Exergaming for Lower Limb Stroke Rehabilitation: A Game Controller for Lower Limb Stroke Rehabilitation

<p><b>The success of stroke rehabilitation requires the patient engage in early, long-term high repetitions and intensive treatment. When comparing clinical and literature statistics, it is confirmed that clinical rehabilitation is not achieving required repetitions and intensity for effective rehabilitation of basic motor skills as prescribed in physiotherapy literature. It is then the patient’s responsibility to carry out the rehabilitation at home without supervision. These exercises can also be very mundane and repetitive, which reduces the patient’s motivation to exercise. Exergames have been found (Alankus et al., 2010, p. 21130, (King, Hijmans, Sampson, Satherley, & Hale, 2012 Deutsch et al., 2009), (Mortazavi et al., 2014), (Shirzad et al., 2015).to improve patients’ engagement with their therapies at home.</b></p> <p>Currently there are systems to facilitate lower limb stroke rehabilitation,but none includes Strength for Task Training (STT). STT is a novel physiotherapeutic method for lower limb rehabilitation and comprises of two main phases: first being the strength training (priming) and second being the task training. Priming is brief weight lifting to excite the neural pathways (neuroplasticity) in the affected region, which primes the brain for learning; this is then promptly followed by task training to maximise gains in the locomotor ability.</p> <p>This project builds up on the research and development of a game controller by Duncan (2016) for lower limb stroke rehabilitation to facilitate STT. This project is a collaboration with Regan Petrie who designed the media aspect of the exergame system.</p> <p>A game controller was developed and this was part of a complete exergaming system which was designed to specifically facilitate STT. This project compiles more research findings together with feedback from the user and the clinicians to help improve the system. This was to ensure that the design is aligned to the specific requirements of functional STT rehabilitation and contextual needs of the patient.</p> <p>The final output is a pair of prototype shoes which included a sensor to measure movement, a pair of weighted sleeve and a pair of balance sole. The weighted sleeve has removable weights and facilitates the strength part of the training. The shoes are the adaptors which allow the user to the balance soles which is used to constantly challenge the user’s balance. The sensors translate limb movement and are for the user to interact with the game. This system provides a simple and safe method to engage in unsupervised STT.</p> <p>Feedback from clinicians indicates that the shoes can facilitate the strength part of the exercise, the sensors the task part of the training, and the balance sole is useful for challenging and improving balance. User testing sessions offer information about: the usability of the system, including ease of use and intuitive design; the aesthetics of the physical objects and whether the system is engaging patients in their therapies.</p>

Exergaming for Lower Limb Stroke Rehabilitation: A Game Controller for Lower Limb Stroke Rehabilitation

<p><b>The success of stroke rehabilitation requires the patient engage in early, long-term high repetitions and intensive treatment. When comparing clinical and literature statistics, it is confirmed that clinical rehabilitation is not achieving required repetitions and intensity for effective rehabilitation of basic motor skills as prescribed in physiotherapy literature. It is then the patient’s responsibility to carry out the rehabilitation at home without supervision. These exercises can also be very mundane and repetitive, which reduces the patient’s motivation to exercise. Exergames have been found (Alankus et al., 2010, p. 21130, (King, Hijmans, Sampson, Satherley, & Hale, 2012 Deutsch et al., 2009), (Mortazavi et al., 2014), (Shirzad et al., 2015).to improve patients’ engagement with their therapies at home.</b></p> <p>Currently there are systems to facilitate lower limb stroke rehabilitation,but none includes Strength for Task Training (STT). STT is a novel physiotherapeutic method for lower limb rehabilitation and comprises of two main phases: first being the strength training (priming) and second being the task training. Priming is brief weight lifting to excite the neural pathways (neuroplasticity) in the affected region, which primes the brain for learning; this is then promptly followed by task training to maximise gains in the locomotor ability.</p> <p>This project builds up on the research and development of a game controller by Duncan (2016) for lower limb stroke rehabilitation to facilitate STT. This project is a collaboration with Regan Petrie who designed the media aspect of the exergame system.</p> <p>A game controller was developed and this was part of a complete exergaming system which was designed to specifically facilitate STT. This project compiles more research findings together with feedback from the user and the clinicians to help improve the system. This was to ensure that the design is aligned to the specific requirements of functional STT rehabilitation and contextual needs of the patient.</p> <p>The final output is a pair of prototype shoes which included a sensor to measure movement, a pair of weighted sleeve and a pair of balance sole. The weighted sleeve has removable weights and facilitates the strength part of the training. The shoes are the adaptors which allow the user to the balance soles which is used to constantly challenge the user’s balance. The sensors translate limb movement and are for the user to interact with the game. This system provides a simple and safe method to engage in unsupervised STT.</p> <p>Feedback from clinicians indicates that the shoes can facilitate the strength part of the exercise, the sensors the task part of the training, and the balance sole is useful for challenging and improving balance. User testing sessions offer information about: the usability of the system, including ease of use and intuitive design; the aesthetics of the physical objects and whether the system is engaging patients in their therapies.</p>

