Posts Tagged Game

[ARTICLE] Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke – Full Text



Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke.


Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups.


At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05).


Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.


The maintenance of the core or upper body control, is essential for maintaining posture and stability while changing positions, performing activities of daily living (ADL), and ambulating [1,2]. Patients who are undergoing physical rehabilitation following stroke, tend to deviate towards the affected side, as a result of postural instability, which induces both asymmetrical trunk movement and trunk muscle weakness. Upper body instability makes it difficult to maintain postural control when performing tasks and leads to functional disability [3]. The lack of postural stability also affects the balance of patients following stroke, increasing the risk of falls, and negatively impacting on patient independence and safety. For example, it has been reported that up to 73% of patients with stroke experience a fall within six months after leaving hospital [4]. Falls following a stroke can have severe consequences, including hip fractures and reduced physical activity due to fear of repeat falls [5]. Therefore, because these factors can have a negative impact on patient rehabilitation following stroke, the improvement of postural stability is an important goal of patient rehabilitation following stroke [6].

Sports that involve paddling with a single oar, such as canoeing and kayaking, are effective outdoor activities that improve postural stability and upper body stabilization [7]. Continuous body adjustment and compensation are required during the single-oar paddling motion to maintain balance during perturbations caused by the movement of the canoe or kayak and the paddle in the water [8]. Currently, canoe paddling training can be conducted using an ergometer to provide a training opportunity that is independent of outdoor conditions and to better control training progression [9]. A paddling ergometer has also been studied for rehabilitation training of patients with paraplegia and has been shown to be effective in improving postural control, balance, motor performance, and upper extremity strength [8,9].

Game-based virtual reality (VR) using gaming consoles is now used as a therapeutic approach for the rehabilitation of patients with stroke and provides an opportunity for patients to perform activities that are difficult in a clinical setting. Furthermore, VR programs are often designed to be more entertaining and enjoyable than traditional physical therapy tasks, thereby encouraging patients to participate in the rehabilitation program.

The use of VR equipment specifically designed for physical rehabilitation is not yet commonly available in clinical settings. Therefore, VR rehabilitation programs using a game-based, motion-controlled console that can be used in clinical settings and at low cost that can utilize a variety of gaming software are needed.

The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke.[…]


Continue —>  Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke

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Figure 2
Game-based virtual reality (VR) canoe paddling training.

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[WEB SITE] Virtual reality games to help patients’ rehabilitation in UAE

The AI system is already in use in Ras Al Khaimah Physiotherapy and Sports Centre and will be rolled out soon in all ministry hospitals.

A therapist will always be present to monitor these sessions of patients.

Games developed specially for rehabilitation in physiotherapy for patients of stroke, cerebral palsy and similar conditions, will be used by the Ministry of Health and Prevention (Mohap) as it rolls out use of artificial intelligence (AI) and virtual reality (VR) in hospitals.

The AI system is already in use in Ras Al Khaimah Physiotherapy and Sports Centre and will be rolled out soon in all other ministry hospitals. “Games are developed for rehab of such patients, for both children and adults, especially those suffering from cerebral palsy and motor delay conditions,” Dr Yousif Mohammed Al Serkal, assistant undersecretary for the hospital sector, told Khaleej Times.

“The AI system is composed of three parts – a TV set, a sensory kinetic bar and an X-Box linked with these. Specific games are used to assess how cognitive a patient is,” he said.

A therapist will always be present to monitor these sessions of patients and will assess their conditions accordingly, he added.

He also explained the advantages of VR using AI in physiotherapy to provide treatment. “This will allow the patient to complete the treatment at his/her home with the possibility of remote rehabilitation,” he said.

“In the treatment of stroke, the virtual reality system evaluates and enhances the recovery of the affected upper parts, in addition to the training for the walking device used for rehabilitation.

“The patient moves at a speed on the motion platform with changing virtual environments being displayed on the front screen to simulate daily activities. In the treatment of the balance disorder, virtual reality is a safe and effective alternative to conventional therapy to improve the balance in patients,” he said. “Patients have reported that they enjoyed VR therapy without suffering from side effects, and with increased motivation.

