Game-based Rehabilitation System Research Articles

A Game-Based Rehabilitation System for Upper-Limb Cerebral Palsy: A Feasibility Study.

Game-based rehabilitation systems provide an effective tool to engage cerebral palsy patients in physical exercises within an exciting and entertaining environment. A crucial factor to ensure the effectiveness of game-based rehabilitation systems is to assess the correctness of the movements performed by the patient during the game-playing sessions. In this study, we propose a game-based rehabilitation system for upper-limb cerebral palsy that includes three game-based exercises and a computerized assessment method. The game-based exercises aim to engage the participant in shoulder flexion, shoulder horizontal abduction/adduction, and shoulder adduction physical exercises that target the right arm. Human interaction with the game-based rehabilitation system is achieved using a Kinect sensor that tracks the skeleton joints of the participant. The computerized assessment method aims to assess the correctness of the right arm movements during each game-playing session by analyzing the tracking data acquired by the Kinect sensor. To evaluate the performance of the computerized assessment method, two groups of participants volunteered to participate in the game-based exercises. The first group included six cerebral palsy children and the second group included twenty typically developing subjects. For every participant, the computerized assessment method was employed to assess the correctness of the right arm movements in each game-playing session and these computer-based assessments were compared with matching gold standard evaluations provided by an experienced physiotherapist. The results reported in this study suggest the feasibility of employing the computerized assessment method to evaluate the correctness of the right arm movements during the game-playing sessions.

Development of an interactive game-based mirror image hand rehabilitation system

To develop a hand rehabilitation device, the patient-specific heterogeneity of physical ailments must be considered in the design process to provide optimized rehabilitation. In this paper, we suggest a low-cost customized manufacturing process of a hand rehabilitation system. We first extract the length and size of the fingers based on a CMOS camera system. Then, the mechanical components of the rehabilitation system were manufactured using a 3D printer. User safety is guaranteed using a simple operation range control connector mechanism which mechanically locks up when the range of motion of each finger is exceeded for finger extension. We verified the usability of the hand rehabilitation system and applied the system to two custom interactive video games.

Training of Hand Rehabilitation Using Low Cost Exoskeleton and Vision-Based Game Interface

Motivating game-based training have the potential to improve therapy for people with neurological impairments. In recent years, the serious games have become extremely useful tools in rehabilitation field. They aim to stimulate the mobility of the body through an immersive experience that puts the user in interactive virtual environment. This paper is concerned about developing a customized augmented reality system for stroke rehabilitation. This will be done through integrating an interactive serious game interface with a hand exoskeleton device. This game-based rehabilitation system allows users to carry out physical rehabilitation therapies using a natural user interface based on Kinect’s skeletal tracking features and the electromyography (EMG) sensor. During game playing, the interactive user interface provides useful real-time feedback information such as the time required to grasp a desired dynamic virtual object, and the assigned score and thus the ability of the proposed system to provide a compensatory action regarding the dynamic behavior of the virtual target. The main goal of the developed virtual environment is to create positive influences on the rehabilitation process. Patient movement information and signals obtained from the developed exoskeleton device are used together to monitor the rehabilitation progress. The developed exoskeleton hand is a 3D printed low cost device suitable for grasping tasks that can be used even for domestic stroke patients. The developed exoskeleton device is not only a mechanical system able to perform the rehabilitation act but also it presents an effective tracking and traceability software solution. The EMG signals measured during hand motion are used to detect the intention of hand opening or closing which in turn will actuate the mechanical structure to accomplish the desired task. Parameters and results of patients’ exercises are stored and analyzed when needed to evaluate patients’ progress. The developed system is tested experimentally and it is able to restore the functions of the upper limb and mainly give patients more motivation to undergo the rehabilitation exercises.

What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately selected) games to be operated on commodity hardware and brings cost-effective rehabilitation systems to more and more patients' home for long-term recovery.

Developing and evaluating effectiveness of 3D game-based rehabilitation system for Total Knee Replacement Rehabilitation patients

With the development and popularization of virtual reality and motion capture technology, physical therapists have had a new option to improve patient rehabilitation effectiveness. However, there were few studies in the past focusing on total knee replacement (TKR) rehabilitation solutions and many restrictions on the assistance devices. This paper aims to explore how users' motivation and perception of system usability affect rehabilitation performance in a 3D game-based rehabilitation environment. Further, we examine the feasibility of applying Kinect-based method in rehabilitation activities to improve performance. A system called the Physical Rehabilitation System (PRS) was developed and deployed in a one-week TKR rehabilitation process. 27 TKR rehabilitants were divided into a control group (Nź=ź11), and an experimental group, which was rehabilitated with a PRS (Nź=ź16), and had, also, to fill out a questionnaire. The group with higher performances generally had stronger motivation and a better evaluation on a PRS (pź<ź.05). The experimental group showed greater improvement with an average knee-bending angle of 109.38. This study shows that motivation influences the effectiveness of rehabilitation, and that PRS acceptance by rehabilitants was indeed able to strengthen their motivation and improve their rehabilitation outcomes.