Arzu Guneysu Ozgur
Maximilian Jonas Wessel
Wafa Johal
ABSTRACT
Rehabilitation aims to ameliorate deficits in motor control via intensive practice with the affected limb. Current strategies, such as one-on-one therapy done in rehabilitation centers, have limitations such as treatment frequency and intensity, cost and requirement of mobility. Thus, a promising strategy is home-based therapy that includes task specific exercises. However, traditional rehabilitation tasks may frustrate the patient due to their repetitive nature and may result in lack of motivation and poor rehabilitation. In this article, we propose the design and verification of an effective upper extremity rehabilitation game with a tangible robotic platform named Cellulo as a novel solution to these issues. We first describe the process of determining the design rationales to tune speed, accuracy and challenge. Then we detail our iterative participatory design process and test sessions conducted with the help of stroke, brachial plexus and cerebral palsy patients (18 in total) and 7 therapists in 4 different therapy centers. We present the initial quantitative results, which support several aspects of our design rationales and conclude with our future study plans.
Supplemental Material
- R. Aarhus, E. Grönvall, S.B. Larsen, and S. Wollsen. Turning training into play: Embodied gaming, seniors, physical training and motivation. Gerontechnology, 10(2):110--120, 2011.Google Scholar
Cross Ref
- G. Alankus, A. Lazar, M. May, and C. Kelleher. Towards customizable games for stroke rehabilitation. In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, pages 2113--2122. ACM, 2010. Google ScholarDigital Library
- T. Apted, J. Kay, and A. Quigley. Tabletop sharing of digital photographs for the elderly. In Proceedings of the SIGCHI conference on Human Factors in computing systems, pages 781--790. ACM, 2006. Google ScholarDigital Library
- L. Axelrod, G. Fitzpatrick, J. Burridge, S. Mawson, P. Smith, T. Rodden, and I. Ricketts. The reality of homes fit for heroes: design challenges for rehabilitation technology at home. Journal of Assistive Technologies, 3(2):35--43, 2009.Google ScholarCross Ref
- B. Bonnechère, B. Jansen, L. Omelina, J. Van Sint, et al. The use of commercial video games in rehabilitation: a systematic review. International journal of rehabilitation research, 39(4):277--290, 2016.Google Scholar
- B. Bonnechère, B. Jansen, L. Omelina, and S. Van Sint Jan. Do patients perform their exercises at home and why (not)? a survey on patients' habits during rehabilitation exercises. Ulutas Med J, 2:41--6, 2016.Google ScholarCross Ref
- J.W. Burke, M. McNeill, D. Charles, P.J. Morrow, J. Crosbie, and S. McDonough. Augmented reality games for upper-limb stroke rehabilitation. In Games and Virtual Worlds for Serious Applications (VS-GAMES), 2010 Second International Conference on, pages 75--78. IEEE, 2010. Google ScholarDigital Library
- J.W. Burke, M. McNeill, D.K. Charles, P.J. Morrow, J.H. Crosbie, and S.M. McDonough. Optimising engagement for stroke rehabilitation using serious games. The Visual Computer, 25(12):1085, 2009. Google ScholarDigital Library
- M.S. Cameirao, I.B.S. Bermúdez, E. Duarte Oller, and P.F. Verschure. The rehabilitation gaming system: a review. Stud Health Technol Inform, 145(6), 2009.Google Scholar
- M.S. Cameirão, S.B. i Badia, E.D. Oller, and P.F. Verschure. Neurorehabilitation using the virtual reality based rehabilitation gaming system: methodology, design, psychometrics, usability and validation. Journal of neuroengineering and rehabilitation, 7(1):48, 2010.Google Scholar
