[Abstract] Dance-based exergaming on postural stability and kinematics in people with chronic stroke – A preliminary study

ABSTRACT

Introduction

The study evaluated the feasibility, and compliance of a dance-based exergaming (DBExG) on postural stability (PS) and lower extremity (LE) kinematics, along with post-intervention changes in gait function and falls self-efficacy in people with chronic stroke (PwCS).

Methods

Fifteen PwCS underwent DBExG for six weeks using Kinect “Just Dance 3.” Pre- to post- changes were recorded during DBExG assessment on a fast-paced song (130 bpm) using an 8-camera motion capture system to assess PS (center of mass [CoM] excursions [EXs] in the anterior-posterior [AP] and mediolateral [ML] directions) and LE kinematics (hip, knee, and ankle joint angle EXs). Gait function was also assessed with gait parameters, such as gait speed, cadence, and gait symmetry on an electronic walkway. Falls self-efficacy was recorded with Falls Efficacy Scale (FES).

Results

The AP and ML CoM EXs and paretic joint angle EXs significantly increased pre- to post- DBExG assessment (p < .05). Gait parameters, and falls self-efficacy measures significantly changed pre- to post- DBExG (p < .05).

Conclusions

Results exhibited the feasibility of the proposed DBExG for positively impacting postural stability, and kinematics, along with increasing gait function and falls self-efficacy among PwCS.

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[WEB] Free Memory Games for Adults and Seniors

By Robert Zak 

Developing the thinking faculty has been one thing humans have worked hard on and still do. Scientists, doctors, and psychologists have weighed in. A lot of strides over the years have been made.

One advancement that may be taken lightly is the use of video games to sharpen thinking. This has been proven to be a very effective memory boosting activity. Online memory games have the ability to help you grasp and retain more information. They can make you sharper and have the ability to improve your cognitive skills, your concentration, and your visual memory.

These are free memory games that adults, seniors and everyone else should try!

Also read: Do Brain Training Apps Really Work?

1. Lumosity

Platforms: Web, Android, iOS

Lumosity consists of online memory games for both adults and kids. The games are put together by scientists who adapt cognitive training exercises that have been developed by leading researchers into games.

To use this online memory enhancing service, you need to sign up with your email address. After signing up, based on your education, your age, and your profession, you will receive a set of three games. These games are aimed at gradually sharpening the memory by increasing focus, skill, attention to detail and ability to solve problems.

After completing a game, you can compare your scores with the millions of online players in the database. You can then gauge where you stand, how much you have improved and how far you need to go.

2. New York Times Crossword

Platforms: Web, Android, iOS

The reputable American newspaper The New York Times has a long and illustrious tradition of crossword puzzles. Now, crosswords may not seem directly like memory games, but a lot has been written about the connections between crosswords and healthy memory function.

Of course, there are a lot of crossword apps out there, but the NYT one feels like a clever and high-level one, with interesting phrases that will activate those neural pathways.

You can get access to the same crosswords you find in the paper through an app or through your browser, so head on over and become part of this age-old NYT tradition.

3. Memozor

Just like Lumosity, memozor is not just one game but a suite of games. You will find games like matching pairs, Simon, and abacus. These games are categorized by age groups, which include babies, kids, adults, and seniors.

A good point about this platform is that it has memory games for two players and includes card memory games and themed memory games.

The games are free and unlimited. Additionally, they are all responsive and will work well across all your devices.

Also read:5 of the Best Brain-Training Apps for Android

4. Sudoku

Platforms: Web, Android, iOS

Sudoku is a highly addictive puzzle game. Unlike crossword puzzles, they are number based. You are given nine 3-by-3 matrices of numbers. You will be required to complete the blank spaces with numbers from 1 to 9. In doing this, you have to make sure that each number only appears once per matrix, column, and row.

There are plenty of Sudoku sites out there, but the simply-titled Sudoku.com is the best one – the site feels slick and modern, and the accompanying iOS and Android apps are nice and up-to-date.

Apart from helping to improve memory, it is a good game for improving deduction, as you will be doing a lot of that throughout the game.

5. Mind Games

For memory-enhancing games, Mind Games leaves nothing hidden. This website is more a combo of memory-enhancing games, hosting a number of games, and, of course, they all are free.

