New research published online in the Journal of Critical Care from Johns Hopkins researchers claims that video games are a good supplement to traditional physical therapy for patients in intensive care units (ICU).
"Patients admitted to our medical intensive care unit are very sick and, despite early physical therapy, still experience problems with muscle weakness, balance and coordination as they recover,” says study lead Michelle E. Kho, P.T., Ph.D, assistant professor of Physical Medicine and Rehabilitation at Johns Hopkins. "We are always looking for creative ways to improve rehabilitation care for critically ill patients, and our study suggests that interactive video games may be a helpful addition."
Johns Hopkins researchers selected 22 critically ill adult patients to use video games over a one-year period as part of routine physical therapy. These patients were also part of a group of 410 patients who received standard early physical therapy in the medical ICU during the same time frame from Hopkins’ physical therapists. The patients in the study were mostly males 32 - 64 years-old and were admitted to the medical ICU due to such health problems as respiratory failure, sepsis, and cardiovascular issues.
Over the one-year period, the 22 patients participated in 42 physical therapy sessions using Wii Fit and Wii Sports. Almost half of the 20-minute sessions included patients who were mechanically ventilated. Participants played boxing, bowling and games that made use of the balance board. The physical therapists chose the activities primarily to improve patients’ stamina and balance.
"As always, patient safety was a top priority, given that healthy people playing video games may be injured during routine gaming, but when properly selected and supervised by experienced ICU physical therapists, patients enjoyed the challenge of the video games and welcomed the change from their physical therapy routines," says senior author, Dale M. Needham, M.D. ,Ph.D., associate professor and medical director of the Critical Care Physical Medicine & Rehabilitation Program at Johns Hopkins.
Needham added that video game therapy activities were short in duration because the timing was ideal for severely deconditioned patients, and cost less than most ICU medical equipment. As an addition to regular physical therapy, the video games helped boost patients’ interest in therapy and motivation to do more of it. While the results were good, researchers cautioned that even more research is needed to determine whether the video games improve patients’ abilities to do the tasks that are the most important to them.
"Our study had limitations because the patients were not randomly selected, the video game sessions were infrequent and the number of patients was small," Kho noted. "Our next step is to study what physical therapy goals best benefit from video games."
You can learn more about John Hopkins research at www.hopkinsmedicine.org.
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As a game maker and the co-president of Games for Change, I was thrilled to be invited by Kotaku to discuss some of the recent developments in the field of games for learning, health and social impact. Games for Change, founded in 2004, is a non-profit and a global advocate for games that have positive impact on our society.
Ironically, this growing global movement has gained more recognition and support from the general public than it has from game makers and hard-core gamers.
We're partially to blame. The hyperbolic premise that games will "change the world" works well as a press headline, but it's less effective with those who understand the limitations of the media and how difficult it is to create a compelling game, let alone a game with a purpose.
So instead of dreaming about what's possible, I want to share some examples of games and game-related projects that are already making a difference and why we should care.
Games in the classroom
When the 82-year-old Supreme Court Justice Sandra Day O'Connor took the stage at the 2008 Games for Change Festival and announced her intention to use games to teach civic education in the U.S., many were skeptical. But they were sympathetic to her notion that most U.S. kids can name the three judges on American Idol but not the three branches of Government. Since then, her iCivics team, along with Filament Games, created a rich portfolio of civics games that are integrated into 12,000 classrooms in 50 states.
Since August 2009, iCivics has reached 1.2 million players, and evaluation data show that 78% of students surveyed gained a better understanding of how their government worked. 47% even continued playing at home just for fun!
See also: The Quest to Learn school, led by game designer Katie Salen.
You should care because: you want to see schools that are more adjusted to the 21st century and provide compelling experiences for their students.
Games in the developing world
Social entrepreneur Dr. Paul Polak famously said that the majority of our world's designers are focusing all their efforts on products and services for only 10% of the population. The other 90% (5.1 billion people) live on less than $10 a day. And in many developing countries, the system fails to teach kids even the most basic skills. More and more international development organizations–-USAID, the World Bank, the UN, and private foundations–-are looking into gaming technology to bridge some of these gaps.
ZMQ, an Indian game developer, has led one of the best-known efforts in this space with their Java mobile games that focus on HIV/AIDS. Their games have reached 67 million devices with 10.3 million sessions registered. Evaluation showed significant increases in learning and qualitative research showed changes in attitude and safer sex practices.
