Serious Games for Assessment and Training in Post-stroke Robotic Upper-limb Telerehabilitation

Abstract

Research shows that better results in post-stroke rehabilitation are obtained when patients receive more intensive therapy. However, the increasing affected population and the limited healthcare resources prevent the provision of intense rehabilitation care. Thus, there is a need for a more autonomous and scalable care provision methods that can be transferred out of the clinic and into home environments. Serious games in combination with robotic rehabilitation can provide an affordable, engaging, and effective way to intensify treatment, both at the clinic and at home. Furthermore, they can offer quantitative assessment of motor performance, allowing individualized treatments and to keep the patient and their therapists informed about therapy progress. Towards this end, a set of games for assessment and training of upper-limb motor impairment after stroke with the ArmAssist is presented. A special effort has been made to design the assessment games in order to be able, not only to measure the effectiveness of the training, but also to compare the assessment results with the standard assessment scales used in the clinic. Feedback from usability testing of previous versions of the system has also been crucial for the final design. Preliminary results of an ongoing clinical testing are presented.

A usability study in patients with stroke using MERLIN, a robotic system based on serious games for upper limb rehabilitation in the home setting.

“…The movements are used to interact with the implemented serious games on the software, which are divided into different levels depending on the patients' stage of recovery and cognitive capabilities. The games include assessment and training (24) and they were codesigned by patients and physiotherapists (25). 7 training games are available, such as choosing letters to make a word, discovering pairs, solitaire or doing a puzzle, for example.…”

Serious Gaming Technology in Upper Extremity Rehabilitation: Scoping Review

“…Additionally, there are more complicated and time-consuming approaches identified in this category, including developments of exoskeleton robotic devices that focus on specific parts of the hand. These are studies in which robotic gloves were developed to control the fingers [35,42,61,79,[150][151][152][153][154][155][156], and in which robotic arms were created to cover the surface from the shoulder to the wrist [4][5][6][7][8][9][10][11]48,49,110,139,[157][158][159][160][161]. Additionally, many research teams have focused on the development of a handle to obtain control of the arm force and movement [12,56,135,[162][163][164][165][166][167][168][169][170][171][172][173] or similar robotics [174][175][176]…”

A Usability Study in Patients With Stroke Using MERLIN, a Robotic System Based on Serious Games for Upper Limb Rehabilitation in Home Setting

“…It includes games for both training and assessment (24). 7 training games are available, which were co-designed with patients and physiotherapists (25). The games can be con gured to train shoulder abduction/adduction, wrist prono-supination, hand open/close, or elbow exion-extension and combinations of those movements.…”