Posts Tagged Serious games

[Abstract+References] A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation

Abstract

In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients’ attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.

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[BOOK] Serious Games in Physical Rehabilitation: From Theory to Practice – Google Books

Front Cover
SpringerOct 30, 2017 – Medical – 146 pages

Marketing text: This innovative book explores how games can be serious, even though most people generally associate them with entertainment and fun. It demonstrates how videogames can be a valuable tool in clinics and demonstrates how clinicians can use them in physical rehabilitation for various pathologies. It also describes step by step their integration in rehabilitation, from the (gaming) technology used to its application in clinics. Further, drawing on an extensive literature review, it discusses the pros and cons of videogames and how they can help overcome certain obstacles to rehabilitation.

The last part of the book examines the main challenges and barriers that still need to be addressed to increase and improve the use and efficacy of this new technology for patients. The book is intended for physiotherapists and clinicians alike, providing a useful tool for all those seeking a comprehensive overview of the field of serious games and considering adding it to conventional rehabilitation treatment.

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[BOOK] Chapter 4: The Design Process and Usability Assessment of an Exergame System to Facilitate Strength for Task Training for Lower Limb Stroke Rehabilitation

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Abstract

Successful stroke rehabilitation relies on early, long-term, repetitive and intensive treatment, which is rarely adhered to by patients. Exergames can increase patients’ engagement with their therapy. Marketed exergaming systems for lower limb rehabilitation are hard to find and, none yet, facilitate Strength for Task Training (STT), a novel physiotherapeutic method for stroke rehabilitation. STT involves performing brief but intensive strength training (priming) prior to task-specific training to promote neural plasticity and maximize the gains in locomotor ability. This research investigates how the design of an exergame system (game and game controller) for lower limb stroke rehabilitation can facilitate unsupervised STT and therefore allow stroke patients to care for their own health. The findings suggest that specific elements of STT can be incorporated in an exergame system. Barriers to use can be reduced through considering the diverse physiological and cognitive abilities of patients and aesthetic consideration can help create a meaningful system than promotes its use in the home. The semantics of form and movement play an essential role for stroke patients to be able to carry out their exercises.

1. Background

With over 15 million cases worldwide every year [1], strokes are a leading cause of serious long-term disability [23]. Up to 75% of people affected by stroke have lower limb mobility limitations [34], including hemiplegia (muscle paralysis) or hemiparesis (muscle weakness) down one side of the body [5]. The World Health Organization (WHO) has highlighted the need for home health care that calls for rehabilitative devices, self-monitoring tools and self-management skills [6].

Success for stroke rehabilitation relies on early, intensive, long term repetitive treatment to regain motor control [57] by learning to use existing redundant neural pathways [8]. However, although abundantly prescribed by clinicians, as little as 31% of patients perform these exercises correctly and consistently, often due to their monotonous nature [9].

Recent studies show that systems of rehabilitative devices with incorporated digital games for exercising (exergames) improve patient engagement with their home-based therapies. This has promoted beneficial patient outcomes for different long-term conditions, including upper limb stroke rehabilitation [51011], and more effective recovery [12]. While there exist systems designed for upper-limb stroke rehabilitation [51314] and for improving gait and balance [1517], only one was found targeted specifically towards lower limb stroke rehabilitation [18].[…]

Continue —> The Design Process and Usability Assessment of an Exergame System to Facilitate Strength for Task Training for Lower Limb Stroke Rehabilitation | InTechOpen

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[Thesis] Serious Games for Health Rehabilitation

FACULDADE DE ENGENHARIA DA UNIVERSIDADE DO PORTO
Serious Games for Health Rehabilitation
Paula Alexandra Carvalho de Sousa Rego

Abstract
Serious Games are growing into a significant area spurred by the growth in the use of video games and of new methods for their development. They have important applications in several distinct areas such as: military, health, government, and education. As such, their purpose is to be used for other purposes than pure entertainment, which is normally associated with the concept of game. The interest for Serious Games arises from the fact that games have a set of features that makes them very effective to engage users and keep their motivation at higher levels.

