ABSTRACT

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Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder where motor dysfunction gradually increases. PD-specific dopaminergic drugs can ameliorate symptoms, but neurologists also strongly recommend physiotherapy combined with regular exercise. As there is no known cure for PD, traditional rehabilitation programs eventually tire and bore patients to the point of losing interest and dropping out of those programs just because of the predictability and repeatability of the exercises. This can be avoided with the help of current technology, character-based, interactive 3D games promote physical training in a nonlinear fashion, and can provide experiences that change each time the game is played. Such “exergames” (a combination of the words “exercise” and “game”) challenge patients into performing exercises of varying complexity in a playful and interactive environment. In this work we present a Unity3D-based platform hosting two exergames tailored to PD patients with mild to moderate symptoms. The platform employs Microsoft Kinect, an affordable off-the-shelf motion capture sensor that can be easily installed in both home and clinical settings. Platform navigation and gameplay rely on a collection of gestures specifically developed for this purpose and are based upon training programs tailored to PD. These gestures employ purposeful, large-amplitude movements intended to improve postural stability and reflexes and increase upper and lower limb mobility. When the patient’s movements, as detected by Kinect, “match” a preprogrammed gesture, an onscreen 3D cartoon avatar responds according to the game context at hand. In addition, ingame decision-making aims at improving cognitive reaction.

We report on a Kinect-based, augmented reality, real-time physiotherapy platform tailored to Parkinson's disease (PD) patients. The platform employs a Kinect sensor to extract real-time 3D skeletal data (joint information) from a patient facing the sensor (at 30 frames per second). In addition, a small collection of exercises practiced in traditional physiotherapy for PD patients has been implemented in the Unity 3D game engine. Each exercise employs linear or circular movement patterns and poses very light-weight processing demands on real-time computations. During an exercise, trainer instruction demonstrates correct execution and Kinect-provided 3D joint data are fed to the game engine and compared to exercise-specific control routines to assess proper posture and body control in real time. When an exercise is complete, performance metrics appropriate for that exercise are computed and displayed on screen to enable the attending physiotherapist to fine-tune the exercise to the abilities/needs of an individual patient as well as to provide performance feedback to the patient. The platform can operate in a physiotherapist's office and, following appropriate validation, in a home environment. Finally, exercises can be parameterized meaningfully, depending on the intended purpose (motor assessment versus plain exercise at home).