Video Games In Rehabilitation Research Articles

Effect of Video Games for Rehabilitation on Mobility in Autonomous Older People

BACKGROUND: Autonomous elderly are generally healthy persons in stable clinical status, who do not have any exacerbations, despite of the presence of chronic polymorbidity. Video games for rehabilitation (VGR) could provide more fun and emotion in the routine physiotherapy (PT) sessions and to attract more people stay physically active. AIM: The aim of the study was to evaluate the effect of self-designed 3D camera VGR on mobility and motor abilities in generally healthy older people. MATERIALS AND METHODS: The type of the research is an experimental single-centered study, pre-test and post- test design, conducted at a physical rehabilitation outpatient center. The study is conducted with fifty healthy older people, divided into two groups. The assignment into two groups was according to the preference of the participants to attend video games after routine PT sessions for 7 weeks, 3 times weekly. The experimental group (EG) included 24 women (mean age 76.75 ± 6.89) and the control group consisted of 26 women (mean age 73.69 ± 6.89). The persons were allocated according to their willingness to participate in the study and inclusion (age above 65 years, cooperative, agreeing to participate, and willing to sign a consent form) and exclusion criteria (current exacerbation of a chronic disease, sudden onset of an acute illness, or trauma). The effect on the calf muscle mass, balance, and gait in both groups after the intervention, was evaluated by calf centimetry, Romberg test, functional reach test, 5 times sit-to-stand test, and 10-m walk test. RESULTS: The applied video games positively affected the functional mobility, strength, and endurance of the lower limbs in the EG. Significant differences between the groups were found regarding static standing balance (p < 0.01), functional balance (p < 0.05), and maximum speed gait (p < 0.05) assessed by Mann–Whitney U-test, Wilcoxon, and Student’s t-test. CONCLUSION: The present self-designed video game applied as an additional intervention was more effective than conventional PT alone in mobility, balance, and gait in apparently healthy older people.

Occupational therapy rehabilitation of industrial setup hand injury cases for functional independence using modified joystick in interactive computer gaming in Anand, Gujarat

Background: The prevalence of hand injury cases in India from road traffic incidences is about 30% and the total number of hand injuries would go higher on adding the industrial injury cases. Several studies have provided preliminary descriptions of the benefits of virtual reality and video games in rehabilitation training. There are many studies showing beneficial utility of video games in rehabilitation and improvement of functional independence of the hand injury patients using high-cost video game such as “Wii” and others. Aims and Objectives: This study aims to find the impact of low-cost video game therapy against the conventional therapy in improving the hand function in terms of range of motion, grip strengths, and functional independence. Materials and Methods: Patients coming to occupational therapy unit with hand injury fulfilling inclusion-exclusion criteria and agreeing to participate in the study were randomly divided into two groups - conventional therapy group and video game group based on the computer-generated random allocation. The duration of therapy was same for the two groups. The readings for hand function in terms of range of motion, grip strengths, and functional independence were documented for both the groups before the treatment and after the treatment and were compared statistically for finding the difference if any. Results: The findings of the study showed that both the groups had improved in terms of the hand function as in the range of motion, grip strengths, and functional independence at the end of treatment irrespective of the treatment arm they were in P 0.05). However, the experimental group seemed to enjoy their treatment more than their counterparts as expressed in informal communications; therefore, we may conclude the gaming method to be more preferred method of the treatment for the condition. Conclusion: We conclude that the video gaming method is as effective as that of the conventional method for improving the strengths, grip, range of motion, and functional independence in hand injury cases, but the video gaming being more interesting and involving, is deemed to be much more enjoyable by the patients compared to the conventional. Since the patients find it interesting, they look forward for more of the sessions. This is a positive motivation for the compliance of the patients for completing the treatment properly and getting maximum benefit of the therapy.

Interactive design of patient-oriented video-games for rehabilitation: concept and application

Purpose: Serious video-games are innovative tools used to train the motor skills of subjects affected by neurological disorders. They are often developed to train a specific type of patients and the rules of the game are standardly defined. A system that allows the therapist to design highly patient-oriented video-games, without specific informatics skills, is proposed.Method: The system consists of one personal computer, two screens, a Kinect™ sensor and a specific software developed here for the design of the video-games. It was tested with the collaboration of three therapists and six patients, and two questionnaires were filled in by each patient to evaluate the appreciation of the rehabilitative sessions.Results: The therapists learned easily how to use the system, and no serious difficulties were encountered by the patients. The questionnaires showed an overall good satisfaction by the patients and highlighted the key-role of the therapist in involving the patients during the rehabilitative session.Conclusions: It was found that the proposed system is effective for developing patient-oriented video-games for rehabilitation. The two main advantages are that the therapist is allowed to (i) develop personalized video-games without informatics skills and (ii) adapt the game settings to patients affected by different pathologies.Implications for rehabilitationVirtual reality and serious video games offer the opportunity to transform the traditional therapy into a more pleasant experience, allowing patients to train their motor and cognitive skills.Both the therapists and the patients should be involved in the development of rehabilitative solutions to be highly patient-oriented.A system for the design of rehabilitative games by the therapist is described and the feedback of three therapists and six patients is reported.

