WO2014124002A1

WO2014124002A1 - Method, system, and computer program for diagnostic and therapeutic applications of gaming and media technology

Info

Publication number: WO2014124002A1
Application number: PCT/US2014/014868
Authority: WO
Inventors: Sarah REBSTOCK; Julia FINKEL; Christina L. BAXTER; Angela FLETCHER
Original assignee: Children's National Medical Center
Priority date: 2013-02-05
Filing date: 2014-02-05
Publication date: 2014-08-14

Abstract

An interactive play defined by virtual augmented patient environments created in the initial patient interaction with the device. By combining rehabilitative therapy, multisensory therapy, and multidisciplinary approaches with augmented reality, while simultaneously acquiring patient data for evaluation and real time therapy modulation, the patient can be examined, evaluated, and provided multisensory therapy in one place by one clinician. This can be further extrapolated outside of the clinic with a portable embodiment that provides for continued rehabilitation and neuroplasticity training, for example, in the patient's home.

Description

METHOD, SYSTEM, AND COMPUTER PROGRAM FOR DIAGNOSTIC AND THERAPEUTIC APPLICATIONS OF GAMING AND MEDIA TECHNOLOGY

FIELD OF THE INVENTION

The present invention relates generally to collecting real-time biomedical patient data, and more particularly, to collecting real-time biomedical patient data during interactive game play within custom designed virtual environments.

BACKGROUND OF THE INVENTION

Understanding and diagnosing complex pain syndromes has been largely subjective and poorly understood in the medical community for the last 20 years. Pain is a complex phenomenon involving many factors such as physiological, emotional, cognitive, and cultural. Advancements in complex pain medicine diagnostics have been inadequate. Over the same time period, the number of patients with complex and chronic pain has reached almost epidemic proportions, with 20% of the population experiencing headaches and lower back pain costing billions of dollars yearly in the United States.

The diagnosis of pediatric pain syndromes often involves an average of 4.5 physician encounters per patient before the correct diagnosis is obtained. In addition, multiple medical tests are typically performed as part of the medical evaluation. Patients and their families have often got tired of seeing multiple clinical providers, and have lost interest and faith in the medical system.

U.S. Patent Number US 2011/0202553 Al discloses a wall integrated multisensory therapy device that functions as a multisensory device, but does not incorporate virtual reality and is completely tactile in nature.

U.S. Patent Number 6702767 discloses a multisensory stimulation system and method of use. However, it does not incorporate virtual reality and is completely tactile, and does not use a virtual environment. U.S. Publication number 2011/0202553 Al describes a database for simulators in voxel terms, but does not discuss a medical application, nor does it describe an embodiment that is portable and can be used outside the clinical environment.

Snow World (U.S. Publication number 2009/0271008A1) is an interactive technology application for the use in healthcare treatments. However, it does not simultaneously extract, display, and store data in real time during patient interaction with biomedical devices, and does not combine physical therapy, data acquisition, or multisensory stimulation therapy.

SUMMARY

The present invention involves interactive play defined by virtual augmented patient environments created in the initial patient interaction with the device. Market research has showed that a high percentage of pediatric patients are familiar with video game-play scenarios, but adults may benefit as well from use of these technologies. By combining rehabilitative therapy, multisensory therapy, and multidisciplinary approaches with augmented reality, while simultaneously acquiring patient data for evaluation and real time therapy modulation, the patient can be examined, evaluated, and provided multisensory therapy in one place by one clinician. This can be further extrapolated outside of the clinic with a portable embodiment that provides for continued rehabilitation and neuroplasticity training, for example, in the patient's home, allowing greater access to non- invasive chronic pain medical treatment modalities. In this scenario, the patient's progress can be monitored remotely with data sent to the pain medicine care provider to monitor progress and compliance. The present invention provides an innovative patient care delivery model that can change the current healthcare delivery system and also translate into global applications for both pediatric and adult populations.

Although the present invention is presented for use in diagnosing and treating pain syndromes as an example, it is also globally applicable to all areas of healthcare delivery and to develop tools and techniques to diagnose, treat, and eliminate pain. Melding dance game strategies with range of motion measurements can provide a comparison between normal ranges (based on population averages) and those of the patient. Use of game scenarios can provide our target audience the ability to become immersed in game-play by serving as a distracter during diagnosis and treatment of their ailments.

