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Kennard M, Hassan M, Shimizu Y, Suzuki K. Max Well-Being: a modular platform for the gamification of rehabilitation. Front Robot AI 2024; 11:1382157. [PMID: 38883401 PMCID: PMC11176482 DOI: 10.3389/frobt.2024.1382157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
This study proposes a modular platform to improve the adoption of gamification in conventional physical rehabilitation programs. The effectiveness of rehabilitation is correlated to a patient's adherence to the program. This adherence can be diminished due to factors such as motivation, feedback, and isolation. Gamification is a means of adding game-like elements to a traditionally non-game activity. This has been shown to be effective in providing a more engaging experience and improving adherence. The platform is made of three main parts; a central hardware hub, various wired and wireless sensors, and a software program with a stream-lined user interface. The software interface and hardware peripherals were all designed to be simple to use by either a medical specialist or an end-user patient without the need for technical training. A usability study was performed using a group of university students and a group of medical specialists. Using the System Usability Scale, the system received an average score of 69.25 ± 20.14 and 72.5 ± 17.16 by the students and medical specialists, respectively. We also present a framework that attempts to assist in selecting commercial games that are viable for physical rehabilitation.
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Affiliation(s)
- Maxwell Kennard
- Graduate School of Science and Technology, University of Tsukuba, Tsukuba, Japan
| | - Modar Hassan
- Institute of Systems and Information Engineering, University of Tsukuba, Tsukuba, Japan
| | - Yukiyo Shimizu
- Department of Rehabilitation Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kenji Suzuki
- Institute of Systems and Information Engineering, University of Tsukuba, Tsukuba, Japan
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2
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Urbina J, Abarca VE, Elias DA. Integration of music-based game approaches with wearable devices for hand neurorehabilitation: a narrative review. J Neuroeng Rehabil 2024; 21:89. [PMID: 38811987 PMCID: PMC11134927 DOI: 10.1186/s12984-024-01379-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/10/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Restoring hand functionality is critical for fostering independence in individuals with neurological disorders. Various therapeutic approaches have emerged to address motor function restoration, with music-based therapies demonstrating notable advantages in enhancing neuroplasticity, an integral component of neurorehabilitation. Despite the positive effects observed, there remains a gap in the literature regarding implementing music treatments in neurorehabilitation, such as Neurologic Music Therapy (NMT), especially in conjunction with emerging fields like wearable devices and game-based therapies. METHODS A literature search was conducted in various databases, including PubMed, Scopus, IEEE Xplore, and ACM Digital Library. The search was performed using a literature search methodology based on keywords. Information collected from the studies pertained to the approach used in music therapy, the design of the video games, and the types of wearable devices utilized. RESULTS A total of 158 articles were found, including 39 from PubMed, 34 from IEEE Xplore, 48 from Scopus, 37 from ACM Digital Library, and 35 from other sources. Duplicate entries, of which there were 41, were eliminated. In the first screening phase, 152 papers were screened for title and abstract. Subsequently, 89 articles were removed if they contained at least one exclusion criterion. Sixteen studies were considered after 63 papers had their full texts verified. CONCLUSIONS The convergence of NMT with emerging fields, such as gamification and wearable devices designed for hand functionality, not only expands therapeutic horizons but also lays the groundwork for innovative, personalized approaches to neurorehabilitation. However, challenges persist in effectively incorporating NMT into rehabilitation programs, potentially hindering its effectiveness.
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Affiliation(s)
- Javier Urbina
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, 15008, Lima, Peru
| | - Victoria E Abarca
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, 15008, Lima, Peru.
| | - Dante A Elias
- Biomechanics and Applied Robotics Research Laboratory, Pontificia Universidad Católica del Perú, 15008, Lima, Peru
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Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
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Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
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Pimentel-Ponce M, Romero-Galisteo RP, Palomo-Carrión R, Pinero-Pinto E, Antonio Merchán-Baeza J, Ruiz-Muñoz M, Oliver-Pece J, González-Sánchez M. Gamification and neurological motor rehabilitation in children and adolescents: a systematic review. Neurologia 2024; 39:63-83. [PMID: 38065433 DOI: 10.1016/j.nrleng.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/07/2021] [Indexed: 12/25/2023] Open
Abstract
INTRODUCTION Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS From a total of 469 studies, 11 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), neurological gait disorders (1), and neurological impairment of balance and coordination (1). CONCLUSION The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.
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Affiliation(s)
| | - R P Romero-Galisteo
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - R Palomo-Carrión
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia, Universidad de Castilla la Mancha, Toledo, Spain
| | - E Pinero-Pinto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - J Antonio Merchán-Baeza
- Grupo de investigación Methodology, Methods, Models and Outcomes of Health and Social Sciences (M30), Facultad de Cienciasde la Salud y Bienestar, Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Vic, Barcelona, Spain
| | - M Ruiz-Muñoz
- Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - J Oliver-Pece
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - M González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica deMálaga (IBIMA), Málaga, Spain
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Bae S, Park HS. Development of Immersive Virtual Reality-Based Hand Rehabilitation System Using a Gesture-Controlled Rhythm Game With Vibrotactile Feedback: An fNIRS Pilot Study. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3732-3743. [PMID: 37669214 DOI: 10.1109/tnsre.2023.3312336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
Recently, virtua reality (VR) has been widely utilized with rehabilitation to promote user engagement, which has been shown to induce brain plasticity. In this study, we developed a VR-based hand rehabilitation system consisting of a personalized gesture-controlled rhythm game with vibrotactile feedback and investigated the cortical activation pattern induced by our system using functional near-infrared spectroscopy (fNIRS). Our system provides vibrotactile feedback as the user matches their hand gestures to VR targets customized to their pre-recorded hand gestures. Cortical activation was measured via fNIRS during 420 seconds of alternating gameplay and rest in 11 healthy subjects and one stroke survivor. Regions of interest (ROI) were the prefrontal cortex (PFC), the premotor cortex & the supplementary motor area (PMC&SMA), the primary sensorimotor cortex (SM1), and the somatosensory association cortex (SAC). The mean success rate of gesture matching among healthy subjects was 90 % with a standard deviation of 10.7 %, and the success rate of the stroke survivor was 79.6 %. The averaged cortical activation map for the 11 healthy subjects and the individual cortical activation map for the single stroke survivor showed increased hemodynamic responses of oxygenated hemoglobin (HbO) during the VR-based hand rehabilitation compared to the resting condition. Paired t-test analysis demonstrated a significant increase in HbO activation values in 19 out of 51 channels, corresponding to all ROIs except the left PFC and PMC&SMA, which exhibited high subject variability. The experimental results indicate that the proposed system successfully activated brain areas related to motor planning/execution, multisensory integration, and attention.