The use of commercial video games in rehabilitation: a systematic review.

The aim of this paper was to investigate the effect of commercial video games (VGs) in physical rehabilitation of motor functions. Several databases were screened (Medline, SAGE Journals Online, and ScienceDirect) using combinations of the following free-text terms: commercial games, video games, exergames, serious gaming, rehabilitation games, PlayStation, Nintendo, Wii, Wii Fit, Xbox, and Kinect. The search was limited to peer-reviewed English journals. The beginning of the search time frame was not restricted and the end of the search time frame was 31 December 2015. Only randomized controlled trial, cohort, and observational studies evaluating the effect of VGs on physical rehabilitation were included in the review. A total of 4728 abstracts were screened, 275 were fully reviewed, and 126 papers were eventually included. The following information was extracted from the selected studies: device type, number and type of patients, intervention, and main outcomes. The integration of VGs into physical rehabilitation has been tested for various pathological conditions, including stroke, cerebral palsy, Parkinson's disease, balance training, weight loss, and aging. There was large variability in the protocols used (e.g. number of sessions, intervention duration, outcome measures, and sample size). The results of this review show that in most cases, the introduction of VG training in physical rehabilitation offered similar results as conventional therapy. Therefore, VGs could be added as an adjunct treatment in rehabilitation for various pathologies to stimulate patient motivation. VGs could also be used at home to maintain rehabilitation benefits.

Pacientes com a Doença de Parkinson são capazes de melhorar seu desempenho em tarefas virtuais do Xbox Kinect®: “uma série de casos”

<p>A utilidade dos videogames na reabilitação de pacientes com Doença de Parkinson (PDP) vem sendo demonstrada. Contudo, a discussão sobre a seleção dos jogos utilizados ainda é escassa, embora fundamental para recomendação de seu uso terapêutico. Não foram, até o momento, encontrados estudos sobre a utilização do Xbox Kinect<sup>® </sup>(XK) na reabilitação de PDP. O objetivo deste estudo foi investigar as modificações de desempenho de PDP, decorrentes do treino, por meio das mudanças nas pontuações de jogos do XK, em cada sessão. Sete PDP em estágios leve a moderado realizaram 14 sessões de treinamento em quatro jogos previamente selecionados. As pontuações foram registradas para análise da curva de desempenho entre as sessões. Foram feitas análises de variância para medidas repetidas considerando-se um grupo e 14 sessões, seguidas por testes <em>Post Hoc Tukey-Kramer</em> para verificar as diferenças entre as mesmas (p≤ 0.05). Os resultados mostraram que os PDP melhoraram seu desempenho em todos os jogos, porém em momentos diferentes. Concluiu-se que os PDP do presente estudo mostraram capacidade de melhorar o desempenho em jogos do XK, mas que a melhora depende das demandas e da presença de fatores facilitadores da aprendizagem, reforçando a importância da sua escolha com propósito de reabilitação.</p>

A controlled pilot trial of two commercial video games for rehabilitation of arm function after stroke

Objectives: To investigate the acceptability and potential efficacy of two commercial video games for improving upper extremity function after stroke in order to inform future sample size and study design. Design: A controlled clinical trial design using sequential allocation into groups. Setting: A clinical occupational therapy department. Subjects: Twenty-four first-stroke patients. Interventions: Patients were assigned to one of three groups: conventional group, Wii group, and XaviX group. In addition to regular one-hour conventional rehabilitation, each group received an additional half-hour of upper extremity exercises via conventional devices, Wii games, or XaviX games, for eight weeks. Main measures: The Fugl-Meyer Assessment of motor function, Box and Block Test of Manual Dexterity, Functional Independence Measure, and upper extremity range of motion were used at baseline and postintervention. Also, a questionnaire was used to assess motivation and enjoyment. Results: The effect size of differences in change scores between the Wii and conventional groups ranged from 0.71 (SD 0.59) to 0.28 (SD 0.58), on the Fugl-Meyer Assessment of motor function (d = 0.74) was larger than that between the XaviX and conventional groups, ranged from 0.44 (SD 0.49) to 0.28 (SD 0.58) (d = 0.30). Patient enjoyment was significantly greater in the video game groups (Wii mean 4.25, SD 0.89; XaviX mean 4.38, SD 0.52) than in the conventional group (mean 2.25, SD 0.89, F = 18.55, p < 0.001), but motivation was not significantly different across groups. Conclusion: Patients were positive to using video games in rehabilitation. A sample size of 72 patients (24 per group) would be appropriate for a full study.

