Posts Tagged games

[Abstract] RehabFork: An Interactive Game-assisted Upper Limb Stroke Rehabilitation System – IEEE Conference Publication

Abstract

In this paper, we present the design and development of a game-assisted stroke rehabilitation system RehabFork that allows a user to train their upper-limb to perform certain functions related to the task of eating.

The task of eating is divided into several components: (i) grasping the eating utensils such as a fork and knife; (ii) lifting the eating utensils; (iii) using the eating utensils to cut a piece of food; (iv) transferring the food to the mouth; and (v) chewing the food. The RehabFork supports the user through sub-tasks (i)–(iii).

The hardware components of RehabFork consist of an instrumented fork and knife, and a 3D printed pressure pad, that measure and communicate information on user performance to a gaming environment to render an integrated rehabilitation system.

The gaming environment consists of an interactive game that utilizes sensory data as well as user information about the severity of their disability and current level of progress to adjust the difficulty levels of the game to maintain user motivation. Information pertaining to the user, including performance data, is stored and can be shared with care providers for ongoing oversight.

Source: https://ieeexplore.ieee.org/abstract/document/9176168

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[Abstract + References] Feasibility of Wearable Sensing for In-Home Finger Rehabilitation Early After Stroke

Abstract

Wearable grip sensing shows potential for hand rehabilitation, but few studies have studied feasibility early after stroke. Here, we studied a wearable grip sensor integrated with a musical computer game (MusicGlove). Among the stroke patients admitted to a hospital without limiting complications, 13% had adequate hand function for system use. Eleven subjects used MusicGlove at home over three weeks with a goal of nine hours of use. On average they achieved 4.1 ± 3.2 (SD) hours of use and completed 8627 ± 7500 grips, an amount comparable to users in the chronic phase of stroke measured in a previous study. The rank-order usage data were well fit by distributions that arise in machine failure theory. Users operated the game at high success levels, achieving note-hitting success >75% for 84% of the 1061 songs played. They changed game parameters infrequently (31% of songs), but in a way that logically modulated challenge, consistent with the Challenge Point Hypothesis from motor learning. Thus, a therapy based on wearable grip sensing was feasible for home rehabilitation, but only for a fraction of subacute stroke subjects. Subjects made usage decisions consistent with theoretical models of machine failure and motor learning.

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via Feasibility of Wearable Sensing for In-Home Finger Rehabilitation Early After Stroke – IEEE Journals & Magazine

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[Abstract + References] A Feasibility Study on the Application of Virtual Reality Technology for the Rehabilitation of Upper Limbs After Stroke – Conference paper

Abstract

The purpose of this study was to explore the clinical feasibility of virtual reality (VR) for the rehabilitation of upper limbs of stroke. In this study, it was found and suggested that future research should focus on the content design and application of VR rehabilitation games. While using VR to increase the interestingness of rehabilitation, one can also integrate VR and other technologies to achieve complementary benefits. In addition, in terms of the design of VR rehabilitation games, it was suggested that VR rehabilitation game researchers investigate the needs of the target users and design VR games that meet the needs of the target users in future work. Finally, this study demonstrates the clinical feasibility of applying VR technology for the rehabilitation of upper limbs after stroke, as well as highlights the aspects that still need to be addressed by researchers. These aspects are important targets of designing a VR system suitable for stroke upper limb rehabilitation.

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via A Feasibility Study on the Application of Virtual Reality Technology for the Rehabilitation of Upper Limbs After Stroke | SpringerLink

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[Abstract] Upper Limb Movement Modelling for Adaptive and Personalised Physical Rehabilitation in Virtual Reality – Thesis

Abstract

Stroke is one of the leading causes of disability with over three-quarters of patients experiencing an upper limb impairment varying in severity. Early, intense, and frequent physical rehabilitation is important for quicker recovery of the upper limbs and the prevention of further deterioration of their upper limb impairment. Rehabilitation begins almost immediately at the hospital. Once released from the hospital it is intended that patients continue their rehabilitation program at home supported by a community stroke team. However, there are two main barriers to rehabilitation continuing effectively at this stage. The first is limited contact with a physiotherapist or occupational therapist to guide and support an intensive rehabilitation programme. The second is that conventional rehabilitation is tough to maintain immediately after stroke due to fatigue, lack of concentration, depression and other effects. Stroke patients can find exercises monotonous and tiring, and a lack of motivation can result in patients failing to engage fully with their treatment. Lack of participation in prescribed rehabilitation exercises may affect recovery or cause deterioration of mobility.