“This technique is also used to treat children with developmental disorders, including positive developments in both perceived and performance capabilities in areas of daily activities including social activities that they have not been able to do before.”

The virtual therapy also assists cerebral palsy patients in the reorganisation of the brain and movement ability and visual cognitive skills, in addition to social participation and personal factors.

More about VR with AI

The UAE Strategy for Artificial Intelligence (AI) is a project within the Centennial Plan 2071. The plan will also include virtual reality (VR) rehabilitation in physiotherapy for stroke patients, patients suffering from balance disorder and children with development disorders, cerebral palsy and Parkinson’s syndrome.

VR rehabilitation technology makes use of virtual world simulation to meet various requirements for effective medical intervention to achieve the best results using the video game controller and the moving sensor. Scientific studies have proven the effectiveness of this innovative technique in the rehabilitation and treatment of many such cases.


AI boost to healthcare

Healthcare industry stands to gain significantly by inducting artificial intelligence into various processes. The technology can take the fear out of procedures and make treatments more effective. The UAE has been experimenting on this front and results are encouraging so far. Innovation through AI is becoming more meaningful with its human-centric approach, and the medical experts are now looking at expanding its scope.


via Virtual reality games to help patients’ rehabilitation in UAE – Khaleej Times

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[Abstract+References] Iterative Design of an Upper Limb Rehabilitation Game with Tangible Robots


Rehabilitation aims to ameliorate deficits in motor control via intensive practice with the affected limb. Current strategies, such as one-on-one therapy done in rehabilitation centers, have limitations such as treatment frequency and intensity, cost and requirement of mobility. Thus, a promising strategy is home-based therapy that includes task specific exercises. However, traditional rehabilitation tasks may frustrate the patient due to their repetitive nature and may result in lack of motivation and poor rehabilitation. In this article, we propose the design and verification of an effective upper extremity rehabilitation game with a tangible robotic platform named Cellulo as a novel solution to these issues. We first describe the process of determining the design rationales to tune speed, accuracy and challenge. Then we detail our iterative participatory design process and test sessions conducted with the help of stroke, brachial plexus and cerebral palsy patients (18 in total) and 7 therapists in 4 different therapy centers. We present the initial quantitative results, which support several aspects of our design rationales and conclude with our future study plans.


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via Iterative Design of an Upper Limb Rehabilitation Game with Tangible Robots

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[WEB SITE] Using Virtual Reality to Make Users Want to Exercise

[VIDEO] High-Tech Treadmill Uses Virtual Reality to Encourage Cardiovascular Fitness

Businesses are finding more uses for Virtual Reality (VR) as the technology develops.

VR is no longer only for gaming or enjoyment. An American company called Blue Goji is using VR to improve one’s health by making exercise more fun.

Blue Goji has offices in Austin, the capital of Texas. The company demonstrated its cardiovascular workout machine, called the Infinity treadmill, at the recent South by Southwest festival. The event is held every year in Austin.

A person using the treadmill wears a virtual reality headset when exercising. Before starting, the user is connected to a belt to prevent falls. Then, the user plays a VR game while running on the machine. The game can transport the user into the virtual world, where he or she can be racing against virtual people.

The cost of the hardware and computer software program is $12,000. That is a lot of money for most people. But Kyra Constam of Blue Goji says the virtual reality treadmill is ideal for places where people go to exercise, like a high-end gymnasium or recreation center. She added that people seeking treatment at physical therapy or rehabilitation centers would find the equipment useful.

Recently, Leonardo Mattiazzi tested the Infinity treadmill. Mattiazzi said he had a strong feeling to actually get running and do something that pushed his limits. He said the experience was more interesting than running inside the gym without actually going anywhere.

Motion sickness less likely

Constam said the active use of virtual reality helps solve a common problem while wearing a VR headset. She noted that a lot of VR experiences cause motion sickness because people are in motion during the game, but not moving in real life. But when the user is moving on the treadmill and in the game, the chances of motion sickness are reduced, she said.

However, users who tested the treadmill while wearing the VR headset each had a different experience. It took Leonardo Mattiazzi 10 seconds to set the controls to running in the virtual world.

