Who and where are we Presenter: From Funen hospital Tonny Jæger, Development-physiotherapist and Master of Information Technology From Funen hospital Birgitte E Mathiessen Peder Jest, Niels E. Pedersen From Maersk Mc-Kinney Møller Institute for Production Tech. University of Southern Denmark Henrik Hautop Lund From Entertainment Robotics Thomas Klitbo From MedCom Lars Hulbæk Thank you for your nice introduction. As you mentioned, im working as a development-physiotherapist at the department for physiotherapy at Funen Hospital (Sygehus Fyn). We are located on Funen, and we like to mention us self as the heart of Denmark, the place where famous people are born, I could mention APM, who founded the Maersk Mc-Kinney Møller shipping company, he is born in Svendborg, near the Funen hospital where this developmemt-project goes on, and of cource i could mention HCA, he is born in Odense, where the other 3 co-operators are comming from. We are a part of the co-operation between the Maersk Mc-Kinney Møller Institute for Production Tech. Placed at the University of Southern Denmark, the firm Entertainment Robotics and the Danish Centre for Health Telematics

Once upon a time In the summer 2000, professor Henrik Hautop Lund and Thomas Klitbo from the Maersk Institute started a collaboration with Kompan playground systems and equipment Together they thougt out the idea of body games from passive vertical soft- ware games to active horizontal ”play- ware” games It started at the Mærsk institute, which has the aim, to let academia and industry work in collaboration, and develop new technologies for intelligent systems. The Institute’s core research areas are among others: modern artificial intelligence and its usage in robots and other technological artefacts. In this aim professor Henrik Hautop Lund and Thomas Klitbo from the Maersk Institute started a collaboration with Kompan playground systems and equipment They found that inactivity and overweight, especially among children, is a growing problem in the industrial countries. That was why they develloped ”Body games”. The principles is to go from passive vertical software games (like ”Game-boy) to active horizontal ”playware” games, as you see at these pictures, where the children have to act physically at the computer interface.

From playing to training If it is possible to make children move, why do we not try to use the same principles to make our patients train? And maybe it is possible to be better to document the effect of various movements in the physioterapeutic treatment too? Tonny,- try it out! The ”group 4” met with different interests: Professor Henrik Hautop Lund, he was interested in cooperating with the the market, The head-doctor of Funen hospital, Peder Jest, and the head of the The department of therapy, Birgitte Mathiessen, both were interested in developing new rehabilitation tools And Chief-consult Lars Hulbæk, from The Danish Center for Health Telematics, he was interested in spreading out electronic communication in the health sector. They found that I, as project leader, should try out the ideas in a prototype development and – test of the new rehabilitation tool. Pay attention at ”various movements”. Today it is of course possible to document the effect of precise movements, as bicycling and rowing. It is possible to measure joint mobility and muscular strength, but what about measuring functional everyday movements ”We want to develop and test a prototype of a new rehabilitation tool”

From then to now The end of 2005 Spring 2006 Summer 2006 Automn + winter 2006-2007 2007 ”Group 4” took action Ideas + wishes to the prototype Prototype develoment and cross-sectional brain-stormings Fieldtrials and report First meeting with the cardiac group + RESTORE As mentioned, the ”Group 4” took action 1 and ½ year ago. The first ½ year of 2006 was an very interactive periode, were therapists, IT-develloppers, designers, doctors etc. brougt up ideas and wishes to this new tool. Along with the development of the tool there frequently has been crosssektional brainstormings, which has been very exiting. I´ll promise you,- it´s 2 very different worlds meeting each other. The next slides tells about the process, from last spring until now. One could say from Tromsø Telemedicine and e-healt Conferense 2006 until Tromsø Telemedicine and e-healt Conferense 2007.

Ideas + wishes to the prototype Both floor and wall-based tiles More light (direction) Plain surface Easy to model This is the original playground version, wich we had following ideas and wishes to develop: Both floor and wall-based tiles Looking down at the floor all the time was a problem for the heartpatients, and the PT´s want to motivate the patients for moving both arms and legs (the whole body) More light (direction) It has to be easy to see the light, and it would be better if there is light were you have to step. Plain surface Plain surface No bulps, for elderly patients. Easy to model That means,- fore example easy to change from floor to wall, from a square to a long and slender ”catwalk”

Prototype development The designer at work The programmer at work As you se the designer has started from the bottum, he has made each tile a little bigger, the light is made as a circle (a ”ring of fire”) where you have to step, and even though you ar stepping at the ”ring of fire, you can see the light. Infrared connections is made instead of plugs For the safety, magnetic joints is made to secure the tiles from seperating, the bottom is made non-skidding, and the hardware is placed in a secure box that holds more than 200 kilo before breaking down. One of the tiles is made as a ”master”-tile, which decides every light-direction. If you are using the vertical an horisontal version at the same time, radio-connections is nessesary between the horisontal an vertical tiles. The designers and programmers have succeeded to comply with our ideas and wishes, and furthermore making the tiles light, easy to work with, and easy to recharge.

The prototype tiles Both floor and wall-based More light Easy to model Magnetic connections Plain surface More light Colour shift with heavier weight Possibilities in direction making Easy to model No plugs Magnetic and infrared connections Easy to recharge And here you are, the first 2 tiles, with the wanted qualities.

The fieldtrial http://www.sygehusfyn.dk/wm216477 (Start først original colourrace) As a training tool, the original playing game, was still popular. Cometition is a great motivation factor, also to heartpatients. (start dernæst øvelser brugt i tests) In the fieldtrial, we did test the use and the effect of the prototype. Following tests was performed: Colourrace floor, pay antention to the similtarity with handplayer movements. Colourrace wall, pay atention to the requirement to the patients orientation and reaction ability. Unfortunalely it wasn´t possible to test the combined version of colourrace floor and wall, while it wasn´t develloped from the start of the fieldtrial. Long step, pay attention to the requirement to the patients balance ability Stepper, pay attention to the lights in front of the patient, the colour change the quikker she steps.

Some of the results from the fieldtrial Fitness training with colourrace and stepper (>75% hrm) Coordination training with colourrace at wall Balance training with longstep ”It´s a needed new individual training device Competition is motivating Further development is needed, e.g. Easier to use for the patients More possibilities for the therapist Better reliability The whole report (in Danish) at http://www.sygehusfyn.dk/wm214159

Further possibilities today After the fieldtrial has started, several possibilities develloped, e.g. (skift til videoklip m. andreøvelser) Colourrace floor + wall, pay attention to the need for orientation both at the wall and the floor. Radio connection between wall and floor is needed Simon says, pay attention to the difference from the other games, this one doesnt require quick movements, but kognitive skills, to remember the patterns of light.

Possibilities in the future http://www.steptest.dk/index.php What about a standadized test, today we are using the staircase-climbing test, but no staicases are standadized. (Video ideer til øvelser igangsættes) What about remote training and monitoring, e.g. at home. RESTORE Remote stroke rehabilitation. What about a walk at the intelligent floor, where patterns and weight can be supported

Thank You for Your attention Any questions?