High-tech therapies: treatments and entertainment

Innovation in healthcare takes unexpected turns when it moves away from drugs. Using music or games, the EuroMov Digital Health in Motion* research unit is developing cutting-edge therapeutic treatments for movement rehabilitation.

"A king without entertainment is a man full of misery". Pascal's thought may well have inspired EuroMov DHM's movement science researchers, as several of their innovations combine treatment and distraction. Firstly, through music, whose virtues for walking and balance inspired the BeatMove smartphone application. " By imposing an external rhythm, music improves walking in people suffering from Parkinson's disease," explains Benoît Bardy, a professor of movement and health sciences. With his team, he is developing software capable of adaptively synchronizing music with step cadence.

In practical terms, patients need to equip themselves with a smartphone and headphones, as well as insoles fitted with motion sensors. " During the first minute of walking, the
algorithmdetects step characteristics to parameterize the application and choose the corresponding song," explains Benoît Bardy. The BeatMove software draws from a database of almost 600 tracks to find the one that matches the right cadence. As there's no question of upsetting the walker, he can choose from five musical genres: pop, rock, classical, variety and jazz.

Halving the number of falls

"The great innovation of this algorithm is that it adapts the rhythm of the music to that of walking in real time. The app manages a 10-20% variation in cadence to compress or expand the music, without it being noticeable to the ear. Then, if the walker's rhythm changes too much, the app automatically changes the track," explains Benoît Bardy. The choice of music was made with the University of Ghent in Belgium, to cover a very wide range. " The artificial intelligence used also enables the algorithm to anticipate movement, to manage parasitic events such as climbing a sidewalk, to manage changes in rhythm such as climbing a staircase...", adds the researcher. BeatMove also gradually increases cadence subliminally to reach an optimum speed, calculated for each patient. This acceleration counterbalances the tendency of Parkinson's sufferers to slow down their walking, often out of caution or fear of falling.

Initial results are spectacular. In 2021, a study of 40 patients showed a halving of falls, stabilization of walking and a 20% increase in speed. A large-scale clinical study of 400 patients is currently underway nationwide, conducted under the responsibility of Clinique Beau Soleil with Dr. Valérie Cochen de Cock to ensure that the beneficial effects are linked to the application and not just to the resumption of regular physical activity.

The distraction of effort

Twenty publications and a patent later, the BeatHealth start-up is now ready to bring the Beat-Move application to market. Several improvements are already planned, in particular the removal of sensors to use only those present in smartphones. Another prospect, with the Companies on campus program of the I-Site and the CHU of
Montpellier, is to offer this non-medicinal solution to obese people to encourage them to engage in physical activity, taking advantage of the motivating effect of music. The distraction of effort is also the argument behind another EuroMov project: the Medimoov platform of therapeutic games for movement rehabilitation.

"The project's starting point was a group of doctoral students at the Montpellier Laboratory of Computer Science, Robotics and Microelectronics, who were determined to demonstrate the positive effects of video games," recalls Antoine Seilles, then a doctoral student at the laboratory and now CEO of Naturalpad, the company set up to develop Medimoov. The group of young researchers was interested in the benefits of dynamic video games for physical exercise, and in particular for falls prevention and rehabilitation in nursing homes. Their project resonated with specialist doctors, who noted that three quarters of their elderly patients interrupted their rehabilitation, bored by repetitive practice or fear of hurting themselves.

From piracy to space conquest

All that remains is to design games that are both effective and fun. " Naturalpad has developed an iterative process for designing games, in collaboration with caregivers and patients, to fully understand therapeutic needs and the desire to play," explains Antoine Seilles. Interviews with caregivers help to select the most effective movements for rehabilitation. "Occupational therapists want the player to use wide-ranging movements that mobilize both hands. Physiotherapists, on the other hand, focus on precise movements for more targeted rehabilitation. We also talk to players to understand what they want," explains the developer. While the caregivers are banking on familiar game worlds, such as a driving simulator, the patients - on the other hand - are asking for piracy, space conquest or even car racing with no speed limits! "Some patients wanted a game about hunting, a desire that wasn't easy to reconcile with caregivers critical of the presence of weapons and the developers' own reticence, which was generally anti-hunting. In the end, our game features rabbits and wild boars shooting at balloons from which hunters are suspended... a solution that satisfied everyone!" laughs Antoine Seilles.

Today, the fifteen-strong Naturalpad team develops games for people with a wide range of pathologies, and in particular those with severe disabilities. Since the first
game was developed in 2011, the company now offers its games to 150 medical establishments, half of which are Ehpad.

* EuroMov DHM (UM, IMT Mines Ales)