Remote therapy frameworks play the main role in home-based telerehabilitation. These remote therapies are exergames that help in the physical and cognitive rehabilitation of the patient. The objective of this review is to present the frameworks of home-based therapies using exergames and to identify the points that can be improved in the development of future systems. To carry out this research, the criteria of the PRISMA were adopted.  Literature searches were conducted up to April 2021 in the Web of Sicence, Pubmed, Cochrane, Embase and Scopus databases. The search query was: (("game*" OR "exergame*") AND  ("rehabilitation") AND ("remote" OR "telerehabilitation" OR "telemedicine")). We have selected a total of  fourteen  studies. We found five types of frameworks: Client-Server, Web-Based, Layers,  Cloud Based and  Multi users. We identified that it may be advantageous to mix the features of these frameworks to have a cheaper home-based system and prevent the patient from having to purchase more powerful computers. In addition, there are some challenges that need to be studied that will also help reduce costs for the patient:  1) Reduce the need for high processing of exergames on the patient's computer; 2) Prevent the patient from having to purchase expensive external devices for motion tracking.

This article presents a study on the impact of video frame losses on the quality perceived by users. Video compression standards, such as MPEG, use a sequence of frames called Group of Pictures (GOP), which is a video compression method which a frame is expressed in terms of one or more neighboring frames. This dependence between frames impacts directly in the quality because a loss of a reference frame prevents the decoding of other frames in GOP, thereby reducing the user-perceived quality. The assessment of quality in this article is estimated by Peak Signal Noise Ratio (PSNR), which compares the original and the received images. Computer simulations were used to show that the degradation on the quality may vary for different patterns of GOPs and type of lost frames.

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Nowadays, electronic games are used in areas other than entertainment, referenced in the literature as Serious Games when used in educational activities, professional training, and exergames when used in training to improve physical Ątness or medical rehabilitation therapies. Through exergames, rehabilitation therapies can be developed in clinics or hospitals and at the patientŠs home, improving its engagement in therapy since, because they are computer games, they are understood as fun and not as a repetitive exercise. However, despite the advantages of using exergames, they introduce costs to the patient, such as the device where the game is played and the device used to control it. Another disadvantage is that the therapist does not follow up on the session unless the patient travels to the clinic or Hospital or the therapist travels to the patientŠs home. This work proposes the use of various new technologies to solve the different issues found in the literature, which are: build an input device via video object tracking and use it to control the exergame, which is executed on a remote game server and, by using a game streaming application, its rendered frames streamed to the patient over the Internet. Additionally, a real-time audio and video communication channel between the patient and the therapist is implemented as part of this Framework, allowing them to interact during the telerehabilitation session without needing to be in the same physical space.