This thesis examines the hypothesis that upper limb stroke rehabilitation can be made more accessible and enjoyable through the use of modern commercial virtual reality (VR) hardware, with personalised models of user hand motion adapted to user capability over time, and VR games with tasks that utilise natural hand gestures as input controls to execute personalised physical rehabilitation exercises. To support the investigation of this hypothesis a novel adaptive, gamebased, virtual reality (VR) rehabilitation system has been designed and developed for self-managed rehabilitation. Hands are tracked using a Leap Motion Controller, with hand movements and gestures used as in input controller for VR tasks. A user-centred design methodology was adopted, and the final version of the system was evolved through several versions and iterative testing and feedback through trials with able-bodied testers, stroke survivor volunteers, and practising clinicians.

A key finding of the research was that an adapted form of Fitts’s law, that models difficulty of reaching and touching objects in 3D interaction spaces, could be used to profile movement capability for able-bodied people and stroke patients vii in upper arm VR stroke rehabilitation. It was also found that even when Fitts’s law was less effective, that the statistics of the regression quality were still informative in profiling users. Fitts law regression statistics along with information on task performance (such as percentage of hits) could be used to adapt task difficulty or advising rest. Further, it was found that multiple regression could provide better movement capability profiles with a modified form of Fitts law to account for varying degrees of difficulty due to the angles of motion in 3D space. In addition, a novel approach was developed which profiled sectors of the 3D VR interaction space separately, rather than treat movement through the whole space as being equally difficult. This approach accounts for some stroke patients having more difficulty moving in some directions than others, e.g. up and left. Results demonstrate that this has potential but may need to be investigated further with stroke patients and with larger numbers of people.

The VR system that utilised the movement capability model was evolved over time with a user-centred design methodology, with input from able-bodied people, stroke patients, and clinicians. A final longitudinal study investigated the suitability of three bespoke games, the usability of the system over a longer time, and the effectiveness of the movement profiler and adaptive system. Throughout this experiment, the system provided informative user movement profile variations that could identify unique movement behaviour traits in individuals. Results showed that user performance varied over time and the adaptive system proved effective in changing the difficulty of the tasks for individuals over multiple sessions. The VR rehabilitation games incorporated enhanced gameplay and feedback, and users expressed enjoyment with the interactive experience. Throughout all of the experiments, users enjoyed wearing a VR headset, preferring it over a standard PC monitor. Most users subjectively felt that they were more effective in completing tasks within VR, and results from experiments provided empirical evidence to support this view. Results within this thesis support the proposal that an appropriately designed, adaptive gamebased VR system can provide an accessible, personalised and enjoyable rehabilitation system that can motivate more regular rehabilitation participation and promote improved motor function.

via Upper Limb Movement Modelling for Adaptive and Personalised Physical Rehabilitation in Virtual Reality — Ulster University

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[WEB PAGE] Stroke Therapy At Home with VR Games

Rutgers virtual reality tools show promise for at-home stroke recovery

Screenshot of Rutgers VR stroke recovery airplane game.

A small propeller plane operated by Allen DeNiear climbs into the sky. With a stark desert valley, seemingly inhabited by nothing more than cacti, visible on the red earth below, DeNiear makes a small motion with his hand. The plane pitches downward and dives.

DeNiear is not a pilot.

Nevertheless, his eyes focus on his targets, a series of orbs floating in the sky at various altitudes. His goal is simple enough: collect the orbs without crashing.

His reality, for the moment, is virtual.

Ready, player one.

Sitting in a lab at the Rutgers School of Health Professions in Newark, DeNiear moves his hand again. In his lap, a small infrared camera linked to the computer running the virtual reality (VR) flight simulator registers his hand movement. The plane ascends, and he collects another orb.

Both the motion and the game seem deceptively easy, but for DeNiear, who is recovering from a stroke and has limited mobility in his right hand, arm, and shoulder, the move is more than meets the eye, and the game, which can be played from anywhere you can fit a laptop, could wind up revolutionizing physical therapy treatments for stroke victims.

Today, DeNiear is with his Rutgers recovery team. But tomorrow, when he needs to do therapeutic work on his hand and arm, he’ll do it from home. No appointment is needed, the trek to a rehab center is eliminated, and—because the games are a lot more fun than monotonous rehab programs—he is more likely to actually do his exercises, thanks to the at-home approach to rehabilitation being tested and refined by Rutgers researchers.

Improving at-home therapy’s low score.

Standard at-home physical therapy regimens for stroke recovery are both boring and frustrating for patients. “The adherence to home exercise programs is incredibly low,” said Gerry Fluet, an associate professor in the rehabilitation and movement sciences department. A physical therapist by trade, Fluet’s research is focused on using VR games to increase patient participation in at-home therapy programs.