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Lee C, Ahn J, Lee BC. A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs. Bioengineering (Basel) 2023; 10:1142. [PMID: 37892872 PMCID: PMC10604191 DOI: 10.3390/bioengineering10101142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/13/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs.
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Affiliation(s)
- Chihyeong Lee
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea;
| | - Jooeun Ahn
- Department of Physical Education, Seoul National University, Seoul 08826, Republic of Korea;
- Institute of Sport Science, Seoul National University, Seoul 08826, Republic of Korea
| | - Beom-Chan Lee
- Institute of Sport Science, Seoul National University, Seoul 08826, Republic of Korea
- Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA
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Amos G, Rode D, Maffiuletti NA, Bizzini M, Mauch M, Easthope CA, Haufe F, Xiloyannis M, Wolf P, Riener R. Gamification of Physical Therapy Exercises Using Commercial Entertainment Content: A Safety and Feasibility Study. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941172 DOI: 10.1109/icorr58425.2023.10304694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Independent physiotherapy at home is a crucial element of rehabilitative care for a wide range of conditions as it constitutes a large portion of the overall therapy dose. However, up to 80% of individuals who are prescribed at-home physiotherapy do not consistently adhere to their treatment schedule, resulting in poor treatment outcomes. This is likely due to a lack of motivation and progress tracking in the current standard of care. We have developed a novel software prototype that allows users to control commercial entertainment content, such as video games or interactive music videos, with their movements during physiotherapy. By connecting therapy to proven entertainment content, we aim to improve on the current motivational deficits. This study investigated the safety and feasibility of this concept in a controlled environment over four physical therapy sessions with seven patients suffering from musculoskeletal and neurological conditions. As a secondary outcome, patients were asked about their enjoyment, perceived competence and effort using the Intrinsic Motivation Inventory (IMI) questionnaire. All participants were able to interact with the presented entertainment content and completed the study with no adverse events. Despite the diversity in pathology, age and training scenarios, the entertainment content maintained the patients' enjoyment with a high average rate of 6/7 on the IMI scale. Interacting with commercial entertainment content by doing physical therapy exercises was feasible, safe, and well-received over the six-week study period.
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8
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Malone LA, Hill NM, Tripp H, Wolpert DM, Bastian AJ. A novel video game for remote studies of motor adaptation in children. Physiol Rep 2023; 11:e15764. [PMID: 37434268 PMCID: PMC10336020 DOI: 10.14814/phy2.15764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/13/2023] Open
Abstract
Here we designed a motor adaptation video game that could be played remotely (at home) through a web browser. This required the child to adapt to a visuomotor rotation between their hand movement and a ball displayed in the game. The task had several novel features, specifically designed to allow the study of the developmental trajectory of adaptation across a wide range of ages. We test the concurrent validity by comparing children's performance on our remote task to the same task performed in the laboratory. All participants remained engaged and completed the task. We quantified feedforward and feedback control during this task. Feedforward control, a key measure of adaptation, was similar at home and in the laboratory. All children could successfully use feedback control to guide the ball to a target. Traditionally, motor learning studies are performed in a laboratory to obtain high quality kinematic data. However, here we demonstrate concurrent validity of kinematic behavior when conducted at home. Our online platform provides the flexibility and ease of collecting data that will enable future studies with large sample sizes, longitudinal experiments, and the study of children with rare diseases.