In one embodiment, sets of coordinate data and differences between patient capabilities and normal ranges are recorded during game play and saved for further evaluation, customization of treatment plans, statistical analysis, and clinical research. One embodiment of the present invention includes custom software that provides off-sets between patient and normal subject capabilities to provide a visual representation of these differences (e.g. on a video screen; tablet). Scheduled range of motion testing during the course of physical therapy program can be used to obtain data that indicates improvement over the duration of the prescribed treatment program.

One embodiment of the present invention utilizes noncontact goniometry to obtain patient data and utilizes virtual reality for use in custom designed environments.

One embodiment of the present invention, a pod-type bed is used as a biofeedback device and custom middleware code. The perceptual pod bed shape was developed and designed by Alberto Frias (U.S. Patent number D553866). The biofeedback bed encourages relaxation, and can be used to measure and decrease a patient's sympathetic tone and obtain other physiological data for use in patient care.

In one embodiment, the present invention utilizes the Kinect natural user interface, designed originally for the video gaming world, in order to measure differences of baseline range of motion for physical therapy patients. Measuring the difference between baseline data and data obtained during sessions with the present invention provides physicians and therapists an accurate method for determining improvement or regression of their physiological state while distracting the patient through game-play.

In one embodiment, a multisensory therapy model is utilized to augment and stimulate neuroplasticity in creating new neural pathways thereby decreasing pain. Capturing the output of a biomedical device provides a direct way to process and format output data for visualization. The disclosed embodiments of the present invention provide a system, method, and computer program for collecting real-time biomedical patient data during interactive game play within custom designed virtual environments for the diagnosis and treatment of medical illnesses, e.g., pain syndromes.

In one embodiment, there is provided a system, method, and computer program that provides strategically positioned interactive stations for information sharing and diagnosis prior to therapeutic intervention; technology that facilitates a customized, individualized treatment plan; infrared technology used for diagnostic applications and for monitoring and implementing virtual manipulatives during pain rehabilitation; application development to support rehabilitation and acquire patient data simultaneously; pain education applications and health applications through digital and virtual reality media (for example, kids health support channels, blogs, chat room, related applications, etc.); integration of diagnostic and therapeutic devices into the virtual reality environment; tracking patient data during interactive game play; simultaneously extracting, displaying, and storing real time patient data; concurrently capturing patient motion data and biomedical device data; illustrating range of motion and subjective physiologic response to pain; extrapolating patient data through the use of a wireless patient monitoring device and multiple bio-medical devices with integration capabilities to communicate with the technology driven patient interactive gaming device; interfacing biomedical devices with a computer program and server database for visual data projection comprising, a patient data tracking means during interactive game play; medical and rehabilitative multisensory treatment modalities within virtual and augmented environments while tracking real time objective patient data; facial mapping with a natural user interface to measure facial cues as a pain scale for more objective pain monitoring; occupational therapeutic modalities of fine motor and daily living skills training; and mapping muscle fasciculations.

One embodiment of the present invention provides a portable system, method, apparatus and computer program for use outside the clinical environment. BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detailed description thereof taken in connection with the accompanying drawings, in which:

Figure 1 shows an exemplary block diagram of the system architecture;

Figures 2A and 2B show an example of a non-contact video instrument in use, and the corresponding visual display of patient data, respectively;

Figures 3A and 3B show an example of the use of an algometer to interface with the system, and the display screen for visualization of patient data obtained with an algometer, respectively.

Figure 4 shows an example screenshot of real-time patient data provided by a biofeedback machine; and

Figure 5 shows an example of a biofeedback bed to interface with the system.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

The disclosed embodiments are merely exemplary, and it should be understood that the invention may be embodied in many various and alternative forms. The figures are not to scale, and some features may be exaggerated or minimized to show details of particular elements, while related elements may have been eliminated to prevent obscuring novel aspects. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting.

Some disclosed embodiments are in a medical environment as an example, and that is not to be interpreted as limiting. One embodiment of the present invention incorporates bio-medical patient data into virtual and augmented reality environments using Kinect or similar technology to diagnose and treat medical illnesses such as pain syndromes. Other embodiments include a portable system, method, apparatus, and computer program that can be used outside the clinical environment.