From the above discussion, the design of computer games can offer valuable contributions to develop effective games in the rehabilitation area. In rehabilitation programs, one of the major problems reported are related to the motivation and engagement of patients in the exercises training sessions using traditional therapy approaches. Patients rapidly lose their interest and get bored doing the, usually repetitive, rehabilitation tasks.

This thesis addresses Serious Games for Health Rehabilitation (SGHR), and provides an indepth study and survey of the existent games and features. With this study we were able to devise a taxonomy that enables researchers and practitioners to use a systematic approach to study, classify and compare SGHR. This taxonomy is validated by a set of experts in the interrelated domain of knowledge. The research led us to identify and propose several important features and guidelines to include in SGHR. As a result, we propose, discuss and describe a framework for the development of serious games. The framework integrates a set of features of natural and multimodal interaction, social interaction (collaboration and competitiveness) and progress monitoring, which can be used to increase the motivation of the patients during the rehabilitation process.

To validate the proposed framework and features, a set of serious games were developed. These games are intended to be used in rehabilitation sessions, and their main goal is to increase the users’ motivation during the rehabilitation process. The developed games were designed based on well established rehabilitation systems and rehabilitation tasks. We describe the design and implementation of the games with respect to our proposed framework. The resulting game platform includes a set of features, such as competitiveness, collaboration and handicap mechanisms, with the aim of promoting the engagement and motivation of the patients involved in the rehabilitation process. The resulting system is a Web platform that enables games to be played online, making it more accessible to all users, including patients in rehabilitation. Besides that, the web platform provides a low cost solution to patients training and enables home rehabilitation, in addition to traditional therapy.

Final experiments were performed in order to validate the proposed framework and provide scientific evidence that it is possible to use serious games for health rehabilitation to increase the motivation of users. Experiments were conducted with healthy people and elderly users. The scores achieved in all the tests used were quite good with emphasis for the very good SUS and IMI scores achieved.

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[Abstract] Virtual Reality and Serious Games in Neurorehabilitation of Children and Adults: Prevention, Plasticity, and Participation

Use of virtual reality (VR) and serious games (SGs) interventions within rehabilitation as motivating tools for task specific training for individuals with neurological conditions are fast-developing. Within this perspective paper we use the framework of the IV STEP conference to summarize the literature on VR and SG for children and adults by three topics: Prevention; Outcomes: Body-Function-Structure, Activity and Participation; and Plasticity. Overall the literature in this area offers support for use of VR and SGs to improve body functions and to some extent activity domain outcomes. Critical analysis of clients’ goals and selective evaluation of VR and SGs are necessary to appropriately take advantage of these tools within intervention. Further research on prevention, participation, and plasticity is warranted. We offer suggestions for bridging the gap between research and practice integrating VR and SGs into physical therapist education and practice.

Source: Virtual Reality and Serious Games in Neurorehabilitation of… : Pediatric Physical Therapy

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[Abstract+References] A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation

Abstract

In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients’ attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.

Source: A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation | SpringerLink

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[ARTICLE] New Approaches to Exciting Exergame-Experiences for People with Motor Function Impairments – Full Text

Abstract:

The work presented here suggests new ways to tackle exergames for physical rehabilitation and to improve the players’ immersion and involvement. The primary (but not exclusive) purpose is to increase the motivation of children and adolescents with severe physical impairments, for doing their required exercises while playing. The proposed gaming environment is based on the Kinect sensor and the Blender Game Engine. A middleware has been implemented that efficiently transmits the data from the sensor to the game. Inside the game, different newly proposed mechanisms have been developed to distinguish pure exercise-gestures from other movements used to control the game (e.g., opening a menu). The main contribution is the amplification of weak movements, which allows the physically impaired to have similar gaming experiences as the average population. To test the feasibility of the proposed methods, four mini-games were implemented and tested by a group of 11 volunteers with different disabilities, most of them bound to a wheelchair. Their performance has also been compared to that of a healthy control group. Results are generally positive and motivating, although there is much to do to improve the functionalities. There is a major demand for applications that help to include disabled people in society and to improve their life conditions. This work will contribute towards providing them with more fun during exercise.

