database of 750 objects is used to programmatically generate appropriate
questions for the game, providing both targeted therapy and unique game-play every
time. The design of the games has been informed by therapists and by discussions with
a Public Patient Involvement (PPI) group.
Results: Pilot MaLT trials have been conducted with three stroke survivors for the duration
of 6 to 8 weeks. Patients’ performance is monitored through MaLT’s reporting facility
presented as graphs plotted from patient game data. Performance indicators include
reaction time, accuracy, number of incorrect responses and hand use. The resultant
games have also been tested by the PPI with a positive response and further suggestions
for future modifications made.
Conclusion: MaLT provides a tool that innovatively combines motor and language therapy for high
dosage rehabilitation in the home. It has demonstrated that motion sensor technology
can be successfully combined with a language therapy task to target both upper limb
and linguistic impairment in patients following brain injury. The initial studies
on stroke survivors have demonstrated that the combined therapy approach is viable
and the outputs of this study will inform planned larger scale future trials.
Keywords
Multidisciplinary - motor rehabilitation - language rehabilitation - stroke - brain
injury - games based therapy - Kinect