VR learning curve

Kyra Constam said there generally is a learning curve for VR. The first time users feel lost, but “the more you do it, the more you get used to it,” she said.

Mark Sackler was a first time user. He said he felt a little sick at one point during the game. But he thought the experience was surprisingly realistic.

After carefully studying the users’ experiences, Blue Goji plans to begin selling the Infinity treadmill to the public in 2019.

VOA’s Elizabeth Lee reported on this story from Texas. Xiaotong Zhou adapted her report for Learning English. George Grow was the editor.

via Using Virtual Reality to Make Users Want to Exercise

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[WEB SITE] Game On: Virtual Reality as Pain Treatment Shows Promise in Early Trials

Imagine being in pain, but happily distracted from your suffering by being totally immersed in floating lazily down a river or tossing fish to hungry otters that pop up out of nowhere. Such scenarios of a 360-degree world are possible via virtual reality (VR), whereby a patient sits in a chair wearing a head visor connected to a computer and holds a small wireless device in his or her hand to change direction.

“Although [VR] is very early in its inception for treating painful conditions, we are hopeful that VR will interest other research and payors,” said James Choo, MD, owner and medical director of Pain Consultants of East Tennessee, in Knoxville, which conducted two clinical studies of VR. “I think there is a lot of potential for VR, especially if you marry VR to other pain treatments that are not widely available but that we know work, such as cognitive-behavioral therapy and mindfulness meditation for lower back pain.”

However, he added that few pain psychologists are practicing in the United States, and cognitive-behavioral therapy is time-consuming. “We have never had scalable treatments that work and that can be highly disseminated,” Dr. Choo said. “With VR, if you have the right software, there is an enormous potential to disseminate that type of care to millions of people rather than just a handful of patients who have access to the one pain psychologist that might be in their region.”

Similarly, mindfulness-based instruction through VR may be plausible.

“The effects of the type of VR program that we used derive from a game,” Dr. Choo said. “It is not just a passive immersive experience of looking around at the scene. You are actually playing a game—interacting with the environment itself. Besides distracting pain, VR is fun, like playing a video game.”

Dr. Choo said the immersive experience of being in a virtual environment and simply being distracted from pain are helpful. In addition, “perhaps even the immersive experience has its own analgesic effect,” he said. “But we do not understand quite yet the neuropathways that are being affected that cause the analgesic effect. Once we do, then we will be able to better target the type of VR programs that best suit the patient and their particular pain needs.”

Ted Jones, PhD, a clinical psychologist at Pain Consultants of East Tennessee, heard a conference speaker last year refer to VR as a syringe, meaning its effect “depends on the content.” He added, “Historically, since the late 1980s, VR has been used for procedural pain—basically for burn pain and injections in an inpatient setting or a burn unit. However, the majority of pain [treated by clinicians] is outpatient pain. So we are taking what has been used for inpatient procedural pain and using it for outpatient pain.”

To date, VR treatments at the clinic have been isolated to two completed studies, using software called Cool! developed by Firsthand Technology.

“What we have found is that if you give someone doses of VR, it cuts their pain dramatically,” said Dr. Jones, who was principal investigator of both trials. “However, there is no [long-term] effect. A week later, the patient is right back where he or she started, both painwise and depression-wise and stresswise. It is similar to a person coming to a pain clinic, giving them a dose of medicine and sending them home.”

The first study, conducted in 2015 and published last year in PLOS ONE (2016;11:e0167523), consisted of 30 patients with chronic pain. Participants were asked about their pain before and after a single, five-minute session of VR conducted at the clinic.

“The study decreased pain by 55% to 60%,” Dr. Jones said. “VR is like distractionon steroids, because when your brain is in a virtual world, it is like you are there. In comparison, morphine reduces pain by only one-third.”

The second study, performed last year at the clinic, involved 10 patients with neuropathic pain. The protocol was three sessions of VR, each lasting 20 minutes and spaced one week apart.

“Pain was cut by roughly 70%, due to the longer exposure sessions and multiple treatments,” Dr. Jones said. “There was also a lingering effect. Most patients reported that their pain continued to be less for about one day on average after each session.”