“We’re trying to create something that’s more pleasurable and interesting than opening your hand 50 times while you watch it and wish it would move more,” he said. “We set out to develop simulations that people would stop in the middle of their day to play, and tomorrow, pick them up and play them again, and then again the day after that.”

Why games?

By building the physical rehabilitation regimen into a game, Fluet and his team are able to turn the monotony of stroke rehabilitation into something that is a lot more fun than it used to be. This is important, he said, because after a stroke, a person must put in a lot of work to regain control of the hand.

Without gaming therapy, people are exercising at home two or three times a week, for about five to 10 minutes, if they even bother doing it at all, Fluet said. Meanwhile, people in the lab’s study using the VR games at home are averaging anywhere from 60 to 90 minutes of exercise therapy in a week, with no additional reminders or encouragement. In the real world, this could translate into a much more cost effective and impactful form of stroke rehabilitation.

“We’re seeing tangible, measurable results,” he said.

Rutgers professors Qinyin Qiu (left) and Gerry Fluet (right) work with patient Allen DeNiear (center).

At-home arcade.

The game library developed so far has a dozen titles. In addition to piloting a plane, players can drive a car, run through a maze, hit the keys of a piano, and more—all from a Windows-based application developed by Fluet’s long-time collaborator Qinyin Qiu, an assistant professor in the Department of Rehabilitation and Movement Sciences at Rutgers, and Amanda Cronce, a digital designer in the Department of Biomedical Engineering at New Jersey Institute of Technology (NJIT), as part of a collaboration between Rutgers Biomedical and Health Sciences and the Motor Control and Rehabilitation Lab led by Sergei Adamovich at NJIT.

The study has patients play the VR games at home for at least 15 minutes a day, every day for three months. The gaming application collects the patient data and transfers it to a remote data server so Qiu and Fluet can monitor the at-home progress. They can even use the application real-time chat with the patient.

“We’re really trying to turn this into tele-rehab,” said Qiu, adding that the team is exploring go-to-market strategies and commercialization opportunities for their project through an I-Corps grant.

Leveling up.

DeNiear is, self-admittedly, “not a video game person,” but he embraces gaming as a method for recovering from his stroke. “As you’re playing the game, it breaks the monotony of what you’re supposed to be doing. If I didn’t have the games, it would be a lot slower,” he said of his recovery. “It helped speed the process up, I think.”

Today, DeNiear has regained enough mobility to be able to drive again, and write with his right hand. He is still not 100 percent recovered, and he acknowledges that he may never be totally back to his old self. But he is committed to making the most of his situation by taking advantage of opportunities to participate in studies like Fluet and Qiu’s at-home VR physical therapy program.

“You gotta work at it,” he said. “You gotta do it.”

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[Abstract + References] Upper Limb Rehabilitation Therapies Based in Videogames Technology Review

Abstract

Worldwide, stroke is the third cause of physical disability, rehabilitation therapy is a main topic of focus for the recovery of life quality. Rehabilitation of these patients presents great challenges since many of them do not find the motivation to perform the necessary exercises, or do not have the economic resources or the adequate support to receive physiotherapy. For several years now, an alternative that has been in development is game-based rehabilitation, since this could be used in a hospital environment and eventually at patients home. The aim of this review is to present the advances in videogames technology to be used for rehabilitation and training purposes- in preparation for prosthetics fitting or Neuroprosthesis control training–, as well as the devices that are being used to make this alternative more tangible. Videogames technology rehabilitation still has several challenges to work on, more research and development of platforms to have a larger variety of games to engage with different age-range patients is still necessary.
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2. E. Vogiatzaki , Y. Gravezas , N. Dalezios , D. Biswas , A. Cranny , and S. Ortmann , “ Telemedicine System for Game-Based Rehabilitation of Stroke Patients in the FP7- ‘ StrokeBack ’ Project ,” 2014 .

3. W. Johnson , O. Onuma , and S. Sachdev , “ Stroke: a global response is needed ,” Bull. World Heal. Organ ., vol. 94 p. 634 – 634A , 2016 .

4. A. Tabor , S. Bateman , E. Scheme , D. R. Flatla , and K. Gerling , “ Designing Game-Based Myoelectric Prosthesis Training ,” in Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems – CHI ’17 , 2017 , pp. 1352 – 1363 .

5. B. Lange et al. , “ Interactive game-based rehabilitation using the Microsoft Kinect ,” Proc. – IEEE Virtual Real ., no. November 2016 , pp. 171 – 172 , 2012 .

