Title: Kinecting the Moves: The kinematic potential of rehabilitation-specific gaming to inform treatment for hemiplegia Event Title: The International Conference Series on Disability, Virtual Reality and Associated Technologies (ICDVRAT) 2014 Location: Gothenburg, Sweden Event website: http://icdvrat.reading.ac.uk Event Date: September 2-4, 2014 Presenter(s): Stephanie Glegg Authors: Stephanie M N Glegg, Chai-Ting Hung, Bulmaro A Valdes, Brandon D G Kim, H F Machiel Van der Loos Learn more about the FEATHERS Project and research team here: http://caris.mech.ubc.ca/feathers/ References 1. J Galvin, D Levac (2011) Facilitating clinical decision-making about the use of virtual reality within paediatric motor rehabilitation: Describing and classifying virtual reality systems. Dev Neurorehabil, 14(2):112-122. doi: 10.3109/17518423.2010.535805 http://www.ncbi.nlm.nih.gov/pubmed/21410403 2. L Luna-Oliva, R Ortiz-Guitierrez, PR Martiniz, I Alquacil-Diego, C Sanchez-Camarero, M del Carmen (2013) Kinect Xbox 360 as a therapeutic modality for children with cerebral palsy in a school environment: A preliminary study. NeuroRehabil, 33(4):513-521. doi: 10.3233/NRE-131001. http://www.ncbi.nlm.nih.gov/pubmed/24018364 3. F Orihuela-Espina, I Fernandez del Castillo, L Palafox, E Pasaye, I Sanchez-Villavicencio, R Leder (2013) Neural reorganization accompanying upper limb motor rehabilitation from stroke with virtual reality- based gesture therapy. Topics in Stroke Rehabil, 20(3):197. doi: 10.1310/tsr2003-197. http://www.ncbi.nlm.nih.gov/pubmed/23841967 4. S Tatla S (2014) The development of the pediatric motivation scale for children in rehabilitation: A pilot study (MSc thesis) The University of British Columbia, Vancouver, BC. https://circle.ubc.ca/handle/2429/45920 5. BA Valdés, CGE Hilderman, CT Hung, N Shirzad, HFM Van Der Loos (2014) Usability testing of gaming and social media applications for stroke and cerebral palsy upper limb rehabilitation. Proc IEEE EMBC, under review.

1. Kinecting the Moves: The kinematic potential of rehabilitation-specific
gaming to inform treatment for hemiplegia
1Therapy Department, Sunny Hill Health Centre for Children, Vancouver, CANADA; 2Department of Mechanical Engineering, University of British Columbia, Vancouver, CANADA;
3Department of Electrical & Computer Engineering, University of British Columbia, Vancouver, CANADA
Stephanie M N Glegg1 | Chai-Ting Hung2 | Bulmaro A Valdés2 | Brandon D G Kim3 | H F Machiel Van der Loos2 |
Introduction
Virtual reality is increasingly being used as a treatment tool.
Commercial systems often fail to meet the therapeutic needs &
physical capacity of rehabilitation populations. Novel user
interfaces and gaming applications developed in collaboration
with clients & therapists can expand these systems’ potential.
Purpose
• To describe the development of two commercial interfaces
that were adapted to promote bilateral arm use using a
social media-based game platform
• To share preliminary kinematic data extracted for its clinical
relevance to therapists
Methods
System Description
Movement Modes
Point Mirror Symmetry Mode Visual Symmetry Mode
Participants
Subject 1 Subject 2 Healthy Control
Procedure
User Test Session: Participants were introduced to the apps
& interfaces, and played Lucky Pirate (OUAT Entertainment) in
both modes following instructions on movement and task
requirements. 90min session was audio and video recorded,
with moderator, note-taker, caregiver and therapist present.
Ethics approval and informed consent were obtained.
Kinematic Data: PlayStation: 3D position of Move controllers;
Kinect: 3D position of all upper limb joints. Data shown was
recorded over 2.5-3 minutes per participant from 6 joints
(wrists, shoulders, shoulder centre, hip centre) during Visual
Symmetry mode on Kinect. Directional movement analysis was
based on segmented horizontal & vertical movements.
Results & Discussion
Performance Data for One Session
Table 1: Total distance (TD) travelled in 2D & range of motion (ROM) at
the wrist, in metres, over 210 seconds
Data Analysis on Directional Movement
Shoulder Compensation: (a) Paretic sides moved in longer, less
direct trajectories than unaffected sides. (b) Synchronization
attempts evidenced by both hands stopping close to same height.
(c) Subject 2 data showed clear evidence of right shoulder
compensation (left shoulder moved down, to left & backwards;
right shoulder moved up, to left & forward).
(b)
(b)
(c)
Vertical Offsets (both hands in an upward movement):
Conclusions and Future Work
Kinematic analysis from commercial motion tracking data may be
an additional assessment tool for therapists by providing
information about quality & amount of movement. Next steps for
the FEATHERS project involves the evaluation of an eight-week
home-based treatment program using the system.
Feathers Motion Application
• Bilateral movement software
interface
• Continuously maps hand with
least movement into cursor
motion in real-time
Feathers Play Application
• Connections with peers &
therapists
• Access to Facebook games
• Review of game scores
• Program monitoring & treatment
progression by therapist
Subject
Horizontal Vertical
TD ROM TD ROM
Left Right Left Right Left Right Left Right
1 7.04* 6.07 0.40 0.58 8.22* 6.69 0.40 0.56
2 8.32 9.11* 0.45 0.49 13.85 7.64* 0.60 0.50
Control 4.94 4.11 0.34 0.28 6.99 7.35 0.41 0.49
About the FEATHERS Project
http://caris.mech.ubc.ca/feathers
References &
e-Resources
Contact
Stephanie Glegg, MSc (RS), OTR
sglegg@cw.bc.ca @stephglegg
Acknowledgements
We acknowledge the FEATHERS team, the staff from
Sunny Hill Health Centre for Children, Reality Controls
Inc., Brendan Sexton, and the participants and their
families. This project was funded by the Peter Walls Solutions Initiative.
• 19 year old male
• 2 years post-brachial plexus &
traumatic brain injury
• Decreased shoulder range of
motion in flexion, extension &
external rotation
• 13 year old male
• 14 months post-stroke
• No active forearm supination
• Decreased shoulder external
rotator & wrist flexor/extensor
strength
• 28 year old male
• Right-hand
dominant
Left
hemiparesis
Right
hemiparesis
Functional
Engagement in
Assisted Therapy
through Exercise
Robotics
Values calculated with respect to
paretic side. All offsets show
decreasing trend with respect to
motion time, suggesting subjects
were attempting to reach same
vertical position at end of motion.
OR
(a) (a)