Serious Games For Rehabilitation Research Articles

Developing a Motion Sensor-Based Game to Support Frozen Shoulder Rehabilitation in Older Adults through a Participatory Design Approach.

Objective: Although some serious games have been developed for physical therapy, little work has been conducted through a participatory design approach. Therefore, a game prototype was developed, which involved related stakeholders in the design process. Materials and Methods: The iterative participatory design process was adopted with the input of 18 patients with frozen shoulder symptoms, 4 health professionals, 2 game designers, and 5 researchers in an iterative process to design, test, and evaluate the game prototype. In total, 17 patients participated in the interviews to explore their needs and desires for a serious game. The health professionals participated in the interviews to understand the medical requirement and experience pertaining to frozen shoulder and were included in the workshop to give feedback on the game prototype. At the conclusion of the iterative design process, a Kinect-based prototype game with three levels was used for a case study with one patient who was diagnosed with frozen shoulder and has been receiving medical treatment in the hospital. Results: Based on the outcomes derived from data collected among diverse stakeholders, the prototype game underwent iterative development by the team and was assessed by a participant with frozen shoulder symptoms. Findings revealed that the participant demonstrated enhanced shoulder mobility and a reduction in pain intensity, despite the lack of significant improvement for health-related quality of life. Nevertheless, the participant reported a positive experience with the prototype game. Conclusion: This study underscores the importance of involving diverse stakeholders in the development process to create more effective and user-centric serious games for rehabilitation. The participatory approach, exemplified by the prototype game, demonstrates potential improvements in both user experience and overall effectiveness during the rehabilitation process.

Effects of Serious Games for Patients With Chronic Obstructive Pulmonary Disease: Systematic Literature Review.

The use of serious games for rehabilitation has been an emerging intervention in health care fields, referred to as an entertaining and positive activity. Although related studies have been conducted on patients with chronic obstructive pulmonary disease (COPD), a more comprehensive study that summarizes and evaluates its effects in this area is needed. This review aimed to systematically evaluate the effects of serious games in promoting rehabilitation and related outcome measures of serious game-based engagement in patients with COPD. This review adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Searches were performed in the following databases: PubMed, Scopus, Embase (via Ovid), CINAHL, Science Direct, and China Biology Medicine disc. Only quantitative studies were included in this review, and the methodological quality and bias of the included studies were evaluated using related tools. Several outcomes, including clinical outcomes and serious game-based engagement outcomes, were ultimately collected in this review. The results were summarized and evaluated using descriptive methods due to significant heterogeneity. In total, 11 studies were included. Serious games played a potentially positive effect on pulmonary function and exercise capacity. However, no consistent findings were reported on dyspnea and psychological status. Additionally, serious game engagement showed favorable findings on adherence, enjoyment, and acceptability. Furthermore, no serious adverse effects were identified in all included studies. This review preliminarily indicated the potential benefits of serious games in promoting rehabilitation for patients with COPD, despite the limited quality of the included studies. More studies with high methodological quality are needed to further explore the effects of serious games in this field.

Design of Customized Virtual Reality Serious Games for the Cognitive Rehabilitation of Retrograde Amnesia After Brain Stroke

Abstract This article presents a software platform to design serious games for the rehabilitation of severe memory loss by means of virtual reality (VR). In particular, the focus is on retrograde amnesia, a condition affecting patient's quality of life usually after brain stroke. Currently, the standard rehabilitation process includes showing pictures of familiar environments to help memory recover, while the proposed rehabilitation solution aims at developing patient-specific serious games for memory loss starting from 3D scanning of familiar environments. The Occipital Structure sensor and the Skanect application have been used for the virtualization of the real objects and the environment. Instead of following the traditional approach to design a video game during which the game logic is specifically developed for a virtual scene and the software code is not meant to be recombined, a modular procedure has been designed using Unity to interface the virtual objects of each acquired environment without modifying the game logic. In addition, the developed solution makes available a set of software modules for patient's monitoring and data management to automatically generate medical reports, which can be easily connected to each new serious game. A test has been performed to assess the main features of the VR platform and its usability recruiting ten testers. Medical personnel evaluated positively the platform, and they highlighted the importance of objective data to improve the ecological validity of the cognitive rehabilitation for retrograde amnesia.

