Differences in Physiological Reactions Due to a Competitive Rehabilitation Game Modality

A Multimodal Software Architecture for Serious Exergames and Its Use in Respiratory Rehabilitation

Serious Exergames (SEGs) have been little concerned with flexibility/equivalence, complementarity, and monitoring (functionalities of systems that deal with a wide variety of inputs). These functionalities are necessary for health SEGs due to the variety of treatments and measuring requirements. No known SEG architectures include these three functionalities altogether. In this paper, we present the 123-SGR software architecture for the creation of an SEG that is appropriate to the needs of professionals and patients in the area of rehabilitation. An existing SEG was adapted and therapy-related sensor devices (Pneumotachograph, Manovacuometer, Pressure Belt, and Oximeter) were built to help the patient interact with the SEG. The architecture allows the most varied input combinations, with and without fusion, and these combinations are possible for both conscious and unconscious signals. Health and Technology professionals have assessed the SEG and found that it had the functionalities of flexibility/equivalence, complementarity, and monitoring, and that these are really important and necessary functionalities. The 123-SGR architecture can be used as a blueprint for future SEG development.

Influence of Robotic Therapy on Severe Stroke Patients

Robotic rehabilitation has emerged as a promising approach to enhance motor recovery after stroke, but there is limited knowledge about its efficacy in individuals who have experienced severe stroke. The study presented in this paper aims to analyze the effect of robotic therapy on the recovery of patients with severe stroke when combined with conventional rehabilitation therapies, and we want to observe whether there is a relationship between the clinical assessment provided by the therapist and the data recorded by the robotic device. Participants were divided into an experimental group and a control group, both receiving 15 sessions of conventional therapy in three consecutive weeks, but the experimental group underwent three out of five sessions per week with a robotic device. Both groups were evaluated using clinical scales, and in addition the experimental group was evaluated using an assessment game incorporated in the robotic device that provides session data such as the level of assistance needed by each user to complete the activity, or the score obtained in the game. These preliminary results showed that patients who received robot-assisted therapy had better motor function recovery compared to those who only received conventional therapy. In addition, it is also observed that the robot assistance needed by patients in the experimental group decreased as the sessions progressed, suggesting that robot-assisted therapy could be an effective tool for severe stroke patients.

Patients' physiological reactions to competitive rehabilitation therapies assisted by robotic devices

BACKGROUND

The aging of the population and the progressive increase in life expectancy in developed countries is leading to a high incidence of cerebrovascular diseases. Several studies have demonstrated that robot-assisted rehabilitation therapies combined with serious games can improve rehabilitation outcomes. Social interaction in the form of multiplayer games has been highlighted as a potential element to increase patient's motivation and exercise intensity, which professionals have described as one of the determining factors in maximizing rehabilitation outcomes. Despite this, it has not been widely studied. Physiological measures have been proven as an objective tool to evaluate patients' experience in robot-assisted rehabilitation environments. However, they have not been used to evaluate patients' experience in multiplayer robot-assisted rehabilitation therapies. The main objective of this study is to analyze whether the interpersonal interaction inherent in a competitive game mode affects the patients' physiological responses in robot-assisted rehabilitation environments.

METHODS

A total of 14 patients participated in this study. The results of a competitive game mode were compared with a single-player game mode with different difficulty levels. Exercise intensity and performance were measured through parameters extracted from the game and the information provided by the robotic rehabilitation platforms. The physiological response of patients in each game mode was measured by the heart rate (HR) and the galvanic skin response (GSR). Patients were asked to fill out the IMI and the overall experience questionnaire.

RESULTS

The exercise intensity results show that high-difficulty single-player game mode is similar in terms of intensity level to a competitive game mode, based on velocity values, reaction time and questionnaire results. However, the results of the physiological responses of the patients measured by GSR and HR are lower in the case of the competitive mode compared to the high-difficulty single-player game mode, obtaining results similar to those obtained in the low-difficulty single-player game mode.

CONCLUSIONS

Patients find the competitive game mode the most fun, which is also the mode they report experiencing the most effort and stress level. However, this subjective evaluation is not in line with the results of physiological responses. This study concludes that interpersonal interaction inherent to a competitive game mode influences patients' physiological responses. This could mean that social interaction is an important factor to consider when interpreting the results obtained from physiological measurements.

Development of a single actuator exoskeleton for wrist and forearm rehabilitation

Recent estimations state that the absolute number of strokes will increase in the future. For this reason, novel rehabilitation therapies, such as robot-assisted therapy, are essential to speed up patient recovery. This paper describes the design, development, and control aspects of a light-exoskeleton addressing forearm and wrist motions using one actuator. Besides, usability pilot study results are presented.