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

Abstract

Stroke represents a global concern that currently affects a significant part of the world's population. Physical rehabilitation plays a fundamental role for stroke patients to recover mobility and improve quality of life. This process is costly, considering that patients must attend face-to-face rehabilitation sessions in hospitals or rehabilitation centers. Plus, there is a lack of specialized medical staff, who are usually insufficient to properly address the growing number of stroke patients that need physical rehabilitation. This situation has been exacerbated by the COVID-19 pandemic, as some of the human resources have been devoted to fight against the pandemic, and the physical presence of rehabilitation patients in hospitals has been severely limited. This paper proposes PhyRe Up!, a novel remote rehabilitation system that uses mixed reality and gamification techniques. PhyRe Up! has been devised for stroke patients to perform therapeutic exercises at home, with great precision, and with the potential supervision of clinicians. The system aims to increase the patient's motivation as well as maintaining the quality of performance for the exercises, similar to the obtained levels when attending face-to-face sessions with therapists. The underlying architecture combines declarative, procedural, and conditional knowledge to manage the rehabilitation process, which offers flexibility and scalability to enhance the capabilities of the proposed system. Experimental results highlight how the combination of mixed reality and gamification significantly influences the accuracy of rehabilitation exercises previously defined by therapists. Particularly, the conducted experiments in the first validation phase of PhyRe Up! shows that our proposal drastically reduces the intermediate steps required to complete an exercise thanks to the provided visual feedback. The accuracy with which the patient performs the assessed exercise for the first time is greater than when using traditional rehabilitation techniques.

Evaluation of custom-made VR exergame for at-home Stroke rehabilitation. A longitudinal single-arm study.

“…These improvements were not only evidenced in the improved range of motion data but were also perceived by the participants in their daily lives, according to their unofficial reports. We believe this influence in the participant's daily life led to increased adherence to therapy and a more positive attitude toward the entire rehabilitation process proposed in the intervention protocol [49] [50].…”

Considerations for at-home upper-limb rehabilitation technology following stroke: Perspectives of stroke survivors and therapists

“…It also could allow patients with more limited function practice the whole task of grasping, lifting, and moving a cup of varied loads with assistance from the robotic system. Some work in mixed-reality for rehabilitation has been done in virtual reality, 41 and mixed reality has been used in medical training simulators. 42 Design features.…”

Design recommendations for XR-based motor rehabilitation exergames at home

“…To do so, the game input must reliably track the patients' movements and consider the user's specific needs and goals. Standard tracking devices are camera systems, balance boards (e.g., Wii fit), and accelerometers (e.g., VR headset and controller) (Gómez-Portes et al, 2021;Rüth et al, 2023).…”