Personalized Exergames Language: A Novel Approach to the Automatic Generation of Personalized Exergames for Stroke Patients

Abstract

Physical rehabilitation of stroke patients is based on the daily execution of exercises with face-to-face supervision by therapists. This model cannot be sustained in the long term, due to the involved economic costs, the growing number of patients, and the aging population. Remote rehabilitation tools have emerged to address this unmet clinical need, but they face the double challenge of motivating patients and ensuring an effective remote rehabilitation. In this context, exergames allow patients to play while performing repetitive therapeutic tasks in a safe and ecological environment. This work proposes the design of Personalized Exergames Language (PEL), a language whose sentences can be processed via software in order to automatically generate exergames. The definition of exergames through PEL, guided by an effective methodology of the design and generation of personalized exergames, will include both game mechanics and the necessary metrics to monitor, guide, and adapt the rehabilitation of each patient. The integration of authoring tools are considered to visually guide the therapist when designing exergames. A study has been carried out with stroke patients and therapists from a hospital and two community centers, in order to evaluate several exergames, automatically generated using PEL, in terms of usability, understanding, and suitability.

PhyRe Up! A System Based on Mixed Reality and Gamification to Provide Home Rehabilitation for Stroke Patients

“…However, the underlying details of the language, such as vocabulary, syntax, and semantics, are not provided because it is beyond the scope of this paper. This information is deeply described and explained in [32].…”

Proteo: A Framework for Serious Games in Telerehabilitation

“…Moreover, it was found that TR services are effective both for children and adults with disabilities, and professionals have also reported high levels of satisfaction and acceptance of TR services [5,[10][11][12]. However, it is expected that advancements in technology can increase the usability and effectiveness of TR, but current TR systems do not usually allow for therapists to customize or adapt these systems to the characteristics of the patient and setting, and they are limited to specific patient conditions [13][14][15][16][17][18]. This can be due to different factors such as the complexity of the process, the technical aspects of TR service development, and the heterogeneity of patients with disabilities.…”

A Fuzzy Recommendation System for the Automatic Personalization of Physical Rehabilitation Exercises in Stroke Patients

“…On these foundations, we also designed a language whose sentences are processed by a software that can automatically generate personalized exergames that motivate the patient to perform rehabilitation exercises. In this article, we focus on the automated and intelligent personalization of the rehabilitation process adapted to each patient [11]. Thus, this paper proposes a fuzzy system for the recommendation of rehabilitation exercises for stroke patients.…”

“…Finally, a representative value is obtained after performing the defuzzification step that uses the EPPL co defined in Equation (11). In the aggregated fuzzy set, as shown in Figure 8, the total area is divided into five sub-areas.…”

“…After that, a single fuzzy set is obtained by combining the previous outputs using the function 10. The result is as follows: µ(x) = max{µ 2 (x), µ 7 (x), µ 13 (x)} Finally, the output, i.e., EPPL co , is computed using the centroid function defined in (11). Similar to the previous example, the total area is divided into six sub-areas.…”