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Affiliation(s)
- Laura A. Malone
- Kennedy Krieger InstituteBaltimoreMarylandUSA
- Department of NeurologyJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Department of Physical Medicine and RehabilitationJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Nayo M. Hill
- Kennedy Krieger InstituteBaltimoreMarylandUSA
- Department of NeuroscienceJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Haley Tripp
- Kennedy Krieger InstituteBaltimoreMarylandUSA
| | - Daniel M. Wolpert
- Mortimer B. Zuckerman Mind Brain Behavior InstituteColumbia UniversityNew YorkNew YorkUSA
- Department of NeuroscienceColumbia UniversityNew YorkNew YorkUSA
| | - Amy J. Bastian
- Kennedy Krieger InstituteBaltimoreMarylandUSA
- Department of NeuroscienceJohns Hopkins School of MedicineBaltimoreMarylandUSA
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9
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Alarcón TA, Presti-Silva SM, Simões APT, Ribeiro FM, Pires RGW. Molecular mechanisms underlying the neuroprotection of environmental enrichment in Parkinson's disease. Neural Regen Res 2023; 18:1450-1456. [PMID: 36571341 PMCID: PMC10075132 DOI: 10.4103/1673-5374.360264] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Parkinson's disease is the most common movement disorder, affecting about 1% of the population over the age of 60 years. Parkinson's disease is characterized clinically by resting tremor, bradykinesia, rigidity and postural instability, as a result of the progressive loss of nigrostriatal dopaminergic neurons. In addition to this neuronal cell loss, Parkinson's disease is characterized by the accumulation of intracellular protein aggregates, Lewy bodies and Lewy neurites, composed primarily of the protein α-synuclein. Although it was first described almost 200 years ago, there are no disease-modifying drugs to treat patients with Parkinson's disease. In addition to conventional therapies, non-pharmacological treatment strategies are under investigation in patients and animal models of neurodegenerative disorders. Among such strategies, environmental enrichment, comprising physical exercise, cognitive stimulus, and social interactions, has been assessed in preclinical models of Parkinson's disease. Environmental enrichment can cause structural and functional changes in the brain and promote neurogenesis and dendritic growth by modifying gene expression, enhancing the expression of neurotrophic factors and modulating neurotransmission. In this review article, we focus on the current knowledge about the molecular mechanisms underlying environmental enrichment neuroprotection in Parkinson's disease, highlighting its influence on the dopaminergic, cholinergic, glutamatergic and GABAergic systems, as well as the involvement of neurotrophic factors. We describe experimental pre-clinical data showing how environmental enrichment can act as a modulator in a neurochemical and behavioral context in different animal models of Parkinson's disease, highlighting the potential of environmental enrichment as an additional strategy in the management and prevention of this complex disease.
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Affiliation(s)
- Tamara Andrea Alarcón
- Department of Physiological Sciences; Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria, Brazil
| | - Sarah Martins Presti-Silva
- Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria; Department of Biochemistry and Immunology, Institute o Biological Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Ana Paula Toniato Simões
- Department of Physiological Sciences; Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria, Brazil
| | - Fabiola Mara Ribeiro
- Department of Biochemistry and Immunology, Institute o Biological Sciences, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, Belo Horizonte, Brazil
| | - Rita Gomes Wanderley Pires
- Department of Physiological Sciences; Laboratory of Molecular and Behavioral Neurobiology, Health Science Center, Universidade Federal do Espirito Santo, Vitoria, Brazil
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Alfieri FM, da Silva Dias C, de Oliveira NC, Battistella LR. Gamification in Musculoskeletal Rehabilitation. Curr Rev Musculoskelet Med 2022; 15:629-636. [PMID: 36301514 PMCID: PMC9789284 DOI: 10.1007/s12178-022-09797-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW This study is a narrative review aiming at evaluating the current literature of the last 5 years on gamification and musculoskeletal rehabilitation. The article search involved the following MeSH terms at PubMed: "gamification," "exergaming," and "rehabilitation." Original studies in English language were included. RECENT FINDINGS After careful analysis of the search results, 17 articles were included in this review. The use of games for rehabilitation was investigated in musculoskeletal rehabilitation conditions such as shoulder surgery, impingement syndrome, rheumatoid arthritis, osteoarthritis, low back pain, fibromyalgia, fracture, and ligament reconstruction. Results were similar or superior to conventional physical therapy or home-based exercises, with the additional benefit of improving motivation to the exercise program. Improvements in quality of life and perceived health status were also observed. The cost-effectiveness of this type of technology was also mentioned as an advantage of exergames in musculoskeletal rehabilitation. Studies involving gamification in musculoskeletal rehabilitation stress the potential of this resource in several aspects of physical fitness, health, and quality of life, also improving motivation and adherence to the exercise treatment.
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Affiliation(s)
- Fábio Marcon Alfieri
- Centro de Pesquisa Clinica do Instituto de Medicina Física e Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil and Master in Health Promotion–Adventist University Center, São Paulo, Brazil
| | - Caren da Silva Dias
- Physical Therapy–Instituto de Medicina Física e Reabilitação, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Linamara Rizzo Battistella
- Departamento de Medicina Legal, Ética Médica e Medicina Social e do Trabalho da Faculdade de Medicina, Universidade de São Paulo, São Paulo, and Centro de Pesquisa Clinica do Instituto de Medicina Física e Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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11
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Sipatchin A, García García M, Sauer Y, Wahl S. Application of Spatial Cues and Optical Distortions as Augmentations during Virtual Reality (VR) Gaming: The Multifaceted Effects of Assistance for Eccentric Viewing Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159571. [PMID: 35954927 PMCID: PMC9368505 DOI: 10.3390/ijerph19159571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 07/31/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
Abstract
The present study investigates the effects of peripheral spatial cues and optically distorting augmentations over eccentric vision mechanisms in normally sighted participants with simulated scotoma. Five different augmentations were tested inside a virtual reality (VR)-gaming environment. Three were monocular spatial cues, and two were binocular optical distortions. Each was divided into three conditions: baseline with normal viewing, augmentation with one of the assistance methods positioned around the scotoma, and one with only the simulated central scotoma. The study found that the gaming scenario induced eccentric viewing for the cued augmentation groups, even when the peripheral assistance was removed, while for the optical distortions group, the eccentric behavior disappeared after the augmentation removal. Additionally, an upwards directionality of gaze relative to target during regular gaming was found. The bias was maintained and implemented during and after the cued augmentations but not after the distorted ones. The results suggest that monocular peripheral cues could be better candidates for implementing eccentric viewing training in patients. At the same time, it showed that optical distortions might disrupt such behavior. Such results are noteworthy since distortions such as zoom are known to help patients with macular degeneration see targets of interest.