Software Engineering Frameworks Used for Serious Games Development in Physical Rehabilitation: Systematic Review.

BackgroundSerious games are a support in the rehabilitation process for treating people with physical disabilities. However, many of these serious games are not adapted to the patient’s needs because they are not developed with a software engineering framework with a set of activities, actions, and tasks that must be executed when creating a software product. Better serious games for rehabilitation will be developed if the patient and therapist requirements are identified, the development is planned, and system improvements and feedback are involved. The goal is that the serious game must offer a more attractive environment, while maintaining patient interest in the rehabilitation process.ObjectiveThis paper submits the results of a systematic review of serious games in physical rehabilitation identifying the benefits of using a software engineering framework.MethodsA systematic research was conducted using PubMed, PEDro (Physiotherapy Evidence Database), IEEE Xplore, ScienceDirect, ACM Digital Library, Mary Ann Liebert, Taylor & Francis Online, Wiley Online Library, and Springer databases. The initial search resulted in 701 papers. After assessing the results according to the inclusion criteria, 83 papers were selected for this study.ResultsFrom the 83 papers reviewed, 8 used a software engineering framework for its development. Most of them focused their efforts on 1 or more aspects, such as data acquisition and processing, game levels, motivation, therapist supervision.ConclusionsThis systematic review proves that most of the serious games do not use a software engineering framework for their development. As a result, development systems overlook several aspects and do not have a standardized process, eventually omitting important implementation aspects, which impact the patient’s recovery time.

The Use of The ARCS Motivation Model on Special Needs Patients through Serious Games for Rehabilitation: A Systematic Review

Motivation is one of the vital keys for special needs patients to feel sustain with their performances during rehabilitation therapies. as technology grows, serious games have become one of the assistive technology tools that used in rehabilitation field to help special needs patients to undergo their exercise. In this regard, the adaptation of special needs patients in using serious games for rehabilitation have attracted scholars to conduct number of relevant studies. Accordingly, a systematic review was conducted to identify the motivation attributes that influence special needs patients while playing serious games for rehabilitation. After the identification and screening processes, the use of the ARCS motivation model is to classify the motivation attributes into four main factors: attention, relevance, confidence, and satisfaction. A total number of 29 motivation attributes have been found from the previous studies that vigorously important in determining the rehabilitation performance of special needs patients. Each motivation attribute which repeatedly used in the recent studies from the year 2011 to 2019 has been grouped as one. As result, the most used attribute in the previous research is motivation. The essential of motivation in ensuring confidence level and satisfaction among special needs patients while undergoing rehabilitation therapies is very important and has been successfully proven on the results. In other words, the previous studies have shown a positive experience of special needs patients in gaining and sustaining their motivation through serious games for rehabilitation by using the ARCS model. Keywords: Serious Games, Special Needs, Motivation, Rehabilitation

Filtering motion signals from Microsoft Kinect® in the context of stroke rehabilitation

The Microsoft Kinect® sensor has been employed for developing serious games and for biomechanics analysis. Both applications, when combined in the context of motor rehabilitation, might provide relevant data for therapists. However, the reliability of clinical data obtained with Kinect® is affected by filtering parameters which should be chosen according to spectral characteristics of the signals. In this paper we aim at determining the spectral characteristics of kinematics data collected with Kinect® during a serious game and to suggest adequate filtering. The motor tasks of lateral trunk inclination, trunk rotation, and shoulder abduction performed with heading, ski, and goalkeeper games originated 45 time series derived from 5 healthy people and 87 time series of 4 people with stroke. Time series were analyzed using the Fourier analysis and empirical mode decomposition (EMD). A residual analysis was performed to determine the optimal cutoff frequencies of the fourth-order low-pass Butterworth filters. Fourier and EMD analyses evidenced that the highest spectral power for header and goalkeeper tasks is below 3 Hz and for skiing, it is below 0.8 Hz. The ideal cutoff frequencies were around 3 Hz and 5 Hz and differed between healthy and stroke groups. The range of motion was affected by the cutoff frequencies. The signals captured by Kinect® have the main spectral components at lower frequencies and should be filtered at cutoff frequencies below 6 Hz. We recommend including the determination the impact of signal processing on clinical indicators in the workflow when developing a serious game for rehabilitation.