6. C. Prahm , I. Vujaklija , F. Kayali , P. Purgathofer , and O. C. Aszmann , “ Game-Based Rehabilitation for Myoelectric Prosthesis Control ,” JMIR Serious Games , vol. 5 , no. 1 , pp. 1 – 13 , 2017 .

7. B. D. Winslow , M. Ruble , and Z. Huber , “ Mobile, Game-Based Training for Myoelectric Prosthesis Control ,” Front. Bioeng. Biotechnol .,vol. 6 , no. July , pp. 1 – 8 , 2018 .

8. “ The SENIAM Project ,” 2019 . [Online]. Available: http://www.seniam.org . [Accessed: 21-Jan-2019 ].

9. M. B. I. Reaz , M. S. Hussain , and F. Mohd-Yasin , “ Techniques of EMG signal analysis: Detection, processing, classification and applications ,” Biol. Proced. Online , vol. 8 , no. 1 , pp. 11 – 35 , 2006 .

10. R. S. Armiger and R. J. Vogelstein , “ Air-Guitar Hero: A real-time video game interface for training and evaluation of dexterous upper-extremity neuroprosthetic control algorithms ,” Circuits Syst. Conf. BIOCAS 2008 , pp. 121 – 124 , 2008 .

11. H. Oppenheim , R. S. Armiger , and R. J. Vogelstein , “ WiiEMG: A real-time environment for control of the Wii with surface electromyography ,” in Proceedings of 2010 IEEE International Symposium on Circuits and Systems , 2010 , pp. 957 – 960 .

12. G. I. Yatar and S. A. Yildirim , “ Wii Fit balance training or progressive balance training in patients with chronic stroke: a randomised controlled trial ,” J. Phys. Ther. Sci ., vol. 27 , no. 4 , pp. 1145 – 1151 , 2015 .

13. N. Norouzi-Gheidari , M. F. Levin , J. Fung , and P. Archambault , “ Interactive virtual reality game-based rehabilitation for stroke patients ,” in 2013 International Conference on Virtual Rehabilitation, ICVR 2013 2013 .

14. B. Lange , C. Chang , E. Suma , B. Newman , A. S. Rizzo , and M. Bolas , “ Development and Evaluation of Low Cost Game-Based Balance Rehabilitation Tool Using the Microsoft Kinect Sensor ,” 2011 , pp. 1831 – 1834 .

15. Y. Chen et al. , “ Game Analysis, Validation, and Potential Application of EyeToy Play and Play 2 to Upper-Extremity Rehabilitation ,” no. December , 2014 .

16. P. Visconti , F. Gaetani , G. A. Zappatore , and P. Primiceri , “ Technical features and functionalities of Myo armband: An overview on related literature and advanced applications of myoelectric armbands mainly focused on arm prostheses ,” Int. J Smart Sens. Intell. Syst ., vol. 11 , no. 1 , pp. 1 – 25 , 2018 .

17. S. S. Esfahlani and G. Wilson , “ Development of Rehabilitation System (ReHabgame) through Monte-Carlo Tree Search Algorithm ,” 2018 , pp. 1 – 8 .

18. “ Welcome to Myo Support ,” 2019 . [Online]. Available: https://support.getmyo.com/hc/en-us [Accessed: 19-Jan-2019 ].

19. “ PAULA 1.2 | Myo Software | Myo Hands and Components |Upper Limb Prosthetics | Prosthetics | Ottobock US Healthcare .”[Online]. Available: https://professionals.ottobockus.com/Prosthetics/Upper-Limb-Prosthetics/Myo-Hands-and-Components/Myo-Software/PAULA-1-2/p/646C52~5V1~82 [Accessed: 21-Jan-2019 ].

20. J. Lewis , P. Merritt , M. Bowler , and D. Brown , “ Evaluation of the suitability of games based stroke rehabilitation using the Novint Falcon ,” 2018 , no. August .

21. G. Ghazaei , A. Alameer , P. Degenaar , G. Morgan , and K. Nazarpour , “ Deep learning-based artificial vision for grasp classification in myoelectric hands ,” J. Neural Eng ., vol. 14 , no. 3 , 2017 .

22. B. Terlaak , H. Bouwsema , C. K. V. D. Sluis , and R. M. Bongers , “ Virtual training of the myosignal ,” PLoS One , vol. 10 , no. 9 , 2015 .

23. J. W. Burke , M. D. J. McNeill , D. K. Charles , P. J. Morrow , J. H. Crosbie , and S. M. McDonough , “ Designing Engaging, Playable Games for Rehabilitation ,” in 8th International Conference on Disability, Virtual Reality and Associated Technologies (ICDVRAT) , 2010 , pp. 195 – 201 .

 

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[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.

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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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