One embodiment of the present invention provides a system that includes hardware, tools, control software and user interface in order to perform the diagnosis and treatment of pain syndromes. Figure 1 shows an exemplary block diagram of the system architecture of an embodiment of the present invention. Multiple biomedical devices (l a, lb, l c) capture patient motion data and biomedical data concurrently. In one embodiment, this data is used to illustrate both range of motion and subjective physiologic response to pain. This data will be extrapolated from the patient via interfacing with a wireless patient monitoring device and multiple biomedical devices which integrate into a patient interactive gaming device.

The biomedical devices (l a, l b, lc) communicate with the middleware system (2) that uses original code via the Unity gamming engine and MicroSoft .Net framework that interprets the output of each biomedical device. In this example, the middleware system (2) provides communications for the streaming output and input of the various biomedical devices. Once converted, input data becomes a usable data set for visualization. The middleware system (2) processes multiple unique streams of data received via its input channels and outputs/stores the formatted data to a custom database management system for further visualization processing. It also serves as the causeway between the biomedical device(s), database storage, and the visualized output of the measurements taken by the biomedical devices. Accordingly, the middleware system (2) takes a data stream of each biomedical device and formats the data for visualization on, e.g., a tablet screen or a video monitor.

A set of baseline range of motion measurements can be obtained utilizing a multisensory room (3) equipped with interactive therapeutic distracter games and a non-contact video instrument (e.g., the Kinect natural user interface) that measures angles and/or allows an object to be rotated to a precise angular position for analysis. In one embodiment, based on a 20 skeletal point system, the points are tracked in 3D space and X, Y, and Z coordinates for each point is provided. Each skeletal point is stored in corresponding tables within a managed database. Range of motion differences can be measured for each of the points within specified muscle groups. Patient measurements are gathered, saved, and compared against a normal range of motion baseline. Data from patients is collected by using the non- contact video instrument technology and inputting angle measures of optimal range of motion exercises into the database. These motion measurements are correlated with each individual patient without the need for direct contact of a standard goniometer device.

According to one embodiment, interactive therapeutic distracter games are created to capture not only the baseline range of motion data but also motion that extends beyond a perceived range of motion as the result of game play. In one embodiment, the areas of incorrect body mechanics are illuminated and compared to the areas of injury, further contributing to diagnostic measures. Patient range of motion after game play is measured against the baseline sample. Periodic measurements are gathered over the course of therapy and measured against the patient's baseline range of motion measurements. The results of the prescribed therapy are recorded and displayed via a timeline.

In one embodiment, a sampling of 100 non-afflicted subjects, within the patient demographic, are tested to yield a numerical average equivalent for range of motion evaluations. From this sampling (within +/- 5 degrees of accuracy) patient range of motion evaluations are measured against. Custom software is written to provide off-sets between patient capabilities measured against normal test case capabilities and to provide a visual representation of these differences (for screen, tablet). Scheduled range of motion testing during the course of physical therapy program may yield data that indicates improvement over the duration of the prescribed treatment program.

In one embodiment, interactive games are defined based on virtual augmented patient environments created in the initial patient interaction with the device. Data sets of position coordinates are used to develop visual templates. Visual templates provide acceptable normal positions and allow gathering of patient's measured range of motion capabilities in a fun and visually stimulating environment. Patient range of motion capabilities are tested by way of visual templates that encourage the patient to remain within the boundaries of a human-like figure or avatar. Patients slowly follow the avatar template through a series of pre-determined positions and holds. These motions and holds in the augmented environment are developed to target specific muscle groups and areas of pain in the body. Thus the games not only distract and encourage neuroplastic brain changes through multisensory therapy, but also target and encourage body specific rehabilitation and desensitization. Theses motions and position holds are saved as coordinates and are automatically made during sequenced timed holds.

Differences between patient range of motion capabilities and normal range of motions are used as a baseline for therapeutic and diagnostic intervention.