1. Introduction

For a number of years, the possibility of applying serious games for rehabilitation purposes has been thoroughly investigated [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28]. It is often claimed that serious games reduce health system costs and efforts as they enable in-home rehabilitation without loss of medical monitoring, and in so doing provide an additional fun factor for patients [22,23,24]. Multiple reviews have summarized the very powerful contributions and reveal that the systems are generally evaluated as feasible, but no state of general applicability has yet been reached [2,3,5,7,11,13].
Most studies are quite specialised and tend to cover the same groups of largely elderly patients (e.g., stroke and Parkinson’s), which do not constitute a credible target group per se for gaming among the population. In addition, the impression is that the same functionalities are being tested repeatedly, without any evolution. Above all, other groups like children and adolescents with chronic diseases are rarely addressed, even though they are an excellent target group and would probably benefit greatly from using exergames as they need to move like any other child but are mostly limited to performing their exercises with a physiotherapist. This is generally boring, time-consuming and prevents them from playing with friends during this time. If instead they could play games involving physical exercises, without it feeling like rehabilitation, due to proper immersion and motivation, they would possibly need fewer sessions with the therapist, which may in turn improve their social life. Commercially available games would be good enough for many children with physical disabilities, if only they were configurable and adaptive to their potential and needs. Remote controls (RC) are typically not sufficiently configurable (button functions cannot be changed or the RC cannot be used with one hand) and are only made for hands (why not for feet or the mouth?) Some RCs are not sufficiently precise in detection, and so the user ends up tired and loses motivation. Motion capture devices like the Kinect sensor seem to provide better prerequisites for exergaming purposes but feature important limitations too, (e.g., detection of fine movements and rotations) such that the needs of many people are still not be covered by commercial solutions.
However, this is not due to the sensors, but rather the software, which lacks configurability for special needs, such as simple adjustments of level difficulties or the option of playing while seated. For the latter, some Kinect games are available [29], but those are hardly the most liked ones, as has been stated by affected users [30]. Therefore, more complex solutions are required to adapt a game to problems like muscle weaknesses (most games require wide or fast movements), spasticity (“strange” movements are not recognized) or the available limbs (for instance configuring a game to be controlled with the feet for players without full hand use).
To fill these gaps, the authors of the work presented here are pursuing the overall aim (as part of a long-term project) of creating an entertaining exergaming environment for adventure games that immerses the players into a virtual world and makes them forget their physical impairments. Knowledge of the gaming industry is applied to create motivating challenges that the users have to solve, which are sufficiently addictive to make the exercises pass to an unconscious plane. The gaming environment is configurable to the user’s potential and requirements. Challenges will be programmable by a therapist and will also adapt themselves to the players automatically real-time, by observing their fatigue or emotional state (lowering the difficulty or switching to more relaxing exercises when needed)…

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Figure 8. Different scenes while the volunteers were playing. (a) “The Paper-Bird”, (b) “The Ladder”, (c) “The Boat” and (d) “Whack-a-Mole”.

Continue —> Sensors | Free Full-Text | New Approaches to Exciting Exergame-Experiences for People with Motor Function Impairments | HTML

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[ARTICLE] Modeling Based on Computational Intelligence for Physiotherapeutic Rehabilitation Games – Full Text PDF

Abstract.

Over the last years, the use of computational environments, like serious games, has been one of the strategies to improve commitment and motivation of patients undergoing rehabilitation. Beyond providing motivation, these systems are able to simulate life activities and provide means to automatically monitor users interactions, assuring that the patient is performing the exercises correctly, thus allowing the user to perform the exercises without the need of constant monitoring by a health professional. The aim of this work is to develop a modeling for construction of serious games, whose interaction is given by gestures performed by hand and wrist. The model includes an automatic continuous evaluation of rehabilitation exercises executed by the patient and dynamic game balancing using computational intelligence methods.