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Affiliation(s)
| | | | - Yannick Sauer
- Institute for Ophthalmic Research, 72076 Tübingen, Germany
| | - Siegfried Wahl
- Institute for Ophthalmic Research, 72076 Tübingen, Germany
- Carl Zeiss Vision International GmbH, 73430 Aalen, Germany
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12
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Lukacs MJ, Salim S, Katchabaw MJ, Yeung E, Walton DM. Virtual reality in physical rehabilitation: a narrative review and critical reflection. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2105077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Michael J. Lukacs
- Health and Rehabilitation Sciences, Western University, Canada
- Bone and Joint Institute, Western University, Canada
| | - Shahan Salim
- Public Health and Health Systems, University of Waterloo, Canada
| | | | - Euson Yeung
- Physical Therapy, University of Toronto, Canada
| | - David M. Walton
- Bone and Joint Institute, Western University, Canada
- School of Physical Therapy, Western University, Canada
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13
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Brons A, Braam K, Broekema A, Timmerman A, Millenaar K, Engelbert R, Kröse B, Visser B. Translating Promoting Factors and Behavior Change Principles Into a Blended and Technology-Supported Intervention to Stimulate Physical Activity in Children With Asthma (Foxfit): Design Study. JMIR Form Res 2022; 6:e34121. [PMID: 35877162 PMCID: PMC9361148 DOI: 10.2196/34121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022] Open
Abstract
Background Children with asthma can decrease the impact of their disease by improving their physical activity (PA). However, health care providers lack interventions for children with asthma that effectively increase their PA levels and achieve behavior change. A technology-supported approach can positively influence PA and physical functioning in children. Objective The aims of this study were to develop a technology-supported intervention that facilitates health care providers in promoting PA for children (aged 8 to 12 years) with asthma and to systematically describe this developmental process. Methods Intervention mapping (IM) was applied to develop a blended and technology-supported intervention in cocreation with children with asthma, their parents, and health care providers. In accordance with the IM framework, the following steps were performed: conduct a needs assessment; define the intervention outcome, performance objectives, and change objectives; select theory-based intervention methods and strategies; create components of the intervention and conduct pilot tests; create an implementation plan; and create an evaluation plan. Results We developed the blended intervention Foxfit that consists of an app with a PA monitor for children (aged 8 to 12 years) with asthma and a web-based dashboard for their health care provider. The intervention focuses on PA in everyday life to improve social participation. Foxfit contains components based on behavior change principles and gamification, including goal setting, rewards, action planning, monitoring, shaping knowledge, a gamified story, personal coaching and feedback, and a tailored approach. An evaluation plan was created to assess the intervention’s usability and feasibility for both children and health care providers. Conclusions The IM framework was very useful for systematically developing a technology-supported intervention and for describing the translational process from scientific evidence, the needs and wishes of future users, and behavior change principles into this intervention. This has led to the technology-supported intervention Foxfit that facilitates health care providers in promoting PA in children with asthma. The structured description of the development process and functional components shows the way behavior change techniques are incorporated in the intervention. Trial Registration International Clinical Trial Registry Platform NTR6658; https://tinyurl.com/3rxejksf
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Affiliation(s)
- Annette Brons
- Digital Life Center, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Information and Computing Sciences, Utrecht University, Utrecht, Netherlands
| | - Katja Braam
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Haarlem, Netherlands
| | - Aline Broekema
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | | | - Karel Millenaar
- Play and Civid Media, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Raoul Engelbert
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Ben Kröse
- Digital Life Center, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- Department of Computer Science, University of Amsterdam, Amsterdam, Netherlands
| | - Bart Visser
- Centre of Expertise Urban Vitality, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
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14
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Gmelig Meyling C, Verschuren O, Rentinck IR, Engelbert RHH, Gorter JW. Physical rehabilitation interventions in children with acquired brain injury: a scoping review. Dev Med Child Neurol 2022; 64:40-48. [PMID: 34309829 PMCID: PMC9292549 DOI: 10.1111/dmcn.14997] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2021] [Indexed: 12/14/2022]
Abstract
AIM To synthesize the evidence about the characteristics (frequency, intensity, time, type) and effects of physical rehabilitation interventions on functional recovery and performance in daily functioning in children and young people with acquired brain injury (ABI), including traumatic brain injuries (TBI) and non-TBI, during the subacute rehabilitation phase. METHOD Using scoping review methodology, a systematic literature search was performed using four databases. Articles were screened by title and abstract and data from eligible studies were extracted for synthesis. RESULTS Nine of 3009 studies were included. The results demonstrated a variety of intervention characteristics: frequency varied between 1 and 7 days per week; time of intervention varied between 25 minutes and 6 hours a day; intervention types were specified in seven studies; and none of the included studies reported details of intensity of intervention. All studies reported positive results on the International Classification of Functioning, Disability and Health: Children and Youth (ICF-CY) levels of body function and activities after the intervention period, with study designs of included studies being cohort studies without concurrent controls (n=7) or case reports (n=2). INTERPRETATION Inconsistency in results hampers generalizability to guide clinical practice. Physical interventions during subacute rehabilitation have potential to improve functional recovery with intervention characteristics as an important factor influencing its effectiveness. Future well-designed studies are indicated to gain knowledge and optimize rehabilitation practice in paediatric ABI and high-quality research including outcomes across all ICF-CY domains is needed.
