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1. SILNYERFIT Avoid objects by moving left _ or right af You character Keep gt walking until you reach the shop If you hit an object you will get a warning and lose some time Wait to cross the street until the traffic light turns green To cross over obstacles like this trunk on the road lift the knee as high as possible Scoring rine e oo CL 2 Number of spent steps taken Obstacles hit Obstacles avoided 37 7 Walking exercises A Stroll standard settings Standard difficulty settings SILNYERFIT This is a very short distance walk with only one traffic light and no further obstacles This is a Somewhat longer walk The patient has to step sideward to avoid stationary obstacles This walk is roughly the same length as in the previous setting This time the walk contains obstacles such as Stairs and tree trunks that require the patient to make a high step This is a longer distance walk in which the patient needs to avoid a number of moving obstacles as well as Stationary obstacles and high steps Alternative applications Patients can use a stroller as long as the knees are visible to the camera Patient can hold on to parallel bars for support This also helps them keep in the same spot The game can also be played by two patients Let the patients stand 50cm or more apart They will walk the same distance and encounter the same objec
2. Arm exercises Eggs standard settings Standard difficulty settings SILNYERFIT This is an exercise where the hand rests on the table The patient must move his hand left and right There are no cats or golden eggs This is the same exercise as above with the cat and golden egg added If the cat appears the patient has to raise his hand to chase it away The golden egg gives extra time This setting adds a small pillow making the exercise much harder This setting is played without a table It uses the cat and the golden egg but allows for a large pillow Playing this exercise without any support is very strenuous Alternative applications The upper extremity can be suspended in an anti gravity suspension device Put a towel or a board with wheels between the upper extremity and the arm to facilitate movement 62 Arm exercises Eggs detailed settings Detail menu Movement oe Support hand on table Choose the type of exercise see exercise Train without table support description Distance y Set how far the patient Minimum Standard Maximum has to move his her arm Turn the cat on off The cat must be chased away by raising your hand Game elements To chase the cat away you have to raise your hand a Va on We select a small a The golden egg falls faster and yields more points pillow This makes the a s Turn the golden egg on off This makes the timing more
3. User manual March 2010 Version 2 0 2 Contents Contents Introduction The management module Safety issues 3 Creating a new patient menu 77 Summary 4 Signing on as a patient 77 Basic use Creating a menu using detailed settings 78 Turning the system on off 5 Troubleshooting Using the mouse and remote 6 Troubleshooting overview 79 Navigating the menu s 7 Recalibrating the camera 80 Choosing the right exercise 10 Hardware checks 83 How to help a patient 12 Contact Phone email website support 85 Exercise description Sitting exercises The Fox 13 Sitting exercises Puzzle 17 Sitting exercises Picknick 21 Sitting exercises Volleyball 25 Sitting exercises Funfair 29 Walking exercises The Fox 33 Walking exercises A Stroll 37 Walking exercises Flowers 41 Balance exercises The Mole 45 Balance exercises Puzzle 49 Wheelchair exercises Flowers 53 Arm exercises Memory 57 Arm exercises Eggs 61 Cardio exercises The Fox 65 2008 2010 SilverFit BV Alphen aan den Rijn All rights reserved Cardio exercises The Mole 69 Using elements of the SilverFit games or manual without prior written Cardio exercises Vegetable Garden 73 consent by SilverFit is strictly prohibited and will be prosecuted Manual edition 2010 01 SILNYERFIT Safety considerations SilverFit should be used by therapists The SilverFit is a tool for therapists to provide exercises in geriatric rehabilitation It is intended for patients who are often fr
4. 1 Set parameters Click on the Button to get the screen below Set camera exposure Y ym time to 33 ms SwissRanger Exposure ms Threshold Amplitude threshold 2 Clipping 1m Transform 1m ft Calibration Mark Position Save Parameters Set treshold between 60 100 This sets the minimum level of light the camera reacts to These trackbars set the red lines of the clipping area see page 1 4 Set to maximum as shown This trackbar sets the floor height Set in the middle as shown This trackbar sets the user position Set in the middle as shown Advanced parameters Save after setting parameters Please contact SilverFit at 0172 425 139 before making any changes to the camera calibration 2 Set camera angle Close the parameter screen Stand 3m in front of the camera and assume T position as shown Press the button Remain in T position for 5 seconds Repeat until the bubble man appears in a straight angle in all 3 views If after calibration the bubble man sticks out of the dark green area the camera angle needs to be readjusted 3 Adjust treshold if needed You can adjust for noise or unseen objects by adjusting the Treshold in the parameter screen If you see a lot of noise set the treshold higher If you see holes in the bubble man set the treshold lower Camera calibration guide 3 3 4 Set floor height In the parameter screen set the floor
5. as Sere 7 SILNYERFIT The exercise can be done by one or two patients The patients may either sit or stand next to each other Two players will appear on screen By moving either their hands their head or part of their upper body forward or upward the patient can hit a ball to the other side of a net In this way it is possible to play either a competitive game try to get the ball on the ground on the other side or a collaborative game try to keep the ball in the air as long as possible Current score of left and right patient Remaining time Left patient Hit this ball Right patient or computer player In collaborative mode the score board shows the number of time the ball has been hit during this rally The best rally this game appears above the timer Scoring Right patient in second place In collaborative mode both patients score the same amount of points the longest unbroken rally Left patient wins 25 Sitting exercises Volleyball standard settings Standard difficulty settings SILNYERFIT Play with the computer to create the longest rally The computer will almost always hit the ball Play against the computer the computer player is not at a very high level Play with another patient to get the longest possible rally Play with two patients against each other Alternative applications The game can be played in one or two patient mode As the system will
6. Confirm with left mouse click 3 Turn off TV 4 Unplug power Navigation using the mouse Basic operation Tricks and tips Control mouse with your wrist You do not need to move your arm to control the mouse A small wrist movement will do You can calibrate the mouse by making a quick bottom left to top right movement Press left button to choose For example to choose a menu item press a If the mouse is operational you will see lights on the front button or proceed to the next screen If you see no lights turn on the mouse with the switch on the back If this does not work the battery has to be charged Put the mouse in the mouse holder to charge lor If the mouse does not work Press right button to cancel This brings you back to the previous screen a You can also use the right button to exit a LAI Press the play button on the mouse during a game to open a small camera screen This screen shows the current camera view and can help you to troubleshoot i wi Press the vol button on the mouse to turn the sound on off Hold the button and move the mouse to the left to lower the volume Press button and move the mouse to the right to increase the volume game SILNYERFIT Navigation using the remote Using the remote The remote has been designed for use by the patient Therefore it s not possible to access the patient data files and detail menu screens using the remote It
7. Flowers lost Cactuses Flowers lost to turtles hit to lambs 53 Wheelchair exercises Flower game standard settings Standard difficulty settings SILNYERFIT This is a very simple basic setting The field contains only flowers The game will end after the patient has completed one field This setting starts with just flowers but will build up over time to include the other challenges It uses more complex graphics There is no time limit This setting is similar to the one above but introduces a time limit This setting is starts at a higher level of difficulty and sets a more stringent time limit Alternative applications Use simplified graphics if the full graphics are too difficult for the patient 54 Wheelchair exercises Flower game detailed settings Detail menu Playing field Movement Full graphics He Set the size of the playing field left right and front back Switch between normal graphics and simplified graphics that are easier to see Simplified graphics You will start at a calm pace Here you can see which challenges will occur Determine which challenges none turtles cactuses lambs hedgehogs all of these will appear during the game Buildup vl Clear one Se ee One field game ends after 1 field is cleared Repeat the same field Repeat game ends after 3 identical fields Increase difficulty over time Increase difficulty play on
