Abstract
BackgroundA high number of upper extremity myoelectric prosthesis users abandon their devices due to difficulties in prosthesis control and lack of motivation to train in absence of a physiotherapist. Virtual training systems, in the form of video games, provide patients with an entertaining and intuitive method for improved muscle coordination and improved overall control. Complementary to established rehabilitation protocols, it is highly beneficial for this virtual training process to start even before receiving the final prosthesis, and to be continued at home for as long as needed.ObjectiveThe aim of this study is to evaluate (1) the short-term effects of a commercially available electromyographic (EMG) system on controllability after a simple video game-based rehabilitation protocol, and (2) different input methods, control mechanisms, and games.MethodsEleven able-bodied participants with no prior experience in EMG control took part in this study. Participants were asked to perform a surface EMG test evaluating their provisional maximum muscle contraction, fine accuracy and isolation of electrode activation, and endurance control over at least 300 seconds. These assessments were carried out (1) in a Pregaming session before interacting with three EMG-controlled computer games, (2) in a Postgaming session after playing the games, and (3) in a Follow-Up session two days after the gaming protocol to evaluate short-term retention rate. After each game, participants were given a user evaluation survey for the assessment of the games and their input mechanisms. Participants also received a questionnaire regarding their intrinsic motivation (Intrinsic Motivation Inventory) at the end of the last game.ResultsResults showed a significant improvement in fine accuracy electrode activation (P<.01), electrode separation (P=.02), and endurance control (P<.01) from Pregaming EMG assessments to the Follow-Up measurement. The deviation around the EMG goal value diminished and the opposing electrode was activated less frequently. Participants had the most fun playing the games when collecting items and facing challenging game play.ConclusionsMost upper limb amputees use a 2-channel myoelectric prosthesis control. This study demonstrates that this control can be effectively trained by employing a video game-based rehabilitation protocol.
Highlights
The initial control of a myoelectric prosthesis can be a frustrating experience, especially after the already traumatic event of losing a limb
Results showed a significant improvement in fine accuracy electrode activation (P
This study demonstrates that this control can be effectively trained by employing a video game-based rehabilitation protocol. (JMIR Serious Games 2017;5(1):e3) doi:10.2196/games
Summary
The initial control of a myoelectric prosthesis can be a frustrating experience, especially after the already traumatic event of losing a limb. At least 50% of upper extremity amputees report problems with prosthesis control and functionality [3,4], which can be attributed to the need for receiving more training in handling the prosthesis [5,6]. Patients are presented with a variety of tasks promoting the development of coping strategies for dealing with the activities of daily living, and introducing the embodiment of the prosthetic system itself. To effectively control their prosthesis, patients need to learn how to properly contract their muscles; the strength of activation and isolation of a single muscle are important parameters [1,9,10]. Complementary to established rehabilitation protocols, it is highly beneficial for this virtual training process to start even before receiving the final prosthesis, and to be continued at home for as long as needed
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