The games are divided into sections, and you will be able to choose between memory, math, puzzle, word, and Sudoku. There are more than ten games to choose from in each section.

Frequently Asked Questions

1. Do memory and brain training games actually improve memory?

As is often the case in the world of science, the actual evidence for memory games improving brain function is “promising” but “inconclusive”. A survey conducted by AARP found that about two out of three adults aged 50 and over believe that brain training games do help their memory function, but of course that’s maybe just a personal perception.

2. Do memory games help dementia?

The most promising studies on this front came in 2016, when a meta-analysis at the University of Sydney showed that brain training games can help maintain brain function among adults with “mild cognitive impairment” (a key risk factor for dementia). Once diagnosed with dementia however, these exercises aren’t shown to be effective.

3. Are memory games important for preschoolers?

Memory games are a great way to get kids to focus and think hard about solving problems. There’s a lack of research into this, but surely you’d rather they did brain training games than watch another episode of Paw Patrol?

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[Review] Telerehabilitation – A Viable Option for the Recovery of Post-Stroke Patients – Full Text

Abstract

As the number of stroke survivors is continuously growing, with an important number suffering from consequent functional deficits, the rehabilitation field is facing more complex demands. Technological progress gives us the opportunity to remotely assist patients while they exercise at home through telerehabilitation (TR), addressing the problems of limited medical resources and staff, difficult transportation, or living a long distance from rehabilitation centers. In addition, TR is a way to provide continuity in long-term post-stroke recovery during the COVID-19 pandemic, which limits traveling and human interaction. While the implementation of TR is increasing, the biggest challenges are to raise patients’ acceptability of the new method and their motivation and engagement during the program. In this review, we aimed to find methods to address these challenges by identifying the patients who benefit the most from this therapy and efficiently organizing the space and technology used for telerehabilitation. User-friendly technologies and devices along with therapists’ constant support and feedback are some of the most important aspects that make TR an efficient intervention and an alternative to conventional therapy.

1. Introduction

Strokes are a frequent condition affecting 15 million people every year, of which 5 million survivors live with a consequent disability [1,2]. Healthcare and medical technologies have rapidly evolved in the last years, increasing the survival rate after stroke and therefore raising the number of patients with infirmities [3,4]. Post-stroke patients usually suffer from impaired motor function of one or more limbs, diminished sense of touch, cognition or swallowing alterations and speech and language difficulties [5]. Motor deficit of one of the upper limbs, present in about 80% of patients, is one of the most frequent consequences of stroke, and produces a dire need of rehabilitation therapy [6,7]. Loss of upper limb functionality severely impacts patients’ quality of life [6,8]. The average time hospitalized post-stroke patients spend training their upper limbs is insufficient for total function recovery [7,9]. As a result of short hospitalizations and limited human resources available for face-to-face rehabilitation therapy, the majority of stroke survivors are discharged with functional deficits and are in need of continuous recovery treatment [6,10]. Statistics show that an important number of patients do not take part in rehabilitation programs after the acute phase of a stroke [11]. It is considered that the best time to work with the neuroplasticity and deficit recovery ability is within the first 6 months after a stroke [10,12]. However, there is evidence that also supports an intense recovery program during the chronic phase of the disease [6,12]. Thereby, post-stroke rehabilitation has an important role when applied in any stage of the disease, with its absence having consequences such as pathological motor pattern development, non-use of the affected limb, spasticity enhancement, joint rigidity, increased pain and disability [12,13,14]. In addition, rehabilitation programs initiated in the clinic and continued at patients’ homes represent a therapeutic alternative to hepatotoxic and nephrotoxic medications administered to relieve pain and trophic effects [15,16].Rehabilitation therapy has proven its efficacy when task-oriented and applied in large doses, intensively, with many repetitions and continuously, in order to facilitate relearning [7,12,17]. The results seem to be directly proportional to the training period [7,17]. For example, improvements of arm function have been obtained after sessions summing 3 h or more per week [10]. Traditional exercises provided for patients upon discharge in order to be practiced at home have low adherence because of motivation loss, lack of pleasure while exercising and tasks that are either too hard or too easy [9]. Stroke rehabilitation represents a complex field that brings together physiotherapy, occupational therapy, speech and language therapy and neuropsychology [10]. As a result of the high costs of individual therapy sessions provided by a specialist, this is not the standard approach to chronic post-stroke patients.Teletherapy represents an alternative in the form of a variety of communication technologies, robotic devices or computer games used at home under the remote guidance of the therapist, and is a promising option that can stimulate motivation and prevent boredom [6,8]. Telerehabilitation (TR) implies access anytime and anywhere, through the Internet and technology, to qualitative rehabilitation services of any kind: physiotherapy, occupational therapy, speech and language therapy and neuropsychology [3]. It allows patients to have continuity in the rehabilitation of their acute or chronic conditions in cases of shortage of healthcare staff and medical resources, difficult transport, living in rural areas with difficult access to rehabilitation centers or mobility and interpersonal contact restrictions in the case of a pandemic [18].The purpose of this literature review was to identify in the literature the main challenges that may be faced when trying to initiate post-stroke telerehabilitation with the help of technology, and to contribute to the decision-making process in this emerging field. According to this, the secondary objectives were represented by: identifying patient categories who may benefit from telerehabilitation, the optimal organization of the patient’s domestic space, the suitable choice of TR devices taking into account the patient’s needs, the organizational needs of the therapist’s workspace, ways of increasing the patient’s motivation and adherence to treatment and innovative methods in TR.[…]