8. catch them Branches should be avoided by leaning away Chickens can be caught by raising one or both arms in the air Current score Remaining time Catch as many grapes as you can Move the fox by Avoid the leaning left and right branches Raise both arms to make the fox jump and catch the chicken This gives a small time bonus Overall score 1 per grape caught Grapes Grapes Chickens Branches hit caught missed caught 65 Cardio exercises the Fox standard settings Standard difficulty settings This is basic setting Only one grape will appear at a time and there are no branches or chickens Compared to the walking fox exercise the distance to be walked is doubled With this setting the number of grapes and the speed at which they fall increases over time based on the patient s performance Branches and chickens are added This setting is similar to the one above but starts at a higher pace This setting is similar to the previous ones but starts at a very high pace Cardio exercises the Fox detailed settings Detail menu Movement fio Set how far the hen Move short distance patient has to walk to move the fox DA Move maximum distance DEN E Set the starting level number Difficulty Y e of grapes and speed ara Easy 1 grape many grapes Click here to let the game automatically Adapt to player adjust the difficulty based on the patient s performance Turn off for
9. challenging SL ame very tough Q a 8 y 8 A smaller pillow requires more precision act ANS UIST eM ae v Adjust level to player Check to let the number of chickens chickens at the start of chickens 2 6 and the speed adapt to the the game performance of the patient Duration Set the game s duration Press to start exercise with current settings A LNI 63 Arm exercises Eggs calibrating a table Calibration procedure Train on a table Before you can play this game the camera Step 1 Determine table position Put the table in front of the system Train on a table Before you can play this game the camera has to Step 1 Table position calibrated Step 2 Check and start game Sit t bi hand on the SILNYERFIT Place a table so that the patient can sit behind it at 2 3m from the SilverFit The table should not bee too small Ideally it should have straight edges and only one color Make sure the chair is away from the table Start the game Normally the table will show up as a line if you come close to it Walk away from the table and make sure there are no other objects or people close to the table Then press the left mouse button Now sit behind the table If all is well it should not show up as a line anymore Put your hand on the table and move it around The blue tag hand should follow your movements If so you are ready to start the game If not press the right m
10. does well They will come from both sides The animals move very fast making them hard to hit This setting is very sensitive to any movement It can be used for patients who cannot make large movements but it will sometimes trigger unintended throws Alternative applications As the system will recognize any upward forward movements you can let the patient use their arms or stand up or jump or step forward or nod their head etc in order to hit the ball 30 Sitting exercises Funfair detailed settings Detail menu Set the amount of movement required to Movement hit the ball If this is set to small any movement will trigger an action The a patient can play by just nodding their Sensitive to any Large movement movement required head but it is easy to trigger unintended actions If set to large strong movement is required and the reaction is more robust Difficulty i j Adapt to player Determine the speed Easy Hard N of the animals Animals start Click to make the animals move faster if the patient does well Determine from which direction the animals come D Let Right Rigt eeel Duration Set the duration of the exercise Press to start exercise with current settings LNS 31 Sitting exercises Funfair troubleshooting Troubleshooting SILNYERFIT Unintended throws any upward or forward movement will trigger an action fro
11. done in three ways 1 The patient places his hand ona table and pushes the hand forward and backward In an alternative exercise the Scoring patient rests his hand on the table and lifts it up when required It is also possible to do the exercise without a table It then trains reaching grabbing ability mm The game shows a number of objects that the patient should try to remember The list of objects grows longer as the patient does better mm In the versions played on a table the patient moves his hand forward upward when the next object in the sequence is shown on top You can see the measured position of the hand on the track on the right If green arrows appear bring the hand back to the resting position first In the game without a table the patient moves his until he reaches the correct object Then he grabs the object by moving his hand forward in a grabbing movement Overall score 1 point each time an object is remembered Longest sequence of objects remembered 57 Arm exercises Memory standard settings Standard difficulty settings SILNYERFIT This is an exercise where the hand rests on the table The patient must move his hand forward on the table if the right object is shown on top This is an exercise where the hand rests on the table The patient must lift his hand from the table when the right object is shown on top In this setting the patient moves his hand freely to grab
12. fixed level Game elements YS You have turned off the chicken Choose the type of challenges ek You have turned off the branch YOU want to appear z Currently set duration Duration g 0 1 ar ME Move the trackbar to set the game s duration Click to start exercise with current settings A IN ERFIT 67 Cardio exercises the Fox Troubleshooting Fox makes small sudden moves to left and right most probably this happens when the patient comes close to an object the wall or the therapist Make sure the patient has enough space to do the exercise The playing area is small and the fox jumps around You have inadvertently selected the sitting version of the fox game Select the cardio version instead from the main menu or choose the 3m settings in the detail menu troubleshooting Fox does not jump The game reacts to hands that are stretched forwards and upwards Stretching your hand by the side of your body does not trigger a jump SILNYERFIT 68 Cardio exercises The Mole When to use contra indications Goal This game trains fitness by providing a dynamic balance exercise Used for Fitness rehabilitation after cardiac intervention COPD Contra indications Patient should be fit enough and have good balance skills Exercise description The patient stands about 2 3m from the screen so that his feet appear in the middle square Wh
13. height so that the floor checkered area is at the right vertical level compared to the bubble man It is OK if you do not see the legs go down all the way to the floor 5 Adjust clippings If you can see the floor bring up the floor clipping until it disappears Make sure the legs remain visible SHE AAAA s iay Clipping The ceiling top right clipping can be brought down until the line is just above the bubbleman if he raises his hands The left right clippings should be set so that the bubble man is visible everywhere in the playing area but not outside of it Move left and right to see if you remain within the clippings If other objects a table a wall just outside the playing field show up in the bubbles set the clipping smaller so these disappear The front clipping does not matter The back clipping should be set such that you do not see the back wall or objects behind the patient SILNYERFIT Please contact SilverFit at 0172 425 139 before making any changes to the camera calibration 6 Test While still in the camera test screen walk around If you see objects gt remove objects or adjust clippings If you see noise gt make treshold higher If you see incomplete bubbleman gt make sure there is no direct sunlight and or make treshold higher If the bubbleman disappears too early behind the red line gt adjust clipping to create larger area An object is causing trouble Remove th
14. object the wall or the therapist Make sure the patient has enough space to do the exercise The playing area is small and the fox jumps around You have inadvertently selected the sitting version of the fox game Select the walking version instead from the main menu or choose the 1 5m or 3m settings in the detail menu Fox does not jump The game reacts to hands that are stretched forwards and upwards Stretching your hand by the side of your body does not trigger a jump Keeping your arms above your head will not make the fox jump over and over lower the arms and raise them again to make the fox jump Fox jumps too much the game can react to an upwards movement of the hands even if they are not fully raised Sometimes a therapist standing close by can also cause the fox to jump 36 Walking exercises A Stroll exercise overview When to use contra indications Goal This game trains walking on the spot lifting the knee It trains this in an ADL traffic environment Used for Total knee general fitness alzheimer Contra indications Patient should be able to stand and bend lift his knee Exercise description The patient stands in front of the screen and walks on the spot by lifting his knees He can move left or right to avoid objects Any object he hits causes some time loss As an option select high steps the patient has to lift his knees up high to step over these