Development of an EMG-Controlled Serious Game for Rehabilitation.

A majority of the seven million stroke survivors in the U.S. have hand impairments, adversely affecting performance of a variety of activities of daily living, because of the fundamental role of the hand in performing functional tasks. Disability in stroke survivors is largely attributable to damaged neuronal pathways, which result in inappropriate activation of muscles, a condition prevalent in distal upper extremity muscles following stroke. While conventional rehabilitation methods focus on the amplification of existing muscle activation, the effectiveness of therapy targeting the reorganization of pathological activation patterns is often unexplored. To encourage modulation of activation level and exploration of the activation workspace, we developed a novel platform for playing a serious game through electromyographic control. This system was evaluated by a group of neurologically intact subjects over multiple sessions held on different days. Subjects were assigned to one of two groups, training either with their non-dominant hand only (unilateral) or with both hands (bilateral). Both groups of subjects displayed improved performance in controlling the cursor with their non-dominant hand, with retention from one session to the next. The system holds promise for rehabilitation of control of muscle activation patterns.

Serious game for rehabilitation of the lower limb of hemiparetics patients after stroke

Introduction/Background Hemiparesis is the classic clinical condition of stroke and is related to important locomotor limitations. The treatment strategies traditionally chosen are limited by the monotony, boredom and repetitiveness of the exercises. Serious games (SG) combine specific physical training with a higher attentional and motivational level, increasing adherence to treatment. The aim of this study was to verify the therapeutic effects of exercise program using a SG developed for evaluation and rehabilitation of hemiparetic patients after stroke. Material and method Non-Randomized Controlled Clinical Trial involving 24 patients (12 men) was conducted. Patients were divided into 2 groups. One group consisted in realize exercises with a SG mim-Pong (experimental, Fig. 1 ) and the other group a conventional physical therapy (control). Both groups completed the 20-session treatment protocol. The following variables evaluated were: muscle strength, motor control, motor impairment, spasticity, functional mobility and gait speed. Data were analyzed with descriptive statistics, paired Student's t-test and effect size calculation. Results Patients did not differ in terms of sociodemographic characteristics at baseline. In the experimental group, significant improvements were observed for all variables ( Table 1 ). Large effect sizes were found for muscle strength of hamstrings, quadriceps femoris and hamstrings scores, Fugl-Meyer Assessment Scale and Modified Ashworth Scale. In the control group the improvements were lower than experimental group with small to moderate effect sizes. Significant differences were found only for game scores (QFS and HS) probably due to learning during the training phase conducted before assessment with the SG. Conclusion These results suggest that SG promote superior improvements to those obtained with conventional treatment of hemiparetic patients after stroke. This superiority is probably due to increased attention demand and motivation during interventions with SG.

Patients’ follow-up using biomechanical analysis of rehabilitation exercises

Thanks to the evolution of game controllers video games are becoming more and more popular in physical rehabilitation. The integration of serious games in rehabilitation has been tested for various pathologies. Parallel to this clinical research, a lot of studies have been done in order to validate the use of these game controllers for simple biomechanical evaluation. Currently, it is thus possible to record the motions performed by the patients during serious gaming exercises for later analysis. Therefore, data collected during the exercises could be used for monitoring the evolution of the patients during long term rehabilitation. Before using the parameters extracted from the games to assess patients’ evolution two important aspects must be verified: the reproducibility of measurement and a possible effect of learning of the task to be performed. Ten healthy adults played 9 sessions of specific games developed for rehabilitation over a 3-weeks period. Nineteen healthy children played 2 sessions to study the influence of age. Different parameters were extracted from the games: time, range of motion, reaching area. Results of this study indicates that it is possible to follow the evolution of the patients during the rehabilitation process. The majority of the learning effect occurred during the very first session. Therefore, in order to allow proper regular monitoring, the results of this first session should not be included in the follow-up of the patient.

Can serious games be incorporated with conventional treatment of children with cerebral palsy? A review.

