Gamifying rehabilitation: MILORD platform as an upper limb motion rehabilitation service

Abstract

Motor learning is based on the correct repetition of specific movements for their permanent storage in the central nervous system (CNS). Rehabilitation relies heavily on the repetition of specific movements, and game scenarios are ideal environments to build routines of repetitive exercises that have entertaining characteristics. In this respect, the gamification of the rehabilitation program, through the introduction of game-specific techniques and design concepts, has gained attention as a complementary or alternative to routine rehabilitation programs. A gamified rehabilitation program promises to gain the patient's attention, to reduce the monotony of the process and preserve motivation to attend, and to create virtual incentives through the game, toward maintaining compliance to the “prescribed” program. This is often achieved through goal-oriented tasks and real-time feedback in the form of points and other in-game rewards. This paper describes MILORD rehabilitation platform, an affordable technological solution, which aims to support health professionals and enable remote rehabilitation, while maintaining health service characteristics and monitoring. MILORD is an end-to-end platform that consists of an interactive computer game, utilizing a leap motion sensor, a centralized user management system, an analysis platform that processes the data generated by the game, and an analysis dashboard presenting a set of meaningful features that describe upper limb movement. Our solution facilitates the monitoring of the patients' progress and provides an alternative way to analyze hand movement. The system was tested with normal subjects and patients and experts to record user's experience, receive feedback, identify any problems, and understand the system's value in monitoring and support motion defect and progress. This small-scale study indicated the capacity of the analysis to quantify the movement in a meaningful way and express the differences between normal and pathological movement, and the user experience was positive with both patients and normal subjects.

Gamification in Rehabilitation: The Role of Subjective Experience in a Multisensory Learning Context – A Narrative Review

“…In two instances (Fotopoulos et al, 2022;LaPiana et al, 2020), the platform was employed in the presence of the physiotherapist during the rehabilitation session or learned under supervision and then continued independently at home.…”

“…In the study of Fotopoulos et al (2022), five stroke patients were instructed by the physiotherapist and followed a customized exercise program independently Original Contributions -Originalbeiträge after leaving the hospital, while in study of Epalte et al (2020), stroke patients performed the exercises at home without the supervision of the physiotherapist. In all other cases, patients with neurological conditions performed the exercises under the guidance of the physiotherapist.…”

“…In two studies (Aartolahti et al, 2022;Fotopoulos et al, 2022), gamification was initiated during hospitalization and was subsequently customized and implemented by the physiotherapist. The patient then continued using gamification independently at home.…”

“…Each figure is also represented on a valence scale, indicating the individual's positive or negative emotional experience, and a dominance scale, indicating their sense of control or influence over the situation. Fotopoulos et al (2022) administered the User Experience Questionnaire (1-7) to evaluate the overall user experience by measuring six key dimensions: attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty. It typically consists of 26 statements that users rate on a scale from 1 (strongly disagree) to 7 (strongly agree).…”

“…Several studies emphasize how gamification represents an alternative approach for rehabilitation pathways that risk becoming repetitive and dull. The literature (examples from this review include Fotopoulos et al, 2022, andThen et al, 2020) suggests that users do not feel highly engaged in this type of intervention. They may simply continue self-efficacy exercises at home, which could be more cost-effective, leaving greater access to physiotherapy for other patients.…”