‘Still Out of Reach’

However, depression, anxiety, beliefs about pain and how to cope with pain did not change over time. “In other words, VR did not provide patients any emotional or cognitive benefit,” Dr. Jones said.

Dr. Jones said a single VR unit costs between $3,000 and $4,000. Although it’s a dramatic drop from the previous $8,000 cost, “it is still out of reach for most patients,” he said. “Further, many of the units currently available have a lot of wires and require a high-end machine. You cannot take it home with you—physically or financially.”

To address these shortcomings, Pain Consultants of East Tennessee and the University of Tennessee plan on conducting a pilot study of 10 to 20 patients this fall with the portable Samsung Gear VR, which has an easy-to-use headset and some pain and relaxation applications, along with a Fitbit fitness mobile device to detect activity level and record pain.

“We will determine if daily VR home use is effective, which should be the case, based on our two previous studies,” Dr. Jones said. “Using VR at home several times a day is like being prescribed a pain reliever to be taken two or three times daily. VR has the chance to replace as-needed pain medicine at home.”

The occupational therapy department at the pain clinic is also scheduled to incorporate VR into therapy for conditions such as phantom limb pain and stroke pain. “For this application, VR acts like a mirror, so patients can see and restore movement,” Dr. Jones said.

Despite enthusiasm about VR for pain, there are several hurdles and challenges to make the modality effective in the clinical space. Besides no payors yet, “we need more in-depth studies to show its efficacy for [specific] conditions,” Dr. Choo said.

Apart from employing VR as simply a game, VR may be used as a substitute therapist in certain cases, or for biometric functioning and rehabilitation. “These are completely different programs,” Dr. Choo said. “Therefore, we have to be very specific on the types of software programs we use and the way they deliver care.”

For instance, VR could be used to help patients meditate or provide biofeedback.

“One of the key [goals] is for VR to become a scalable model,” Dr. Choo said. “The unit we are using is not portable. But in the future, we envision all VR units being extremely portable, easy to use and accessible.”

Dr. Jones added, “VR has a lot of potential. We just need to match it to the right patient at the correct setting and the right cost.”

—Bob Kronemyer

Source: Game On: Virtual Reality as Pain Treatment Shows Promise in Early Trials – Pain Medicine News

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[Master’s thesis] Tracking, monitoring and feedback of patient exercises using depth camera technology for home based rehabilitation – ANNA RIDDERSTOLPE – Full Text PDF


Neurological and chronic diseases have profound impacts on a person’s life. Rehabilitation is essential in order to maintain and promote maximal level of recovery by pushing the bounds of physical, emotional and cognitive impairments. However, due to the low physical mobility and poor overall condition of many patients, traveling back and forth to doctors, nurses and rehabilitation centers can be exhausting tasks. In this thesis a game-based rehabilitation platform for home usage, supporting stroke and COPD rehabilitation is presented. The main goal is to make rehabilitation more enjoyable, individualized and easily accessible for the patients.

The game-based rehabilitation tool consists of three systems with integrated components: the caregiver’s planning and follow-up system, the patient’s gaming system and the connecting server system. The server back end components allow the storage of patient specific information that can be transmitted between the patient and the caregiver system for planning, monitoring and feedback purposes. The planning and follow-up system is a server system accessed through a web-based front-end, where the caregiver schedules the rehabilitation program adjusted for each individual patient and follow up on the rehabilitation progression. The patient system is the game platform developed in this project, containing 16 different games and three assessment tests. The games are based on specific motion patterns produced in collaboration with rehabilitation specialists. Motion orientation and guidance functions is implemented specifically for each exercise to provide feedback to the user of the performed motion and to ensure proper execution of the desired motion pattern.

The developed system has been tested by several people and with three real patients. The participants feedback supported the use of the game-based platform for rehabilitation as an entertaining alternative for rehabilitation at home. Further implementation work and evaluation with real patients are necessary before the product can be used for commercial purpose.

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[VIDEO] A virtual reality game to help stroke patients – Futuris – YouTube

At a sophisticated lab in Barcelona, researchers are convinced that computer models based on virtual reality can help people who have suffered strokes, by providing them with better rehabilitation techniques. The claim is not just science fiction.