The use of video games in rehabilitation is becoming more popular to clinicians. These games are embedded in off-the-shelf commercial entertainment applications or especially-developed for clinical purposes. Treatment of cerebral palsy (CP) children is a challenging task for clinicians. Lack of motivation and progress monitoring are two important factors clinicians need to deal with. The use of serious games (SG), sometimes referred to as Virtual Rehabilitation (VR), could therefore be an interesting adjuvant to conventional treatment for these patients. This is however a new discipline and many scientific issues remain to be solved. The aim of this paper is to describe available conventional treatment for CP children together with the level of evidence of each approach. A systematic review of the use of SG in rehabilitation is then conducted. 31 papers (7 randomized clinical trials, 16 cohort studies and 8 single-cases studies) were selected and analyzed, and their level of evidence compared to the conventional treatment. These studies reported outcomes for 352 patients. In summary, this review shows that it is difficult to compare those studies despite the large amount of patients. This is due to the lack of standardization in patient rehabilitation strategy and to the use of various clinical scales and scores. This non-standardization in patient follow-up between previously-published works make evidence-based conclusions difficult to obtain in order to support these techniques objectively. The use of SG for rehabilitation purposes currently meets similar issues. This paper proposes standardization strategies in order to improve treatment comparison and SG use in rehabilitation.

재활치료와 기능성게임

Abstract We pursue pleasure through game but also possibly get positive effects. The serious game is a game that achieves a certain goal by using the positive effects of games. This paper describes the serious game and rehabilitation. Also, it describes the types of medical serious games and actual development condition of serious games for rehabilitation, and suggest ways to inspire utilization of the serious games for rehabilitation. Key Words : Computer Game, Rehabilitation, Serious Game, Occupational Therapy, Information Technology * 이 연구는 2014년도 광주대학교 대학 연구비의 지원을 받아 수행되었음.Received 5 February 2014, Revised 20 February 2014Accepted 20 April 2014Corresponding Author: Hwangyong Kim(Gwangju University) Email: hkim97@gwangju.ac.krⒸ The Society of Digital Policy & Management. All rights reserved. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is ISSN: 1738-1916 properly cited.

KINECT를 활용한 재활 치료용 기능성 게임 개발

본 연구는 장시간 동일한 자세로 자리에 앉아 있거나 컴퓨터 작업을 오래함으로써 생긴 어깨 통증을 호소하는 이들, 몸의 움직임이 적어 신체적 이상이 온 이들을 대상으로 치료를 동반한 운동 목적의 기능성 게임 설계와 프로토타입 단계의 게임 개발이다. 선택된 음악의 비트에 맞추어 신체를 움직이는 리듬액션게임으로서, 플레이어가 도전하는 동안 불편을 가진 신체 부위의 기능 개선뿐만 아니라 환자의 색채 치료를 병행할 수도 있다. 게임 기획서에 따라 제작된 프로토타입 게임은 XNA Game Studio와 동작 인식이 가능한 키넥트 인터페이스 기술을 활용하여 개발하였다. 조작이 용이한 인터페이스 기술과의 접목, 음악의 빠르기와 공의 출현 속도로 난이도를 조절하며 신체 움직임에 따라 수준별 콘텐츠 제공을 시도해 보았다. 향후 연구는 신체 장애 정도에 따라 움직임을 조절할 수 있도록 다양한 비트의 음악과 플레이어의 다양한 행위를 추가하고, 일반 재활 효과와의 비교 검증 시스템과 현장 테스트가 요구된다. This paper designs a serious game for rehabilitation of patients with body pains because they sit down for a long time in the same position, or less physical movement. Activity-based game induces to player improvements in physical exercise with fun elements of the game through entertainment to help the body function and substantially increases the player's commitment during challenging goal. This research is a game design that combines the treatment of color and movement of body to the rhythm of the music. We constructed with XNA Game Studio and KINECT interface with gesture recognition technology. We need to research of evaluation system and test for the actual effect of the treatment and advanced functions of game playes like adding various musics and variety of motion.

Significance of serious game for rehabilitation in super-aging society(<Special feature>Game as a service)

Significance of serious game for rehabilitation in super-aging society(<Special feature>Game as a service)