- M.S. Cameirão, S.B. i Badia, L. Zimmerli, E.D. Oller, and P.F. Verschure. The rehabilitation gaming system: a virtual reality based system for the evaluation and rehabilitation of motor deficits. In Virtual Rehabilitation, 2007, pages 29--33. IEEE, 2007.Google ScholarCross Ref
- J.H. Cauraugh and J.J. Summers. Neural plasticity and bilateral movements: a rehabilitation approach for chronic stroke. Progress in neurobiology, 75(5):309--320, 2005.Google ScholarCross Ref
- J. Crosbie, S. Lennon, M. McGoldrick, M. McNeill, and S. McDonough. Virtual reality in the rehabilitation of the arm after hemiplegic stroke: a randomized controlled pilot study. Clinical Rehabilitation, 26(9):798--806, 2012.Google ScholarCross Ref
- J.J. Daly, N. Hogan, E.M. Perepezko, H.I. Krebs, et al. Response to upper-limb robotics and functional neuromuscular stimulation following stroke. Journal of rehabilitation research and development, 42(6):723, 2005.Google Scholar
- M.P. Dijkers, R. Erlandson, K. Kristy, D. Geer, A. Nichols, et al. Patient and staff acceptance of robotic technology in occupational therapy: a pilot study. Journal of rehabilitation research and development, 28(2):33, 1991.Google Scholar
- L.R.A. Dos Santos, A.A. Carregosa, M.R. Masruha, P.A. Dos Santos, M.L.D.S. Coêlho, D.D. Ferraz, and N.M.D.S. Ribeiro. The use of nintendo wii in the rehabilitation of poststroke patients: a systematic review. Journal of Stroke and Cerebrovascular Diseases, 24(10):2298--2305, 2015.Google ScholarCross Ref
- S.E. Fasoli, H.I. Krebs, J. Stein, W.R. Frontera, and N. Hogan. Effects of robotic therapy on motor impairment and recovery in chronic stroke. Archives of physical medicine and rehabilitation, 84(4):477--482, 2003.Google Scholar
- S.E. Fasoli, H.I. Krebs, J. Stein, W.R. Frontera, R. Hughes, and N. Hogan. Robotic therapy for chronic motor impairments after stroke: Follow-up results. Archives of physical medicine and rehabilitation, 85(7):1106--1111, 2004.Google Scholar
- G. Fitzpatrick, M. Balaam, and S.R. Egglestone. Involving stroke survivors in designing for rehabilitation at home. Therapeutic Strategies A Challenge for User Involvement in Design, page 13, 2010.Google Scholar
- F. Garcia-Sanjuan, J. Jaen, and V. Nacher. Tangibot: a tangible-mediated robot to support cognitive games for ageing people usability study. Pervasive and Mobile Computing, 34:91--105, 2017. Google ScholarDigital Library
- K.M. Gerling, F.P. Schulte, and M. Masuch. Designing and evaluating digital games for frail elderly persons. In Proceedings of the 8th international conference on advances in computer entertainment technology, page 62. ACM, 2011. Google ScholarDigital Library
- C. Grefkes and N.S. Ward. Cortical reorganization after stroke: how much and how functional? The Neuroscientist, 20(1):56--70, 2014.Google ScholarCross Ref
- M.K. Holden. Virtual environments for motor rehabilitation. Cyberpsychology & behavior, 8(3):187--211, 2005.Google ScholarCross Ref
- J.A. Hosp and A.R. Luft. Cortical plasticity during motor learning and recovery after ischemic stroke. Neural plasticity, 2011, 2011.Google Scholar
- J.K. Hsu, R. Thibodeau, S.J. Wong, D. Zukiwsky, S. Cecile, and D.M. Walton. A "wii" bit of fun: The effects of adding nintendo wii® bowling to a standard exercise regimen for residents of long-term care with upper extremity dysfunction. Physiotherapy Theory and Practice, 27(3):185--193, 2011.Google ScholarCross Ref
- M. Hudson. Applying exergaming input to standard commercial digital games. In Proceedings of the 2016 CHI Conference Extended Abstracts on Human Factors in Computing Systems, pages 1886--1895. ACM, 2016. Google ScholarDigital Library
- Y.-X. Hung, P.-C. Huang, K.-T. Chen, and W.-C. Chu. What do stroke patients look for in game-based rehabilitation: a survey study. Medicine, 95(11), 2016.Google Scholar
