Article

This paper proposes a novel system (using the Nintendo Wii remote) that
offers customised, non-immersive, virtual reality-based, upper-limb stroke
rehabilitation and reports on promising preliminary findings with stroke survivors. METHOD: The system novelty lies in the high accuracy of the full
kinematic tracking of the upper limb movement in real-time, offering strong
personal connection between the stroke survivor and a virtual character when
executing therapist prescribed adjustable exercises/games. It allows the
therapist to monitor patient performance and to individually calibrate the system
in terms of range of movement, speed and duration. RESULTS: The system was tested
for acceptability with three stroke survivors with differing levels of
disability. Participants reported an overwhelming connection with the system and
avatar. A two-week, single case study with a long-term stroke survivor showed
positive changes in all four outcome measures employed, with the participant
reporting better wrist control and greater functional use. Activities, which were
deemed too challenging or too easy were associated with lower scores of
enjoyment/motivation, highlighting the need for activities to be individually
calibrated. CONCLUSIONS: Given the preliminary findings, it would be beneficial
to extend the case study in terms of duration and participants and to conduct an
acceptability and feasibility study with community dwelling survivors.
Implications for Rehabilitation Low-cost, off-the-shelf game sensors, such as the
Nintendo Wii remote, are acceptable by stroke survivors as an add-on to upper
limb stroke rehabilitation but have to be bespoked to provide high-fidelity and
real-time kinematic tracking of the arm movement. Providing therapists with
real-time and remote monitoring of the quality of the movement and not just the
amount of practice, is imperative and most critical for getting a better
understanding of each patient and administering the right amount and type of
exercise. The ability to translate therapeutic arm movement into individually
calibrated exercises and games, allows accommodation of the wide range of
movement difficulties seen after stroke and the ability to adjust these
activities (in terms of speed, range of movement and duration) will aid
motivation and adherence -
key issues in rehabilitation.
With increasing
pressures on resources and the move to more community-based rehabilitation, the
proposed system has the potential for promoting the intensity of practice
necessary for recovery in both community and acute settings.

Langue : ANGLAIS