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[WEB SITE] NeuroRehabLab | Exploring the human brain through Virtual Environment interaction

OUR MISSION

The NeuroRehabLab is an interdisciplinary research group of the University of Madeira that investigates at the intersection of technology, neuroscience and clinical practice to find novel solutions to increase the quality of life of those with special needs. We capitalize on Virtual Reality, Serious Games, and Brain-Computer Interfaces to exploit specific brain mechanisms that relate to functional recovery to approach motor and cognitive rehabilitation by means of non-invasive and low-cost technologies.

more —> NeuroRehabLab | Exploring the human brain through Virtual Environment interaction

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[ARTICLE] Multi-User Virtual Reality Therapy for Post-Stroke Hand Rehabilitation at Home. – Full Text PDF

Abstract

Our paper describes the development of a novel multi-user virtual reality (VR) system for post-stroke rehabilitation that can be used independently in the home to improve upper extremity motor function. This is the pre-clinical phase of an ongoing collaborative, interdisciplinary research project at the Rehabilitation Institute of Chicago involving a team of engineers, researchers, occupational therapists and artists. This system was designed for creative collaboration within a virtual environment to increase patients’ motivation, further engagement and to alleviate the impact of social isolation following stroke. This is a low-cost system adapted to everyday environments and designed to run on a personal computer that combines three VR environments with audio integration, wireless Kinect tracking and hand motion tracking sensors. Three different game exercises for this system were developed to encourage repetitive task practice, collaboration and competitive interaction. The system is currently being tested with 15 subjects in three settings: a multi-user VR, a single-user VR and at a tabletop with standard exercises to examine the level of engagement and to compare resulting functional performance across methods. We hypothesize that stroke survivors will become more engaged in therapy when training with a multi-user VR system and this will translate into greater gains.

 

  1. INTRODUCTION

Stroke is the leading cause of major, long-term disability in adults in the United States [1]. Every 40 seconds someone in
the U.S. has a stroke [2] and more than 700,000 people suffer a new or recurrent stroke each year. The majority of stroke survivors endure chronic impairment [1], which dramatically impacts their lives physically, psychologically and socially. Stroke incidence is even greater in low to middle income countries. Around 50% of all stroke survivors will have residual hemiparesis involving the upper extremity [4, 5], which can have a profound, adverse impact on self-care, employment, and overall quality of life. A number of studies [6, 7, 8, 9] have shown that upper extremity motor control can still be improved, even in stroke survivors with chronic hemiparesis subsequent to stroke. Many patients continue to be highly motivated to achieve further gains after standard rehabilitation has been completed, seeking out new methods, technologies and practices that can improve upper extremity motor control.

Repetitive movement practice proved to be crucial for maximizing therapeutic benefits [15]. The necessary repetition of rehabilitation exercises can be tedious, however [10, 11, 12] and many patients, including stroke survivors, discontinue treatment long before optimal results have been achieved. Lack of motivation, disengagement, and boredom contribute to impeded progress in rehabilitation [13]. Additionally, opportunities for task practice in the clinic are becoming increasingly limited due to shortened hospital stays [14] and a reduced number of allotted outpatient therapy sessions (Figure 1). Furthermore, lack of transportation can prevent outpatient stroke survivors from taking full advantage of the available therapy sessions.

Tele-rehabilitation seems a possible solution, but current telerehabilitation systems [7, 16] largely consist of teleconferencing between the therapist and the client. Therapist-client interaction is limited and quantitative measurement of performance is lacking. Instead, we propose a multi-user virtual reality environment (VRE) in which the therapist and client can interact with each other and with objects in the VRE.

An inexpensive motion capture system allows control of avatars, as well as collection of movement kinematics. Our system is innovative, because it brings the therapist and client together in the virtual space to work together in real-time. Alternatively, or additionally, the client can participate with a training partner, potentially another patient, providing additional motivation and encouragement. One study showed that impaired subjects prefer competitive/cooperative multi-user rehabilitation games compare to single-user rehabilitation games [17]. This system can mitigate issues related to transportation and limited clinical access by providing home-based training environment developed specifically for upper extremity rehabilitation.

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