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Figure 4
TR Network setup.

[BLOG POST] Futuristic remote tech is empowering a “revolution” in stroke rehab at home

by Sarah Sarsby 

Thanks to a “technological revolution” in stroke rehabilitation, stroke recoveries could now take a smoother path, with a new interactive health system from Evolv offering telemonitored rehabilitation sessions in stroke survivors’ homes.

Designed with Microsoft’s Azure Kinect camera at its centre, the compact Evolv RehabKit can monitor a user’s precise movements, keeping a close eye on them as they take part in a series of task-based games and exercises. These form part of EvolvRehab, a pioneering virtual rehabilitation platform that runs on the RehabKit.

The therapeutic game-like activities in EvolvRehab have been designed by professional therapists to bolster stroke and brain injury survivors’ self-confidence while increasing their mobility, assisting in their ongoing progression to stand, reach, grasp, walk and speak.Advertisement | Continue story below

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Having already seen “life-changing” results in its initial phases, Evolv RehabKit could become even more transformational, according to Microsoft.

Traditional stroke rehabilitation methods are centred around patients having face-to-face sessions in hospitals and specialist centres, which can last for months and sometimes years.

In contrast, the Evolv RehabKit can be used independently at home, with sessions replicating approved exercises, personalised by professional therapists for each survivor. This frees up clinicians’ time and improves patient outcomes through engaging games while easing pressure off the NHS.

David Fried, CEO of Evolv, said: “Our goal was to help deliver rehabilitation out of the clinical setting, providing the repetitive therapeutic activity that’s required to improve outcomes for stroke survivors directly into their homes ideally, or it could be in a day centre, community centre, or residential care home. It can help take the burden off the NHS sites.

“Microsoft is a really big part of that.”

The Evolv RehabKit has also been used to benefit others needing physical rehabilitation, such as those with Parkinson’s, multiple sclerosis, spine and brain injuries, or those who are at risk of falls.

Running from a mini-PC, EvolvRehab is powered by a suite of Microsoft technology, chiefly Azure Kinect, which captures the movement of the user. It also comes with Microsoft Teams, meaning patients and their therapists can communicate via video calls to set goals, share progress and provide feedback.

All the data gathered is stored in the Microsoft Azure cloud. Information and performance results can only be accessed by the user’s authorised physiotherapist. Healthcare professionals can also use Power BI to visualise patient performance and create user reports.

David further highlighted how the Evolv RehabKit offers a service that can’t be replicated elsewhere.

He added: “You need to treat stroke survivors like elite athletes, the same concept, training every day, a healthy lifestyle, positivity and repetition over and over again to improve performance. But you can’t have hundreds of them showing up to an NHS Trust and doing 1000s of repetitions of exercises in a rehabilitation ward.”

The rehabilitation technology has proved particularly helpful during the COVID-19 pandemic, where lockdown restrictions made it impossible for many therapists and stroke patients to meet in person.