- M.J. Johnson. Recent trends in robot-assisted therapy environments to improve real-life functional performance after stroke. Journal of NeuroEngineering and Rehabilitation, 3(1):29, 2006.Google ScholarCross Ref
- L.Y. Joo, T.S. Yin, D. Xu, E. Thia, P.F. Chia, C.W.K. Kuah, and K.K. He. A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke. Journal of rehabilitation medicine, 42(5):437--441, 2010.Google Scholar
- H. Kim, L.M. Miller, I. Fedulow, M. Simkins, G.M. Abrams, N. Byl, and J. Rosen. Kinematic data analysis for post-stroke patients following bilateral versus unilateral rehabilitation with an upper limb wearable robotic system. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 21(2):153--164, 2013.Google ScholarCross Ref
- H.I. Krebs, S. Mernoff, S.E. Fasoli, R. Hughes, J. Stein, and N. Hogan. A comparison of functional and impairment-based robotic training in severe to moderate chronic stroke: a pilot study. NeuroRehabilitation, 23(1):81--87, 2008.Google ScholarCross Ref
- H.I. Krebs, B.T. Volpe, M. Ferraro, S. Fasoli, J. Palazzolo, B. Rohrer, L. Edelstein, and N. Hogan. Robot-aided neurorehabilitation: from evidence-based to science-based rehabilitation. Topics in stroke rehabilitation, 8(4):54--70, 2002.Google Scholar
- J.A. Kumar, M. Binal Motawar PT, and K. Lakshminarayanan. Usability evaluation of low-cost virtual reality hand and arm rehabilitation games. Journal of rehabilitation research and development, 53(3):321, 2016.Google Scholar
- K.E. Laver, S. George, S. Thomas, J.E. Deutsch, and M. Crotty. Virtual reality for stroke rehabilitation. The Cochrane Library, 2015.Google ScholarCross Ref
- A.C. Lo, P.D. Guarino, L.G. Richards, J.K. Haselkorn, G.F. Wittenberg, D.G. Federman, R.J. Ringer, T.H. Wagner, H.I. Krebs, B.T. Volpe, et al. Robot-assisted therapy for long-term upper-limb impairment after stroke. New England Journal of Medicine, 362(19):1772--1783, 2010.Google ScholarCross Ref
- M. Ma and K. Bechkoum. Serious games for movement therapy after stroke. In Systems, Man and Cybernetics, 2008. SMC 2008. IEEE International Conference on, pages 1872--1877. IEEE, 2008.Google Scholar
- P. Maciejasz, J. Eschweiler, K. Gerlach-Hahn, A. Jansen-Troy, and S. Leonhardt. A survey on robotic devices for upper limb rehabilitation. Journal of neuroengineering and rehabilitation, 11(1):3, 2014.Google Scholar
- T. Nef, G. Quinter, R. Müller, and R. Riener. Effects of arm training with the robotic device armin i in chronic stroke: three single cases. Neurodegenerative diseases, 6(5--6):240--251, 2009.Google Scholar
- Nintendo. Wii health and safety precautions.Google Scholar
- D. Novak, A. Nagle, U. Keller, and R. Riener. Increasing motivation in robot-aided arm rehabilitation with competitive and cooperative gameplay. Journal of neuroengineering and rehabilitation, 11(1):64, 2014.Google Scholar
- O. ONeil, C. Gatzidis, and I. Swain. A state of the art survey in the use of video games for upper limb stroke rehabilitation. In Virtual, Augmented Reality and Serious Games for Healthcare 1, pages 345--370. Springer, 2014.Google Scholar
- A. Özgür, W. Johal, F. Mondada, and P. Dillenbourg. Haptic-enabled handheld mobile robots: Design and analysis. In Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems, pages 2449--2461. ACM, 2017. Google ScholarDigital Library
- T. Park, C. Yoo, S.P. Choe, B. Park, and J. Song. Transforming solitary exercises into social exergames. In Proceedings of the ACM 2012 conference on Computer Supported Cooperative Work, pages 863--866. ACM, 2012. Google ScholarDigital Library
- D. Rand, R. Kizony, and P.T.L. Weiss. The sony playstation ii eyetoy: low-cost virtual reality for use in rehabilitation. Journal of neurologic physical therapy, 32(4):155--163, 2008.Google Scholar
