Virtual Reality for Older People

Persons older than 75 years of age are more susceptible to falls and are a greater burden to the healthcare system than their younger counterparts. While devices like the Nintendo Wii can potentially increase balance control, virtual reality games available for the Wii are not designed as exercise therapy programmes for older people. Targeted therapies are more likely to increase function and decrease falls risk. An interdisciplinary approach that integrates the knowledge of engineers with clinicians can enable the development of a virtual reality home-based exercise programme with off-the-shelf equipment. Several targeted exercise therapy games have been developed to encourage at home exercise using novel software with Wii balance boards and the Kinect Sensor.

Stepping game: The participant must stand on the back board (bottom in the image) and aim to hit the yellow target area on the other board with the foot shown on the side of the screen (in this case, the right foot). If the task is done correctly, the target will turn green. If the incorrect foot is used, the system alerts the user to the other foot and the user must step back on to the first board and try again. The user must correctly step before the system allows them to pass to the next trial. During this time, the system measures and saves the data from the reaction time (time to initial movement), the time for the movement, the amount of weight transferred when stepping as well as the size of step.

Balance game: A labyrinth game was developed that requires the user to shift their centre of pressure (on the balance board) to manoeuvre a ball into a hole (on a screen). There are three main components viewed on the screen by the user while balancing on the Wii board; the table, the ball and the hole. The table was designed to tilt in the direction of the user’s COP. The tilt angle was dependent on the distance of the COP from the centre of the board. The ball rolls in the direction that the table is tilted towards and its magnitude is relative to the angle of the tilt. The aim of the game is for the user to shift their weight to move the pink ball across the green table into the black hole, while avoiding the white holes.

Balloon catching game: Balloon volleyball is a common strategy for training balance. It is used as a method to challenge a person’s standing balance with a degree of perturbations that are unpredictable. Ankle, knee, hip and stepping balance control strategies are often employed as the balance challenge component of the task increases. However the activity requires at least two people to pass the balloon to each other. We chose to develop a game that would allow keen balloon volleyball players the opportunity to practice independently at home while also being able to quantify functional improvement while stretching and reaching. The purpose of this clinical task was to require individuals to focus on catching a balloon. The activity was designed to employ stepping balance control strategies where the participant was required to move outside their base of support, as well to incorporate bilateral synchronous upper limb strategies to catch the balloon.