Patients’ physiological reactions to competitive rehabilitation therapies assisted by robotic devices

Abstract

Background The aging of the population and the progressive increase in life expectancy in developed countries is leading to a high incidence of cerebrovascular diseases. Several studies have demonstrated that robot-assisted rehabilitation therapies combined with serious games can improve rehabilitation outcomes. Social interaction in the form of multiplayer games has been highlighted as a potential element to increase patient’s motivation and exercise intensity, which professionals have described as one of the determining factors in maximizing rehabilitation outcomes. Despite this, it has not been widely studied. Physiological measures have been proven as an objective tool to evaluate patients’ experience in robot-assisted rehabilitation environments. However, they have not been used to evaluate patients’ experience in multiplayer robot-assisted rehabilitation therapies. The main objective of this study is to analyze whether the interpersonal interaction inherent in a competitive game mode affects the patients’ physiological responses in robot-assisted rehabilitation environments. Methods A total of 14 patients participated in this study. The results of a competitive game mode were compared with a single-player game mode with different difficulty levels. Exercise intensity and performance were measured through parameters extracted from the game and the information provided by the robotic rehabilitation platforms. The physiological response of patients in each game mode was measured by the heart rate (HR) and the galvanic skin response (GSR). Patients were asked to fill out the IMI and the overall experience questionnaire. Results The exercise intensity results show that high-difficulty single-player game mode is similar in terms of intensity level to a competitive game mode, based on velocity values, reaction time and questionnaire results. However, the results of the physiological responses of the patients measured by GSR and HR are lower in the case of the competitive mode compared to the high-difficulty single-player game mode, obtaining results similar to those obtained in the low-difficulty single-player game mode. Conclusions Patients find the competitive game mode the most fun, which is also the mode they report experiencing the most effort and stress level. However, this subjective evaluation is not in line with the results of physiological responses. This study concludes that interpersonal interaction inherent to a competitive game mode influences patients’ physiological responses. This could mean that social interaction is an important factor to consider when interpreting the results obtained from physiological measurements.

Assessment of Gamified Mixed Reality Environments for Upper Limb Robotic Rehabilitation: Pilot Study on Healthy Adults

“…Consequently, within the field of rehabilitation robotics, there has been a growing interest in integrating gamified VR solutions to enhance stimulation, interaction, and movement during the rehabilitation process. These VR solutions tipically utilize non-immersive technologies, such as computer or tablet screens, to present visual and cognitive stimuli through gamified 2D environments and thus promote rehabilitation for various body parts including the hand [25,26], ankle [27], elbow [23] or upper limb [13,22]. While non-immersive VR solutions offer advantages such as ease of use, portability, cost-effectiveness, and reduced motion sickness, they may also result in limited immersion and realism, as well as constraints on range of motion and potential distractions.…”

“…The literature indicates a growing interest in integrating gamified VR applications into robot-assisted rehabilitation therapies. However, most developments have been non-immersive, utilizing conventional graphical displays like computer monitors [13]. To our knowledge, none of these applications have been fully or partially immersive through the use of Head Mounted Displays (HMDs).…”