Abstract
BackgroundBrain plasticity is an important factor in prosthesis usage. This plasticity helps with brain adaptation to learn new movement and coordination patterns needed to control a prosthetic hand. It can be achieved through repetitive muscle training that is usually very exhausting and often results in considerable reduction in patient motivation. Previous studies have shown that a playful concept in rehabilitation can increase patient engagement and perseverance.ObjectiveThis study investigated whether the inclusion of video games in the upper limb amputee rehabilitation protocol could have a beneficial impact for muscle preparation, coordination, and patient motivation among individuals who have undergone transradial upper limb amputation.MethodsTen participants, including five amputee participants and five able-bodied participants, were enrolled in 10 1-hour sessions within a 4-week rehabilitation program. In order to investigate the effects of the rehabilitation protocol used in this study, virtual reality box and block tests and electromyography (EMG) assessments were performed. Maximum voluntary contraction was measured before, immediately after, and 2 days after interacting with four different EMG-controlled video games. Participant motivation was assessed with the Intrinsic Motivation Inventory (IMI) questionnaire and user evaluation survey.ResultsSurvey analysis showed that muscle strength and coordination increased at the end of training for all the participants. The results of Pearson correlation analysis indicated that there was a significant positive association between the training period and the box and block test score (r8=0.95, P<.001). The maximum voluntary contraction increment was high before training (6.8%) and in the follow-up session (7.1%), but was very small (2.1%) shortly after the training was conducted. The IMI assessment showed high scores for the subscales of interest, perceived competence, choice, and usefulness, but low scores for pressure and tension.ConclusionsThis study demonstrated that video games enhance motivation and adherence in an upper limb amputee rehabilitation program. The use of video games could be seen as a complementary approach for physical training in upper limb amputee rehabilitation.
Highlights
A myoelectric prosthesis is a popular choice among upper limb amputees [1], most users stop using it after sometime owing to control difficulties, muscle fatigue, and lack of motivation to practice before getting used to the control mechanism [2]
This study investigated whether the inclusion of video games in the upper limb amputee rehabilitation protocol could have a beneficial impact on the course of treatment and patient motivation, with the hypothesis that the functional outcome of motor rehabilitation is directly proportional to the duration of the therapeutic session [25,26,27] and patient interest to take part in rehabilitation [28]
We showed that incorporating video games in an upper limb amputee rehabilitation protocol would provide benefits to the rehabilitation output
Summary
A myoelectric prosthesis is a popular choice among upper limb amputees [1], most users stop using it after sometime owing to control difficulties, muscle fatigue, and lack of motivation to practice before getting used to the control mechanism [2]. It has been shown that virtual reality (VR) platforms, in the form of video games, provide amputees with an interactive and immersive technique for enhanced muscle coordination and overall control, which has been found to be very helpful for a patient to start training before getting an actual prosthetic hand [11]. Brain plasticity is an important factor in prosthesis usage This plasticity helps with brain adaptation to learn new movement and coordination patterns needed to control a prosthetic hand. It can be achieved through repetitive muscle training that is usually very exhausting and often results in considerable reduction in patient motivation. The use of video games could be seen as a complementary approach for physical training in upper limb amputee rehabilitation
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