Fatigue-aware videogame using biocybernetic adaptation: a pilot study for upper-limb rehabilitation with sEMG

• Published in: Virtual reality : the journal of the Virtual Reality Society 2023-03, Vol.27 (1), p.277-290
• Main Authors: Montoya, Maria Fernanda, Muñoz, John, Henao, Oscar Alberto
• Format: Article
• Language: English
• Subjects: Adaptation; Artificial Intelligence; Computer & video games; Computer Graphics; Computer Science; Effectiveness; Electromyography; Games; Image Processing and Computer Vision; Limbs; Muscular fatigue; Physical and Cognitive Rehabilitation; Psychological Interventions; Rehabilitation; S.I. : Virtual Reality for Therapy; Therapy; User Interfaces and Human Computer Interaction
• ISSN: 1359-4338; 1434-9957
• DOI: 10.1007/s10055-021-00561-y

Physical rehabilitation has been widely used to restore or maintain motor capabilities of patients with upper-limb mobility limitations. Despite its effectiveness, physical rehabilitation has several difficulties in engaging patients with the multiple therapeutical sessions required to obtain measurable benefits. Novel technologies incorporate gamification strategies to encourage participants to play during the rehabilitation sessions (instead of counting repetitions), providing benefits for therapy adherence. “Serious” or also called applied games have been used as a complementary therapy for neuromuscular disorders. However, the therapy effectiveness of several serious games for health has been questioned by the clinical experts since crucial factors associated with the physical rehabilitation are not commonly included in the gameplay. This study reports the use of a physiologically aware serious game developed using surface electromyography (sEMG) to capture upper-limb muscular fatigue levels of participants. We carried out a pilot study lasting four weeks with five participants diagnosed with monoparesis/hemiparesis to evaluate the feasibility of using the fatigue-adaptive game called Force Defense as a complementary tool for physical rehabilitation in a local community-based rehabilitation center. Preliminary results suggest a positive user gameplay experience as well as good usability of the system reported by participants after the first intervention session. Moreover, we showed how the physiological adaptation was able to encourage participants to maintain exertion in the therapeutically desired zone, thus improving the system’s effectiveness. Participants also improved in their functional abilities of the upper limbs and the game performance measured in pre- and post-moments and reported reduced levels of perceived fatigue after the end of the training program.