Perceptions of using videogames in rehabilitation: a dual perspective of people with multiple sclerosis and physiotherapists

Purpose: Our aim was to describe experiences of using Nintendo Wii Fit™ for balance exercise, from the perspectives of patients with multiple sclerosis (MS) and their physiotherapists (PT). Methods: Individual interviews with 15 patients with MS were conducted, recruited from a multi-centre study investigating the effects of balance exercising using Wii Fit. We also conducted a single focus group interview with nine PT involved in the study. The interviews were audio-recorded, transcribed, and analysed using content analysis. Results: Both patients and PT said that exercising with Wii Fit games was fun, and that it challenged the patients’ physical and cognitive capacities. The competitive content in the games provided motivation to continue playing. Patients and PT reported improved body control and, more importantly, positive effects on balance and walking in daily life. The PT regarded Wii training as an effective alternative to other balance training, but some felt unsure in how to manage the video game. The patients regarded Wii training as a possible home training solution. Conclusions: Patients with MS and their PT considered Wii Fit exercises to be fun, challenging, and self-motivating. Exercising with Wii games can address balance impairments in MS, and can be performed at home as well as in rehabilitation settings.Implications for RehabilitationNintendo Wii Fit™ can be used as a fun and challenging way to perform balance exercises.The competitive content embedded in the games triggers continued playing and exercising.The positive effect on balance control can improve standing and walking in everyday activities.

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.

Using Commercial Video Games for Upper Limb Stroke Rehabilitation: Is This the Way of the Future?

Background: The increasing number of people living with poststroke sequelae has stimulated the search for novel ways of providing poststroke rehabilitation without putting additional stress on overburdened health care systems. One of them is the use of commercially available technology and off-the-shelf video games for hemiparetic upper limb rehabilitation. Methods: The MEDLINE, EMBASE, and Cochrane Library databases were searched using key word synonyms for stroke, upper limb, and video games. Included studies investigated upper limb stroke rehabilitation using commercially available consoles and video games, reported outcomes that included measures of upper limb functionality, and were published in a peer-reviewed journal written in English. Results: Thirteen studies were identified - 6 published as full articles and 7 as abstracts. Studies were generally small and only 3 were randomized. The gaming systems investigated were the Nintendo Wii (n = 10), EyeToy PlayStation (n = 2), and CyWee Z (n = 1). The Nintendo Wii appears to provide the greatest benefits to patients, with improvements seen in upper extremity function measures such as joint range of motion, hand motor function, grip strength, and dexterity. Three studies indicate that video therapy appears to be safe and that long-term improvements continue at follow-up. Conclusions: At present, the evidence that the use of commercial video games in rehabilitation improves upper limb functionality after stroke is very limited. However, this approach has the potential to provide easily available and affordable stroke rehabilitation therapy in settings where access to therapy is limited by geographical or financial constraints.

Video Games and Rehabilitation

Patient nonadherence with therapy is a major barrier to rehabilitation. Recovery is often limited and requires prolonged, intensive rehabilitation that is time-consuming, expensive, and difficult. We review evidence for the potential use of video games in rehabilitation with respect to the behavioral, physiological, and motivational effects of gameplay. In this Special Interest article, we offer a method to evaluate effects of video game play on motor learning and their potential to increase patient engagement with therapy, particularly commercial games that can be interfaced with adapted control systems. We take the novel approach of integrating research across game design, motor learning, neurophysiology changes, and rehabilitation science to provide criteria by which therapists can assist patients in choosing games appropriate for rehabilitation. Research suggests that video games are beneficial for cognitive and motor skill learning in both rehabilitation science and experimental studies with healthy subjects. Physiological data suggest that gameplay can induce neuroplastic reorganization that leads to long-term retention and transfer of skill; however, more clinical research in this area is needed. There is interdisciplinary evidence suggesting that key factors in game design, including choice, reward, and goals, lead to increased motivation and engagement. We maintain that video game play could be an effective supplement to traditional therapy. Motion controllers can be used to practice rehabilitation-relevant movements, and well-designed game mechanics can augment patient engagement and motivation in rehabilitation. We recommend future research and development exploring rehabilitation-relevant motions to control games and increase time in therapy through gameplay.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A61) for more insights from the authors.

Human limb tracking using simulated annealing for a low-cost rehabilitation system

In this work, an algorithm for human limb movement tracking is presented. This proposal considers the problem as an optimisation problem and attempts to solve it using an implementation of simulated annealing aided by detected skin features. The parameters of the presented algorithm are set using a general-purpose framework for automatic parameter selection. Application on small video sequences shows good results with selected parameters. Also, some drawbacks of the methods to be considered in practical use are discussed. This technique has been designed for use in the development of a real-time interaction interface in video games for rehabilitation of patients with motor disabilities, and as an offline pose analysis framework to evaluate individual progress in the therapy of those patients.