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Affiliation(s)
- Christiaan Gmelig Meyling
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation MedicineUtrecht UniversityUtrechtthe Netherlands,Department of Pediatric RehabilitationDe Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Olaf Verschuren
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation MedicineUtrecht UniversityUtrechtthe Netherlands
| | - Ingrid R Rentinck
- Department of Pediatric RehabilitationDe Hoogstraat RehabilitationUtrechtthe Netherlands
| | - Raoul H H Engelbert
- Department of RehabilitationAmsterdam Movement SciencesAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands,Faculty of HealthCentre of Expertise Urban VitalityAmsterdam University of Applied SciencesAmsterdamthe Netherlands,Department of PediatricsAmsterdam UMCEmma Children’s HospitalUniversity of AmsterdamAmsterdamthe Netherlands
| | - Jan Willem Gorter
- UMC Utrecht Brain Center and Center of Excellence for Rehabilitation MedicineUtrecht UniversityUtrechtthe Netherlands,Department of PediatricsCanChild Centre for Childhood Disability ResearchMcMaster UniversityHamiltonONCanada
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15
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Iosa M, Verrelli CM, Gentile AE, Ruggieri M, Polizzi A. Gaming Technology for Pediatric Neurorehabilitation: A Systematic Review. Front Pediatr 2022; 10:775356. [PMID: 35155305 PMCID: PMC8832052 DOI: 10.3389/fped.2022.775356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/05/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION The emergence of gaming technologies, such as videogames and virtual reality, provides a wide variety of possibilities in intensively and enjoyably performing rehabilitation for children with neurological disorders. Solid evidence-based results are however required to promote the use of different gaming technologies in pediatric neurorehabilitation, while simultaneously exploring new related directions concerning neuro-monitoring and rehabilitation in familiar settings. AIM OF THE STUDY AND METHODS In order to analyze the state of the art regarding the available gaming technologies for pediatric neurorehabilitation, Scopus and Pubmed Databases have been searched by following: PRISMA statements, PICOs classification, and PEDro scoring. RESULTS 43 studies have been collected and classified as follows: 11 feasibility studies; six studies proposing home-system solutions; nine studies presenting gamified robotic devices; nine longitudinal intervention trials; and eight reviews. Most of them rely on feasibility or pilot trials characterized by small sample sizes and short durations; different methodologies, outcome assessments and terminologies are involved; the explored spectrum of neurological conditions turns out to be scanty, mainly including the most common and wider debilitating groups of conditions in pediatric neurology: cerebral palsy, brain injuries and autism. CONCLUSION Even though it highlights reduced possibilities of drawing evidence-based conclusions due to the above outlined biases, this systematic review raises awareness among pediatricians and other health professionals about gaming technologies. Such a review also points out a definite need of rigorous studies that clearly refer to the underlying neuroscientific principles.
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Affiliation(s)
- Marco Iosa
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) Santa Lucia Foundation, Rome, Italy
| | | | - Amalia Egle Gentile
- National Centre for Rare Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agata Polizzi
- Department of Educational Science, Chair of Pediatrics, University of Catania, Catania, Italy
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16
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Gamified Dual-Task Training for Individuals with Parkinson Disease: An Exploratory Study on Feasibility, Safety, and Efficacy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312384. [PMID: 34886114 PMCID: PMC8657071 DOI: 10.3390/ijerph182312384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 12/02/2022]
Abstract
Objectives: The feasibility and safety of the use of neurorehabilitation technology (SMARTfit® Trainer system) by physical therapists in implementing a gamified physical-cognitive dual-task training (DTT) paradigm for individuals with Parkinson disease (IWPD) was examined. Additionally, the efficacy of this gamified DTT was compared to physical single-task training (STT), both of which were optimized using physio-motivational factors, on changes in motor and cognitive outcomes, and self-assessed disability in activities of daily living. Methods: Using a cross-over study design, eight participants with mild-to-moderate idiopathic PD (including one with mild cognitive impairment) completed both training conditions (i.e., gamified DTT and STT). For each training condition, the participants attended 2–3 sessions per week over 8.8 weeks on average, with the total amount of training being equivalent to 24 1 h sessions. A washout period averaging 11.5 weeks was inserted between training conditions. STT consisted of task-oriented training involving the practice of functional tasks, whereas for gamified DTT, the same task-oriented training was implemented simultaneously with varied cognitive games using an interactive training system (SMARTfit®). Both training conditions were optimized through continual adaptation to ensure the use of challenging tasks and to provide autonomy support. Training hours, heart rate, and adverse events were measured to assess the feasibility and safety of the gamified DTT protocol. Motor and cognitive function as well as perceived disability were assessed before and after each training condition. Results: Gamified DTT was feasible and safe for this cohort. Across participants, significant improvements were achieved in more outcome measures after gamified DTT than they were after STT. Individually, participants with specific demographic and clinical characteristics responded differently to the two training conditions. Conclusion: Physical therapists’ utilization of technology with versatile hardware configurations and customizable software application selections was feasible and safe for implementing a tailor-made intervention and for adapting it in real-time to meet the individualized, evolving training needs of IWPD. Specifically in comparison to optimized STT, there was a preliminary signal of efficacy for gamified DTT in improving motor and cognitive function as well as perceived disability in IWPD.