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[GAME] Mobility Mission –

Mobility Mission

Mobility Mission is an entertaining online game that addresses post-stroke mobility challenges. Stroke is a serious condition, and learning to deal with the effects of surviving a stroke can be challenging. This game will help you gain a better understanding of post-stroke mobility challenges such as spasticity, paralysis, foot drop, as well as management and treatment options you can discuss with your healthcare provider. As you travel through the four levels of the game you will learn how to improve your safety at home and acquire tips to lower your risk of falling. Your journey is waiting!


Your journey is waiting! This fun and interactive game will boost your confidence and knowledge about stroke and common post-stroke mobility issues.

Source: Mobility Mission |


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[WEB SITE] Getting your kicks with Kinect for Windows – Kinect for Windows Product Blog

A wall, a ball, and a kid: think about it. When you were a youngster on a playground, and a wall and a ball were at hand, what would you do? If you were like most kids, you’d kick or throw that ball against the wall, moving around with the unbridled energy of youth as the ball bounced back to you, again and again.

It’s exactly that sort of natural, simple exercise that Wall Ball, a Kinect for Windows game, seeks to recreate. Or as psychologist and game developer Tino Ågren of Mixxus Studio says, “A kid in the schoolyard moves around without thinking about it being ‘exercise.’ I like games to work in the same way—you turn Wall Ball on and start moving around, getting your pulse up, just because it’s fun.”

With Wall Ball, you don’t need a playground or a physical wall or ball—just a Kinect for Xbox One sensor and a Kinect Adapter for Windows, which allows the sensor to be hooked up to a compatible Windows PC. You candownload the game itself from the Windows Store.

During game play, the Kinect sensor’s skeletal tracking follows your movements as you simulate kicking an onscreen soccer ball (you get five balls in each round). Every time one of your kicks hits the wall, you score a point—and you can earn bonus points when you hit objects that randomly appear on the wall. You also need to watch the ball as it rebounds from the wall—if you let it get past you, you’ll be penalized one ball. The game offers three levels of play: easy (or beginner), standard, and seated mode (for use by people with mobility issues).

In creating Wall Ball, Ågren used the Kinect Unity package in the Kinect for Windows SDK 2.0, which allowed him to develop the entire game in Unity. The physics simulations, which enable the skeletal tracking to accurately predict the flight of the ball, were the biggest challenge. Once he had the physics down, he knew he was on the way to creating an enjoyable way to burn off some physical energy anytime you have a few minutes. Ågren is especially happy to have made the game available through the Windows Store, which he feels is “a really good platform…a good way to reach a lot of different people.”

He hopes to see Wall Ball and Country Ramble, another of Mixxus Studio’s Kinect for Windows games, reach beyond typical video gamers. He even foresees their use in retirement homes, helping elderly folks stay physically active by playing fun games that don’t require a mastery of electronic controllers. A blessing also for those of us who are still trying to figure out our TV universal remotes!

The Kinect for Windows Team

Key links

Source: Getting your kicks with Kinect for Windows – Kinect for Windows Product Blog

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[ARTICLE] Usability evaluation of low-cost virtual reality hand and arm rehabilitation games – Full Text PDF


The emergence of lower-cost motion tracking devices enables home-based virtual reality rehabilitation activities and increased accessibility to patients. Currently, little documentation on patients’ expectations for virtual reality rehabilitation is available.

This study surveyed 10 people with stroke for their expectations of virtual reality rehabilitation games. This study also evaluated the usability of three lowercost virtual reality rehabilitation games using a survey and House of Quality analysis. The games (kitchen, archery, and puzzle) were developed in the laboratory to encourage coordinated finger and arm movements.

Lower-cost motion tracking devices, the P5 Glove and Microsoft Kinect, were used to record the movements. People with stroke were found to desire motivating and easy-to-use games with clinical insights and encouragement from therapists. The House of Quality analysis revealed that the games should be improved by obtaining evidence for clinical effectiveness, including clinical feedback regarding improving functional abilities, adapting the games to the user’s changing functional ability, and improving usability of the motion-tracking devices.

This study reports the expectations of people with stroke for rehabilitation games and usability analysis that can help guide development of future games.

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