In the embodiment shown in Figure 1, a server connects the infusion/diagnostic rooms (4), patient check-in stations, and waiting areas to the other components. The waiting areas include novel applications of media technology that provide an interactive virtual environment that gives a user experience initiating the education and therapeutic processes, treatment modalities, and the ability to conduct preliminary assessments of patients, while simultaneously collecting patient objective and subjective data, further driving individualized treatment programs and exponential research opportunities for enhanced medical treatment options. Additionally, the waiting areas offer multiple engagement opportunities for both adults and children, providing patient/family centered care. Visitors entering the center are welcomed in the waiting area with colorful, engaging interactive display areas. This area is an opportunity to engage both children and adults. The displays serve varied purposes that include:

gathering real-time data for research, submitting requests, and/or providing useful information and resources. Each of the display areas has touch screen monitors at various heights to entertain and educate patients and parents about pain while psychologically preparing them for the patient process in a non- threatening environment. Utilizing state of the art technologies, the waiting area incorporates the use of touch screen monitors that provide meaningful information and serve as a venue for the patients to engage in a program designed to prepare them for the diagnostic, clinical, and therapeutic processes that occur throughout the clinics multi-sensory and multi-disciplinary care delivery model.

A tablet controller dashboard (5) will provides medical personnel the ability to access rehabilitative, diagnostic, and therapeutic treatment programs at the same time as obtaining real time patient data and act as a master hub of game control and program selection. This tablet serves as the core display unit for providers in their practice and can be customized for specific healthcare specialties. Healthcare personnel will be issued a data pad that allows for session builds, patient monitoring, and record keeping based on the patient data collected during the check-in process and previous visits. From a custom built menu-driven interface, the therapist can select specific exercises for the patient and collect the results of their progress during that specific session. Each activity area within the clinic can be controlled by the data pad. The data pad will help to monitor overall patient performance and will provide vital information for the therapist and provider as they go forward in the prescription of continued therapy.

At check-in, patients will be provided a computerized tablet for data entry, which will begin the patient tracking and customization process. A patient Radio-Frequency Identification (RFID) wristband tagging system (6) will be used to identify the patient and monitor patient progress while they are interacting with the system. This tagging system will collect patient interactive experiences throughout the entire clinic, including the infusion room, multi-sensory room, and POD bed (a womb-like multisensory biofeedback bed) room and will be able to report patient data over time and individual patient program outcomes. The wristbands will personalize the exercise experience via the interactive media components and the natural user interface provided by a motion capture device.

One embodiment of the present disclosure allows the healthcare providers to frame the development of individualized treatment programs and research incentive game playing via biofeedback integration and ability to track and monitor the mind's control over the body. It also provides visual tracking of counterproductive range of motion areas of the body illuminated in contrasting colors to detect correct and incorrect body technique further aiding in optimal diagnostic measure.

In one embodiment, each patient is given an opportunity to build and save their own avatar and/or special transport vehicle. The avatar can provide instructions, humorous comments, and words of encouragement. Using a set of predesigned building blocks each patient will be able to construct a fun, colorful, and whimsical transport vehicle. Both the avatar and transport vehicle will play a role during successful completion of a patient's individualized treatment program further defined in other areas of the clinic, such as the multi-sensory room. For example, during the rehabilitative pain medicine program, a child will be challenged to increase physical function, simultaneously changing and desensitizing the pain pathways to re-establish normal pain responses in the central nervous system. The child will perform a series of activities designed to facilitate diagnosis of various painful conditions, enabling the development of individualized and precise treatment modalities. Every movement is digitally tracked, collecting data including range of motion and i. child's progress. The healthcare providers will then use this data to design optimal treatment approaches for the child's unique medical needs.

Figure 2A shows an example of a non-contact video instrument in use, showing a display of physiological data while the subject is interacting with a customized video game. Figure 2A includes a display of physiological data and a customized video game. Figure 2B shows an example of the display screen showing real-time measurements obtained through non-contact goniometry for monitoring and analysis in real time.

Embodiments of the present disclosure use non-contact video instruments, initially designed for the video gaming world, to measure differences of baseline range ofjnertion for physical therapy patients. This baseline and the results of extended play provide physicians/therapists an accurate method for determining the improvement or regression of physiological status while distracting the patient through game-play. The use of a technology such as Kinect and incorporating a visualized data overlay will create augmented realities on output screens. For example, the output from biomedical devices will output a layer over the patient avatar or the game play on the output screens such as the tablet or patient monitor. The utilized biomedical technologies and devices may include but are not limited to an algometer, non-contact goniometry, biofeedback technology, heart rate variability, skin temperature, subtle altered muscle group usage and associated compensation, and pain behavior recognition to produce objective data from which pain syndromes can be diagnosed and rehabilitation progress can be objectively monitored. Embodiments of the present disclosure capture the output of a biomedical device in order to provide a direct route for processing and formatting output data for visualization.