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17
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Pimentel-Ponce M, Romero-Galisteo RP, Palomo-Carrión R, Pinero-Pinto E, Merchán-Baeza JA, Ruiz-Muñoz M, Oliver-Pece J, González-Sánchez M. Gamification and neurological motor rehabilitation in children and adolescents: A systematic review. Neurologia 2021; 39:S0213-4853(21)00049-9. [PMID: 33867183 DOI: 10.1016/j.nrl.2021.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 12/30/2020] [Accepted: 02/07/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment. METHODS We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale. RESULTS From a total of 469 studies, 10 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6studies), followed by developmental coordination disorder (3), and neurological impairment of balance and coordination (1). CONCLUSION The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.
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Affiliation(s)
| | - R P Romero-Galisteo
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
| | - R Palomo-Carrión
- Departamento de Enfermería, Fisioterapia y Terapia Ocupacional, Facultad de Fisioterapia, Universidad de Castilla la Mancha, Toledo, España
| | - E Pinero-Pinto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, España
| | - J A Merchán-Baeza
- Grupo de investigación Methodlogy, Methods, Models and Outcomes of Health and Social Sciences (M30), Facultad de Ciencias de la Salud y Bienestar, Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Vic, Barcelona, España
| | - M Ruiz-Muñoz
- Departamento de Enfermería y Podología, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | - J Oliver-Pece
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universidad de Málaga, Málaga, España
| | - M González-Sánchez
- Departamento de Fisioterapia, Facultad de Ciencias de la Salud, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
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18
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A Survey on Gamification for Health Rehabilitation Care: Applications, Opportunities, and Open Challenges. INFORMATION 2021. [DOI: 10.3390/info12020091] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Research trends in gamification have shown a significant diversity in various areas of e-health, particularly in addressing the issues of rehabilitation and physical activity. Rehabilitation requires better engaging tools that help to increase the patient’s motivation and engagement in particular forms of rehabilitation training. Adopting gamification in rehabilitation offers different treatment and care environments when implementing rehabilitation training. As gamification is increasingly being explored in rehabilitation, one might not realize that using various techniques in gamified applications yields a different effect on gameplay. To date, varied gamification techniques have been utilized to provide useful experiences from the perspective of health applications. However, a limited number of surveys have investigated the gamification of rehabilitation and the use of suitable game techniques for rehabilitation in the literature. The objective of this paper is to examine and analyze the existing gamification techniques for rehabilitation applications. A classification of rehabilitation gamification is developed based on the rehabilitation gamifying requirements and the gamification characteristics that are commonly applied in rehabilitation applications. This classification is the main contribution of this paper. It provides insight for researchers and practitioners into suitable techniques to design and apply gamification with increased motivation and sustainable engagement for rehabilitation treatment and care. In addition, different game elements, selection blocks, and gamification techniques are identified for application in rehabilitation. In conclusion, several challenges and research opportunities are discussed to improve gamification deployment in rehabilitation in the future.
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19
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Sports Gamification: Evaluation of Its Impact on Learning Motivation and Performance in Higher Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031267. [PMID: 33572557 PMCID: PMC7908154 DOI: 10.3390/ijerph18031267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 11/16/2022]
Abstract
In this study, the impacts of sports gamification on college students' learning motivation and learning performances were explored by training students majoring in physical education to play tennis. A total of 150 students from a physical education college were selected to participate in this experimental teaching, and they were divided into the experimental group (EG) and the control group (CG). Based on the above purposes, the differences in the teaching methods and teaching objectives of the EG and the CG is that the former uses games as a key method in tennis teaching. All participants were asked to complete questionnaires, with the purpose of evaluating the learning motivation of tennis before and after sports game intervention. Additionally, the differentiated learning motivation and learning performance between EG and CG before and after experimental teaching was tested and evaluated. Results demonstrate that students in the EG have significantly increased their intrinsic motivation and introjected regulation, thereby showing better results than CG in key test items. In addition, the above result reveals the positive role of sports gamification in promoting the learning motivation and performance of college students.
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20
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Narducci E, Mouttet K, Shahbazi A, Pool D, Tan T. A Study of the Safety and Functionality of Gamified Electromyographic Biofeedback for Children with Cerebral Palsy. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:5180-5183. [PMID: 33019152 DOI: 10.1109/embc44109.2020.9175654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cerebral palsy is a neurodevelopmental condition that affects 17 million individuals worldwide. Traditionally, methods of therapy are repetitive and monotonous, generating immense difficulty in maintaining patient motivation and engagement. This project's objective was to provide a novel method of therapeutic intervention that was co-designed by therapists and had the capacity to increase patient motivation and enjoyment. The system developed incorporated the use of muscle activations retrieved from a bespoke surface electromyography subsystem, to control custom computer games to increase therapy uptake. The safety and functionality of this device was verified through a series of trials performed on adults without any muscular impairments. Furthermore, a feasibility evaluation was conducted whereby the system was demonstrated to a group of healthcare professionals to gain their feedback. The trial results confirmed the safety and functionality of the system, with professional therapists confirming its clinical potential and its perceived benefits.
