Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Summary

Here, we present a protocol to develop and apply a mobile game-based virtual reality program for the recovery of upper limb dysfunction in patients with stroke. The present study shows that the mobile program is feasible and effectively promotes upper limb recovery in stroke patients.

Abstract

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. Game-based therapy can promote patients' engagement in rehabilitation therapy as a more interesting and a motivating tool. Mobile devices such as smartphones and tablet PCs can provide personalized home-based therapy with interactive communication between patients and clinicians. In this study, a mobile VR upper extremity rehabilitation program using game applications was developed. The findings from the study show that the mobile game-based VR program effectively promotes upper extremity recovery in patients with stroke. In addition, patients completed two weeks of treatment using the program without adverse effects and were generally satisfied with the program. This mobile game-based VR upper extremity rehabilitation program can substitute for some parts of the conventional therapy that are delivered one-on-one by an occupational therapist. This time-efficient, easy to implement, and clinically effective program would be a good candidate tool for tele-rehabilitation for upper extremity recovery in patients with stroke. Patients and therapists can collaborate remotely through these e-health rehabilitation programs while reducing economic and social costs.

Introduction

Stroke is one of the most common causes of neurological impairment in adults. Recovery from impairment after a stroke is usually incomplete, and approximately 50% of patients are left with disabilities, making them dependent on others¹. In particular, upper limb dysfunction makes stroke survivors dependent on others for assistance with activities of daily living (ADL)². Regaining the lost function in the upper extremities may be more difficult to achieve than returning the normal function of ambulation to the lower extremities. Although bilateral lower extremity movement is indispensable for locomotion, patients can perf....

Protocol

The study was approved by the Seoul National University Bundang Hospital Institutional Review Board, and all participants gave written informed consent before screening.

1. Game Contents Development

NOTE: The mobile game-based upper extremity virtual reality program for patients with stroke (MoU-Rehab) consists of mobile game applications.

1. Install the studio and environment for development using a programing language.
2. Collect data on x, y and z-axis locations of patients' movements through the built-in sensors of the smartphone.
3. Allocate storage for data on the motion, ....

Results

A total of 24 patients were enrolled and assigned to either the control or the experimental group (Table 1). A greater improvement in the FMA-UE, B-stage, and manual muscle testing was found after treatment with the mobile game-based VR upper extremity rehabilitation program than with conventional therapy (Figure 3). The effect was maintained until the one-month follow-up. This means MoU-Rehab was not inferior to the conventional therapy that.......

Discussion

Patients with stroke usually have disabilities related to motor impairments due to incomplete motor recovery. Such disabilities, lengthy travel time to a clinic, or socioeconomic difficulties can hinder patients' access to adequate rehabilitation therapy. A ubiquitous healthcare (u-Health) program can be a good option for removing those barriers. As a part of such a u-Health program, a mobile game-based VR rehabilitation program was developed for upper limb recovery after ischemic stroke in the present study. Our fin.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Galaxy Note 10.0	Samsung	Galaxy Note 10.0	Tablet PC
Galaxy S2	Samsung	Galaxy S2	Smartphone
Bluetooth	Bluetooth SIG	Bluetooth	short-distance wireless connection
Java	Oracle	Java	programming language