15. recognize any upward forward movements you can let the patient use their arms or stand up or jump or step forward or nod their head etc in order to hit the ball 26 Sitting exercises Volleyball detailed settings Detail menu Set the amount of movement required to hit the ball If this is set to small any Sant ine movement will trigger an action The see ae patient can play by just nodding their Movement any movement required head but it is easy to trigger unintended actions If set to large strong movement is Game mode required and the reaction is more robust Set to determine the rules either collaborative or competitive ee Set the total time The game will always finish the last rally when the time is up Click to set the number of patients Duration Number of players Opponent difficulty 5 ey Hard For a one patient game set the strength of the computer Press to start exercise Opponent with current settings LN 2 Sitting exercises Volleyball troubleshooting Troubleshooting SILNYERFIT Player hits too early any upward or forward movement will trigger an action from the figure on screen Make sure to start the action only when the ball is very close If the ball is still triggered too early try sitting closer to the camera and or setting the movement slider in the detail menu to large movements 28 Sitting exercises
16. the right object This setting is similar to the one above but the patient has to move his hand further In addition the set of objects to remember is more complex from a cognitive point of view Alternative applications The upper extremity can be suspended in an anti gravity suspension device Put a towel or a board with wheels between the upper extremity and the arm to facilitate movement 08 Arm exercises Memory detailed settings Detail menu Basic movement Move hand over table Lift hand from table Choose the type of exercise see exercise description Distance Set how far the patient Min Standard Max has to move his her arm If move hand freely is In exercises with a table the objects will turn Set the turning speed here selected select the number of objects the Set the type of objects to remember Basic Picture level objects can be described with one simple patient has to choose from here word hard objects are less familiar or less easy to describe Press to start exercise with current settings A WERFIT 59 Move hand and arm freely 2 Arm exercises Memory calibrating a table Calibration procedure Train on a table Before you can play this game the camera Step 1 Determine table position Put the table in front of the system Train on a table Before you can play this game the camera has to Step 1 Tabl
17. to choose so the cognitive element of the exercise is much easier Choice displays 2 3 pieces making the exercise harder Click to start exercise with current settings Choice of pieces Sitting exercises Puzzle troubleshooting Troubleshooting SILNVERFIT Pieces move by themselves this can happen if the patient is not well detected and the system is following another person or object Make sure the patient is sitting on a chair with as few objects around as possible Check if the patient is visible in the camera view i on the remote or by on the mouse If not place the chair at the right distance 2 3m and ask the patient to move his body or arms until he shows up Pieces do not move check if the patient is visible in the camera view see above Also make sure the therapist is not seen on camera If the patient is in wheelchair with built in table remove these accessories If only the patient is visible and the pieces still do not move check if the settings in the detail menu correspond to the movement made In the standard settings the game reacts only to body movements not to arm movements If arm movements are selected the game will not react to body movements 20 Sitting exercises Picnic exercise overview When to use contra indications Goal This game trains strength and agility of the lower extremity for a seated patien
18. Funfair exercise overview When to use contra indications Goal This game trains moving the arm or the upper body It is intentionally non specific as to the exact movement made Used for Activation exercise for early rehabilitation or keeping fit Contra indications The exercise may strain the arm if done for too long The exercise requires good timing skills Exercise description The patients sits in a chair in front of the screen Wooden animals are moving across the screen Any movement upwards or forwards by the patient will trigger the person on the screen to throw a ball If the ball hits the animal you score points As the system will recognize any upward forward movements you can let the patient use their arms or stand up or jump or step forward or nod their head etc in order to hit the ball Current score Remaining time Animal to hit S Patient character You will throw the male or female ball here Hitting an animal on the right spot three times will earn you a trophy Hit the glowing part of animals to earn a trophy Hit the bull s eye on all other animals Overall score 1 point per hit 5 points per trophy Animals hit Trophies earned 29 Sitting exercises Funfair standard settings Standard difficulty settings SILNYERFIT The animals will move very slowly and come only from the left The animals will start slowly and start to move faster if the patient
19. IT Please feel free to contact us in case Something does not work Something is not clear You would like to report a safety hazard We could improve a certain feature You have thought of an alternative application You have an idea for an additional exercise Any other topic you would like to share with us 85
20. Move somewhat to the side back or sit down to minimize the disturbance It is also possible to use help a patient more intensively If the therapist fully mimics the patient s movements the camera will react to the combined movement 12 Sitting exercises The Fox exercise overview When to use contra indications Goal This game trains upper body control leaning left and right Used for Post CVA MS balance impairments maintaining upper body flexibility for long term wheelchair users Contra indications The patients should be able to lean left right without falling over Exercise description SILNYERFIT The patient sits on a chair or wheelchair about 2 3m from the screen Press OK left mouse button when patient is ready to start When grapes appear the patient leans left or right to move the fox towards the grapes and catch them Branches should be avoided by leaning away Chickens can be caught by raising both arms in the air Current score Remaining time Avoid the branches Move the fox by Catch as many leaning left and right grapes as you can Raise both arms to make the fox jump and catch the chicken This gives a small time bonus Overall score 1 per grape caught Grapes Grapes Chickens Branches hit caught missed caught 13 Sitting exercises the Fox standard settings Standard difficulty settings SILNYERFIT This is a very simple basic setting Only
21. Move the scissors by Approach a flower walking around to cut it Turtles and later on lambs try to eat the flowers as well If they succeed you will lose a pair of scissors or some time Beat them to the flower to prevent this Cactuses and hedgehogs should be avoided If you hit them you will loose a pair of scissors or some time Walk around them to prevent this Overall score 1 per flower Hedgehogs hit Flowers lost Cactuses Flowers lost to turtles hit to lambs 41 Walking exercises Flower game standard settings Standard difficulty settings SILNYERFIT This is a very simple basic setting The field contains only flowers and will be shown with simplified graphics The game will end after the patient has completed one field This setting starts with just flowers but will build up over time to include the other challenges It uses more complex graphics There is no time limit This setting is similar to the one above but introduces a time limit This setting is starts at a higher level of difficulty and sets a more stringent time limit Alternative applications Use simplified graphics if the full graphics are too difficult for the patient 42 Walking exercises Flower game detailed settings Detail menu Playing field Movement Full graphics He Set the size of the playing field left right and front back Switch between normal graphic
