Posts Tagged games

[Abstract + References] Virtual System Using Haptic Device for Real-Time Tele-Rehabilitation of Upper Limbs

Abstract

This paper proposes a tool to support the rehabilitation of upper limbs assisted remotely, which makes it possible for the physiotherapist to be able to assist and supervise the therapy to patients who can not go to rehabilitation centers. This virtual system for real-time tele-rehabilitation is non-invasive and focuses on involving the patient with mild or moderate mobility alterations within a dynamic therapy based on virtual games; Haptics Devices are used to reeducate and stimulate the movement of the upper extremities, at the same time that both motor skills and Visual-Motor Integration skills are developed. The system contains a virtual interface that emulates real-world environments and activities. The functionality of the Novint Falcon device is exploited to send a feedback response that corrects and stimulates the patient to perform the therapy session correctly. In addition, the therapy session can vary in intensity through the levels presented by the application, and the amount of time, successes and mistakes made by the patient are registered in a database. The first results show the acceptance of the virtual system designed for real-time tele-rehabilitation.

References

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[Abstract] A Virtual Reality based Training and Assessment System for Hand Rehabilitation – IEEE Conference Publication

Abstract

Virtual reality is widely applied in rehabilitation robot to help post-stoke patients complete rehabilitation training for the body function recovery. Most of virtual rehabilitation training systems lack scientific assessment standards and doctors don’t usually use quantitative examinations but qualitative observation and conversation with patients to evaluate the motor function of limb. Based on this situation, a virtual rehabilitation training and assessment system is designed, which contains two rehabilitation training games and one assessment system. The virtual system can attract patient attention and decrease the boredom of rehabilitation training and assessment. Compared with the existing rehabilitation assessment methods, the proposed virtual assessment system can give the assessment results similar to Fugl-Meyer Assessment, which is more quantitative, interesting and convenient. Five volunteers participate in the study of assessment system and the experimental results confirm the effectiveness of assessment system.

I. Introduction

In recent years, according to American Heart Association, stroke is the leading cause of serious long-term disability in the US and about 795,000 people suffer from a stroke each year [1]. China is also facing the same problem. The stroke is the first leading cause of death. Every year, 2.4 million people suffer from stroke [2]. Fortunately, about 60-75 percent of those can survive. However, about 65 percent of them still remain severely handicapped because of the neurological damage caused by stroke, for example, movement disorders, hemiparesis and so on [3], [4]. Those sequelae have an effect on body movement function, especially arm and hand function [4], [5]. The lost of hand movement function will affect the Activities of Daily Living (ADLs), which will decrease the quality of life [6].[…]

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[Abstract] Dynamic Difficulty Adjustment in Virtual Reality Applications for Upper Limb Rehabilitation – IEEE Conference Publication

Abstract

The objective of this paper was to compare the incidence of a rehabilitation game in motor ability with dynamic difficulty adjustment (ADD) in comparison to a manual configuration. To achieve that, a virtual tool called “Bug catcher” was developed, which is focused in upper limb rehabilitation. This tool uses a dynamic difficulty adjustment based in fuzzy logic. The population involved for the present study were made by 2 users, a 18-year-old patient with a hemiparesis that limits her motor ability in her left upper limb, and a 37-year-old patient with motor monoparesis in his right upper limb. This tool was used in both users, each one with a different configuration (automatic or manual), and the motor ability from both participants was objectively measured using Box and Blocks Test, applied before, during and after each session; additionally, a performance index (percentage of success) was defined in order to determine the progress of the participants in the virtual tool. As a result, it was obtained that user number one using the game with ADD, managed to obtain not only a better performance in the sessions but also an important advance in her motor skill in comparison to the user 2 with the manual configuration.

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[Abstract] Gesture Interaction and Augmented Reality based Hand Rehabilitation Supplementary System – IEEE Conference Publication

Abstract:

The existing systems of hand rehabilitation always design different rehabilitation medical apparatus and systems according to the patients’ needs. This kind of system always contain problems such as complexity, using only single training programs, inconvenient to wear and high cost. For these reasons, this paper uses gesture recognition technology and augmented reality technology to design a simple and interactive hand rehabilitation supplementary system. The system uses a low-cost, non-contact device named Leap Motion as the input device, and Unity3D as the development engine, realizing three functional modules: conventional training, AR game training and auxiliary functions. This rehabilitation training project with different levels of difficulty increases the fun and challenge of the rehabilitation process. Users can use the system to assist the treatment activity of hand rehabilitation anytime and anywhere. The system, which has good application value, can also be used in other physical rehabilitation fields.