Devices that can be interfaced with the present invention include, but are not limited to those that perform the following functions: algometery, digital facial mapping, non-contact cutaneous

thermography, and/or a use of a POD biofeedback bed (shown in Figure 5). Figure 3 shows an example of how an algometer may interface with the system. An algometer is a device that captures patient pain data. In one embodiment of the present invention, the algometer communicates with the middleware to extract biomedical device data and allow visualization of pain amount, physical location, and threshold. The visualized converted biomedical device data is merged with the on-screen virtual information provided by the non-contact video instrument. As a result an augmented reality display of live action game play and visualized regions of pain are displayed and tracked simultaneously in real-time.

Digital Facial Mapping can be accomplished using a non-contact video device (for example, the Kinect Face Tracking Software Development Kit by MicroSoftand). Custom software provides a method to capture facial expressions in patients that have altered or diminished verbal communication ability. This recognition system is designed to capture subtle expression variations during range of motion diagnostics. Each subsequent facial scan provides additional information and the software continues to learn and increase its ability to recognize subtle changes and algorithmically associate the information with pain thresholds. Though originally designed as a method of controlling game play via facial expression or creating talking avatars, the face tracking capabilities of the MicroSoft Kinect coupled with specific custom software provide the healthcare providers with the ability to map subtle changes of facial expressions. This ability is particularly useful in the non-verbal patient population, as this technology will be able to directly correlate facial movements to pain response and will allow healthcare providers, researcher, and other individuals to redefine and validate pain scores of infants and the non-verbal patient with objective digital precision.

In one embodiment, non-contact thermography is performed using an infrared device that obtains topical thermography data and medical data and integrates it into an objective format for healthcare providers to diagnose various pain illnesses and better treat various pain-related illnesses. Accordingly, there is provided an objective physiologic pain rehabilitation monitoring system that uses the integration of topical thermography within virtual environments and game play.

In one embodiment, a POD bed is utilized as a biofeedback device, creating a therapeutic environment for patients while simultaneously collecting patient biomedical data. Figure 4 shows an screenshot example of such biofeedback data. The POD bed (shown in Figure 5) is a temperature controlled water bed including (but not limited to) the following capabilities: sound vibration, music, and patient monitoring (heart rate variability, skin temperature, and other physiological parameters will be measured allowing the patient to practice biofeedback techniques, and is also able to integrate with interactive games and collect and interpret patient data.

In one embodiment, technologies and devices that may include, but are not limited to, the algometer, non-contact goniometry, biofeedback technology, heart rate variability, skin temperature, subtle altered muscle group usage and associated compensation, and pain behavior recognition are used to produce objective data from which the following exemplary pain syndromes (as specified using ISD-9 Codes) amy be diagnosed and rehabilitation progress objectively monitored:

307.8 psychogenic pain

337.2 reflex Sympathetic Dystrophy

337.21 RSD of upper limb

337.22 RSD of lower limb

337.29 RSD of other specified site

338.21 chronic pain due to trauma

338.22 chronic pain due to post thoracotomy pain etc

The specific embodiments described above have been shown by way of example and it should be understood that these embodiments may be susceptible to various modifications and alternative forms. It should be further understood that the claims are not intended to be limited to the particular forms disclosed, but rather to cover all modifications, equivalents, and alternatives falling within the spirit and scope of this disclosure.

As used herein, the terms "comprises," "comprising," "including," and "includes" are to be construed as being inclusive and open-ended. Specifically, when used in this document, the terms "comprises," "comprising," "including," "includes," and variations thereof, mean the specified features, steps or components included in the described invention. These terms are not to be interpreted to exclude the presence of other features, steps or components. The foregoing description of the preferred embodiments of the invention has been presented to illustrate the principles of the invention and not to limit the invention to the particular embodiment illustrated. It is intended that the scope of the invention be defined by all of the embodiments encompassed within the following claims and their equivalents.

REFERENCES

Weghorst S, et al. Medical interface research at the HIT Lab. Virtual Reality. 2008; 12:201-214.