22. SILNVYERFIT Unable to reach sides the game measures the actual movement of the patient during the game to determine how far he she should move Let the patient lean left and right a few times to reset the calibration If the patient sits closer to the screen he has to move less far Move the patient closer if the required movement is too large The degree of movement can also be adjusted in the detail menu Fox off center the system will assume the patient is in the center of the screen when you press OK If the patient moves afterwards e g moves his chair or walks to his chair the center will be off Restart the game with the patient sitting Make sure the therapist is behind and below the patient Playing area is very large and the fox is almost not moving you have selected the walking version of the fox game Go back to the menu and select the sitting version Fox does not jump the game reacts to hands that are stretched forwards and upwards Stretching your hand by the side of your body does not trigger a jump Fox jumps too much the game can react to an upwards movement of the hands even if they are not fully raised Let the patient rest his hands on his lap when he does not want the fox to jump 16 Sitting exercises Puzzle exercise overview When to use contra indications Goal This game trains sit stand and leaning left and right Used for Post CVA MS orthopedic surgery amput
23. ail and vulnerable A skilled therapist should judge whether a particular patient is able to do the exercise required and monitor the safety of the patient during the exercise The system cannot monitor or guarantee the safety of your patients Although some patients can train by themselves judging whether this is possible or not is the sole responsability of the therapist Particularly vulnerable patients may require continuous assistance see the relevant section for some suggestions on how to do this In no event will SilverFit be liable for any direct indirect incidental special consequential or other damages including personal injury arising out of the negligent use of the SilverFit by any person Introduction to SilverFit A very short summary The SilverFit is a virtual therapy system It provides exercises for physical rehabilitation e g after a stroke a knee or hip operation or an accident We try to include all relevant gross motor Skills over time Patients can use the system as part of their physiotherapy program This manual describes the operation of the system in detail A summary of the scientific background and other relevant information can be obtained from our website or by email at info silverfit n Turning the system on or off To turn on 1 Plug in power 2 Turn on computer 3 Turn on TV 4 This menu appears SILNVYERFIT To turn off 1 Left click off button 2
24. as you start a game The system screen does not turn on Refer to the game description for specific information on troubleshooting Most likely the camera needs to be recalibrated See next chapter Most likely a cable has come loose See chapter on hardware Please contact SilverFit at 0172 425 139 before making any changes to the camera calibration or the hardware C EPOE SILNYEREIT The SilverFit needs updates service at least once a year If this is not being done in the required frequency SilverFit cannot guarantee the proper working of the SilverFit and its software 79 Camera calibration guide 1 3 Explaining the camera check screen cienki elare Sit i Depth map raw data as seen by the camera This is not visible in some versions Camera view angle camera cannot see outside the dark green area Clipping area things that happen outside the red box are ignored ERFIT A Click to calibrate Set to full body Mcye About u Scene Setup Calibration Background Side view as interpreted by the camera Leave box unchecked el E Please contact SilverFit at 0172 425 139 before making any changes to the camera calibration Click to set parameters e So Sa Frontal view as interpreted by the camera Height of the floor as set by the parameters Top view as interpreted by the camera 80 Camera calibration guide 2 3
25. ation retrain sit stand ability Contra indications Sit stand exercise should not be used if patient has insufficient strength to stand up safely without being aided Exercise description SILNYERFIT The patient sits on a chair or wheelchair about 2 3m from the screen The patient leans left right with the upper body and performs a sit stand sit exercises To start Select a picture from the range of easy very hard pictures Press OK left mouse button when patient is ready to start Rules Stand up E Target for this a Sy picture piece Lean left for The next piece Lean right this piece should go here for this piece The screen shows a 3x3 or larger grid with one piece in grey There are 3 pieces around the grid The patient has to choose which piece fits in the grey area To do so he leans towards the correct piece to get the pieces on the left or right or he stands up to get the piece on top On the easy settings only the correct piece is shown On difficult settings the patient has to choose Scoring Time taken to complete puzzle of Picture of pieces chosen mistakes 17 Sitting exercises Puzzle standard settings Standard difficulty settings SILNYERFIT This is a very simple basic setting Only one puzzle piece will appear and the patient does not have to stand up This is the easiest setting from a cognitive point of view Two puzzle pieces will appear but the
26. camera may pick up the patients knee Put the table closer or put a piece of cloth in front of the table if this happens Table has moved If the table accidentally moves after calibration the calibration is lost Start a game that does not use the table stop it and restart the table game to recalibrate 60 Arm exercises Eggs exercise overview When to use contra indications Goal This game trains lateral movement of the zs P Current upper extremity 4 Say i EY score Used for Post CVA Remaining time Contra indications The exercise may strain the arm if done for too long The exercise requires good Catching a golden timing skills egg gives extra time Move the pillow An Indicates you have dropped this with your hand to chicken s egg Be more careful or the Exercise description cote USES chicken will leave This exercise can be done in three ways If a cat shows up close to the chickens raise your hand up from the table to chase it away 1 The patient places his hand ona To make the game more challenging you can opt table and moves it left and right for a smaller pilllow In some exercise settings he may also need to lift his hand In an alternative exercise the patient moves the hand left and Overall score 1 point per egg right unsupported while sitting or caught standing 2 3m from the camera i w Eggs Golden eggs Chickens caught missed missed by cat I ERFIT 61
27. dup Clear one aues One field game ends after 1 field is cleared Repeat the same field Repeat game ends after 3 identical fields Increase difficulty over time Increase difficulty play on until time runs out Limited amount of time Set duration here 30 sec 3 min Select to play with a timer If this box is not checked the game lasts until 3 tools are broken Duration Click to start exercise with current settings Cardio exercises Vegetable Garden troubleshooting Troubleshooting Tool makes strange jumps the exercise requires the patient to use a large area This may bring the patient close to walls or other objects that may interfere with the camera Move the objects that are in the way or place the SilverFit in a larger open space or adjust the playing field in the detail menu Squatting to get vegetables at the back is too hard in some cases with vegetables at the very back the tool jumps when you try to squat so that you miss the vegetable This happens especially for short people and is caused by the fact that the camera temporarily does not see the patient well It can be solved by squatting more quickly or using a slightly smaller playing area SILNYERFIT 76 The management module 1 2 Creating a menu for a new patient Sign in as a patient You can create a custom menu for a specific patient From the main menu click on the admin button From the main menu click
28. e object or set the clippings Play Balance Molegame Basic setting The feet should move smoothly without any jumps If they jump a lot reset the floor clippings Play Walking flowergame 3 fields Walk to all of the edges of the field The scissors should not make any jumps If they do there are probably objects in the way or you are close to a wall Try readjusting the side and back clippings Play Walking the fox intensive Stand 2 3m form the camera and raise your arms The fox should jump If not check the ceiling clipping and camera angle 82 Hardware check guide 1 2 First step Before trying anything else turn the system off and turn it back on Checking camera connection If the camera is powered you should see a square of small red lights around the central lens The camera is powered with a black wire You can turn the ring on this wire to make sure it is attached well The camera connects to the computer through a USB cable Checking screen connections If the TV is turned on there will be a blue backlight on the power button The TV should have a power cable and a video cable that connects to the computer In some cases the TV also has a separate sound cable SILNYERFIT Please contact SilverFit at 0172 425 139 before making any changes to the hardware Checking computer connections If the computer is turned on there will be a backlight on the power button The computer has the fo
