Serious Gaming Technology in Upper Extremity Rehabilitation: Scoping Review (Preprint)

Abstract

BACKGROUND Serious gaming is increasingly gaining attention as a potential new component in clinical practice. Specifically, its use in the rehabilitation of motor dysfunctions has been intensively researched during the past three decades. OBJECTIVE This scoping review aims to evaluate the current role of serious games in the upper extremity rehabilitation and identify common methods and practice, technology patterns as well as gaps. This objective is approached via the exploration of published research efforts over the years. METHODS The literature research, using the PubMed and Scopus databases, included articles published until June 2019. The eligibility criteria were (i) to include any form of introduced game-based arm rehabilitation, (ii) to be a study published in a peer-reviewed journal or conference, (iii) to introduce a game in an electronic format, (iv) to be a study in English, (v) to not be a review, meta-analysis, editorial or commentary. The review identified 169 relevant articles. RESULTS The results indicate an increasing research trend in the domain of serious gaming deployment in upper extremity rehabilitation. Furthermore, differences regarding the number of publications and the game approach were noted between studies which used commercial devices in their rehabilitation systems, with studies which created any type of robotic arm, glove or other devices for the connection with the game platform. A significant observation concerns the evaluation of the introduced systems. Although one-third of the studies evaluate in real use their implementations including patients, in most cases, there is the need for a bigger number of participants and better testing of the rehabilitation scheme efficiency over time. Most of the studies which included some form of assessment for the introduced rehabilitation game, mentioned among others the user experience as a factor for the system’s evaluation. Besides the user experience assessment, the most common evaluation method involving patients was the use of medical standard tests. Finally, a few studies attempted to extract game features in order to introduce quantitative measurements for the evaluation of the patient’s improvement. CONCLUSIONS This paper presents an overview of a significant research topic and highlights the current state of the field. Despite all the attempts for the development of a rehabilitation system, there is not a definite answer of whether a serious game is a favorable means for the upper extremity functionality improvement, but it is certainly constitutes a supplementary means for motivation. The development of a unified performance quantification framework and the conductance of wider scale experiments could generate richer evidence and contribute in this direction.