At 65, Arthur Halls is dealing with chronic obstructive pulmonary disease, severe angina, coronary blockage of the heart and hypertension – together these things have severely impacted his way of life. “Two years ago, there was very little I could do,” says Halls. “With your lungs and your heart and that, you’ve got to be very very careful.”
But that changed after he began fall-prevention therapy with the Medical Interactive Recovery System, or Mira, which uses video games for physical rehabilitation. Through a series of games that get users to do the kind of moves they’d normally be doing in physiotherapy, Halls feels like he can do a lot more.
“It’s about building the confidence up,” he says. “Now I have the confidence to do these games without any serious damage, unless I was very stupid and did something strenuous.”
Halls began using Mira two years ago as part of a study with Manchester University, which looked at how the games could help with fall prevention. Every Friday a group from Halls’s care facility gets together to play what has been dubbed “exergames”. They’re the last group left from the trial – and the hope is it will be picked up by the local council.
Another member of the group, Donald Long, had a hard time getting up and down the stairs. Now he says, it’s no trouble at all.
Mira was born in 2011, when chief executive and co-founder Cosmin Mihaiu – then a student in Romania – was brainstorming ideas for a software competition run by Microsoft. He took inspiration from when he broke his arm as a seven-year-old. His key memory wasn’t the pain or the cast: it was how mundane the physiotherapy was.
He says: “We all asked ourselves: ‘Would patients be interested in playing their way through recovery?’”
It’s part of a trend of gamification of the everyday. There are few aspects of life that can’t be turned into a game – from to-do apps that turn household chores or healthy eating goals into role-playing games, to fitness trackers that notify you of just how lazy you are when your friend goes for a 5km morning run. Even the most mundane tasks can become entertaining.
In Mira’s case, the rehabilitation exercises seven-year-old Mihaiu hated so much have been turned into addictive mini games. A Microsoft Kinect camera captures the user’s movements, which then translate into in-game actions. For example, raise your arm and move a bee from flower to flower to pollinate. Angle your body, and help a cartoon frog jump from lily pad to lily pad. And you can’t cheat – if you don’t do the right exercise, the camera won’t capture the movements.
“We wanted to make sure that everyone, no matter their age or condition, could get what they needed from the game,” says Mihaiu. “A lot of the commercial games are great for me, because I love playing them, but for a person who is older – in their 60s, say – they might be too complicated.”
Representing their home country of Romania, Mihaiu and his team placed top six in the Microsoft Imagine Cup in 2011. By the next year, their “exergames” had become the basis of their fledgling company. The group’s work has not gone unnoticed: last year it won an AXA Health Tech & You Award. Building on this success, Mira is now being used or trialled by 72 institutions worldwide, 23 of which are in the UK.
Dr Bibhas Roy, a consultant orthopaedic surgeon at Manchester University NHS foundation trust, who specialises in elbow and shoulder injuries, acts as a clinical adviser to Mira. He says he has seen the software have a positive effect on his patients’ motivation during physiotherapy – similar to how step counters motivate users to reach their allotted step numbers in a day. “We do it, because a little gadget tells us we’ve achieved something that day. Our brains want to chase these rewards,” he says.
“Rather than [telling patients]: ‘Do this exercise four times’, [they] make this frog jump and score some points. We know from the video game world that it really works.”
The games collect the data, showing how long it was used and how much movement patients were able to achieve, which a physiotherapist can then use to track progress. “This creates a feedback loop,” says Roy, “because you don’t want to disappoint your physiotherapist by not doing the exercises.”
Mira by no means replaces physiotherapists. In fact, they are the ones required to set the system up, even for home use. They also vouch for its effectiveness.
“There is a little bit of disbelief at first,” says Roy. “’Really? You want me to play a video game?’ But what overcomes that scepticism is that it’s their surgeon asking them. No patient to date has said they don’t want to do it.”
Mihaiu says their work with physiotherapists and doctors at hospitals around the world has helped them hone the system and find new ways to use it. “We have clients using it with older patients for preventative treatments, a critical care unit using it with patients in bed,” he says. “One hospital started using it in their neurology ward.”
Other requests keep coming in – one hospital is thinking of using it for burn victims, while another enquired about using Mira for the rehabilitation of amputees.
Having had some success using the Nintendo Wii in physiotherapy, senior physiotherapist Rebecca Scott, who works at the National Star college for people with disabilities, in Cheltenham, is excited about Mira’s potential. “It definitely motivates patients,” she says.
“My students have been through most of the routine physical therapy, like punching a balloon back and forth, but you can only do that for so long. The computer game gives me data on that same movement, and it’s that measurement that makes it a very useful piece of kit. The patients themselves see the results.”
The next step for Mira, as far as Mihaiu and his team are concerned, is to get it in front of as many people as possible.
“It’s a huge market, and I’m not talking from a business point of view,” he said. “There are thousands of patients who can benefit from it.”
We’re here to promote the people who dare to dream. Innovations in health technology are transforming the way we care for our minds and bodies. That’s why AXA is driven to discover and support the inventors of the future with their Health Tech & You Awards. Find out more about the 2018 finalists here: axahealthtechandyou.com