A Game Controller for Stroke Rehabilitation

<p>Successful stroke rehabilitation relies on early, long-term, repetitive and intensive treatment. Repetitions conducted during clinical rehabilitation are significantly lower than that suggested by physiotherapeutic literature to relearn lost motor capabilities. This leaves patients to achieve this quantity in their home environment. Exercises can be monotonous and repetitive, making it difficult to maintain patient motivation. Exergames have been promoted for use in the home to make rehabilitation entertaining, increasing patients engagement with their therapy. Marketed exergaming systems for lower limb rehabilitation are hard to find, and none as of yet, facilitate Strength for Task Training (STT), a novel physiotherapeutic method for lower limb stroke rehabilitation. Strength for Task Training involves performing brief but intensive strength training (priming) prior to task-specic training to promote neural plasticity and maximise the gains in locomotor ability. This research investigates how the design of a game controller for lower limb stroke rehabilitation can facilitate unsupervised STT to compliment clinical contact time. The game controller was developed as part of a complete exergaming system designed to specifically facilitate STT. This involved working closely with co-researcher Scott Brebner who designed the exergame media. A user centered design approach was followed to include clinicians and stroke patients in the design process. This ensured the design aligned with the functional requirements of STT and the contextual needs of the patient. Workshops with stroke clinicians and neurophysiologists pointed to the specific areas of STT that a designed system could address. An iterative design process was used to develop, compare and improve concepts through testing with participants and clinicians. User testing involved participants using the game controller to interact with the digital game. The final output was a prototype pair of smart shoes with an attachable weighted sole. The design used removable sensors to translate lower limb movement into ingame interactions. The design of the shoes and weighted sole provided a simple and safe way to engage in unsupervised STT. Research findings suggest that while not all of the STT therapy can be incorporated in an unsupervised and home-based exergame system, there are some essential elements that can. Adaptable hardware was found to be integral to facilitating intensive priming. Barriers to use can be reduced through considering the diverse physiological and cognitive abilities of stroke patients and aesthetic consideration can help create a meaningful game controller that promotes its use in the home.</p>

