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Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation
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Summary March 8th, 2018
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.
Transcript
The overall goal of this program is to provide a mobile game-based upper extremity virtual reality program using a combination of two mobile devices, a smartphone and tablet PC, for patients with stroke. This method can help answer key questions in the u-healthcare field regarding home-based telerehabilitation. The main advantage of this technique is that mobile game-based upper extremity virtual reality programs can provide an inexpensive, ubiquitous, motivating, and interesting treatment for stroke patients.
The implications of this technique centers toward rehabilitation therapy because a mobile game-based upper extremity program can solve the problems faced by patients who have difficulty traveling to a clinic due to transportation, time, cost, or stroke impairment. Begin by escorting the participant into the therapy room, and have them sit at the desk. Place the tablet PC on the desk, and turn it on.
Next, turn on the smartphone, as well as the short-distance wireless connection on the smartphone. Choose the game application on the tablet by touching the screen. Then, put the smartphone in the armband, and attach the armband to the upper arm or forearm of the participant, depending on the desired movement.
Choose either the basic or the customized version of the game. Then, according to the participant's ability, select the game speed, time, a number of target movements, and the expected achievement of the game on the touchscreen of the tablet PC on the customized version. Instruct the participant to move their body according to the commands of the game, allowing the maximal range of motion for calibration.
Then, have them press the start button to begin. Track the participant's upper extremity movements using the built-in sensors of the smartphone, and transfer information about the movement to the tablet PC through the short-distance wireless connection. Provide visual and auditory feedback for the participant on their movement with the display on the tablet PC.Demonstrate the real achievement of the game as compared with the expected achievement at the end of the game.
Finally, observe the participant playing the game. For the Honey Pot Guard game, begin by asking the participant to beat a bear from the honey pot by throwing apples using the movement of the elbow joint. Let the participant throw apples when the flexed elbow is extended.
Next, for the Protect the Bunny game, ask the participant to protect the bunny by catching stones with the net using the movement of the shoulder joint. Ensure that the net moves when the adducted shoulder is abducted. Following that, for the Put Out Fire game, ask the participant to put the fire out with the water hose through the window, which is controlled via the motion of the shoulder.
Ensure that the water hose moves right and left and up and down corresponding to the motion of the shoulder joint. Lastly, for the Flower Splash game, have the participant use their joint motion to water the moving seed with a watering can and make the flowers blossom. A greater improvement in the Fugl-Meyer Assessment of the upper extremity, Brunnstrom stage, and manual muscle testing was found after treatment with the mobile game-based VR upper extremity rehabilitation program than with conventional therapy.
Participants in the experimental group completed the two-week treatment without adverse effects and were generally satisfied based on the provided questionnaire, even though participants had various levels of technology familiarity. While attempting this procedure, it is important to remember to target the desired movement of the upper extremity with special consideration for accompanying problems related to stroke, such as hemiplegic shoulder pain and spasticity. Don't forget that working with this program in a home setting requires monitoring a patient's adherence to the program, and continuous, immediate feedback related to performance should be given to increase interest in motivation in rehabilitation therapy.
After its development, this technique paved the way for researchers in the field of rehabilitation by exploring the efficacy and feasibility of a mobile rehabilitation program for the recovery of upper limb function in patients with stroke. After watching this video, you should have a good understanding of how to design and deliver a mobile rehabilitation program. that is, increase the hours of repetitive, goal-oriented therapy without increasing costly therapy time or requiring expensive equipment.
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