29. e position calibrated Step 2 Check and start game Sit t bi hand on the SILNYERFIT Place a table so that the patient can sit behind it at 2 3m from the SilverFit The table should not bee too small Ideally it should have straight edges and only one color Make sure the chair is away from the table Start the game Normally the table will show up as a line if you come close to it Walk away from the table and make sure there are no other objects or people close to the table Then press the left mouse button Now sit behind the table If all is well it should not show up as a line anymore Put your hand on the table and move it around The blue tag hand should follow your movements If so you are ready to start the game If not press the right mouse button and repeat the steps above Troubleshooting table calibration Table remains visible Some tables do not show up as a Clear line in step 1 and remain visible as collection of black dots after step 2 If the hand can still be detected this is nota problem However if the hand is not detected well see if you can use another table Hand jumps forward and backward Make sure there are no objects on the table other than the patient s hand during the calibration or the exercise Also the patient s hand should not get too close to the other side of the table If this does happen use a bigger table If the table is very small and far from the camera the
30. ements more precisely In this setting the distance the patient has to tap is increased Also ants and cockroaches are added These walk away after a while setting a time challenge for the patient Alternative applications Patient can be seated ona balance cushion or wobble board to make the exercise more challenging By setting the distance in the detail menu very high you can require a patient to kick upwards instead of tap 22 Sitting exercises Picnic detailed settings Detail menu Movements Click to determine which squares are in play green E g turn off all squares on the left if patient should only train right leg Medium Long Set how far the patient has to tap The Long setting requires most You do not have to pull back your feet after scoring people to kick Taller If this option is selected the patient has to pull back his feet after hitting a creature His feet people can reach farther Set the speed of ants 5 ae l and cockroaches Slow Fast Pa Le i gt Set the maximum Ae s 7 7 number of butterflies Currently set duration Click to start exercise with current settings Challenges Choose which bugs should appear Flies sit still and wait to be tapped Cockroaches and ants walk away so they create a time challenge Butterflies have to be avoided They require more coordinated movement Duration _ Set the du
31. emity post CVA Parkinson MS Contra indications There is a relatively high risk of falling A physiotherapist should be behind the patient to catch him her in case of impaired balance or falling risk Current score Remaining time patient s foot Exercise it SLL SILNYERFIT The patient stands about 2 3m from the screen so that his feet appear in the middle square When a mole appears the patient taps with his foot to chase it away If the patient cannot tap he or she can walk towards the mole to chase it off Scoring Step on the mole to score 1 point Ladybugs should be avoided Hitting them costs 2 points The mouse moves and should be Ka caught before it disappears Put one foot on top of each of the leaks to score points Overall score 1 per object hit minus 2 per ladybird Moles Ladybirds Mice Gardenhoses hit hit hit repaired 45 Balance exercises The Mole standard settings Standard difficulty settings SILNYERFIT This is the basic setting Only the mole will appear The game will last one minute Always start a patient on this setting This setting adds the ladybirds The patient has to avoid stepping on them Use this to elicit a more careful movement especially if the patient is very fast This setting adds the mouse and the garden hose Use it with patients who are very good at the game to train soeed and maximum step s
32. en a mole appears the patient taps with his foot to chase it away If the patient cannot tap he or she can walk towards the mole to chase it off SILNYERFIT exercise overview Current score Remaining time patient s foot Step on the mole to score 1 point Ladybugs should be avoided Hitting them costs 2 points The mouse moves and should be g caught before it disappears Put one foot on top of each of the leaks to score points Scoring Overall score 1 per object hit minus 2 per ladybird Mice Moles hit hit hit Ladybirds Gardenhoses repaired 69 Cardio exercises The Mole standard settings Standard difficulty settings SILNYERFIT This is the basic setting Only the mole will appear The game will last one minute This setting adds the ladybirds The patient has to avoid stepping on them Use this to elicit a more careful movement especially if the patient is very fast This setting adds the mouse and the garden hose Use it with patients who are very good at the game to train soeed and maximum step size This is the basic game played by two patients Both patients should have learned the one patient game first before trying the two patient game Alternative applications Patient can stand between vertical bars and support him herself while training Shown here is a patient whose right leg has been amputated Turning only the middle t
33. ending left right while standing Dynamic balance Fine navigational control in wheelchair Move arm on table Raise arm from table Grab reach Move arm in lateral direction on table or unsupported Fast lateral walking Fast reaction speed and dynamic balance Squats 2 Can be done with 2 patients 10 Can be done with 2 patients Simple arm movement Bi 2 Lateral walking Walk in place Walk in small area Wheelchair control Dynamic balance Leaning left right Move arm on table DE Squatting exercise SIAS ERFIT 1 How to help a patient How to help a patient SILNYERFIT As long as the therapist stands behind the patient the camera will react mostly to the patient and not to the therapist It is possible to use tools like the parallel bars to make things easier for the patient It is easy to explain a game by sitting next to a patient However when the game starts the therapist should move back If he does not there is a chance the camera detects the therapist instead of the patient If you have to hold or touch the patient the camera will have difficulty separating patient and therapist Make sure to stand behind the patient to minimize the disturbance If the therapist stands closely behind a sitting person the camera can sometimes interpret the therapist as the upper body and the patient as the lower body
34. er blocking the knee from view will stop the game from working Use the camera view to check if the knees are fully visible Some forms of dark clothing are not seen very well by the camera very wide dresses or skirts can also prevent the camera from properly detecting knee movements Too close message The camera has to see the knees of the patient which is impossible if the patient is too close Sometimes patients walk closer and closer to the screen during play To prevent this you can place a line on the floor or even parallel bars in front of the patient and tell them not to cross the line Fast movement not supported The game has a timer built in that prevents patients from trying to run or walk very fast 40 Walking exercises Flower game exercise overview _When to use contra indications Goal Used for Contra indications This game trains walking in all direction It requires very precise navigation in Space Gait training improving small area coordination Therapist should ensure safety of patients with increased risk of falling by standing behind them Exercise description SILNYERFIT The patient stands in fornt of the screen and walks around in order to pick flowers If the patient approaches a flower it will be cut automatically There is no need to move the hands Current score Remaining scissors if all are lost the game ends
35. ercise setting Access to the detail menu You can save a setting to make it accessible to colleagues Each game menu has a looking glass button Clicking on this button opens a menu fae Press the save settings button with detailed settings for that game When you are satisfied with a particular setting press the save This menu allows you to adjust the exercise settings to E settings button your patient s needs After adjusting the settings start the game with the button on the bottom right Jo Type in name and description Choose the slot l Our local setting 1 Type the name here Click on one of these Give this seting a name buttons i choose nE You can save a 2nd setting here preset game setting it uses only the fly Type a description here Click to save your __ Save lt H oa Click on Save when done right hand panel Adjust game Return to Click to start exercise The setting is added to the menu settings here previous with the current menu setting Your setting Refer to the individual game descriptions for more appears here information on the detailed settings Your description appears here Overview of the exercises Bending left right Bending left right Sit stand Arm movements Tapping with leg Any arm movement Any arm movement SILNVYERFIT Walking on the spot through a small city Walking in a small area A D ea x B
