You’ve heard of video games being used in physical therapy, but what about physical therapy in a video game?  Well ok, it’s only mentioned, but I’ll take what I can get.

My boyfriend is currently playing through the game Mass Effect 2 by BioWare.  It’s a fun, story-driven action role-playing game where you have a spaceship and go to different planets and do cool stuff.  When he showed me the first Mass Effect, I really liked it because it looked great and you can talk to almost everybody in the game.  Instead of a random person sitting at a desk or staring in space, you can have a conversation with that character and get to know them.  Andrew sent me this screen shot from Mass Effect 2:

The text reads: “… moons were the sites of many batarian labor camps during the Anhur rebellions, generating raw materials for the war. When the slaves were finally liberated by Eclipse, the mercenaries found abysmal conditions including whole camps that lacked mass effect fields to keep the gravity at habitable levels. The widespread bone loss among the slaves was part of their master’s final degradation — it would cripple them if they ever left for a standard-gravity world.
The plight of the slaves soon garnered galactic media attention, and several charities sprang up to pay for their physical therapy and find them gainful employment….”

Yay!!! Not only is PT mentioned in a game, but it also emphasizes the importance of bone density.   Bone loss due to uninhabitable gravity levels is not a problem most physical therapists typically face everyday, but bone loss due to osteoporosis and deconditioning is!  The calcium in bone is constantly being broken down and built back up by two different processes moderated by hormones.   Bones adapt to the forces being placed on them. Therefore if a bone is under less force due to immobility or lack of gravity applying forces through the bones this will cause the process of breaking down the bone to speed up more than it is built back up.  This results in a decreased bone density.  (Women are affected more by osteoporosis due the lack of estrogen post-menopause, but all people are affected by age-related demineralization of bone loss which can start in your 30s and increases over time).
The rate at which bone mineral is regained is significantly less than the rate that it is lost (the notes from one of my professors says bone density is lost at 1% per week of bedrest and takes 1 month to regain).  The same principle that bone adapts to the forces placed on it is used to recover lost bone density.  By gradually applying more weight to bone through exercise over time the process of building up the bone is increased.  Don’t forget to take your calcium everybody!

This goes to show why PTs are important in the hospital setting.  After someone has spent weeks in the hospital battling something nasty, their body has undergone deconditioning due to lack of physical activity.  Acute care PTs work to prevent these losses as much as a person can tolerate by keeping them up and active.  After a person has overcome their battle with whatever had them in the hospital so long (pnemonia, infections, organ transplant, all sorts of things), they need PT to help overcome the next battle of deconditioning.  The lack of physical activity not only affects bones, but muscle, joints and puts people at a greater risk of certain heart and lung problems.  PT is necessary to help each person fully recover to who they were before they came to the hospital.

I think the PTs in Mass Effect probably started by using a tilt table to help the former slaves’ bones gradually become strong enough to hold the weight of their own body.  They probably progressed to a gentle walking program and may have built up to some strength training to prepare them for their gainful employment.

Thank you BioWare for sharing the wonders of physical therapy with the world!  Since BioWare was founded by two doctors maybe they would be open to my game idea for a physical therapy video game, right?

Know someone with osteoporosis?  Exercise can be a great treatment.  Not all exercise is appropriate, especially since their bones are already prone to fracturing.  WebMD has a good page on which types of exercise are most helpful.  A physical therapist can help guide appropriate exercise to recover bone loss and improve all over function.