Applying Game-Based Approaches for Physical Rehabilitation of Poststroke Patients: A Systematic Review

Objective. A large number of patients need critical physical rehabilitation after the stroke. This study aimed to review and report the result of published studies, in which newly emerged games were employed for physical rehabilitating in poststroke patients. Materials and Methods. This systematic review study was performed based on the PRISMA method. A comprehensive search of PubMed, Scopus, IEEE Xplore Digital Library, and ISI Web of Science was conducted from January 1, 2014, to November 9, 2020, to identify related articles. Studies have been entered in this review based on inclusion and exclusion criteria, in which new games have been used for physical rehabilitation. Results. Of the 1326 retrieved studies, 60 of them met our inclusion criteria. Virtual reality-oriented games were the most popular type of physical rehabilitation approach for poststroke patients. “The Nintendo Wii Fit” game was used more than other games. The reviewed games were mostly operated to balance training and limb mobilization. Based on the evaluation results of the utilized games, only in three studies, applied games were not effective. In other studies, games had effective outcomes for target body members. Conclusions. The results indicate that modern games are efficient in poststroke patients’ physical rehabilitation and can be used alongside conventional methods.

Analysis of static balance in a patient with parkinson’s disease after using Nintendo Wii Fit® games: a case study

Introduction: Parkinson’s disease (PD) is characterized by involuntary tremors, weakness, festive gait, due to impaired balance, and neuropsychiatric disorders. Baropodometer and stabilometer are used to measure the strength of the feet and analyze the gravitational displacement, respectively. The Nintendo Wii® allows playful interaction to exercise balance. Objectives: To analyze static balance of PD patients after using Wii Fit® pre and post intervention. Methods: The baropodometric and stabilometric evaluation before and after the intervention took place at the University of Fortaleza. Plantar surface, mass division and pressures were evaluated with a baropodometer. Static balance was assessed with a stabilometer. The games used were Penguin Slide, Table Tilt Plus, Tilt City. Results: The left (L) hindfoot mass division went from 16.02 to 27.51%. The anteroposterior oscillations of L foot and right (R) varied from 50 to 49%. The average pressure of R foot was 35.67 to 25.97 kpa. As the appointments passed, the scores on the Wii went up. In the static analysis, it was found the patient presented a better variation in mass division of the L hindfoot, frontal gravitational center L and R and mean pressure on the R foot. The benefits found in the applicability of Wii Fit® as a therapeutic tool result in improvement in correction of posture and balance, enabling better locomotion and motivating the patient. Conclusion: The interaction with virtual reality in a patient with PD is promising for complementary motor treatment, as it delays the evolution of symptoms, improving static balance and providing greater functionality.

Ativação cortical do lobo frontal em adultos jovens e idosos: uma análise eletroencefalográfica durante um exergame para equilíbrio postural

Objetivo: Investigar a atividade cortical no lobo frontal de idosos e adultos jovens durante a execução de um exergame para o equilíbrio postural. Metodologia: Estudo transversal com 20 indivíduos (10 adultos e 10 idosos) submetidos a um exergame. Foi realizada inicialmente uma avaliação sociodemográfica e clínica e em seguida, uma avaliação eletroencefalografica (EEG) com o Emotiv EPOC® durante a execução do exergame Penguin slide da Nintendo Wii Fit. Foram utilizados 8 canais da região frontal e a análise da frequência das ondas alfa e beta. Os dados do EEG foram gravados pelo Emotiv TestBench e importados para o MatLab®. Foi utilizado o programa SPSS 20.0, aplicado o teste Mann-Whitney e adotado significância com p<0,05. Resultados: A média de idade do grupo de idosos (GI) foi de 65,1±4,8 anos e no grupo de adultos jovens (GJ) foi de 22,4±2,3 anos. Não houve diferença no potencial de ativação cortical entre os grupos para as ondas alfa (p=0,058) e beta (p=0,092). Houve maior magnitude no potencial de ativação da onda alfa em ambos os grupos. Para alfa e beta, observou-se um pico de ativação no canal F3 (região frontal esquerda) no GJ e maior quantidade de picos de ativação no GI, com destaque para o canal F4 (região frontal direita). Conclusão: O potencial de ativação cerebral frontal de alfa e beta em jovens e idosos não difere ao desempenhar o exergame para equilíbrio postural Penguin slide.

Pocket Skate: Prototype of A Mobile Projection-Based Game

Introduction: Exergaming is the activity in which this kind of videogame relies on the technology from the body’s movement or reaction. There are several existing commercial devices that has been used as user interface for an exergaming activity such XBOX Kinnect and Nintendo Wii Fit. However, these games platform are quite expensive and considered as luxury as they are a dedicated device only for games. What we propose here a different kind of exergaming, that is by using a typical mobile phone as the censor/controller and combined it with a display device such as a smart TV or a laptop. Methods: We use prototyping model that involve “communication”, where the problem and/or room for improvement is being identified, then “quick plan”, where various information are being analyzed and all the required components are being recorded and verified, and then “quick design”, where the app design be created, and then “prototype construction” when we create the app, and lastly “deployment and feedback” where we tried the app and check for faults. The cycle repeats for fixing any things that did not work. Results: The researcher was able to construct a proof of concept prototype of the app. First, the player will look the hero, a skater, on smart TV or other wireless projection where will be receive mirror feeds from the smartphone. The smartphone itself was placed on the player hips and to control the skater and user must make a small jump to make the skater jump or face side to side to make the skater change direction. Discussion: While the app is still a prototype, yet it was able to show how a game can use a projected-based interface and mixed it the use of gyroscope and accelerometer censors. Future recommendation would be integrating it with calories counters for it to be fully “exergaming”. Keywords: exergaming, gyroscope, accelerometer, virtual reality, Unity 3D Engine