36. hree boxes on in the detail menu creates an easy lateral stepping game or an easy front backward stepping game Two patient mode Score of orange Score of blue patient on left patient on right Feet of blue patient Feet of orange patient Whoever hits the mole first scores a point Blue just scored so grid behind the mole turned blue 70 Cardio exercises Detail menu Movement Click to enable presets You will see the effect in the grid on the right Challenges Here you can choose the kind of challenges you want to appear Move the trackbar to set the game s duration Number of players K NF The Mole detailed settings The mole and other challenges will only appear in the green areas Click on an area to turn it on or off Full exercise E Set required step size in frontward backward direction Set required step size in T lateral direction The game starts with the mole and will increase in difficulty 6 6 Set the maximum number of ladybirds to appear with this trackbar Two player game Click to toggle between one and two patient game Press to start exercise with current settings 71 Cardio exercises The Mole troubleshooting Troubleshooting SILNYERFIT No feet appear the patient is not in the right position or the camera is following another person or object Let the patient move to
37. ize This is the basic game played by two patients Both patients should have learned the one patient game first before trying the two patient game Alternative applications Patient can stand between vertical bars and support him herself while training Shown here is a patient whose right leg has been amputated Turning only the middle three boxes on in the detail menu creates an easy lateral stepping game or an easy front backward stepping game Two patient mode Score of orange patient on left Feet of left orange patient Score of blue patient on right Feet of right Whoever hits the mole first scores a point Blue just scored so grid behind the mole turned blue 46 Balance exercises The Mole detailed settings Detail menu Movement Click to enable presets The mole and other challenges will only appear in the green areas Click on an area E Set required step size in frontward backward direction You will see the effect in the grid on the right Challenges Here you can choose the kind of challenges you want to appear Move the trackbar to set the game s duration Number of players NF to turn it on or off E 4 Set required step size in P lateral direction The game starts with the mole and will increase in difficulty Set the maximum number of ladybirds to appear with this trackbar Two playe
38. k if the settings in the detail menu correspond to the movement made In the standard settings the game reacts only to body movements not to arm movements If arm movements are selected the game will not react to body movements Wheelchair exercises Flower game exercise overview When to use contra indications Goal Used for Contra indications This game trains navigating in a wheelchair Wheelchair users with an intermediate level of wheelchair handling skills The game requires fine motor control of the wheelchair This is often difficult in large electric wheelchairs and only feasible in wheelchairs that turn easily Exercise description SILNVYERFIT The patient sits in a wheelchair and moves the wheelchair around in order to pick flowers If the patient approaches a flower it will be cut automatically There is no need to make any other movement except from navigating the wheelchair Current score Remaining scissors if all are lost the game ends Move the scissors by Approach a flower using the wheelchair to cut it i Turtles and later on lambs try to eat the flowers as well If they succeed you will lose a pair of scissors or some time Beat them to the flower to prevent this Cactuses and hedgehogs should be avoided If you hit them you will loose a pair of scissors or some time Walk around them to prevent this Scoring Overall score 1 per flower Hedgehogs hit
39. le with strong visual acuity and puzzle experience Alternative applications Patient can hold on to parallel bars for support 50 Balance exercises Puzzle detailed settings Detail menu Movement Bend to the left None Slightly Stretch Choose slightly vs S O stretch fully to set the distance the patient has Puzzle size Choose the number of total puzzle pieces 3x3 4x4 5x5 by clicking on the right puzzle Choice of pieces Choice Choose 1 answer to have only the one puzzle piece appear the patient will not have to choose so the cognitive element of the exercise is much easier Choice displays 2 pieces making the exercise harder Click to start exercise with current settings Balance exercises Puzzle troubleshooting Troubleshooting Pieces move by themselves this can happen if the patient is not well detected and the system is following another person or object Make sure there are no other objexts and people cluttering the view Check if the patient is visible in the camera view i on the remote or gt on the mouse If not place the chair at the right distance 2 3m and ask the patient to move his body or arms until he shows up Pieces do not move Check if the patient is visible in the camera view see above Also make sure the therapist is not seen on camera If only the patient is visible and the pieces still do not move chec
40. llowing connections A power cable A video cable to the TV screen A USB cable to the camera A small USB stick receiver for the mouse A small cable with an infrared receiver Sometimes an extra sound cable Sometimes a keyboard Checking mouse issues a If the mouse is operational you will see lights on the front If you see no lights turn on the mouse with the switch on the back If this does not work the battery has to be charged Put the mouse in the mouse holder to charge The computer should have a little stick to receive the mouse info in one of the USB j ports 83 Hardware check guide 2 2 Checking the remote If the remote is operational you will see a light turn on when pressing a button If there is no light change the batteries of the remote The remote must be received by an infrared eye In order to work the remote must be directly pointed at the infrared receiver The receiver must be connected to a USB port in the computer If the receiver reads the remote it will blink with a red light when a button is pressed SILNYERFIT Please contact SilverFit at 0172 425 139 before making any changes to the hardware 84 Contacts Contact details Why contact us www silverfit nl Gouwestraat 11 2407 BB Alphen a d Rijn The Netherlands From Netherlands 0172 425 139 International 31 172 425 139 Support silverfit nl SILNYERF
41. m the figure on screen Make sure to start the action only when the animal is very close If the ball is still triggered too early try sitting closer to the camera and or setting the movement slider in the detail menu to large movements 32 Walking exercises The Fox exercise overview When to use contra indications Used for Contra indications Exercise description SILNYERFIT This game trains lateral sidewards walking Walk training post orthopedic post CVA fall prevention The patients should be able to stand possibly supported by parallel bars The patient stands 2 3m from the screen When grapes appear the patient steps left or right to move the fox towards the grapes and catch them Branches should be avoided by stepping away Chickens can be caught by raising one or both arms in the air Current score Remaining time Catch as many grapes as you can Move the fox by Avoid the leaning left and right branches Raise both arms to make the fox jump and catch the chicken This gives a small time bonus Overall score 1 per grape caught Grapes Grapes Chickens Branches hit caught missed caught 33 Walking exercises the Fox standard settings Standard difficulty settings SILNYERFIT This is a very simple basic setting Only one grape will appear at a time and there are no branches or chickens This makes it easy from a cognitive point of view With this
42. ng of people with good motor and cognitive skills Requires good balance motor skills and flexibility Lean left for The next piece Lean right this piece should go here for this piece Exercise description The screen shows a 3x3 or larger grid with one piece SILNYERFIT in grey There are 2 pieces around the grid The patient The patient stands in front of the has to choose which piece fits in the grey area To do system and leans left right with so he leans towards the correct piece to get the pieces his her full body on the left or right or he stands up to get the piece on top On the easy settings only the correct piece is shown On difficult settings the patient has to choose To start Scoring Select a picture from the range of easy very hard pictures Press OK left mouse button when patient is Time taken to ready to start s complete puzzle of Picture of pieces chosen mistakes 49 Balance exercises Puzzle standard settings Standard difficulty settings SILNYERFIT This is a basic setting from both a cognitive and a physical point of view Only one puzzle piece will appear The patient does not have to lean very far Two puzzle pieces will appear More difficult from a cognitive point of view but similar on a physical level Similar to the previous setting but the patient has to stretch further This setting shows a more challenging 4x4 puzzle and is only applicable for peop