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[Abstract] Towards Bilateral Upper-Limb Rehabilitation after Stroke using Kinect Game – IEEE Conference Publication

Abstract:

This paper presented a game-based rehabilitation of the upper limb after stroke. We designed and developed a game for supporting stroke patients to have an exercise their arms, and the game had functions for recording their playing and showing a performance report. The performance report can infer the progress of bilateral uppper-limb rehabilitation and use for comparing among patient cases. This is because the game used a Kinect device to detect the arm movements in aspect of precision and speed.

 

1. L. Anderson, G. A. Sharp, R. J. Norton, H. Dalal, S. G. Dean, K. Jolly, A. Cowie, A. Zawada, R. S. Taylor, “Home-based versus centre-based cardiac rehabilitation”, The Cochrane Library, 2017.

2. K. Thomson, A. Pollock, C. Bugge, M. C. Brady, “Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice”, Disability and Rehabilitation: Assistive Technology, vol. 11, no. 6, pp. 454-461, 2016.

3. L. Y. Joo, T. S. Yin, D. Xu, E. Thia, P. F. Chia, C. W. K. Kuah, K. K. He, “A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke”, Journal of rehabilitation medicine, vol. 42, no. 5, pp. 437-441, 2010.

4. K. Price, “Health promotion and some implications of consumer choice”, Journal of nursing management, vol. 14, no. 6, pp. 494-501, 2006.

5. J. A. M. Bravo, P. Paliyawan, T. Harada, R. Thawonmas, “Intelligent assistant for providing instructions and recommending motions during full-body motion gaming”, Consumer Electronics (GCCE) 2017 IEEE 6th Global Conference on. IEEE, pp. 1-2, 2017.

 

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[WEB SITE] The Newest Technology Impacting Physical Therapy – Virtual Reality

Digital technologies are increasingly becoming more important in the medical sphere every single day. Already, technologies like telemedicine have proven to be an effective method of treatment and has quickly gained in popularity over the years proving that technology can swiftly replace old systems with new, more efficient methods of treatment. Now, a new technology called Virtual Reality is coming into the therapy world and is changing it forever.
 
HOW IS VR IMPACTING PHYSICAL THERAPY?
Virtual Reality (VR) is now being used by physical therapists for the successful treatment of stroke victims, walking disorders and back pain. The technology has been shown to improve the patients motor learning and coordination skills by using gamified, immersive environments that have been created to help patients suffering from pain and injury relearn the use of their limbs in a way that is motivating and fun.
 
WHY IT MATTERS
Lets be honest, most times physical therapy can be a painful and overwhelming experience. With VR, the patient is able to experience a three-dimensional world surrounding their vision that is quite convincing to the sense’s. Many people report that they actually feel present in another environment, separate from reality. This is the element that aids in eliminating pain during exercises and encourages more repeat workouts. For example, if the patient was exercising their lower limbs, they would be able to appear as if they are walking on a beach or in a forest instead of on a boring treadmill. In another scenario, if the patient was exercising their upper extremities, then they could experience the thrill of being rewarded for successfully climbing up a mountain. Games like this provide motivation at home for the patient to continue exercising, enabling them with visual data on how they are improving their range of motion. These type of “experiences” help to keep the patient on the right path outside of the treatment room, which is a huge bonus because studies have shown that only 30% of exercises get accomplished after leaving rehabilitation.
 
 
What this will do to the therapy industry is still unknown but it is obvious that there is enormous potential for this technology to impact it in a large way.

 

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[Abstract] Towards an Immersive Virtual Reality Game for Smarter Post-Stroke Rehabilitation

Abstract:

Traditional forms of physical therapy and rehabilitation are often based on therapist observation and judgment, coincidentally this process oftentimes can be inaccurate, expensive, and non-timely. Modern immersive Virtual Reality systems provide a unique opportunity to make the therapy process smarter. In this paper, we present an immersive virtual reality stroke rehabilitation game based on a widely accepted therapy method, Constraint-Induced Therapy, that was evaluated by nine post-stroke participants. We implement our game as a dynamically adapting system that can account for the user’s motor abilities while recording real-time motion capture and behavioral data. The game also can be used for tele-rehabilitation, effectively allowing therapists to connect with the participant remotely while also having access to +90Hz real-time biofeedback data. Our quantitative and qualitative results suggest that our system is useful in increasing affordability, accuracy, and accessibility of post-stroke motor treatment.

