Brain Training Online

The ELEMENTS system is a new interactive table top environment that supports movement assessment and rehabilitation for patients recovering from Traumatic Brain Injury.Credit: ZEDBUFFER
LONDON: The first virtual reality artwork for helping brain injury patients to better control their hand and arm movements has been successfully tested by Australian scientists.
ELEMENTS is a 42-inch tabletop TV on which patients can paint, play games and mix sounds by gesturing with brightly coloured, soft plastic shapes. It complements existing rehabilitation therapy for people recovering from brain injury by providing a fun way to practice skills and continuous feedback on their progress.
A team of researchers from RMIT in Melbourne has carried out initial studies on nine patients, reporting that they showed an improved ability to handle objects after using the system.
"The participants improved significantly in terms of their overall motor abilities," said lead author and experimental psychologist Nick Mumford of the study published in the journal Brain Injury.
How ELEMENTS works
Physical rehabilitation helps people with brain injuries rebuild their muscle strength. But many patients also struggle to turn a decision to move an arm into a controlled arm movement.
The ELEMENTS system helps people with brain injuries plan and refine their movements using sounds and animations to give feedback during games. The system has two game types - the sound-mixing game 'Mixer' and drawing games 'Squiggles' and 'Swarm' allow people to draw simple pictures and create music.
'Bases', 'Random Bases', 'Chase' and 'Go-No-Go' are training games where people try to beat their previous scores on tasks.
Stereo cameras constantly track the positions of the plastic shapes above the LCD screen to within 0.1mm and can generate graphs of patients' progress using the training games. "You don't have this capacity for automatic data collection in normal rehabilitation," said Mumford.
Putting brain training to the test
Mumford and his colleagues' study is among a growing number of tests of how virtual reality (VR) could help people with brain injuries regain their reaching, grasping and carrying skills.
Three men aged 20 or 21 with brain injuries from car accidents played 'Bases', 'Random Bases', 'Chase' and 'Go-No-Go' for 12 one-hour sessions over four weeks. In the 'Chase' game they had to drop the plastic cylinder onto a circle that appeared at random. In the more complicated 'Go-No-Go' game, they had to hit circles while avoiding pentagons, triangles and rectangles.
The two simpler games involved moving the cylinder from a base station onto circles that appeared randomly or in sequence. Water ripple animations, clicking sounds and a circle that drew lines below the cylinder helped the men know when they'd hit the target. The accuracy, speed and smoothness of their gestures were recorded using the stereo camera and used to create performance graphs.
An encouraging first step
The researchers found the men's accuracy and skill at moving the cylinder in a straight line to the target improved during the four weeks. They also got better at standard tests of movement control.
Since this initial study, the system has been tested again in nine men and women of various ages. "Our studies aren't large scale, but they're a first step. We're saying our first set of participants have shown that it might work so it's worth continuing with," said Mumford.
The next stage is "looking at taking the system we've got and trying it in different places with more people", said Mumford. ELEMENTS is now being tested on children with MS in London, and the team also plans to make the system more "user friendly for clinicians to operate".
Physical therapist and rehabilitation neuroscientist Mindy Levin at McGill University, Quebec, Canada, who was not involved in the study, said it was important as a "proof-of-principle". But she cautions about a study on three men with brain injuries: "we need to be careful not to draw too broad conclusions from small-scale studies."

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