A systematic review of serious games used for rehabilitation of individuals with Parkinson’s disease

Oliveira, Luciene Chagas de; Mendes, Luanne Cardoso; Lopes, Renato Aquino; Carneiro, José Antonio Serra; Cardoso, Alexandre; Lamounier, Edgard Afonso; Andrade, Adriano O.

doi:10.1007/s42600-021-00162-3

Cited by 8 publications

(14 citation statements)

References 53 publications

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“…This component of the MREP platform includes 3D exergames in virtual environments designed and developed for motor rehabilitation according to the clinical and therapeutic specifications of the HCPs. In recent decades, the potential benefits of virtual reality [ 81 , 82 , 83 , 84 ] and exergaming [ 85 , 86 , 87 ] have been extensively investigated for rehabilitation purposes in several pathologies, as an innovative tool to stimulate motor and cognitive functions, even simultaneously, highlighting the advantages in joining them to traditional therapeutic protocols [ 88 ]. The primary role of exergames is to promote specific motor and cognitive tasks through the experience of playing games in a virtual environment, with the goal of increasing engagement through positive feedback and gamification features typical of video games (motivation, rewards, fun) and, at the same time, to encourage stimulating new rehabilitation goals in the medium–long term as planned by HCPs [ 83 , 89 , 90 ].…”

Section: Methodsmentioning

confidence: 99%

Usability of the REHOME Solution for the Telerehabilitation in Neurological Diseases: Preliminary Results on Motor and Cognitive Platforms

Ferraris

Ronga

Pratola

et al. 2022

Sensors

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The progressive aging of the population and the consequent growth of individuals with neurological diseases and related chronic disabilities, will lead to a general increase in the costs and resources needed to ensure treatment and care services. In this scenario, telemedicine and e-health solutions, including remote monitoring and rehabilitation, are attracting increasing interest as tools to ensure the sustainability of the healthcare system or, at least, to support the burden for health care facilities. Technological advances in recent decades have fostered the development of dedicated and innovative Information and Communication Technology (ICT) based solutions, with the aim of complementing traditional care and treatment services through telemedicine applications that support new patient and disease management strategies. This is the background for the REHOME project, whose technological solution, presented in this paper, integrates innovative methodologies and devices for remote monitoring and rehabilitation of cognitive, motor, and sleep disorders associated with neurological diseases. One of the primary goals of the project is to meet the needs of patients and clinicians, by ensuring continuity of treatment from healthcare facilities to the patient’s home. To this end, it is important to ensure the usability of the solution by elderly and pathological individuals. Preliminary results of usability and user experience questionnaires on 70 subjects recruited in three experimental trials are presented here.

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Section: Methodsmentioning

confidence: 99%

Usability of the REHOME Solution for the Telerehabilitation in Neurological Diseases: Preliminary Results on Motor and Cognitive Platforms

Ferraris

Ronga

Pratola

et al. 2022

Sensors

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“…Because exercises through games are perceived by the individuals as entertainment rather than therapy, these instruments promote more motivation to patients and reinforce adherence to the therapeutic process, contributing to the maintenance and/or improvement of the quality of life of the individuals ( Tarousi et al, 2021 ). In addition to allowing movement training for motor rehabilitation purposes, which is the most commonly found application in the literature for SG ( de Oliveira et al, 2021 ), patient monitoring and motor symptom assessment of a wide range of diseases, such as Parkinson’s disease (PD), can be performed using SG ( Wilkinson et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

“…PD is a neurodegenerative disorder that affects approximately 2% of the population over 60 years old ( Singh & Ganley, 2021 ) and is characterized by the loss of dopaminergic neurons, which promote the appearance of motor symptoms, such as bradykinesia and tremor ( Balestrino & Schapira, 2020 ). Due to the variety and severity of the symptoms of this disease, the importance of implementing technological resources such as SG as a valuable tool for clinical assessment and patient-centered monitoring is highlighted ( de Oliveira et al, 2021 ; Tarousi et al, 2021 ). When used for clinical assessments, SG allows health professionals to provide more personalized follow-up to patients while also assisting them in disease monitoring ( Tarousi et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

RehaBEElitation: the architecture and organization of a serious game to evaluate motor signs in Parkinson’s disease

