August 7th, 2012Top Story The Rise of "Cyber Therapy," or How Games Became a Medical Treatment By George Dvorsky Today many doctors today say the best high-tech treatments are ones you can download from an app store. A trend in digital bootstrapping, using simple technology to solve complicated problems, reveals that the best cure isn't always a brand-new drug or gadget. Sometimes a simple iPad app or game can transform a troubled treatment into a successful therapy. This was the topic of discussion at a talk presented by Anitko's Kel Smith at the WorldFuture 2012 Conference held from July 28 to 30 in Toronto, Ontario. Smith has made a career of exploring and developing "barrier-free" digital experiences — particularly for those who need it the most. Simple tools to change behavior Smith noted how any therapeutic tool, regardless of its cost and technological sophistication, has to be measured in terms of its effectiveness. Ultimately, if the desired end is achieved, the device or intervention should be considered a success. As an example, Smith described the Grace app for iPhone and iPad. It's a simple device that helps autistic children and adults communicate more effectively and comfortably — and it does so by allowing them to build semantic sequences from a series of images that help them construct complete sentences. The app itself was developed to alleviate the frustrations often experienced by autistics when trying to communicate with neurotypicals. "People who are on the spectrum have a tantrum not because of the condition," said Smith, "but because they are being misunderstood." By using this affordable mobile app, autistics are finding new ways to communicate — and in a manner that leads to considerably less stress and angst. Smith also pointed to the example of Mason Ellsworth, a musical prodigy who became paraplegic after being hit by a drunk driver. Ellsworth became depressed and despondent after the accident, unwilling to re-engage in life. Then, after working with California based Smule Apps, he started to rediscover his musical roots by using the Ocarina musical software program. Because of its social nature, he was able to perform with other musicians over the net — and it completely transformed Ellsworth's world. "This simple app offered some tremendously positive emotional associations for Mason," said Smith, adding that "Competence is a continuum by which people adapt to their environment — how we measure that competence is by how you adapt to your environment." In this sense, Ocarina did the trick. Click to view Indeed, it was clear from Smith's presentation that it's often the simplest things that can make the biggest impact. Take the story of Lee Ridley, for example, a British man who is using a speech synthesizer to overcome his cerebral palsy and make a career doing stand-up comedy as The Lost Voice Guy. Playing games Therapists are often frustrated with their patients who, for whatever reason, fail to take their medications. According to Smith, medical nonadherence results in over 125,000 fatalities each year — the fourth leading cause of preventable deaths. In addition, 28% of people returning home from the hospital end up having to go back on account of insufficient touch-points. "We now live in a hi-tech, low-touch society," said Smith. Home visits are a way of addressing the problem, but this strategy has resulted in physical therapists having to drive a total of nearly five billion miles per year — more than UPS's annual run of two billion miles. "Drugs only work for those people who take them," said Smith. The trick, therefore, is to get compliance — and low-tech offers yet another elegant solution. By creating encouraging and fun video games, therapists have been able to motivate their patients into both remembering and administering their medications. The promise of reward, it would seem, can be a very powerful motivator. Games have proven to be particularly effective when working with children. Smith highlighted Medical Acoustics' Lung Flute for the treatment of bronchial conditions. Children don't like blowing into the medical device — but they're required to do so two to three times per day. It was by turning it into a game where the children could inflate and blow up a virtual balloon that the therapists got the compliance they were looking for. But games can be used for more than just compliance. Smith pointed out how Toronto's St. Michael's hospital is using the Nintendo Wii console to improve motor skills in patients by as much as 30%. He also noted how Microsoft's Kinect is helping autistic kids with their motor skills and coordination. Other games can simply create engagement where previously there was none. Waterloo Labs out of Texas has developed a DIY version of Super Mario that can be controlled by just using eye movements — what will be an entirely new gaming opportunity for quadriplegics. Changing realities Though a little bit more sophisticated in the technology department, virtual reality devices are proving to be helpful as well — tools that virtually any hospital can afford. Smith noted how therapists are increasingly taking advantage of a phenomenon called 'cognitive bonding' in which a person feels physically associated with their avatar. For people working through a physical injury or developmental disorder, the act of working with an avatar in a VR environment is allowing them to get more comfortable with moving their bodies through time and space. As they "virtually" move their bodies around, they get better. These tools are also helping with pain management. Pioneering work by Hunter Hoffman at the University of Washington's burn unit has shown that receptors in the brain that respond to heat also respond to pain. Hoffman has been able to take advantage of this phenomenon by transplanting a person to a snowy, blue, and snowman-infested virtual environment. The psychological impact of this "pain distraction" is so pronounced that therapists are no longer having to treat their patients with opiates. And as Smith encouragingly noted, "This cyber therapy, where we're separating body from the mind, is finally starting to gain credibility." Top image via bloomua/shutterstock.com. Inset images via wsa-mobile.org, buffalo.edu, hitlabs.

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