Winning compensations: Adaptable gaming approach for upper limb rehabilitation sessions based on compensatory movements

• Published in: Journal of biomedical informatics Vol. 108; no. C; p. 103501
• Main Authors: Alves, Tomás, Carvalho, Henrique, Simões Lopes, Daniel
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-08-2020; Elsevier
• Subjects: Compensatory behaviors; Difficulty adjustment; Exergaming; Humans; Movement; Rehabilitation strategies; Upper Extremity; Upper-limb; Usability testing; User studies; SUS; ISCSEM; SD; Difficulty adjustment; CI; Compensatory behaviors; Upper-limb; M; User studies; Usability testing; Rehabilitation strategies
• ISSN: 1532-0464; 1532-0480
• DOI: 10.1016/j.jbi.2020.103501

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•We leverage compensatory movements has an automatic difficulty adaptation metric.•We designed a novel interactive system for upper-limb physical rehabilitation.•User studies with health professionals reported high usability scores.•Participants praised both automatic and customizable difficulty adjustment features.
Recent research has been using automatic difficulty adjustment techniques as an effective channel to improve the quality of physical rehabilitation. Notably, these approaches often incorporate adaptation metrics such as emotions and performance. Nonetheless, compensatory movements, which hinder movement correctness and are considered as a core quality evaluation criterion of rehabilitation, have not been considered as an adaptation metric. Weighting how visual feedback interfaces increase patient engagement, we leverage an interactive system with a compensatory movements-based difficulty adjustment framework to enhance the upper-limb physical rehabilitation process. We conducted user tests with professionals (N = 15), which included observation sessions, co-design workshops, semi-structured interviews, and usability testing, to evaluate our prototype. Results showed that our interactive system achieved scores of perceived usability between 74 and 78.17, along with participants praising both the dynamic and manual customization of difficulty parameters. Our findings empower physical therapists and health professionals by reducing their burden on physical rehabilitation monitorization.