Mendes

Sá

Marques

et al. 2023

PeerJ Computer Science

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Background The use of serious games (SG) has received increasing attention in health care, and can be applied for both rehabilitation and evaluation of motor signs of several diseases, such as Parkinson’s disease (PD). However, the use of these instruments in clinical practice is poorly observed, since there is a scarcity of games that, during their development process, simultaneously address issues of usability and architectural design, contributing to the non-satisfaction of the actual needs of professionals and patients. Thus, this study aimed to present the architecture and usability evaluation at the design stage of a serious game, so-called RehaBEElitation, and assess the accessibility of the game. Methods The game was created by a multidisciplinary team with experience in game development and PD, taking into consideration design guidelines for the development of SG. The user must control the movements of a bee in a 3D environment. The game tasks were designed to mimic the following movements found in the gold-standard method tool—Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS)—for the assessment of individuals with PD: hand opening and closing, hand extension and flexion, hand adduction and abduction, finger tapping, and forearm supination and pronation. The user interacts with the game using a wearable interface device that embeds inertial and tactile sensors. The architecture of RehaBEElitation was detailed using the business process model (BPM) notation and the usability of the architecture was evaluated using the Nielsen-Shneiderman heuristics. Game accessibility was evaluated by comparing the overall scores of each phase between 15 healthy participants and 15 PD patients. The PD group interacted with the game in both the ON and OFF states. Results The system was modularized in order to implement parallel, simultaneous and independent programming at different levels, requiring less computational effort and enabling fluidity between the game and the control of the interface elements in real time. The developed architecture allows the inclusion of new elements for patient status monitoring, extending the functionality of the tool without changing its fundamental characteristics. The heuristic evaluation contemplated all the 14 heuristics proposed by Shneiderman, which enabled the implementation of improvements in the game. The evaluation of accessibility revealed no statistically significant differences (p < 0.05) between groups, except for the healthy group and the PD group in the OFF state of medication during Phase 3 of the game. Conclusions The proposed architecture was presented in order to facilitate the reproduction of the system and extend its application to other scenarios. In the same way, the heuristic evaluation performed can serve as a contribution to the advancement of the SG design for PD. The accessibility evaluation revealed that the game is accessible to individuals with PD.

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“…Recently, much attention has been paid to the potential benefits of exergaming [ 15 , 16 , 17 , 18 , 19 , 20 ] and virtual reality [ 21 , 22 , 23 ] for motor rehabilitation and the stimulation of cognitive functions [ 16 , 24 , 25 ]. The combination of physical and cognitive training for the purpose of stimulating the patient with motor exercises while performing concurrent cognitive tasks, has been also investigated [ 26 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment Tasks and Virtual Exergames for Remote Monitoring of Parkinson’s Disease: An Integrated Approach Based on Azure Kinect

Amprimo

Masi

Priano

et al. 2022

Sensors

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Motor impairments are among the most relevant, evident, and disabling symptoms of Parkinson’s disease that adversely affect quality of life, resulting in limited autonomy, independence, and safety. Recent studies have demonstrated the benefits of physiotherapy and rehabilitation programs specifically targeted to the needs of Parkinsonian patients in supporting drug treatments and improving motor control and coordination. However, due to the expected increase in patients in the coming years, traditional rehabilitation pathways in healthcare facilities could become unsustainable. Consequently, new strategies are needed, in which technologies play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. The paper proposes a vision-based solution using the new Azure Kinect DK sensor to implement an integrated approach for remote assessment, monitoring, and rehabilitation of Parkinsonian patients, exploiting non-invasive 3D tracking of body movements to objectively and automatically characterize both standard evaluative motor tasks and virtual exergames. An experimental test involving 20 parkinsonian subjects and 15 healthy controls was organized. Preliminary results show the system’s ability to quantify specific and statistically significant (p < 0.05) features of motor performance, easily monitor changes as the disease progresses over time, and at the same time permit the use of exergames in virtual reality both for training and as a support for motor condition assessment (for example, detecting an average reduction in arm swing asymmetry of about 14% after arm training). The main innovation relies precisely on the integration of evaluative and rehabilitative aspects, which could be used as a closed loop to design new protocols for remote management of patients tailored to their actual conditions.

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A systematic review of serious games used for rehabilitation of individuals with Parkinson’s disease

Cited by 8 publications

References 53 publications

Usability of the REHOME Solution for the Telerehabilitation in Neurological Diseases: Preliminary Results on Motor and Cognitive Platforms

Usability of the REHOME Solution for the Telerehabilitation in Neurological Diseases: Preliminary Results on Motor and Cognitive Platforms

RehaBEElitation: the architecture and organization of a serious game to evaluate motor signs in Parkinson’s disease

Assessment Tasks and Virtual Exergames for Remote Monitoring of Parkinson’s Disease: An Integrated Approach Based on Azure Kinect

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