A Game-Based Virtualized Reality Approach for Simultaneous Rehabilitation of Motor Skill and Confidence

Virtualized reality games offer highly interactive and engaging user experience and therefore game-based approaches (GBVR) may have significant potential to enhance clinical rehabilitation practice as traditional therapeutic exercises are often repetitive and boring, reducing patient compliance. The aim of this study was to investigate if a rehabilitation training programme using GBVR could simultaneously improve both motor skill (MS) and confidence (CON), as they are both important determinants of daily living and physical and social functioning. The study was performed using a nondominant hand motor deficit model in nonambidextrous healthy young adults, whereby dominant and nondominant arms acted as control and intervention conditions, respectively. GBVR training was performed using a commercially available tennis-based game. CON and MS were assessed by having each subject perform a comparable real-world motor task (RWMT) before and after training. Baseline CON and MS for performing the RWMT were significantly lower for the nondominant hand and improved after GBVR training, whereas there were no changes in the dominant (control) arm. These results demonstrate that by using a GBVR approach to address a MS deficit in a real-world task, improvements in both MS and CON can be facilitated and such approaches may help increase patient compliance.

[1]  D. Cervone Randomization tests to determine significance levels for microanalytic congruences between self-efficacy and behavior , 1985, Cognitive Therapy and Research.

[2]  J. McComas,et al.  Benefits of activity and virtual reality based balance exercise programmes for adults with traumatic brain injury: Perceptions of participants and their caregivers , 2005, Brain injury.

[3]  J.E. Deutsch,et al.  Technical and Patient Performance Using a Virtual Reality-Integrated Telerehabilitation System: Preliminary Finding , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[4]  Ian Bogost,et al.  Persuasive Games: The Expressive Power of Videogames , 2007 .

[5]  Grigore C. Burdea,et al.  Guest Editorial Special Theme on Virtual Rehabilitation , 2007 .

[6]  M. Holden,et al.  Telerehabilitation Using a Virtual Environment Improves Upper Extremity Function in Patients With Stroke , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[7]  A. Rizzo,et al.  Game-based telerehabilitation. , 2009, European journal of physical and rehabilitation medicine.

[8]  Heidi Sveistrup,et al.  An Intensive Virtual Reality Program Improves Functional Balance and Mobility of Adolescents With Cerebral Palsy , 2011, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[9]  Mi Young Lee,et al.  Cortical reorganization associated lower extremity motor recovery as evidenced by functional MRI and diffusion tensor tractography in a stroke patient. , 2005, Restorative neurology and neuroscience.

[10]  L. Zollo,et al.  Robotic technologies and rehabilitation: new tools for upper-limb therapy and assessment in chronic stroke. , 2011, European journal of physical and rehabilitation medicine.

[11]  David M Brennan,et al.  Human factors in the development and implementation of telerehabilitation systems , 2008, Journal of telemedicine and telecare.

[12]  Heidi Sveistrup,et al.  Motor rehabilitation using virtual reality , 2004, Journal of NeuroEngineering and Rehabilitation.

[13]  R. C. Oldfield The assessment and analysis of handedness: the Edinburgh inventory. , 1971, Neuropsychologia.

[14]  Trevor G Russell,et al.  Physical rehabilitation using telemedicine , 2007, Journal of telemedicine and telecare.

[15]  Grigore C. Burdea,et al.  A virtual-reality-based telerehabilitation system with force feedback , 2000, IEEE Transactions on Information Technology in Biomedicine.

[16]  Alasdair G. Thin,et al.  Flow Experience and Mood States While Playing Body Movement-Controlled Video Games , 2011, Games Cult..

[17]  G. Burdea,et al.  Telerehabilitation Using the Rutgers Master II Glove Following Carpal Tunnel Release Surgery: Proof-of-Concept , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[18]  M. Tinetti,et al.  Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. , 1994, Journal of gerontology.

[19]  Gerard Jounghyun Kim,et al.  A SWOT Analysis of the Field of Virtual Reality Rehabilitation and Therapy , 2005, Presence: Teleoperators & Virtual Environments.

[20]  Heidi Sveistrup,et al.  Feasibility, Motivation, and Selective Motor Control: Virtual Reality Compared to Conventional Home Exercise in Children with Cerebral Palsy , 2006, Cyberpsychology Behav. Soc. Netw..

[21]  Sue Cobb,et al.  Design and Development of a Virtual-Reality Based System for Improving Vision in Children with Amblyopia , 2011 .

[22]  John L. Sherry Flow and Media Enjoyment , 2004 .

[23]  M. Levin,et al.  Virtual Reality in Stroke Rehabilitation: A Meta-Analysis and Implications for Clinicians , 2011, Stroke.

[24]  Zahra Moussavi,et al.  Effects of an Interactive Computer Game Exercise Regimen on Balance Impairment in Frail Community-Dwelling Older Adults: A Randomized Controlled Trial , 2011, Physical Therapy.

[25]  A Bandura,et al.  Cognitive processes mediating behavioral change. , 1977, Journal of personality and social psychology.

[26]  E. Tunik,et al.  Innovative approaches to the rehabilitation of upper extremity hemiparesis using virtual environments. , 2009, European journal of physical and rehabilitation medicine.

[27]  Rachel Proffitt,et al.  Development of an Interactive Game-Based Rehabilitation Tool for Dynamic Balance Training , 2010, Topics in stroke rehabilitation.

[28]  Andrew K. Przybylski,et al.  The Motivational Pull of Video Games: A Self-Determination Theory Approach , 2006 .

[29]  Henk J Stam,et al.  Energy expenditure in chronic stroke patients playing Wii Sports: a pilot study , 2011, Journal of NeuroEngineering and Rehabilitation.

[30]  D. Theodoros,et al.  Telerehabilitation: current perspectives. , 2008, Studies in health technology and informatics.

[31]  Hunter G Hoffman,et al.  The Effect of Virtual Reality on Pain and Range of Motion in Adults With Burn Injuries , 2009, Journal of burn care & research : official publication of the American Burn Association.

[32]  P. Lehoux,et al.  A systematic review of clinical outcomes, clinical process, healthcare utilization and costs associated with telerehabilitation , 2009, Disability and rehabilitation.