A Game Controller for Stroke Rehabilitation

<p>Successful stroke rehabilitation relies on early, long-term, repetitive and intensive treatment. Repetitions conducted during clinical rehabilitation are significantly lower than that suggested by physiotherapeutic literature to relearn lost motor capabilities. This leaves patients to achieve this quantity in their home environment. Exercises can be monotonous and repetitive, making it difficult to maintain patient motivation. Exergames have been promoted for use in the home to make rehabilitation entertaining, increasing patients engagement with their therapy. Marketed exergaming systems for lower limb rehabilitation are hard to find, and none as of yet, facilitate Strength for Task Training (STT), a novel physiotherapeutic method for lower limb stroke rehabilitation. Strength for Task Training involves performing brief but intensive strength training (priming) prior to task-specic training to promote neural plasticity and maximise the gains in locomotor ability. This research investigates how the design of a game controller for lower limb stroke rehabilitation can facilitate unsupervised STT to compliment clinical contact time. The game controller was developed as part of a complete exergaming system designed to specifically facilitate STT. This involved working closely with co-researcher Scott Brebner who designed the exergame media. A user centered design approach was followed to include clinicians and stroke patients in the design process. This ensured the design aligned with the functional requirements of STT and the contextual needs of the patient. Workshops with stroke clinicians and neurophysiologists pointed to the specific areas of STT that a designed system could address. An iterative design process was used to develop, compare and improve concepts through testing with participants and clinicians. User testing involved participants using the game controller to interact with the digital game. The final output was a prototype pair of smart shoes with an attachable weighted sole. The design used removable sensors to translate lower limb movement into ingame interactions. The design of the shoes and weighted sole provided a simple and safe way to engage in unsupervised STT. Research findings suggest that while not all of the STT therapy can be incorporated in an unsupervised and home-based exergame system, there are some essential elements that can. Adaptable hardware was found to be integral to facilitating intensive priming. Barriers to use can be reduced through considering the diverse physiological and cognitive abilities of stroke patients and aesthetic consideration can help create a meaningful game controller that promotes its use in the home.</p>

Designing a Game for Upper Limb Rehabilitation Following a Stroke

<p>Background: Many stroke survivors suffer from motor impairments such as upper limb hemiparesis accompanied by cognitive and emotional impairments that can affect their ability to function. Rehabilitation interventions are effective in promoting the return of function. However, patients’ engagement is necessary in order to maintain the improvements, and research shows that stroke survivors need more opportunities to engage with rehabilitation outside of the clinic. Digital games can offer a solution by providing an engaging context for performing the exercises correctly and learning new skills. Aims: This research aims to increase engagement with upper limb rehabilitation following a stroke through a custom digital game that facilitates effective rehabilitation methods, and is played with the Able-M, a game controller designed for upper limb rehabilitation by Im-Able. Methods: The development process was based on a human-centred design approach that consisted of a literature review, personas generation, exploratory studies including field observations in a clinic and discussions with therapists, iterative design through qualitative studies including user observations, interviews with patients, and feedback from a neuro-physiotherapist. Conclusions: Based on the design process, the game prototype includes the following elements: Adaptive gameplay for physical and cognitive challenge-skill balance, obstacles to increase challenge, feedback provision to enhance engagement and facilitate motor learning, rhythmic elements to facilitate rhythmic auditory stimulation, narrative based on user research to facilitate focus diversion, and different navigation mechanisms to promote neuroplasticity. High contrast, bird eye view, and third person perspective for ease of use. Limitations and directions for further research are discussed.</p>

Designing a Game for Upper Limb Rehabilitation Following a Stroke

<p>Background: Many stroke survivors suffer from motor impairments such as upper limb hemiparesis accompanied by cognitive and emotional impairments that can affect their ability to function. Rehabilitation interventions are effective in promoting the return of function. However, patients’ engagement is necessary in order to maintain the improvements, and research shows that stroke survivors need more opportunities to engage with rehabilitation outside of the clinic. Digital games can offer a solution by providing an engaging context for performing the exercises correctly and learning new skills. Aims: This research aims to increase engagement with upper limb rehabilitation following a stroke through a custom digital game that facilitates effective rehabilitation methods, and is played with the Able-M, a game controller designed for upper limb rehabilitation by Im-Able. Methods: The development process was based on a human-centred design approach that consisted of a literature review, personas generation, exploratory studies including field observations in a clinic and discussions with therapists, iterative design through qualitative studies including user observations, interviews with patients, and feedback from a neuro-physiotherapist. Conclusions: Based on the design process, the game prototype includes the following elements: Adaptive gameplay for physical and cognitive challenge-skill balance, obstacles to increase challenge, feedback provision to enhance engagement and facilitate motor learning, rhythmic elements to facilitate rhythmic auditory stimulation, narrative based on user research to facilitate focus diversion, and different navigation mechanisms to promote neuroplasticity. High contrast, bird eye view, and third person perspective for ease of use. Limitations and directions for further research are discussed.</p>

