Former arcade game helps Erie rehabilitation patients BY DAVID BRUCE, Erie Times-News Fernando Morales pushed aside his walker and stepped into the Makoto Arena. Three 6-foot tall steel posts surrounded Morales, 49, and Amanda Polizzi, his HealthSouth Rehabilitation Hospital of Erie physical therapy assistant. A recorded voice counted down from four, then a series of red, blue and green lights flashed on the steel posts. Morales, who is recovering from knee-replacement surgery, had to slide his feet to touch the lights on each of the posts. "I feel good. I have to get one of these for my son," Morales said after two 45-second sessions in the arena. A device that was once an arcade game is now helping rehabilitation patients at 100 HealthSouth hospitals, including the one in Erie. HealthSouth Erie, 143 E. Second St., received its Makoto Arena in early June and prescribes it for patients who have suffered strokes, brain injuries and orthopedic surgeries like knee replacement. "We have about five or six patients a day who use it," said Shelly Mayes, HealthSouth Erie's director of therapy operations. "It helps them with their balance, their reaction time, their stamina -- all at the same time." The Makoto Arena was created in the 1990s as a martial arts training device. Its current owner, Makoto USA, discovered it at a children's arcade in Glenwood Springs, Colo., according to the company's website. Makoto USA made changes to the device, including adding more targets and adding a computer. A 2005 study showed that the device improved fitness and brain function. "We have used it with patients who have suffered concussions and other types of brain trauma," Mayes said. "It helps improve their concentration and their focus." Makoto USA pitched the device to hospitals and nursing homes as a rehabilitation device. HealthSouth saw how it could help its patients. Not every HealthSouth patient uses the Makoto Arena, which is located in an otherwise empty room that used to house the hospital's medical records. Each occupational, physical and speech therapist evaluates their patient to see what devices will help them, Mayes said. In Morales' case, his therapists thought using the Makoto Arena would improve his balance and stamina as he prepared for his discharge on Thursday. "When you have knee surgery, you tend to favor that side," Polizzi said. "This forces you to shift your weight, which improves your balance and strength." You don't have to be able to stand on your feet to use the Makoto Arena. The device is large enough to accommodate wheelchair-bound patients, who use a rubber-tipped staff to press the lighted buttons. The buttons themselves are covered with bulletproof glass. "With seated patients, we see improvement in their stamina and upper-body strength," Mayes said. "And since it's a game, they are more likely to use it and stick with it." It doesn't take long for patients to feel the benefits of the Makoto Arena. The typical session lasts 15 minutes, which includes four or five 30- to 60-second rounds and time for rest. "We can program the lights to blink slower or faster, and shine on one, two or all three beams," Polizzi said. "The computer tells us how many lights the patient hits, and their average reaction time." Since Morales is otherwise healthy except for his surgically repaired knee, Polizzi challenged his balance by having him stand on a foam board while he used the Makoto Arena. "It prepares patients for walking on grass and uneven surfaces," Polizzi said. The Makoto Arena won't displace other, more traditional therapeutic devices, Mayes said. "It's another tool in our toolbox," Mayes said.

Fernando Morales, left, touches lights on the Makoto Arena while being helped by Amanda Polizzi, PTA. The machine is used as a physical therapy tool to improve balance and coordination./GREG WOHLFORD, Erie Times-News