Game analysis and clinical use of the Xbox-Kinect for stroke rehabilitation

Abstract

Whole-body movement is required to interact (play) with Microsoft Xbox with the 3D Kinect sensor (Xbox-Kinect) and, therefore, may be suitable for encouraging and practicing movements as part of stroke rehabilitation. We aimed to describe (i) game analysis, (ii) clinical use, and (iii) to characterize the Xbox-Kinect game experience with individuals with chronic stroke. Four therapists played the Xbox-Kinect games and then carried out a games analysis on the basis of the categories suggested by Deutsch. Eleven participants (age 29-69 years) with chronic stroke and varying motor deficits played Xbox-Kinect games for 4-22 sessions as part of a video-game group intervention and the clinical use was documented. The game experience of 'Bowling' (Kinect-Sport) and '20 000 leaks' (Kinect Adventures) was characterized by self-report questionnaires. Detailed tables of game analysis are provided. The clinical use of the console with the participants is presented. Participants reported high enjoyment and 'somewhat-high' perceived exertion after playing the two games and stated that overall the console suited their therapeutic goals. This information can assist clinicians with their clinical reasoning and decision-making for incorporating the Xbox-Kinect into stroke rehabilitation. Potentially, the Xbox-Kinect could be used as an on-going tool to facilitate whole-body movement and physical activity of individuals with chronic stroke.

Effects of Video-Game Based Therapy on Balance, Postural Control, Functionality, and Quality of Life of Patients with Subacute Stroke: A Randomized Controlled Trial

“…Authors such as Ho et al [46] suggest that the combination of rehabilitation based on VR and conventional therapy could be more effective for the acquisition of functional improvements in patients after stroke. ese results are supported by systematic reviews [4,44,47] which indicate that VR produces a beneficial effect on ADL when it is used together with conventional approaches, such as in the present study. Along these lines, Gibbons et al [48] indicate that VR interventions are, at least, as effective as conventional physiotherapy for improving the functional results of the lower limbs after a stroke, on the condition that the protocols that are used are made progressively more intensive considering both time and difficulty.…”

“…e scale used presents the limitation of the lack of validation; however, to our knowledge, no similar tool has quantified these dimensions related to the use of technology in the neurological patient. Other authors [47,59] suggest the need to study the potential acceptability and effectiveness of commercial video games to obtain motivation-related outcomes. In addition, for some authors, the principal characteristics of these interventions are the low cost of the system, its portability, and high levels of acceptance on behalf of patients.…”

Comparison of neuromuscular and cardiovascular exercise intensity and enjoyment between standard of care, off-the-shelf and custom active video games for promotion of physical activity of persons post-stroke

“…Active video games (AVGs) became available for movement focused rehabilitation when gaming consoles such as the Play Station II (PS2) with the Eye Toy camera, the Nintendo Wii and the Microsoft Xbox with the Kinect camera were trialed by clinicians and tested by researchers [5][6][7]. Analyses of the non-custom AVGs associated with the consoles identified elements of motor learning and therapeutic exercise in order to guide the application of AVGs into physical therapy practice, as well as rehabilitation research [8][9][10][11]. Recent surveys of virtual reality and AVGs confirm that AVGs have become part of the repertoire of rehabilitation tools used for persons poststroke.…”

“…Enjoyment is proposed as an important construct to recommend AVG play [25]. It has been measured by the same group of investigators while persons post-stroke: (1) interacted with the PS2 Eye Toy, [5] (2) compared enjoyment while playing the PS2 and the Wii [26] and (3) played Kinect Sports and Adventure games [11]. Across all three studies, enjoyment was reported by persons post-stroke.…”

Kinect Controlled NAO Robot for Telerehabilitation

“…In the recent decade, the Kinect sensor extensively used for human motion assessment and rehabilitation purposes. Kinect sensor integrated with virtual reality for rehabilitation gaming therapy shows promising results for patient's motor and functional recovery [19][20][21][22][23]. Kinect sensor also used for human upper and lower extremity motion assessment for the purpose of recovery improvement tracking and providing feedback [24][25][26][27].…”