In September 2020, Microsoft helped Evolv as it made more RehabKits available to healthcare teams. These were given to stroke survivors, allowing their vital progress to continue at home.

“What we try to do in our platform is offer different types of activities that touch upon different types of therapy. The important thing is the activities can be personalised to each individual at home,” David continued.

“For example, you’d be playing a game where barriers come out towards you, and you have to lift your leg to get over them, which helps balance and coordination. They are games, you are doing repetition, you are doing therapeutic activity that’s prescribed and personalised to you, but you have no idea you are doing exercise – you are simply playing a game.”

Evolv works closely with the specialist National Hospital for Neurology and Neurosurgery in Queen Square, London, which is part of University College London Hospitals NHS Foundation Trust. It has also partnered with academic institutions such as the universities of Reading, East Anglia and Cambridge, as well as collaborating with private physiotherapy providers.

While its physical challenges offer upper and lower extremity training, and fine motor skills for the hand, EvolvRehab also contains dual-tasking ‘exergames’ (exercise while playing gaming). These combine language and motor training to encourage thinking and moving simultaneously.

For example, a word is displayed on-screen along with several pictures of different items, and the “player” must reach out and touch the correct picture of the item based on the given word. At other times, they will touch the item that rhymes with a given word or starts with a certain sound.

It is through gamifying physiotherapy with points and trophies that the EvolvRehab software ensures survivors want to continue treatment, according to Microsoft.

Evolv is part of the Microsoft for Startups and Global Social Entrepreneurship programme, a global programme that offers new companies access to technology and go-to-market and community benefits to help them grow.

EvolvRehab is currently available in 10 different languages, with clinical validation in seven countries, and has been used to provide telerehabilitation in a dozen countries.

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[Abstract] MIDAS: Multi-sensorial Immersive Dynamic Autonomous System Improves Motivation of Stroke Affected Patients for Hand Rehabilitation – Full Text PDF

In this paper, we present the design and development of MIDAS. MIDAS is intended to be a portable immersive system inclusive of an exoskeleton, a smell releasing device, and a VR game that will help stroke patients feel more motivated during a hand rehabilitation session. MIDAS engages four out of five senses during rehabilitation. MIDAS uses EMG signals taken from the subject’s forearm to predict their intention before activating physical assistance (tactile) in the opening or closing of the fingers of their hand. To evaluate the performance of MIDAS, a pilot study is done using established tools to quantify the user experience, comfort, pleasure, and motivation of the subjects in using MIDAS for rehabilitation exercises.
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[WEB] University and charity partnership hopes to revolutionise future of stroke care through rehab tech

Sarah Sarsby 

Credit: University of Strathclyde

A pioneering new partnership between the University of Strathclyde and Chest Heart and Stroke Scotland (CHSS) is bidding to kickstart a revolution in stroke care by making rehabilitation technology accessible.

The aim is to improve stroke patients’ lives and to ease pressure off the NHS by facilitating patients’ recovery.

Academics at the university’s Department of Biomedical Engineering are working with the charity to integrate cutting-edge research in areas like robotics and computer gaming technology with CHSS’s Hospital to Home services. They aim to ensure a smooth transition for stroke patients discharged from hospital.

Over the next year, the partnership will integrate the work of Strathclyde engineers at the university’s Sir Jules Thorn Centre for Co-creation of Rehabilitation Technology and the Hospital to Home stroke services.

The centre uses artificial intelligence (AI) and machine-learned methods used in computer gaming to produce tailored exercise programmes for stroke survivors that encourage and support people in their own rehabilitation.

In the first phase, the work of the partnership is open to people in the west of Scotland, who will be given opportunities to take part in innovative recovery research and transform wraparound recovery support. The technology will then be developed using the insight generated from stroke survivors going through the centre, with the programmes generated made available in community settings across the country.

The first cohort of stroke survivors are already going through the programme, and it is hoped that through fundraising, the numbers will increase significantly over the next year.

Dr Andy Kerr, from Biomedical Engineering at the University of Strathclyde, said: “We are delighted to have Chest Heart & Stroke Scotland as a partner in our bid to revolutionise rehabilitation.

“Our determination is to develop technology that not only helps recovery but can also be used, easily, at home and in the local community, for example leisure centres. We consider this to be a key factor in improving access to rehabilitation technology.