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21
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Baniña MC, Molad R, Solomon JM, Berman S, Soroker N, Frenkel-Toledo S, Liebermann DG, Levin MF. Exercise intensity of the upper limb can be enhanced using a virtual rehabilitation system. Disabil Rehabil Assist Technol 2020; 17:100-106. [DOI: 10.1080/17483107.2020.1765421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Melanie C. Baniña
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Laval, Canada
| | - Roni Molad
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Laval, Canada
| | - John M. Solomon
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
- Centre for Comprehensive Stroke Rehabilitation and Research, Manipal Academy of Higher Education, Manipal, India
| | - Sigal Berman
- Department of Industrial Engineering and Management, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Zlotowski Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Nachum Soroker
- Department of Neurological Rehabilitation, Loewenstein Hospital, Ra’anana, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Silvi Frenkel-Toledo
- Department of Physiotherapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Dario G. Liebermann
- Department of Physical Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Mindy F. Levin
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Laval, Canada
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22
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Hughes CML, Padilla A, Hintze A, Raymundo TM, Sera M, Weidner S, Ontiveros J, Peng T, Encarcion A, Cruz ZA, Warner S, Sany K, Baye M. Developing an mHealth app for post-stroke upper limb rehabilitation: Feedback from US and Ethiopian rehabilitation clinicians. Health Informatics J 2019; 26:1104-1117. [PMID: 31566456 DOI: 10.1177/1460458219868356] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Stroke is the leading cause of adult disability worldwide, with 70 percent of survivors exhibiting residual impairments of the upper limb that require frequent in-person visits to rehabilitation clinic over several months. This study explored rehabilitation clinician's preferences for design features to be included in an mHealth-enabled app for post-stroke upper limb rehabilitation. Data were collected via online survey, sampling participants from Ethiopia (n = 69) and the United States (n = 75). Survey results indicated that Ethiopian and US rehabilitation clinicians have different opinions about the importance of design features that should be included in a stroke tele-rehabilitation system which are likely due to differences in culture, the availability of human and physical resources, and how the field of rehabilitation is organized and managed. Our results, thus, indicate that mHealth technologies must be tailored to the geographical and cultural context of the end users.
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23
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A Theoretical Framework and Conceptual Design for Engaging Children in Therapy at Home-The Design of a Wearable Breathing Trainer. J Pers Med 2019; 9:jpm9020027. [PMID: 31137523 PMCID: PMC6617157 DOI: 10.3390/jpm9020027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 11/20/2022] Open
Abstract
Wearable technologies are being implemented in the health and medical context with increasing frequency. Such technologies offer valuable opportunities to stimulate self-management in these domains. In this context, engagement plays a crucial role. An engaged patient is a patient who is emotionally involved and committed to the therapy or care process. Particularly for children who have to follow some sort of therapy, engagement is important to ensure a successful outcome of the therapy. To design for engagement, a framework based on theories of motivation in child therapy was developed. This framework was applied to the design of a wearable breathing trainer for children with asthma and dysfunctional breathing. As such, the present paper provides knowledge about the implementation of theory on engagement and motivation in design. Expert and first user evaluations found that the resulting prototype is appealing, perceived as useful, and may engage children in breathing training and stimulate self-management.
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24
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Turp M, González JC, Pulido JC, Fernández F. Developing a Robot-Guided Interactive Simon Game for Physical and Cognitive Training. INT J HUM ROBOT 2019. [DOI: 10.1142/s0219843619500038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Enveloping cognitive or physical rehabilitation into a game highly increases the patients’ commitment with their treatment. Specially with children, keeping them motivated is a very time-consuming work, so therapists are demanding tools to help them with this task. NAOTherapist is a generic robotic architecture that uses Automated Planning techniques to autonomously drive noncontact upper-limb rehabilitation sessions for children with a humanoid NAO robot. Our aim is to develop more robotic games for this platform to enrich its variability and possibilities of interaction. The goal of this work is to present our first attempt to develop a different, more complex game that reuses the previous architecture. We contribute with the design description of a novel robotic Simon game that employs upper-limb poses instead of colors and could qualify as a cognitive and physical training. Statistics of evaluation tests with 14 adults and 56 children are displayed and the outcomes are analyzed in terms of human–robot interaction (HRI) quality. The results demonstrate the application-domain generalization capabilities of the NAOTherapist architecture and give an insight to further analyze the therapeutic benefits of the new developed Simon game.
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Affiliation(s)
- Mısra Turp
- Computer Science Department, Universidad Carlos III de Madrid, Av. de la Universidad, 30, 28911 Leganés, Madrid, Spain
| | - José Carlos González
- Computer Science Department, Universidad Carlos III de Madrid, Av. de la Universidad, 30, 28911 Leganés, Madrid, Spain
| | - José Carlos Pulido
- Computer Science Department, Universidad Carlos III de Madrid, Av. de la Universidad, 30, 28911 Leganés, Madrid, Spain
| | - Fernando Fernández
- Computer Science Department, Universidad Carlos III de Madrid, Av. de la Universidad, 30, 28911 Leganés, Madrid, Spain
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25
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Ang ET, Chan JM, Gopal V, Li Shia N. Gamifying anatomy education. Clin Anat 2018; 31:997-1005. [PMID: 30168609 DOI: 10.1002/ca.23249] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/02/2018] [Accepted: 07/13/2018] [Indexed: 12/16/2022]
Abstract
