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.

Games and virtual reality are new concepts applied to upper limb rehabilitation after stroke. To perform upper limb physiotherapy rehabilitation and restore motor skills through virtual reality resources it is necessary to use an arm tracker, which would be the input of the video game. However, one of the main issues when starting a post-stroke rehabilitation game project is choosing the most suitable gross upper limb motion tracking device. Thus, this article aims to explore the gross upper limb motion tracking devices most commonly used in the scientific literature. To carry out this research, literature searches in English were conducted up to December 2020 in the ACM, PubMed and IEEE Xplore databases. We have selected a total of ninety-five (95) articles. In these studies, we identified the most used gross upper limb motion devices and we classified them into 5 different categories: RGB-D skeletal tracking, RGB object tracking, IR marker tracking, LeapMotion and RGB markerless body tracking. We found that most studies (52%) used RGB-D skeletal tracking. In addition, we found fifteen (15) different commercial systems or tracking devices and the most used was Kinect® (47% of all studies). However, it was not possible to generalize whether one device is better than the other. Although the amount of research in this area has increased significantly in recent years, additional studies are still needed to quantify the potential of the use of gross upper limb motion tracking devices in rehabilitation with games in post-stroke treatment.

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Stroke is one of the main causes of longterm disability worldwide. Conventional upper limb physiotherapy programs can be tedious, expensive and require physical transportation. Video games can help solve these problems. In fact, recent studies show that health professionals are increasingly interested in using computer games for poststroke rehabilitation. However, commercial possibilities can be inaccessible and inadequate to the needs of patients and therapists. Also, among academic research solutions, there is a prevalence of: exoskeletons, inertial, magnetic and ultrasonic sensors, all electronics of significant cost and difficult to obtain (imported). In Brazil, it is important to remember that financial conditions can be minimal. In this work, a solution for the following problems: time (for the proper set up of every session; lack of time of the therapist to accompany the rehabilitation sessions), space (for equipment to be stored; for some camera systems to capture the full movement properly), and cost (for private clinicians and patients themselves, some systems can be inaccessible, because they can require sophisticated electronic devices) was attempted, trying to develop a very accessible poststroke rehabilitation exergame alternative. Thus, a video game with an innovative alternative for tracking the 3D movement of the upper limb was made, after reviewing the bibliographic and patent literature and identifying the needs directly from an occupational therapist and her stroke patients, which uses optical capture with a regular camera and colored sphere markers, while maintaining lightweight realtime processing on mobile devices. The game has 2D and 3D versions, for both Windows and Android, simplified interface and progress monitoring. The fact that the controller can be handcrafted by the users makes the game very lowcost, possible to be distributed worldwide, reaching a large number of people, and possible to be played and monitored remotely. The proposed system was tested in order to find out how accurate it can be, compared to a gold standard system (a goniometer). It has been found that the system has limitations, such as low accuracy at obtuse angles, illumination variation, small spheres (the type of marker utilized), occlusions, camera distortions and motion blur. Still, it can be faster than using fiducial markers or Deep Learning, since it is a simpler algorithm, leading to a higher frame rate, which was demonstrated in this work, and can be very accurate when respecting the aforementioned problems. In conclusion, the system seems promising, due to its accessibility, very low cost, customization to the needs of patients and therapists and good tests results, as a complementary alternative for poststroke rehabilitation.

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