Indiana and Rutgers researchers have modified Playstation 3 video game systems to help teenagers with cerebral palsy improve their hand functions. In a pilot trial with three participants, the system improved the teens' abilities to perform a range of daily personal and household activities.

The modified system combined the gaming console with a Fifth Dimension Technologies 5 Ultra sensing glove, a flat-panel television, mouse, keyboard and digital subscriber line modem for Internet communication. Researchers reprogrammed the Playstation console using the open-source Linux operating system and developed games written in Java3D.

The systems were deployed in participants' homes for up to 10 months. A description of the modified system and its use in the pilot trial appears in  IEEE Transactions on Information Technology in Biomedicine.

Each system communicated via the Internet to allow the researchers to oversee participants' exercise routines and evaluate the effectiveness of the systems. The system is an example of both virtual rehabilitation, where patients interact with computer-generated visual environments to perform exercises, and tele-rehabilitation, where patients perform exercises under remote supervision by physical or occupational therapists.

"All three teens were more than a decade out from their perinatal strokes, yet we showed that improvement was still possible ," said Meredith Golomb, associate professor of neurology at the Indiana University School of Medicine. "The virtual reality telerehabiltiaiton system kept them exercising by rewarding whatever movements they could make, and all three showed significant progress in hand function."

For the pilot study, participants were asked to exercise their affected hand 30 minutes a day, five days a week, using games developed by Rutgers engineers. The games were calibrated to the individual teen's hand functionality. An on-screen image of a hand showing normal movements guided the participants in their exercises.

One game promoted range of finger motion by asking participants to clean up bars of "dirty" pixels on the screen to reveal an image. Another promoted finger movement speed by asking participants to flick away an on-screen butterfly. A third promoted hand opening and closing speed by asking participants to manipulate an on-screen unidentified flying object.

After three months of therapy, two participants progressed from being unable to lift large, heavy objects to being able to do so. Participants showed varying improvement in such activities as brushing teeth, shampooing, dressing, and using a spoon. At 10 months, one participant was able to open a heavy door.

"Systems like this have the potential for widespread deployment in outpatient clinics or the homes of people needing rehabilitation services for any number of illnesses or injuries," said Grigore C. Burdea, a noted inventor of virtual rehabilitation technology. "Well-designed custom games are likely to hold patients' attention and motivate them to complete their exercises, versus conventional therapy regimens, which patients may find boring or tedious."