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[Abstract + References] Towards a framework for rehabilitation and assessment of upper limb motor function based on Serious Games – IEEE Conference Publication

Abstract

 Serious Games and Virtual Reality (VR) are being considered at present as an alternative to traditional rehabilitation therapies. In this paper, the ongoing development of a framework focused on rehabilitation and assessment of the upper limb motor function based on serious games as a source of entertainment for physiotherapy patients is described. A set of OpenSource Serious Games for rehabilitation has been developed, using the last version of Microsoft1® Kinect™ as low cost monitoring sensor and the software Unity. These Serious Games captures 3D human body data and it stored them in the patient database to facilitate a later clinical analysis to the therapist. Also, a VR-based system for the automated assessment of motor function based on Fugl-Meyer Assessment Test (FMA) is addressed. The proposed system attempts to be an useful therapeutic tool for tele-rehabilitation in order to reduce the number of patients, time spent and cost to
hospitals.

I. Introduction

Biomechanical analysis is an important feature during the evaluation and clinical diagnosis of motor deficits caused by traumas or neurological diseases. For that reason Motion capture (MoCap) systems are widely used in biomechanical studies, in order to collect position data from anatomical landmarks with high accuracy. Their results are used to estimate joint movements, positions, and muscle forces. These quantitative results improve the tracking of changes in motor functions over time, being more accurately than clinical ratings [1]. For clinical applications, these results are usually transformed into clinically meaningful and interpretable parameters, such as gait speed, motion range of joints and body balance.

References

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K. Otte, B. Kayser, S. Mansow-Model, J. Verrel, F. Paul, A. U. Brandt, T. Schmitz- Hubsch, “Accuracy and reliability of the kinect version 2 for clinical measurement of motor function”, PloS one, vol. 11, no. 11, pp. e0166532, 2016.
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O. O’Neil, C. Gatzidis, I. Swain, “A state of the art survey in the use of video games for upper limb stroke rehabilitation” in Virtual Augmented Reality and Serious Games for Healthcare 1, Springer, pp. 345-370, 2014.
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H. Mousavi Hondori, M. Khademi, “A review on technical and clinical impact of microsoft kinect on physical therapy and rehabilitation”, Journal of medical engineering, vol. 2014, no. 846514, 2014.
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E. D. Ofia, C. Balaguer, R. Cano de la Cuerda, S. Collado Vázquez, A. Jardon, “Effectiveness of serious games for leap motion on the functionality of the upper limb in parkinsons disease: A feasibility study”, Computational Intelligence and Neuroscience, vol. 2018, 2018.
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E. D. Ofia, R. Cano de la Cuerda, P. Sanchez-Herrera, C. Balaguer, A. Jardon, “A review of robotics in neurorehabilitation: Towards an automated process for upper limb”, Journal of Healthcare Engineering, vol. 2018, 2018.
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K. Tanaka, J. Parker, G. Baradoy, D. Sheehan, J. R. Holash, L. Katz, “A comparison of exergaming interfaces for use in rehabilitation programs and research”, Loading…, vol. 6, no. 9, 2012.
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J. E. Deutsch, M. Borbely, J. Filler, K. Huhn, P. Guarrera-Bowlby, “Use of a low-cost commercially available gaming console (wii) for rehabilitation of an adolescent with cerebral palsy”, Physical therapy, vol. 88, no. 10, pp. 1196-1207, 2008.
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H. Sin, G. Lee, “Additional virtual reality training using xbox kinect in stroke survivors with hemiplegia”, American Journal of Physical Medicine & Rehabilitation, vol. 92, no. 10, pp. 871-880, 2013.
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J. Wiemeyer, A. Kliem, “Serious games in prevention and rehabil-itationa new panacea for elderly people?”, European Review of Aging and Physical Activity, vol. 9, no. 1, pp. 41, 2011.
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A. Pfister, A. M. West, S. Bronner, J. A. Noah, “Comparative abilities of microsoft kinect and vicon 3d motion capture for gait analysis”, Journal of medical engineering & technology, vol. 38, no. 5, pp. 274-280, 2014.
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S. K. Jun, X. Zhou, D. K. Ramsey, V. N. Krovi, “A comparative study of human motion capture and computational analysis tools”, The 2nd International Digital Human Modeling Symposium, 2003.
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A. M. d. C. Souza, M. A. Gadelha, E. A. Coutinho, S. R. d. Santos, A. Pantoja, A. Pereira, “A video-tracking based serious game for motor rehabilitation of post-stroke hand impairment”, SBC Journal on 3D Interactive Systems, vol. 3, no. 2, pp. 37-46, 2012.
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Z. Luo, C. K. Lim, I. M. Chen, S. H. Yeo, “A virtual reality system for arm and hand rehabilitation”, Frontiers of Mechanical Engineering, vol. 6, no. 1, pp. 23-32, 2011.
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O. Wasenmuller, D. Stricker, “Comparison of kinect v l and v2 depth images in terms of accuracy and precision”, Asian Conference on Computer Vision Workshop (ACCV workshop), 2016.
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J. Van der Putten, J. Hobart, J. Freeman, A. Thompson, “Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the barthel index and the functional independencemeasure”, Journal of Neurology Neurosurgery & Psychiatry, vol. 66, no. 4, pp. 480-484, 1999.
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E. D. Ofia, A. Jardon, C. Balaguer, Y. Gao, S. Fallah, Y. Jin, C. Lekakou, “The automated box and blocks test an autonomous assessment method of gross manual dexterity in stroke rehabilitation” in Towards Autonomous Robotic Systems TAROS 2017, Cham: Springer, vol. 10454, pp. 101-114, 2017.
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C. Rodriguez-de Pablo, J. C. Perry, F. I. Cavallaro, H. Zabaleta, T. Keller, “Development of computer games for assessment and training in post-stroke arm telerehabilitation”, Engineering in Medicine and Biology Society (EMBC) 2012 Annual International Conference of the IEEE, pp. 4571-4574, 2012.
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[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.