“Our pilot has gone very well at the Sir Jules Thorn Centre for Co-creation of Rehabilitation technology, and we are well placed, with the support of CHSS, to scale up our efforts in the new year.”

Hospital care for stroke patients accounts for seven percent of all NHS beds and five percent of the entire Scottish NHS budget, according to the university. The work from the partnership aims to improve rehabilitation, which has been proven to aid recovery, improve people’s lives and reduce pressures on the NHS.

Jane-Claire Judson, Chief Executive of Chest Heart & Stroke Scotland, commented: “Rehabilitation is a lifeline that helps stroke survivors get their lives back. But cutting-edge rehabilitation technology and support is out of reach of most people in Scotland.

“This partnership will change that. It will kick start a revolution in stroke care in Scotland that will transform care for survivors and reduce pressures on our NHS.”

CHSS has set up a ‘Stroke Care Revolution Fund’ to help fund the venture. The charity is looking to initially raise £160,000 to support the work of the centre and help 450 stroke survivors access the services through the partnership over the next 12 months.

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[BOOK Chapter] Virtual Reality Scene Development for Upper Limb Tendonitis Rehabilitation Game

Karen Sie (Hong Kong Polytechnic University, China), Yuk Ming Tang (Hong Kong Polytechnic University, China) and Kenneth Nai Kuen Fong (Hong Kong Polytechnic University, China)
Source Title: Cases on Virtual Reality Modeling in Healthcare

Rehabilitation Game

Copyright: © 2022 |Pages: 25

DOI: 10.4018/978-1-7998-8790-4.ch005

Abstract

With the development of new technology, it is common that excessive use puts undue strain on the hands and finger tendons. This increases the risk of developing many forms of tendonitis. The objective in this project is to use the latest virtual reality (VR) technology to build a preventive rehabilitation game for raising public awareness of upper limb tendonitis. A survey of 141 respondents was first undertaken to find how much the general public knows about upper limb tendonitis. A virtual game is then created using the Unity3D game engine and 3Ds Max for 3D modeling. It is evaluated after being tested by five participants. The majority of respondents to the questionnaire did not know the cause or implications of tendon issues. Almost half of them spent 8.8 hours per day on computers and smartphones, with only 4 minutes per day spent exercising their hands and fingers. The participants gave positive comments towards the designed rehabilitation game and believe it can help to avoid fatigue caused by prolonged smartphone and computer use.

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Introduction

Virtual Reality (VR) technology was first developed in the mid-1960s and has become increasingly popular over time (Wilson, 1992). The first uses of virtual reality were in military and space-related research (Freitas et. al, 2014). According to Olasky et al. (2015), VR technology was then used in engineering, entertainment, education, and even medical settings. Rizzo and Kim (2005) found that both the therapist and the patient benefit from the use of virtual reality technology in rehabilitation. Therapists can utilize virtual reality surgical simulation to improve performance in real surgery by planning ahead of time. Patients with psychological issues, on the other hand, can be treated in secure virtual rehabilitation settings. Copyright © 2017, IGI Global. Copying or distributing in print or electronic forms without written permission of IGI Global is prohibited.

VR technology not only provides a safe environment for patients to do exercises, but also increases their physical and mental fidelity to do so (Lau et al., 2020). The VR environment enables real-time data collection and analysis, allowing therapists to alter and monitor patient development in order to improve rehabilitation efficiency and effectiveness (De Mauro, 2011). Celinder and Peoples (2012) strongly supported VR now being used on patients with psychosocial issues, neuromotor diseases, and cognitive issues. Moreover, VR has been applied for educational and training purposes in the medical field (Lau et al., 2021). The most common illnesses treated in VR rehabilitation include stroke (Fong et al., 2021), Post-Traumatic Stress Disorder (PTSD), and Parkinson’s disease (Laver et al., 2015). Currently, there are only a few occupational disease applications. According to Liu and Chiang (2020), De Quervain’s Tenosynovitis – a kind of tendonitis over the thumb and wrist, is due to tendon sheath inflammation. For the past twelve years, De Quervain’s Tenosynovitis of the hand or forearm has ranked first among occupational disorders. Tendinosis is more common since there is a lack of public awareness of tendon problems. Rehabilitation also emphasizes on both the prevention and treatment of tendonitis.

