User's Manual

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Therapy Activity 4: Bird Forest
The Bird Forest activity incorporates standard functional exercises including dynamic
reaching and pronation/supination into a virtual reality activity by requiring the patient
to reach out with one or both hands to allow a bird to jump into their hand. Patients
have opportunities to reach from low to high, high to low, from left to right and vice
versa to practice functional reach. These exercises mimic standard functional
exercises that would be practiced during rehabilitation to help the patient regain skills
necessary to live at home with a degree of functional independence, and perform
activities such as unpacking groceries, cooking, unloading a dishwasher, self-care,
etc. HCPs may adjust various activity parameters through the tablet.
Sub-Activity 1: Free Birds
The patient must use their hand(s) to pick up a bird and then move their hand(s) to a
nest, also within arm’s reach, and maintain that position in order to deposit the bird
into the nest. Filling all nests with a bird will reset the activity so it can be played
again.
Sub-Activity 2: Nest Hop
The patient should use their hand(s) to pick up a bird and move it to a colored target
nest in a specific order under time pressure. This sub-activity will exercise both the
patient’s functional and cognitive ability. When a target nest has been filled, a new
target nest will appear, and our patient will have to move the bird from the previous
nest to the new target.
Sub-Activity 3: Bird Match
A bird will need to be picked up and matched to the corresponding colored nest.
When all nests have been filled, the exercise will reset.
Therapy Activity 5: Penguin Sports Park
In these activities, the patient must move their upper extremities to intercept an object
coming at them, in a time dependent manner. These activities require quick cognitive
processing and visual-motor integration to succeed, and thus are more advanced
activities for a neurorehabilitation patient. Other primary skills being challenged are
reflective movements, dynamic postural control, visual recognition, and motor control.
HCPs may adjust various activity parameters through the tablet.
Sub-Activity 1: Chuckleball™
The patient fends off approaching Chuckleballs by deflecting them with their head or
hands. The Chuckleballs will be kicked continually until a new activity is started.
Sub-Activity 2: Chuckleball Arena
Chuckleball Arena requires the patient to protect the goal from kicked Chuckleballs
coming from the penguin in front of them. Chuckleballs can be deflected by either
hand or the head. Depending on the plane of contact of the hand or head, the
Chuckleball will deflect in specific directions and advance patients can learn to defl
ect the Chuckleball into the opposing goal. Other objects and animals in the
environment can also serve as targets. The HCP can control how fast the ball travels
towards the patient, the distance the patient must reach to block the ball, and the
number of balls to be kicked at the patients.
Sub-Activity 3: Flying Fish
Flying fish is similar to Chuckleball where the patient must deflect a fish being pitched
at them with their head or hands. This may elicit a defensive response movement
from the patient in VR. Fish may turn from “good” blue fish which are supposed to be
deflected to “bad” red spiky fish, which need to be avoided. This requires extra
cognitive processing to decide, under time pressure, which fish should be contacted,
and which should be avoided, in addition to predicting where the fish are coming and
integrating proper movement to accomplish the task.