Posts Tagged Computer games

[Abstract] Applying a soft-robotic glove as assistive device and training tool with games to support hand function after stroke: Preliminary results on feasibility and potential clinical impact

Abstract

Recent technological developments regarding wearable soft-robotic devices extend beyond the current application of rehabilitation robotics and enable unobtrusive support of the arms and hands during daily activities. In this light, the HandinMind (HiM) system was developed, comprising a soft-robotic, grip supporting glove with an added computer gaming environment. The present study aims to gain first insight into the feasibility of clinical application of the HiM system and its potential impact. In order to do so, both the direct influence of the HiM system on hand function as assistive device and its therapeutic potential, of either assistive or therapeutic use, were explored. A pilot randomized clinical trial was combined with a cross-sectional measurement (comparing performance with and without glove) at baseline in 5 chronic stroke patients, to investigate both the direct assistive and potential therapeutic effects of the HiM system. Extended use of the soft-robotic glove as assistive device at home or with dedicated gaming exercises in a clinical setting was applicable and feasible. A positive assistive effect of the soft-robotic glove was proposed for pinch strength and functional task performance `lifting full cans’ in most of the five participants. A potential therapeutic impact was suggested with predominantly improved hand strength in both participants with assistive use, and faster functional task performance in both participants with therapeutic application.

I. Introduction

Neurorehabilitation research has shown that training programs for patients after stroke should ideally consist of high intensity, task-specific and functional exercises with active contribution of the patient, to have the best chance for improving arm/hand function [1], [2]. Conventional rehabilitation involves predominantly one-to-one attention of a therapist for each patient, which is a challenge when aiming to provide high intensity training and involves high costs [3], [4]. This is impeded further by an increased ageing of the population, associated with a higher prevalence of stroke patients and less healthcare professionals available to provide such intensive training.

 

via Applying a soft-robotic glove as assistive device and training tool with games to support hand function after stroke: Preliminary results on feasibility and potential clinical impact – IEEE Conference Publication

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[ARTICLE] Participant perceptions of use of CyWee Z as adjunct to rehabilitation of upper-limb function following stroke – Full Text PDF

Abstract

This article reports on the perceptions of 14 adults with chronic stroke who participated in a pilot study to determine the utility, acceptability, and potential efficacy of using an adapted CyWee Z handheld game controller to play a variety of computer games aimed at improving upper-limb function. Four qualitative in-depth interviews and two focus groups explored participant perceptions. Data were thematically analyzed with the general inductive approach. Participants enjoyed playing the computer games with the technology. The perceived benefits included improved upper-limb function, concentration, and balance; however, six participants reported shoulder and/or arm pain or discomfort, which presented while they were engaged in play but appeared to ease during rest. Participants suggested changes to the games and provided opinions on the use of computer games in rehabilitation. Using an adapted CyWee Z controller and computer games in upper-limb rehabilitation for people with chronic stroke is an acceptable and potentially beneficial adjunct to rehabilitation. The development of shoulder pain was a negative side effect for some participants and requires further investigation.

INTRODUCTION

Stroke is the third leading cause of death in New Zealand and a major cause of adult disability for those who experience it [1]. Approximately 85 percent of patients with stroke do not regain upper-limb function and remain dependent on caregivers [2–3], with motor impairments accounting for most poststroke disability [4]. Loss of upper-limb function is a major cause of poor perception of well-being following stroke [5].

Most recovery of upper-limb function occurs in the first 3 months following a stroke; however, significant gains in dexterity, strength, and function with rehabilitation 6 months poststroke have been reported [6–7]. This subacute recovery in motor function can be explained in part by neural reorganization caused by rehabilitation training [8–12]. It is suggested that key factors to upperlimb stroke rehabilitation training are attention, repetition, intensity of practice, reward, progression of complexity, and skill acquisition and that this training should be task-oriented.

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[ARTICLE] Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

Highlights

  • This study focused on technologies, safety and efficacy of exergames for older adults
  • Exergames show good potential as an exercise or rehabilitation tool for older adults
  • Based on the review, recommendations for practice and further research are provided
  • Exergames need to be personalized, safe and address multiple physical functions
  • Future studies should include longer follow-up, social aspects and game adherence

Abstract

Background: There has been a rapid increase in research on the use of virtual reality (VR) and gaming technology as a complementary tool in exercise and rehabilitation in the elderly population. Although a few recent studies have evaluated their efficacy, there is currently no in-depth description and discussion of different game technologies, physical functions targeted, and safety issues related to older adults playing exergames.

Objectives: This integrative review provides an overview of the technologies and games used, progression, safety measurements and associated adverse events, adherence to exergaming, outcome measures used, and their effect on physical function. Methods: We undertook systematic searches of SCOPUS and PubMed databases. Key search terms included “game”, “exercise”, and “aged”, and were adapted to each database. To be included, studies had to involve older adults aged 65 years or above, have a pre-post training or intervention design, include ICT-implemented games with weight-bearing exercises, and have outcome measures that included physical activity variables and/or clinical tests of physical function.

Results: Sixty studies fulfilled the inclusion criteria. The studies had a broad range of aims and intervention designs and mostly focused on community-dwelling healthy older adults. The majority of the studies used commercially available gaming technologies that targeted a number of different physical functions. Most studies reported that they had used some form of safety measure during intervention. None of the studies reported serious adverse events. However, only 21 studies (35%) reported on whether adverse events occurred. Twenty-four studies reported on adherence, but only seven studies (12%) compared adherence to exergaming with other forms of exercise. Clinical measures of balance were the most frequently used outcome measures. PEDro scores indicated that most studies had several methodological problems, with only 4 studies fulfilling 6 or more criteria out of 10. Several studies found positive effects of exergaming on balance and gait, while none reported negative effects.

Conclusion: Exergames show promise as an intervention to improve physical function in older adults, with few reported adverse events. As there is large variability between studies in terms of intervention protocols and outcome measures, as well as several methodological limitations, recommendations for both practice and further research are provided in order to successfully establish exergames as an exercise and rehabilitation tool for older adults.

Source: Exercise and rehabilitation delivered through exergames in older adults: An integrative review of technologies, safety and efficacy

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