 

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[Abstract] MaLT – Combined Motor and Language Therapy Tool for Brain Injury Patients Using Kinect.

Abstract

BACKGROUND:

The functional connectivity and structural proximity of elements of the language and motor systems result in frequent co-morbidity post brain injury. Although rehabilitation services are becoming increasingly multidisciplinary and “integrated”, treatment for language and motor functions often occurs in isolation. Thus, behavioural therapies which promote neural reorganisation do not reflect the high intersystem connectivity of the neurologically intact brain. As such, there is a pressing need for rehabilitation tools which better reflect and target the impaired cognitive networks.

OBJECTIVES:

The objective of this research is to develop a combined high dosage therapy tool for language and motor rehabilitation. The rehabilitation therapy tool developed, MaLT (Motor and Language Therapy), comprises a suite of computer games targeting both language and motor therapy that use the Kinect sensor as an interaction device. The games developed are intended for use in the home environment over prolonged periods of time. In order to track patients’ engagement with the games and their rehabilitation progress, the game records patient performance data for the therapist to interrogate.

METHODS:

MaLT incorporates Kinect-based games, a database of objects and language parameters, and a reporting tool for therapists. Games have been developed that target four major language therapy tasks involving single word comprehension, initial phoneme identification, rhyme identification and a naming task. These tasks have 8 levels each increasing in difficulty. A database of 750 objects is used to programmatically generate appropriate questions for the game, providing both targeted therapy and unique gameplay every time. The design of the games has been informed by therapists and by discussions with a Public Patient Involvement (PPI) group.

RESULTS:

Pilot MaLT trials have been conducted with three stroke survivors for the duration of 6 to 8 weeks. Patients’ performance is monitored through MaLT’s reporting facility presented as graphs plotted from patient game data. Performance indicators include reaction time, accuracy, number of incorrect responses and hand use. The resultant games have also been tested by the PPI with a positive response and further suggestions for future modifications made.

CONCLUSION:

MaLT provides a tool that innovatively combines motor and language therapy for high dosage rehabilitation in the home. It has demonstrated that motion sensor technology can be successfully combined with a language therapy task to target both upper limb and linguistic impairment in patients following brain injury. The initial studies on stroke survivors have demonstrated that the combined therapy approach is viable and the outputs of this study will inform planned larger scale future trials.

KEYWORDS:

 

via MaLT – Combined Motor and Language Therapy Tool for Brain Injury Patients Using Kinect. – PubMed – NCBI

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