The objective of our research is to find out if gamification increases motivation for self-directed learning (SDL) of human anatomy among year 1 medical students, and more importantly, their academic grades (n = 120). At the NUS Yong Loo Lin School of Medicine, anatomy teaching has traditionally been delivered via didactic means. To encourage more active learning, suitable games (non-digital) and the script concordance test were utilized to enhance the process. The flipped classroom approach was also introduced to further trigger active learning. In addition, the use of mobile apps (digital) was also initiated as supplements for SDL. Feedback was collected based on the previously validated PRO-SDL scale. Results from the research yielded inconclusive evidence to support enhanced motivation among our students due to gamification (P > 0.05). However, it did help to encourage active participation for a "fun learning" experience supported by numerous positive comments. More importantly, the participant's continuous assessment (CA1, CA2, and CA3) and objective specific practical exam results were better than the cohort's average (P < 0.05), suggesting that enhanced meta-cognition, and factual recall had taken place. While it is positive, there are some caveats to note with gamification, first and foremost, that it is tutor dependent. Taken together, gamification could represent a new paradigm for anatomy education, and also an opportune time to change the prevailing culture in the healthcare and education industry. Clin. Anat. 31:997-1005, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Eng Tat Ang
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jia Min Chan
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Vik Gopal
- Department of Statistics and Applied Probability, National University of Singapore, Singapore
| | - Ng Li Shia
- Department of Otolaryngology, National University Hospital, Singapore
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26
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Hara M, Kitamura T, Murakawa Y, Shimba K, Yamaguchi S, Tamaki M. Safety and Feasibility of Dual-task Rehabilitation Program for Body Trunk Balance Using Virtual Reality and Three-dimensional Tracking Technologies. Prog Rehabil Med 2018; 3:20180016. [PMID: 32789241 DOI: 10.2490/prm.20180016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 10/15/2018] [Indexed: 01/27/2023] Open
Abstract
Objective The ability to walk is one of the most important basic functional activities of daily living, and the number of patients with walking disability who need rehabilitation is increasing worldwide. The purpose of this first-in-man study was to evaluate the safety and feasibility of an off-label, tailor-made, dual-task rehabilitation program for body trunk balance using the mediVR01 system (mediVR, Inc. Osaka, Japan), which incorporates virtual reality (VR) and three-dimensional tracking technologies. Methods We prospectively enrolled 31 healthy volunteers to take part in the trial (Trial Registration UMIN000029659). After an assessment of body trunk balance, a tailor-made, dual-task, rehabilitation training program lasting 10-15 min was provided. The primary endpoint was the postprocedural number of simulator sickness questionnaire (SSQ) symptoms. The secondary endpoints were adverse events and satisfaction with the program. Results The median age of participants was 68 years, with 67.7% being elderly (>65 years) and 54.8% being male. The number of SSQ symptoms immediately after the rehabilitation programs significantly increased from 0 (interquartile range 0-0) to 0 (0-1.5) (P=0.009), with a significant difference between the young and elderly participants (P-interaction<0.001). The most frequent symptom was sweating (22.6%), followed by fatigue (19.4%). All participants successfully completed the rehabilitation programs without significant adverse events such as fall or injuries. Moreover, all participants considered the VR rehabilitation programs to be enjoyable, and 93.5% of participants reported a sense of achievement. Group attendance was associated with higher levels of satisfaction (P=0.049). Conclusion The tailor-made, dual-task rehabilitation training programs for body trunk balance using VR and three-dimensional tracking technologies were safe and feasible even for elderly participants.
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Affiliation(s)
- Masahiko Hara
- Center for Community-based Healthcare Research and Education, Shimane University, Izumo, Japan.,Department of Medical Device Development, mediVR, Inc., Osaka, Japan
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yuichiro Murakawa
- Division of Stroke Rehabilitation, National Cerebral and Cardiovascular Center Hospital, Suita, Japan
| | - Kyosuke Shimba
- Department of Medical Device Development, mediVR, Inc., Osaka, Japan
| | - Shimpei Yamaguchi
- Department of Medical Device Development, mediVR, Inc., Osaka, Japan
| | - Masatake Tamaki
- Department of Medical Device Development, mediVR, Inc., Osaka, Japan
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27
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Clutterbuck G, Auld M, Johnston L. Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy: a systematic review. Disabil Rehabil 2018; 41:1131-1151. [PMID: 29303007 DOI: 10.1080/09638288.2017.1422035] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE Evaluate effectiveness of active exercise interventions for improving gross motor activity/participation of school-aged, ambulant/semi-ambulant children with cerebral palsy (CP). METHOD A systematic review was conducted following PRISMA guidelines. Five databases were searched for papers including school-aged children with CP, participating in active, exercise interventions with gross motor outcomes measured at the Activity/Participation level. Interventions with previous systematic reviews were excluded (e.g. hippotherapy). Evidence Level and conduct were examined by two raters. RESULTS Seven interventions (34 studies) met criteria. All studies reported on gross motor function, however, a limited number investigated participation outcomes. Strong positive evidence was available for Gross Motor Activity Training (n= 6, Evidence Level II-IV), and Gross Motor Activity Training with progressive resistance exercise plus additional physiotherapy (n = 3, all Evidence Level II). Moderate positive evidence exists for Gross Motor Activity Training plus additional physiotherapy (n = 2, all Evidence Level II) and Physical Fitness Training (n = 4, Evidence Level II-V). Weak positive evidence was available for Modified Sport (n = 3, Evidence Level IV-V) and Non-Immersive Virtual Reality (n = 12, Evidence Level II-V). There was strong evidence against Gross Motor Activity Training plus progressive resistance exercise without additional physiotherapy (n = 4, all Evidence Level II). INTERPRETATION Active, performance-focused exercise with variable practice opportunities improves gross motor function in ambulant/semi-ambulant children with CP. Implications for rehabilitation Active exercise interventions improve gross motor function of ambulant/semi-ambulant children with cerebral palsy. Gross Motor Activity Training is the most common and effective intervention. Practice variability is essential to improve gross motor function. Participation was rarely measured and requires further research, particularly in interventions that embed real-world participation opportunities like Modified Sport.
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Affiliation(s)
- Georgina Clutterbuck
- a School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia.,b The Cerebral Palsy League , Brisbane , Australia
| | - Megan Auld
- a School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia.,b The Cerebral Palsy League , Brisbane , Australia
| | - Leanne Johnston
- a School of Health and Rehabilitation Sciences , University of Queensland , Brisbane , Australia
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