Squachu: a training game to improve oral function via a non-contact tongue-mouth-motion detection system

Impaired articulation, chewing, or swallowing can have a strong impact on Quality of Life. These behaviors can be affected by decreased oral muscle function caused by aging and/or certain medical conditions. Aspiration pneumonitis is a major cause of death among elderly people, and is triggered by impaired swallowing, mainly due to decreased oral muscle strength. To reduce the risk of aspiration pneumonitis, elderly people are often advised to exercise and train their oral muscles. Unfortunately, such training tends to be monotonous and it is often difficult for trainees to detect the effects of the training, i.e., improved oral function. To address this issue, we developed an oral muscle training game called Squachu. Squachu is composed of a non-contact tongue-mouth-motion detection system and a game engine. As motion is tracked using a depth camera, players play the game via mouth and tongue motion and do not have to wear any specialized equipment. Thus, the game is hygienic and easily accessible for daily play. Players tend to assume the game score as a rough indicator of their oral function. Scores can be improved by frequent play of Squachu. Here, we describe the results of a month-long user test. We asked eight participants, aged 74--96, to play Squachu daily. After one month, we found improvements in three out of seven diagnostic criteria for the deterioration of oral function. We also found that some participants became more interested in voluntary game play, as they checked and compared their game scores with others.