Post on 07-May-2015
description
Off the Shelf Kinect Games for Stroke Rehabilitation
Perspective of the Therapist
Penny Standen Division of Rehabilitation and Aging
University of Nottingham Nottingham, UK
p.standen@nottingham.ac.uk
Luke Shires, James Lewis, David Brown, Nasser Sherkat
Computing and Technology team Nottingham Trent University
Nottingham, UK
luke.shires2007@my.ntu.ac.uk
Stroke
Stroke is the third most common disease in the UK with over 100,000 cases annually (Bupa 2011).
Stroke is also the leading cause for long term disability. The cost of treatment and dealing with the long term disabilities
afterwards is estimated to cost the UK economy £8.9 billion a year (Saka, McGuire and Wolfe 2009)
BUPA, 2011. Stroke [online]. . Available at: http://www.bupa.co.uk/individuals/health-information/directory/s/stroke [Accessed 12/9 2012].
SAKA, Ö., MCGUIRE, A. and WOLFE, C., 2009. Cost of stroke in the United Kingdom. Age and Ageing, 38 (1), 27-32.
Upper Limb Rehabilitation
Rehabilitation for an impaired upper limb following stroke requires early and repetitive exercise to maximize recovery (Feys, et al. 2004).
Outpatient facilities can be difficult to travel to for survivors with
mobility problems or long travel distances. New thinking suggests long term rehabilitation may have a
positive effect but clinical resources are directed towards new patients.
FEYS, H., et al., 2004. Early and repetitive stimulation of the arm can substantially improve the long-term outcome after stroke: a 5-year follow-up study of a randomized trial. Stroke, 35 (4), 924-929.
Home Based Rehab
Gives patients the means to rehabilitate as much as they like, when they like. Without increasing clinical resources.
Allows patients to perform effective rehabilitation exercises
independently. Increases the amount of rehabilitation time available to the
patient, and allow cost effective rehabilitation in the long term.
COTS Games
Commercial off the shelf games. Cons
• Games are designed for able bodied users. • Might not encourage the ‘right’ kind of exercise. • Visual and GUI design are often not accessible
Pros • Relatively low cost. • Easily available. • Designed for use in a home setting.
• Recent increase in the popularity of motion controls.
• Games with high production values.
Xbox 360 Kinect
Study Rational
COTS systems have previously been shown to have a positive impact when used in conjunction with a normal course of rehabilitation.
Kinect games provide full body tracking, and new possibilities of
exercises based interaction with games. Want to learn about what works well with COTS games for
stroke, and use this to inform decisions about future rehab systems.
MOUAWAD, M.R., et al., 2011. Wii-based movement therapy to promote improved upper extremity function post-stroke: a pilot study. Journal of Rehabilitation Medicine, 43 (6), 527-533.
Study Rational
COTS studies have focused on proving improvement in limb functionality, but ignored issues surrounding usability of the device for a wide range of stroke patients.
We want to explore the individual joint movements encouraged. And the minimum joint functionality the patients requires to
participate.
Study Configuration Recruit occupational and physiotherapists with experience of
working with stroke patients Participants received a demonstration of each Kinect game. Then
offered unlimited time to play. Answer questionnaire on joint functionality required by the
Kinect game. Allowed to return to the game at any point during the
questionnaire.
Study Configuration
Two games were chosen. Kinect Sports Bowling and Kinect Sports Table Tennis.
Easy to learn as rules match real life equivalent. Short play times allow study to be conducted in reasonable
timeframe. Relatively low excretion for Kinect games titles explored.
Kinect Sports Bowling
Kinect Sports Table Tennis
Interim Results
Recruited six therapists. All therapists completed study. Aiming to recruit twelve overall.
0
1
2
3
4
Min
imum
join
t fun
ctio
nalit
y re
quire
d to
pla
y
Joint movement
0. No motion required. 1. Reduced range of motion. 2. Partial range of motion. 3. Partial range of motion against gravity. 4. Full range of motion against gravity.
Bowling Joint Function Required
0
1
2
3
4
Min
imum
Join
t Fun
ctio
nalit
y Re
quire
d to
pla
y
Joint movement
0. No motion required. 1. Reduced range of motion. 2. Partial range of motion. 3. Partial range of motion against gravity. 4. Full range of motion against gravity.
Table Tennis Joint Function
0. Not encouraged. 1. Encouraged but not required. 2. Implicit to fulfilling required task. 3. Explicit to fulfilling required task.
Bowling Movement Encouraged
0
1
2
3
Join
t Exe
rcise
Enc
oura
ged
Joint movement
0. No exertion. 1. Low. 2. Medium. 3. High. 4. Dangerous.
Bowling Joint Exertion
0
1
2
3
4
Max
imum
Lev
el o
f Exe
rtio
n En
cour
aged
Joint movement
Informal Findings
Requirement to stand presents a serious risk of falling. Especially during table tennis.
Interface is not accessible, confusing to follow. Too many moving
elements.