VR has been used in other types of sickness rehabilitation, and it has been shown to increase patient or user motivation and promote a safe virtual environment (VE) (De Mauro, 2011). There have been numerous studies on the feasibility and escalation of patient motivation through the use of virtual reality in rehabilitation (Fidopiasti et al., 2006). However, existing VR rehabilitation technology is primarily aimed towards patients with psychosocial issues, neuromotor disorders, and cognitive issues. Although there are some VR rehabilitation games for stroke or PTSD patients, there is little research or application for occupational disorders, particularly De Quervain’s Tendinosis. It is perceived that the main favorable advantage of employing VR is to increase patient motivation. Weiss et al. (2006) stressed that motivation is essential for efficient rehabilitation, so VR can be used to treat occupational disorders encouragingly.

The objective of this project is to develop preventive VR scenarios that focus on finger and wrist exercises. The VR game not only allows patients or users to be treated more engagingly, but also raises public awareness of repetitive cumulative trauma disorders and thereby reduces the risk of tendonitis. The intended audience for the game is individuals who have not been diagnosed with De Quervain’s Tendinosis or any other tendon problems in their arms or shoulders. The game allows players to be treated more interactively while also raising public awareness of tendon problems. To develop a VR game, an idea is produced and tweaked several times in order to deliver the most user-friendly VR game environment at a reasonable cost. A non-immersive VR game is developed at the end of the project. The Leap Motion Controller (LMC) is employed as a gesture sensor device to regulate the software’s feedback. A thorough and well-researched examination of VR and its applications, as well as tendon diseases, is completed afterward. Evaluation of the developed game, followed by testing results and questions from testers is done at the end.

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[Abstract] A Systematic Review of the Use of Virtual Reality Games in Post-stroke Rehabilitation – Conference Publication

Abstract

Video games are known for being great at captivating the attention of the user, and by applying Virtual Reality they create vivid, realistic, and exciting experiences. Strokes affect a large portion of the world’s population, causing innumerable deaths, and leaving a great number of its survivors with disabilities in their upper limbs. With this paper we intend to review the role of virtual reality games on the post-stroke recovery of the upper limbs. A systematic search was conducted in March 2021 using IEEE, PubMed, ScienceDirect, and ACM Digital Library databases. According to the 9 articles selected from the 153 surveyed, Virtual Reality has proven to be particularly useful in both keeping patients focused and entertained during their training, which would otherwise be viewed as a repetitive and uninteresting task. Based on the analysis of the reviewed papers, we identify and present in this study several useful techniques for developing an engaging, motivating, and effective Virtual Reality serious game for poststroke rehabilitation.

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[Abstract] A Virtual Reality Serious Game Design for Upper Limb Rehabilitation – IEEE Conference Publication

Abstract

To regain strength and control of the patient’s limb, rehabilitation training is a meaningful part of the recovery process. The rehabilitation training requires the patient to repeat movement exercises, however the process is often tedious and boring.

This paper proposes a design of virtual reality serious game, which focuses on supporting patients to perform rehabilitation training through game playing. The game includes three mini-games targeting three types of training movement of upper limb, and motivates patients to conduct the training by completing the game tasks.

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[Abstract] NOPR: Realisation of a Virtual Reality based Remedial Module for Cognition and Hand Function Rehabilitation

Abstract

Hand function disorders of an individual hinders them from performing activities of daily living with ease and sometimes limit their cognitive growth. As a remedial treatment, nowadays virtual reality (VR) emerged as a gaming platform that has been employed for the rehabilitation of such individuals. User motivation and engagement has risen with the development of VR technology. The developed remedial module is based on a VR platform using two games for upper limb rehabilitation with a hand motion sensing device (HMSD) to provide a solution for sensing hands and fingers movements. The movement was measured with the development of the games based on bilateral hand coordination and manual dexterity, the subset of Bruininks-Oseretsky Test (BOT2) of Motor Proficiency. However, the result of the system considered here is based on the system usability scale (SUS) for healthy individuals. Thus, the system is simple, economical, portable, user-friendly, and does not require intruding external hardware to wear. Hence, over the time these engaging VR rehabilitation games can provide an effective rehabilitation training process for upper limb hemiparesis children.

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