- R. Sanchez, D. Reinkensmeyer, P. Shah, J. Liu, S. Rao, R. Smith, S. Cramer, T. Rahman, and J. Bobrow. Monitoring functional arm movement for home-based therapy after stroke. In Engineering in Medicine and Biology Society, 2004. IEMBS'04. 26th Annual International Conference of the IEEE, volume 2, pages 4787--4790. IEEE, 2004.Google ScholarCross Ref
- G. Saposnik, M. Levin, S.O.R.C.S.W. Group, et al. Virtual reality in stroke rehabilitation. Stroke, 42(5):1380--1386, 2011.Google ScholarCross Ref
- G. Saposnik, R. Teasell, M. Mamdani, J. Hall, W. McIlroy, D. Cheung, K.E. Thorpe, L.G. Cohen, M. Bayley, et al. Effectiveness of virtual reality using wii gaming technology in stroke rehabilitation. Stroke, 41(7):1477--1484, 2010.Google ScholarCross Ref
- M. Shaughnessy, B.M. Resnick, and R.F. Macko. Testing a model of post-stroke exercise behavior. Rehabilitation nursing, 31(1):15--21, 2006.Google ScholarCross Ref
- M.M. Shoja, R.S. Tubbs, A. Malekian, A.H.J. Rouhi, M. Barzgar, and W.J. Oakes. Video game epilepsy in the twentieth century: a review. Child's Nervous System, 23(3):265--267, 2007.Google ScholarCross Ref
- P. Staubli, T. Nef, V. Klamroth-Marganska, and R. Riener. Effects of intensive arm training with the rehabilitation robot armin ii in chronic stroke patients: four single-cases. Journal of neuroengineering and rehabilitation, 6(1):46, 2009.Google Scholar
- K. Thomson, A. Pollock, C. Bugge, and M. Brady. Commercial gaming devices for stroke upper limb rehabilitation: a systematic review. International Journal of Stroke, 9(4):479--488, 2014.Google ScholarCross Ref
- K. Thomson, A. Pollock, C. Bugge, and M.C. Brady. Commercial gaming devices for stroke upper limb rehabilitation: a survey of current practice. Disability and Rehabilitation: Assistive Technology, 11(6):454--461, 2016.Google Scholar
- B. Ullmer and H. Ishii. Emerging frameworks for tangible user interfaces. IBM systems journal, 39(3.4):915--931, 2000. Google ScholarDigital Library
- A. Van Delden, C.L.E. Peper, G. Kwakkel, and P.J. Beek. A systematic review of bilateral upper limb training devices for poststroke rehabilitation. Stroke research and treatment, 2012, 2012.Google Scholar
- J.H. Van der Lee, R.C. Wagenaar, G.J. Lankhorst, T.W. Vogelaar, W.L. Devillé, and L.M. Bouter. Forced use of the upper extremity in chronic stroke patients. Stroke, 30(11):2369--2375, 1999.Google ScholarCross Ref
- M. Vandermaesen, T. De Weyer, K. Luyten, and K. Coninx. Physicube: providing tangible interaction in a pervasive upper-limb rehabilitation system. In Proceedings of the 8th International Conference on Tangible, Embedded and Embodied Interaction, pages 85--92. ACM, 2014. Google ScholarDigital Library
- P. Wang, G.C.H. Koh, C.G. Boucharenc, T.M. Xu, C.C. Yen, et al. Developing a tangible gaming board for post-stroke upper limb functional training. In Proceedings of the Tenth International Conference on Tangible, Embedded, and Embodied Interaction, pages 617--624. ACM, 2017. Google ScholarDigital Library
- J. Whitall, S.M. Waller, K.H. Silver, and R.F. Macko. Repetitive bilateral arm training with rhythmic auditory cueing improves motor function in chronic hemiparetic stroke. Stroke, 31(10):2390--2395, 2000.Google ScholarCross Ref
- H. Woldag and H. Hummelsheim. Evidence-based physiotherapeutic concepts for improving arm and hand function in stroke patients: a review. Journal of neurology, 249(5), 2002.Google Scholar
- G. Yavuzer, A. Senel, M. Atay, and H. Stam. "playstation eyetoy games" improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial. European journal of physical and rehabilitation medicine, 44(3):237--244, 2008.Google Scholar
Index Terms
- Iterative Design of an Upper Limb Rehabilitation Game with Tangible Robots
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