Giovanni (invented name) raises his right arm and, moving his hand, pops the virtual bubbles that flow on the big screen in front of him, in the colored room that seems to come straight out of an amusement park. If it seems normal to you, it is because you don’t know that we are not in Gardaland, but inside the Care Lab in the Don Gnocchi Foundation in Milan. And, above all, that Giovanni is hemiplegic, he has cerebral palsy which severely affects the movements of his right arm.
What we are witnessing, in fact, is not a game, or rather it is a game but applied to rehabilitation. And the Care Lab is a laboratory that uses technology for the rehabilitation of patients in developmental age: inside there is a software (Virtual reality platform for motor and cognitive rehabilitation-Vitamin) which, through the use of virtual reality, allows to enhance motor and cognitive skills.
The idea of the Care lab was born in 2012, and became a reality in 2017, first at the Irccs “Santa Maria Nascente” center of the Don Gnocchi foundation and now also in the Ancona-torrette clinic. It is, explains the bioengineer Paolo Meriggi (he defines himself as “the point of connection between technicians and doctors”), “of a non-immersive virtual reality system. This is a precise choice, because the child must perceive the presence of the therapist and the ‘real’ reality, in a that the rehabilitation game occupies only a part of his visual field. This is because children who are in rehabilitation can also have cognitive deficits, so it is important that they are always aware of the therapist’s presence “.
The activities of the Care Lab are offered to children between 5 and 11 years of age, suffering from pathologies ranging from infantile cerebral palsy to developmental coordination disorders, from cognitive impairment to learning disorders to neuropsychological deficits (such as attention deficit, visual-spatial planning and short-term memory).
All the technological part is hidden so that the little patients have the impression of being in play spaces only, which is very important, explains Meriggi, “to stimulate the participation and motivation of children”.
Since the start of the activities, 170 children have been treated in 2017 through 3,207 rehabilitation sessions and over 150 games have been created for the rehabilitation of the upper limbs, and now work has also begun on the lower ones, thanks to special insoles in which motion sensors are inserted. All thanks to a multidisciplinary team that includes doctors, psychologists, child neuropsychiatrists, neuropsychologists, physiotherapists and, indeed, a bioengineer.
Play environments with different levels of difficulty are projected onto the walls of the room, with which the child interacts as if he were in a video game, constantly followed and accompanied by the therapist. Sensors and measuring devices constantly record activity.
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“Rehabilitation is based on the repetition of gestures and movements. We focus not on the gesture, but on the purpose of the gesture, in a playful way, in this way we obtain the result of keeping the attention on the exercise longer, playing and earning points. The therapist checks that the movements are correct “says the bioengineer.
The use of machines has more advantages. On the one hand, it relieves the therapist of the need to provide stimuli, which is a repetitive and tiring task. On the other hand, it allows you to keep track of progress over time and to review the sessions with a cool head (and from a third eye).
Finally, it allows the collection and measurement of data in a common form, allowing in perspective to build an archive of experiences and measures, fundamental for a scientific study – which is in progress – and an evaluation of the progress and usefulness of this system. of rehabilitation.
“The information recorded by the Care Lab – explains Laura Traini, child neuropsychiatrist and director of the outpatient and daytime rehabilitation activity of the Center – provide the necessary data to monitor the child’s rehabilitation path. The therapist can also personalize and adapt playful activities to the rehabilitation needs and characteristics of the patient, always starting from the project that is drawn up on the basis of a codified protocol, which provides for multidisciplinary assessments by a child neuropsychiatrist, psychologist, neuropsychomotorist, speech therapist and physiotherapist and specific tests at the beginning and end of the path “.
Inside the CARE Lab in Milan there is also an observation room, equipped with one-way mirrors that allow therapists and technicians to analyze the activities carried out by the child without interfering with them.
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The results that emerged in recent years have confirmed the effectiveness of the treatments, for this reason the Foundation intends to equip other Foundation centers with the same technologies in the various territorial contexts in which it operates, to welcome patients with different pathologies and to bring the activity home.
“We are working on a scientific study to measure the greater progress achieved with this system compared to the traditional one, that is, without the aid of virtual reality. At the moment, great effectiveness is emerging both in aspects directly related to treatment – for example those with problems motors improve in that area, if only because, being more involved, puts more effort into the sessions and these can last longer before the child gets tired or loses interest – but also positive side effects, for example on spatial organization “.
And in perspective?
The developments – concludes Paolo Meriggi – go towards augmented reality, the use of robots, and above all the transfer of part of the mechanisms and activities to patients’ homes, so that they can carry out at least part of the rehabilitation at home.