See also: Play Power, creating educational games for $10 8-bit TV consoles
You should care because: impacting the hardest to reach with games is a lofty goal. But these low-cost solutions are creating significant learning opportunities in developing countries.
"Social impact games" can also inspire real-world action, as players are one click away from making a donation, volunteering their time, or gaining the ability to further investigate an issue. An intriguing example is FreeRice from the United Nations World Food Programme (WFP). It's a basic multiple-choice quiz, however, for every question you get correct, 10 grains of rice are donated to the WFP.
Every day, the FreeRice website generates 8 million page views and enough rice to feed 2,500 people (45 million grains of rice to be exact). Designers and developers in our community are working diligently on the next generation of Direct Action games–-with tighter alignment between gameplay, content, and outcomes partnered with a strong social component.
See also: Zynga.org, which raised more than 10 million dollars for non-profit organizations through the purchase of ‘sponsored' virtual goods.
You should care because: breaking the boundaries between the virtual and the real world is a great place for innovation, with straightforward goals and measurable impact.
Young Game Makers
The Scholastic Art and Writing Awards have celebrated students' artwork since 1923 with past winners like Andy Warhol and judges like Langston Hughes. The year 2010 was the first during which "video games" were recognized alongside drawing, photography, and sculpture. It's not only about the perception of games as art—there has also been an increasing body of research that proves the process of making a game and structuring a world with constrained rules enhance "21st century skills," such as systems thinking, problem solving, iterative process, and more.
In 2011, this idea gained serious support when President Obama announced the National STEM Video Game Challenge. Students were invited to utilize game making tools to create new ways to teach Science, Technology, Engineering and Math. The unique challenge saw over 500 entries with 12 winners receiving laptops, educational software, and funds for their schools.
See also: Gamestar Mechanic published by the Institute of Play and E-Line Media.
You should care because: the next generation of game designers are starting early.
New innovation and new funding
There's a long history of public funding for innovation, art, and media. Sesame Street and Mr. Rogers wouldn't be on the air without it. (You can watch Fred Rogers' riveting Senate testimony that helped US public TV keep millions in funding here.)
Together with other organizations, we helped the National Endowment for the Arts (NEA) introduce grants for the creation of digital games. These grants range from $10,000 to $200,000 and exist to support games "that can be considered works of art".
Check also: Game grants by the National Endowment for the Humanities.
You should care because: indie game makers now have new avenues for funding and innovation.
Evaluation and brain research around games
When people question the genuine impact of games beyond raising awareness or PR stunts, my favorite example is Re-Mission by Hopelab—a video game for young people with cancer. A non-profit from Redwood City, their real power is integrating cutting-edge research into everything they do. Their evaluation process led to a publication in a medical journal that proves young cancer patients who played Re-Mission took their drugs more consistently than those in the control group. They also collaborate with researchers at Stanford to analyze brain regions that are activated during gameplay.
See also: Daphne Bavelier's research on how Call of Duty is actually good for you.
You should care because: it will help us all understand the power and the limits of this media – and it's also kind of cool.
We're entering a new and exciting phase. If you consider stage one the point where we spent all our efforts raising awareness and stage two the time spent using hyperbole that gained wider public interest—then now we're entering the third stage of establishing this field: "making it real". We have some early strong proof point, but a long way to go.
The main challenge is that Games for Change are difficult to make and easy to do poorly. You need to form a complex partnership between people who don't speak the same language. Broadly, there's a gap between people who love to play and make games for what they are, and people who want to harness this power for social good – the educators, social innovators, non-profits and government agencies. Until now the latter group dominated the conversation.
To follow the steps of other popular media, like public TV or documentaries, we need to create a robust eco-system and a real opportunity for creators. We need more and better games for change to be created, and of course, more people to play them and use them in real-life. We need the general public to take notice and gain access. That might only happen when we'll see the Angry Birds of social impact games-–the first runway success and household name. That hasn't happened yet, but it's up for grabs.
So if you ever get tired of the big budget games, sequels or yet another expansion pack, and you want to exercise some social responsibility – join the ride. There was never a better time to play in this emerging field. Besides, we can't really do it without you—the people who simply love games.Asi Burak is the Co-President of Games for Change. He's an award-winning executive producer (PeaceMaker, Play the News), and a faculty member of the new MFA in Design for Social Innovation at the School of Visual Arts in NY. Twitter: @aburak
Nice chart to see the breath of games shown at E3 across the three major platform holders, Microsoft, Sony and Nintendo.
Nintendo seem to have showcased more games around their portable product then their home console unit.