43. on the sign in button Click new user Select patient name and click sign in Administration Click on The patient s custom menu the X to appears remove game Click to access different Type patient movements and games name here Patient Custom name menu Administration Select user and click E change to change a menu _ Access Drag the The menu Click to detailed required you are save menu A Select user and click settings for setting to the creating for delete to delete a menu this game menu this patient 11 The management module 2 2 John Doe Press the detailed settings button in the menu creation screen Type in a name for this setting Then press Next Type in a description for this setting Then press Next Making a detailed setting for a particular patient menu Movement Create a custom setting Difficulty Game elements Duration Press Save when done John Doe Th e new setting appears in the patient menu NA G The patient will see the name and description in his menu after signing in John Doe Seated exercises John Doe specia This setting has been made for the manua 18 Troubleshooting How to start troubleshooting Solution One or two of the games do not work properly A lot of the games do not work properly The system gives an error as soon
44. one grape will appear at a time and there are no branches or chickens With this setting the number of grapes and the speed at which they fall increases over time based on the patient s performance This setting adds the chicken and branches Use it with patients who are able to manage more complex visual inputs and movements This setting is similar to the previous one but starts at a higher level so that there are more grapes falling at higher speed from the beginning Alternative applications Patient can be seated on a balance cushion or wobble board to make the exercise more challenging 14 Sitting exercises the Fox detailed settings Detail menu Movement Set how far the hen Move short distance patient has to bend to move the fox DA Move maximum distance DEN E Set the starting level number Difficulty Y e of grapes and speed ara Easy 1 grape many grapes Click here to let the game automatically Adapt to player adjust the difficulty based on the patient s performance Turn off for fixed level Game elements YS You have turned off the chicken Choose the type of challenges ek You have turned off the branch YOU want to appear Duration D 0 1 z 30 Currently set duration Move the trackbar to set the game s duration Click to start exercise with current settings A NO ERFIT 15 Sitting exercises the Fox troubleshooting Troubleshooting
45. ouse button and repeat the steps above Troubleshooting table calibration Table remains visible Some tables do not show up as a Clear line in step 1 and remain visible as collection of black dots after step 2 If the hand can still be detected this is nota problem However if the hand is not detected well see if you can use another table Hand jumps forward and backward Make sure there are no objects on the table other than the patient s hand during the calibration or the exercise Also the patient s hand should not get too close to the other side of the table If this does happen use a bigger table If the table is very small and far from the camera the camera may pick up the patients knee Put the table closer or put a piece of cloth in front of the table if this happens Table has moved If the table accidentally moves after calibration the calibration is lost Start a game that does not use the table stop it and restart the table game to recalibrate 64 Cardio exercises The Fox exercise overview When to use contra indications Used for Contra indications Exercise description SILNYERFIT This game trains lateral sidewards walking Fitness cardiotraining The patients should be fit enough for an intensive workout and suffer no balance issues The patient stands 2 3m from the screen When grapes appear the patient steps left or right to move the fox towards the grapes and
46. patient still does not have to stand up More difficult from a cognitive point of view but similar on a physical level In this setting three pieces will appear The patient will have to stand up 3 5 times This setting shows a more challenging 4x4 puzzle and is only applicable for people with strong visual acuity and puzzle experience Alternative applications Patient can be seated ona balance cushion or wobble board to make the exercise more challenging If the patient cannot stand up use the detail menu to select an alternative movement like raising the hands or bending forward 18 Sitting exercises Puzzle detailed settings Detail menu Select arm only to change the leaning movement and instead move the arm in the equivalent direction Choose slightly vs Bend to the left Movement Sendte None Array SRSA sretcn crcrctl to set the distance the patient has Bend to the right None Arm only sighty Stretch to lean or stand up Choose none to get OOOO rid of puzzle pieces on e a a O None Arm only slightly Fully Forward the left right top Get up from chair wn EFN CITITA This option changes the sit B mm e TER R aS stand exercise so that the Choose the number of total puzzle BEH patient has to bend forward pieces 3x3 4x4 5x5 by clicking on the right puzzle l Choose 1 answer to have only the one puzzle Choice l l l i piece appear the patient will not have
47. r game Click to toggle between one and two patient Press to start exercise game with current settings 47 Balance exercises The Mole troubleshooting Troubleshooting SILNYERFIT No feet appear the patient is not in the right position or the camera is following another person or object Let the patient move to the playing area let all others move away and ask the patient to move around until he is detected If this does not help put your hand in front of the camera for 2 seconds and retry Only one set of feet appears the legs are not well detected A stroller or other object may be in the way or the patient may be wearing non reflective clothes Remove objects and or try with another patient If appropriate ask patient to wear lighter coloured clothes next time The feet sometimes suddenly jump out of the screen some other object or a wall or the therapist is interfering When the patient comes close this object is interpreted as a leg Place the SilverFit in a less constrained space if possible The feet are shaking so much it is hard to play the camera is detecting interference from the floor and should be recalibrated 48 Balance exercises Puzzle exercise overview When to use contra indications Goal Used for Contra indications This game trains upper body balance and lateral flexibility Target picture MS patients general fitness flexibility traini
48. ration of the exercise NF 23 Sitting exercises Picnic troubleshooting Troubleshooting SILNYERFIT Feet are visible but do not react the game is very sensitive to the orientation of the patient compared to the camera Make sure the patient is seated straight in front of the camera with his knees pointing at the system Turning or sitting in an odd posture will diminish the reactivity of the feet Too close message The camera has to see the feet of the patient which is impossible if the patient is too close The optimal distance for this game is about 1 1 5 m further than for most other sitting games Not detected message If the patient sits far from the camera it may take some time before the camera detects him Ask the patient to make some random arm or body movements so he will be detected Alternatively stand very closely behind the patient and make some movements yourself If this does not work move the patient somewhat closer until he is detected 24 Sitting exercises Volleyball exercise overview When to use contra indications Goal Used for This game trains moving the arm or the upper body It is intentionally non specific as to the exact movement made Activation exercise for early rehabilitation or keeping fit Contra indications The exercise may strain the arm if done for too long The exercise requires good timing skills Exercise description
49. s and simplified graphics that are easier to see Simplified graphics You will start at a calm pace Here you can see which challenges will occur Determine which challenges none turtles cactuses lambs hedgehogs all of these will appear during the game Buildup vl Clear one Se ee One field game ends after 1 field is cleared Repeat the same field Repeat game ends after 3 identical fields Increase difficulty over time Increase difficulty play on until time runs out Limited amount of time Set duration here 1 min 10 sec Select to play with a timer If this box is not checked the game lasts until 3 scissors are broken LNEYE REFIT i Duration Click to start exercise with current settings Walking exercises Flower game troubleshooting Troubleshooting SILNYERFIT Scissor makes strange jumps the exercise requires the patient to use a large area This may bring the patient close to walls or other objects that may interfere with the camera Move the objects that are in the way or place the SilverFit in a larger open space or adjust the playing field in the detail menu 44 Balance exercises The Mole exercise overview When to use contra indications Goal Used for This game trains the dynamic balance of the patient It can be used as a fall prevention exercise or to train the short distance mobility of the patient Post orthopedic surgery lower extr
