Thursday, 15 December 2011

Technology within therapy - Biometrics E-Link vs Nintendo Wii

For those who recognise the value of computers within therapy, they probably won't need to be told about the Nintendo Wii but its not the only use of computer gaming within rehabilitation, nor will it be the last.  One criticism of the Nintendo Wii is its lack of specificity, in that there isn't a piece of software that fully meets the needs of therapy.  It doesn't allow you to easily record progress in a manner that is in keeping with therapeutic need and it doesn't let you configure the software that you are using to allow the patient to work at a level and pace which is both suitable and comfortable alongside being therapeutically beneficial.

There are other alternatives on the market though and, unlike the Wii, The E-Link may not be as well known but similarly to the Wii it uses games to support therapeutic activities.  Produced by Biometrics, the E-Link is far more robust tool and treatment for therapists and does all that the Nintendo Wii currently does not.  It records  progression, prints charts, allows the therapist to set goals, targets, offers feedback, saves patient information securely, can be used as an outcome measure in its own right and significantly doesn't allow the patient to 'cheat' or not fully complete the required task/movement.

Its control mechanisms, used by the patient/client are interchangeable and are controlled by several devices.  The first measures angles (angle-x) produced by joint movements,  the second measures EMG muscle activity (myo-x device), the third is mechanical (upper limb kit) requiring patients to physically control a rotating wheel with a choice of handles or grips for hand function and finally a set of pressure plates that measure forces.   It is incredibly versatile and has few limitations, meaning that any joint can be exercised and worked in the way that is therapeutically beneficial.

On the downside the E-Link has two weaknesses - the graphics and the price.  Through discussion with colleagues, and use of the E-Link, the graphics are an obvious comment to make.  They don't come close to the detail or fluency that many have become accustomed to when playing mainstream console games - but developing console style games requires a phenomenal amount of financing which would only ever serve to increase the over all cost of the E-Link system.  From experience its worth mentioning that it shouldn't matter what the game looks and feels like - its the function and the achievements that count.  I still have very fond memories of ZX Spectrum games and would still happily play 'Colin the Cleaner' or 'Dizzy - Treasure Island' purely because I enjoyed the game despite the graphics being grittier than a bucket of course sand.  With the release of E-Links software - version 12 in the New Year the graphics are said to be one focus of improvement within the system and whilst the current graphic could be considered a weakness they certainly are not a flaw.

The price is the second contentious point.  With the Nintendo Wii now at an off the shelf affordable price of around £120 the E-Link, in contrast, costs considerably more.  The difference comes from the two systems being made for very different reasons.  The Wii is a gaming console that has, as an unintended offshoot, been commandeered by therapists and patients alike to enhance their physical well being and abilities.  The E-Link is a purposely designed piece of kit that demands high standards of precision in order to be reliably and specifically used within rehabilitation.

It is easy to comment and state that the Nintendo Wii does all that the E-Link doesn't, it justs costs less and has better graphics - but when the 'rose coloured Nintendo Wii glasses' are removed the Wii isn't so perfect.  The graphics may be exceptional but the games are never specifically designed for rehabilitation, you can't adjust the game play time or the level of difficulty to meet your patients needs.  The movements that are required are too forgiving, in that they don't need to be exact, creating the opportunity for imperfections in the control, and a reduction in the quality, of active movements.  It won't allow you to save specific achievements made by specific patients, or chart their progress and allow you to print out reports.

Often (especially in the early stages of rehabilitation) the games are too 'busy', colourful and so graphically interesting that they distract the patient from the therapeutic purpose of using the game.  Because the games are not designed for the use within therapy they are often quite difficult, setting up for failure, disappointment and potential disinterest from the patient.

Currently the Nintendo Wii can/should only be considered as a therapeutic tool, but those willing to pay the premium and purchase an E-Link system will find themselves offering computer gaming as an assessment tool and/or treatment.

For more information on the E-Link please visit the following website.

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