• Knowing children's capabilities is more relevant than knowing their diagnoses. Also,knowing whether or not a condition is degenerative could be of some relevance.
• The game like Tetris with simple and repetitive input is a potential rehabilitaion therapy option.
  
• The idea of wireless botton is good because it enables more use possiblilities (i.e. push against the wall)
  

• A system made by Biometrics (Capital Equipment - Force Plate cost = $1500, Software cost = $4000) used at NYPCH. The interface for this system utilizes a series of mechanical (i.e. push, pull, rotate, etc.) controlling devices, as well as a myoelectric interface. "Games" come with the system are somewhat boring, majorly moving an object and place somewhere. The senesory/ measureing are very delicate to use. This system logs detailed data into personal record page from every perspective while users using it. From the enormous users manual, each of the games were described by
  i) Description
  ii)Human Requirements
  -Spatial Awareness
  -Concentration
  -Hand/eye Coordination
  -Stamina
  -Perceptual Skills
  iii) Special Attributes
  
• There was a version of Tetris on this system called Blocks. The attributes for Blocks were as follows:
  15. Blocks
  i)Description - Tetris
  ii)Human Requirements
  -good hand/eye coordination
  -concentration
  -perceptual skills
  -decision making skills
  iii)Special Attributes
  -fine movement and control required
  -engaging activity
  -visual tracking and scanning
  -quick reaction needed
  
• How this system use the reading to research purpose (quote from the manual):
  
  - Coefficient of Variation (CV)
  (Measure the variability of the measurements)
  (standard deviation of the measurements X 100)/averageAverage Correlation (AC)
  Compares the average of the three measurements (av1) in the standard grip test with the average of the eight measurements (av2) in the Rapid Exchange Test
  [(av1-av2) X 100]/av1
  
  - Average to Peak Ratio
  Ratio of average force to peak force
  (100 X Average)/peak
  
  Endurance in force/sec
  Rate of fatigue. A negative number is expected as the force is decreasing over time.
  
  [(End value - Peak Value) X 100] / number of seconds from peak to end

Roberta uses this system alot. Though thr tremendous database function is rarely being utilized due to the time/ busyness/ reality(the everyday life activities performance is more relevant then the number reading). She says that translation (carry-over) of the physical skills practiced in using this system is good. Patients practice repetitive motions using this interface to strengthen muscles and practice motions that might be difficult after and injury or surgery. Yet carry-over from the game to cognitve skills is not very proper. Game is often a ’splinter-skill’, meaning that the patient can become very good at playing the game, but not be able to problem solve, or plan ahead in other contexts.

She explained that in her hospital the OTs use a combination of criteria for making the decision to discharge a patient. For physical issues OTs look at:
-Flexion
-Abduction
-Strength
For cognitive issues they look at:
-Sequencing skills
-Left or Right side dominance
-Need for verbal or visual cues
They also do a functional evaluation of everyday life activities and how well a patient can perform them.

She suggested that our game might be a good way to subjectively evaluate a patient’s skills in the above mentioned categories. She also said that it could be useful if the OT was working on physical skills particularly:
-endurance
-range of motion
-strengthening
-balance (sitting, standing, rocking, etc.)

• Captain’s Log software by a company called Brain Train that attempts to correlate improved function with computer game playing.

personal note:

• The idea of having a design that needs repetitive gesture is interesing, the visual feedback with video game is really engaging and delights the therapy. And there are indeed some gesture we do daily and never think it as a problem but may be extremely difficlult for the pacient to do(i.e. twist the towel).

• Berry Visual Motor Intergration (VMI) Test, considering this as a possible evaluation tool for the theraputic merits of our tetris game.
• Kids go through ’spurts’. They keep an interest in something for a period of time, and then move on to something new. The trick is to maintain their interest. Where students were falling short in thier game playing is sometimes interesting.
• Shape recognition is important. Shape matching might be another useful alternative way to play the game. She suggested a game that requires players to choose and appropriate shape and remember where to put it later. Frequent variation in the form of the game would help to teach the cognitive skills that we hope our game will train.

a short talk with a new student, he was high school aged and talkative

• He stated that our version of Tetris was too easy for him. He stated that he needed it to be faster to make it challenging (or gradually becomes difficult as level goes up or the kind that game starts with pieces on the board), although he acknowledged that a slower pace to the game was more appropriate for some students.
• He talked about other games that he likes and mentioned Half Life, Battle Fear, Counter Strike, Pac Man, and Ms Pac Man. He said that he liked Metroid but that it was too hard for him. He mentioned that he wanted to see an alternative controller to an analog controller that requires two hands to use. He thinks the new Nitendo remote controllor is a very good idea because it is intuitive and requires only one hand. He suggested that video games could be social and that he thought a good idea would be to take the best players from our online database and put them together in some kind of tournament.
• “Tetris is addictive, people will play it.”

Enabling Device