50. s also impossible to turn the system off using the remote For this you need the mouse Press to return Press for camera to main menu view see game desciptions Press to select Press to select item to the left Ey item to the right Press to return to y Press to choose previous screen currently or to exit a game selected item lo If the remote does not work a gt If the remote is operational you will see a light turn on when pressing a button If there is no light change the batteries of the remote The remote needs to be pointed at the system to work SILNYERFIT Menu structure Additional options Press three buttons to start V AN JN AN A j Main menu Seated exercises The fox Catch the grapes by leaning left and right This trains the balance of the upper body Choose movement The main menu shows 6 types of movements Choose one of the categories Choose exercise The next menu shows 1 5 game options Choose a game Choose difficulty The next menu shows 4 difficulty settings with the easiest setting on the left Choose a difficulty to start the game Patient login Log in a particular patient Administration Open the patient management section Turn off Turn off the SilverFit system Use detailed settings Adjust the game options using the detailed settings menu Using the detail menu Detail menu screen Saving a custom ex
51. setting the number of grapes and the speed at which they fall increases over time based on the patient s performance This setting adds the chicken and branches Use it with patients who are able to manage more complex visual inputs and movements This setting is similar to the previous one but starts at a higher level so that there are more grapes falling at higher speed from the beginning Alternative applications lt Patient can hold on to parallel bars for support 34 Walking exercises the Fox detailed settings Detail menu Movement fio Set how far the hen Move short distance patient has to walk to move the fox DA Move maximum distance DEN E Set the starting level number Difficulty Y e of grapes and speed ara Easy 1 grape many grapes Click here to let the game automatically Adapt to player adjust the difficulty based on the patient s performance Turn off for fixed level Game elements YS You have turned off the chicken Choose the type of challenges ek You have turned off the branch YOU want to appear z Currently set duration Duration g 0 1 ar ME Move the trackbar to set the game s duration Click to start exercise with current settings A ira per 35 Walking exercises the Fox troubleshooting Troubleshooting SILNYERFIT Fox makes small sudden moves to left and right most probably this happens when the patient comes close to an
52. t Used for Total joint MS Contra indications Recent total hip patients should play only with 4 squares to prevent torque forces on the hip Exercise description The patient sits on a chair wheelchair or a flat surface 3m or more from the screen The patient taps with his feet to chase away bugs that appear on the screen After the bug has been chased away the patient pulls back his feet before tapping again SILNYERFIT Rules Stand up for this piece Remaining time Hit flies on the right with your right foot After hitting a bug your foot turns red Pull it back under the chair before hitting the next bug Avoid hitting butterflies or you will lose points Cockroaches and ants walk on after a short while so you have to catch them quickly Total score 1 per bug minus 2 per butterfly Butterflies hit inadvertently Flies Ants Cockroaches hit hit hit 21 Sitting exercises Picnic standard settings Standard difficulty settings SILNYERFIT This setting only shows four squares so the patient does not need to torque the hip Feet do not have to be pulled back after a tap Only flies appear Six squares so torque of the hip is required Do not use if the patient cannot turn the hip yet Feet have to be pulled back Only flies appear This setting is similar to the one above but now butterflies are added These have to be avoided This requires the patient to control his mov
53. the game ends Move the tool by Approach a vegetable walking around and squat to pick it Rabbits and later on lambs try to eat the vegetables as well If they succeed you will lose a tool or some A time Beat them to the vegetable to prevent this Stones and hedgehogs should be avoided If you hit them you will loose a tool or some time Walk around them to prevent this Overall score 1 per vegetable Hedgehogs hit Vegetables Stones Vegetables lost to rabbits hit lost to lambs 13 Cardio exercises Vegetable Garden standard settings Standard difficulty settings This is a basic setting The field contains only vegetables The game will end after the patient has completed one field This setting starts with just vegetables but will build up over time to include the other challenges It uses more complex graphics There is no time limit This setting is similar to the one above but introduces a time limit This setting starts at a higher level of difficulty and sets a more stringent time limit Cardio exercises Vegetable Garden detailed settings Detail menu Playing field Movement Crouching Set how far the Set the size of the y p q playing field Easy Hard left right and front back You will start at a calm pace Here you can see which challenges will occur Determine which challenges none rabbits stones lambs hedgehogs all of these will appear during the game Buil
54. the playing area let all others move away and ask the patient to move around until he is detected If this does not help put your hand in front of the camera for 2 seconds and retry Only one set of feet appears the legs are not well detected A stroller or other object may be in the way or the patient may be wearing non reflective clothes Remove objects and or try with another patient If appropriate ask patient to wear lighter clothes next time The feet sometimes suddenly jump out of the screen some other object or a wall is interfering When the patient comes close this object is interpreted as a leg Place the SilverFit in a less constrained space if possible The feet are shaking so much it is hard to play the camera is detecting interference from the floor and should be recalibrated 12 Cardio exercises Vegetable Garden exercise overview When to use contra indications This is an intensive exercise where the patient has to move around and squat repeatedly Used for COPD Cardio exercises for fit patients Contra indications Requires a good level of general fitness and balance Exercise description The patient stands 2 3m from the screen and walks around to move a tool on the screen If the tool hovers above a vegetable the patient has to squat to pick the vegetable SILNYERFIT Current score Remaining tools if all are lost
55. ts but they cannot influence each other Note that walking very fast running is not possible 38 Walking exercises A Stroll detailed settings Detail menu Challenges Traffic lights Stationary obstacles Obstacles to d f _ step over t IA 2 Obstacles moving towards you Ball players you need to avoid Distance Number of players A Set the number of patients 1 2 NF Set the number of traffic lights encountered These require the A i patient to stop and wait none a few multiple many Set the number of stationary objects These require the patient to step sideways none a few multiple many g nuo E ee Set the number of obstacles that ee a i require a patient to make a high step lift knee up high none a few ee Set the number of obstacles that move towards the patient The patient has to step aside quickly none a few multiple many Set the number of obstacles that move left right The patient has to time his movement to cross 10 blocks Set the total distance to be Click to start exercise with current settings walked If the distance is very short you may not see all the selected challenges 39 Walking exercises A Stroll troubleshooting Troubleshooting m Ll SILNYERFIT Character does not walk the camera reacts to the knees of the patient It has to be able to see the knees move Any object such as a stroll
56. until time runs out Limited amount of time Set duration here 1 min 10 sec Select to play with a timer If this box is not checked the game lasts until 3 scissors are broken Duration Click to start exercise with current settings Wheelchair exercises Flower game troubleshooting Troubleshooting SILNYERFIT Scissor makes strange jumps the exercise requires the patient to use a large area This may bring the patient close to walls or other objects that may interfere with the camera Move the objects that are in the way or place the SilverFit in a larger open space or adjust the playing field in the detail menu Turning the wheelchair leads to unexpected jumps if the patient uses a very large wheelchair as shown to the left the camera cannot interpret the difference between a front view and a side view This leads to strange jumps of the scissors whenever the wheelchair turns The exercise cannot be performed with this kind of wheelchair 56 Arm exercises Memory exercise overview When to use contra indications Goal Used for This game trains strength and functional use of the upper extremity moving the arm forward upward and reaching for objects Post CVA new shoulder Contra indications The exercise may strain the arm if done for too long The exercise requires good short term memory skills Exercise description SILNYERFIT This exercise can be

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