Hoffman, HG. Virtual Reality Therapy. Scientific American. August 2004; www.VRPain.com.

Hoffman H and HITLab. Virtual Reality Pain Reduction. University of Washington Seattle and U.W. Harborview Burn Center. C:\Documents and Settings\jeschwar\Desktop\HITLab Projects VR Pain Control.mht

Institute for Clinical Sysytems Improvement (ICSI), 5th Edition, November 201 1, Health Care Guideline: Assessment and Management of Chronic Pain.

Grunau RE, et al. Bedside application of the Neonatal Facial Coding System in pain assessment of premature infants. Pain. Jun 1998; 76(3):277-286.

Carlsson AM. Assessment of chronic pain. Pain. May 1983; 16(1): 87-101.

Schasfoort FC, et al. Pain Outcomes: A Brief Review of Instruments and Techniques. Pain. 2008; 137: 323-331.

Disorbio JM, et al. Assessment and Treatment of Chronic Pain: A physician's guide to a biopsychosocial approach. Prac Pain Mgmt. Mar 2006.

http://www.practicalpainmanagement.com/treatments/psychological/assessment-treatment- chronic-pain.

Dworkin RH, et al. Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain. Jan 2005; 1 13(1-2): 9-19.

Walker LS, et al. Parent attention versus distraction: impact on symptom complaints by children with and without chronic functional abdominal pain. Pain. May 2006; 122(1-2): 43-52.

Eccleston C. Videogame Distraction using Virtual Reality Technology for Children

Experiencing Cold Pressor Pain: The Role of Cognitive Processing. Behavior and Research Therapy. May 1995; 33(4): 391-405.

Kabat-Zinn J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results.

General Hospital Psychiatry. April 1982; 4(1): 33-47.

Claims

1. A method comprising:

providing an interactive game play to a person within a custom designed virtual environment;

collecting real-time biomedical data of the person via one or more biomedical devices; storing the real-time biomedical data of the person in a server database that interfaces with the one or more biomedical devices;

tracking movement data of the person during the interactive game play; providing medical and rehabilitative multisensory treatment modalities within the virtual environment during the interactive game play and based on the tracked movements of the person; performing facial mapping of the person via a natural user interface during the interactive game play;

measuring facial cues as a pain scale for an objective pain monitoring based on the facial mapping;

providing occupational therapeutic modalities based on the facial mapping and the tracked movements;

mapping muscle fasciculations based on the facial mapping and the tracked movements; and

displaying a visual data projection of the real-time biomedical data of the person and the tracked movements of the person via a user interface.

2. The method of claim 1, further comprising:

monitoring the person via an infrared detector.

3. The method of claim 1 , further comprising:

providing educational and health applications to the person via a digital or virtual reality media during the game play.

4 A system comprising:

an interactive game play device that provides an interactive game play to a person within a custom designed virtual environment; one or more biomedical devices that collect real-time biomedical data of the person; a server that interfaces with the one or more biomedical devices;

a server database connected to the server;

one or more multisensory devices that interface with the server and track movement data of the person;

a natural user interface that interfaces with the server and monitors the face of the person; and

a dashboard user interface that interfaces with the server,

wherein the server is configured to:

collect real-time biomedical data of the person via the one or more biomedical devices;

store the real-time biomedical data of the person in the server database;

track movement data of the person during the interactive game play via the one or more multisensory devices;

provide medical and rehabilitative multisensory treatment modalities within the virtual environment during the interactive game play and based on the tracked movements of the person;

performing facial mapping of the person via the natural user interface during the interactive game play;

measure facial cues as a pain scale for an objective pain monitoring based on the facial mapping;

provide occupational therapeutic modalities based on the facial mapping and the tracked movements;

map muscle fasciculations based on the facial mapping and the tracked movements; and

display a visual data projection of the real-time biomedical data of the person and the tracked movements of the person via the dashboard user interface.

5. The system of claim 4, further comprising an infrared detector, wherein the server is further configured to monitor the person via the infrared detector.

6. The system of claim 4, wherein the server is further configured to: provide educational and health applications to the person via a digital or virtual reality media during the game play.

7. The system of claim 5, further comprising:

a POD bed, wherein at least one of the one or more biomedical devices is installed in the POD bed.