Robotic Rehabilitation Game Design for Chronic Stroke.

OBJECTIVE This study investigates games intended for use with an upper-limb exoskeleton robot operated unilaterally and bilaterally. Games are evaluated in terms of usability and preference for stroke survivors. Game design considerations relating to the human to machine interface, are also discussed. SUBJECTS AND METHODS Ten hemiparetic stroke survivors completed 12 90-minute sessions using an upper-limb robotic exoskeleton unilaterally and bilaterally. During the sessions subjects played seven different games designed for rehabilitation. At the conclusion of their sessions subjects completed an 83-question survey. RESULTS Subjects preferred static games to dynamic games. Preferred games elicited greater effort. CONCLUSIONS Intermediate goals in addition to ultimate goals should be set with both static and dynamic games such that even with the patient's limited range of motion, speed, or coordination, the game should be playable and provide a sense of accomplishment to the patient. Marking the games' ultimate goals that can be accomplished only by healthy subjects, such as range of motion and workspace, provide references and encouragement to the patient for improving motor control and performance through the process of playing the game.