Natural, Wearable Game Controllers

<p>Natural, wearable game controllers explores how people interact with games and their potential uses. Since the early days of personal computing video games have been used for more than just fun. Such uses include exploration education, simulation of real world environments and the study of human thought processes (Wolf, 2008). As well as video games being used in a wide variety of settings, there has also been considerable variation in the way we interact with them - from basic mouse and keyboard interaction to the introduction of non-traditional gaming systems such the Nintendo Wii and Microsoft Kinect. These different inputs can be fall within a spectrum of abstract and natural game controllers. This thesis looks at the difference between the two and applies this to the creation of a natural wearable game controller. The aim of this thesis was to create a customised human-computer interface (HCI) input device, using a reliable piece of hardware with accompanying software a user could interact with. Through design experiments a wearable game controller was created in the form of a wrap band. Once the wrap band was developed the next step was to see how it could be used as a game controller. Design experiments were conducted, focusing on integration with a pre-existing game, using it as an exercise assessment tool and developing a specific game which could be used for rehabilitation.The area of rehabilitation gaming is broad so this thesis focuses on Weight Bearing Asymmetry (WBA). This is a condition where a person does not evenly distribute their weight between their feet. This thesis explores a range of hardware and software design experiments to see how wearable technology can be used to create a new way of interacting with video games. It looks at the benefits of using wearable technology and gaming for rehabilitation, it’s limitations and future applications of this technology. The thesis concludes that natural wearable game controllers do have potential real world application in both gaming and rehabilitation.</p>

Natural, Wearable Game Controllers

<p>Natural, wearable game controllers explores how people interact with games and their potential uses. Since the early days of personal computing video games have been used for more than just fun. Such uses include exploration education, simulation of real world environments and the study of human thought processes (Wolf, 2008). As well as video games being used in a wide variety of settings, there has also been considerable variation in the way we interact with them - from basic mouse and keyboard interaction to the introduction of non-traditional gaming systems such the Nintendo Wii and Microsoft Kinect. These different inputs can be fall within a spectrum of abstract and natural game controllers. This thesis looks at the difference between the two and applies this to the creation of a natural wearable game controller. The aim of this thesis was to create a customised human-computer interface (HCI) input device, using a reliable piece of hardware with accompanying software a user could interact with. Through design experiments a wearable game controller was created in the form of a wrap band. Once the wrap band was developed the next step was to see how it could be used as a game controller. Design experiments were conducted, focusing on integration with a pre-existing game, using it as an exercise assessment tool and developing a specific game which could be used for rehabilitation.The area of rehabilitation gaming is broad so this thesis focuses on Weight Bearing Asymmetry (WBA). This is a condition where a person does not evenly distribute their weight between their feet. This thesis explores a range of hardware and software design experiments to see how wearable technology can be used to create a new way of interacting with video games. It looks at the benefits of using wearable technology and gaming for rehabilitation, it’s limitations and future applications of this technology. The thesis concludes that natural wearable game controllers do have potential real world application in both gaming and rehabilitation.</p>

A human factors analysis of the Stretch mobile manipulator robot

Assistive and mobile robots have potential to support everyday domestic tasks and enable independence for persons in the home. As a first step to evaluating this potential, we assessed the initial unboxing and setup of Hello Robot’s Stretch RE1– a novel mobile manipulator designed for domestic settings. All study procedures took place in the McKechnie Family LIFE Home, which is a smart home research facility on the University of Illinois Urbana-Champaign campus. We used subject matter experts (SMEs) and followed human factors principles to consider obstacles users with diverse needs and capabilities (e.g., older adults, persons with mobility disabilities) might encounter during the unboxing process. We then conducted 50 trials of user testing and critical task analyses in the LIFE home to assess the feasibility and usability for different use cases. Research team members controlled Stretch by using a game controller. We used Stretch to manipulate 15 different types of objects that would be part of domestic activities needed to live independently, such as tasks needed for meal preparation. We documented the frequency of errors, time spent manipulating the object, and informal qualitative feedback from teleoperators during and after each trial (using a think-aloud protocol). Implications for future domestic robot design using human factors approaches are discussed.