Video Game–Based Rehabilitation Approach for Individuals Who Have Undergone Upper Limb Amputation: Case-Control Study

Abstract

Background Brain plasticity is an important factor in prosthesis usage. This plasticity helps with brain adaptation to learn new movement and coordination patterns needed to control a prosthetic hand. It can be achieved through repetitive muscle training that is usually very exhausting and often results in considerable reduction in patient motivation. Previous studies have shown that a playful concept in rehabilitation can increase patient engagement and perseverance. Objective This study investigated whether the inclusion of video games in the upper limb amputee rehabilitation protocol could have a beneficial impact for muscle preparation, coordination, and patient motivation among individuals who have undergone transradial upper limb amputation. Methods Ten participants, including five amputee participants and five able-bodied participants, were enrolled in 10 1-hour sessions within a 4-week rehabilitation program. In order to investigate the effects of the rehabilitation protocol used in this study, virtual reality box and block tests and electromyography (EMG) assessments were performed. Maximum voluntary contraction was measured before, immediately after, and 2 days after interacting with four different EMG-controlled video games. Participant motivation was assessed with the Intrinsic Motivation Inventory (IMI) questionnaire and user evaluation survey. Results Survey analysis showed that muscle strength and coordination increased at the end of training for all the participants. The results of Pearson correlation analysis indicated that there was a significant positive association between the training period and the box and block test score (r8=0.95, P<.001). The maximum voluntary contraction increment was high before training (6.8%) and in the follow-up session (7.1%), but was very small (2.1%) shortly after the training was conducted. The IMI assessment showed high scores for the subscales of interest, perceived competence, choice, and usefulness, but low scores for pressure and tension. Conclusions This study demonstrated that video games enhance motivation and adherence in an upper limb amputee rehabilitation program. The use of video games could be seen as a complementary approach for physical training in upper limb amputee rehabilitation.

Comparison of Conventional and Virtual Reality Box and Blocks Tests in Upper Limb Amputees: A Case-Control Study

“…This effect may be minimal or no association at all based on the study by Huygelier et al [57]. No muscle cramps or fatigue were experienced by any participant which shows that virtual activity of using Myo Gesture Control Armband is not fatiguing at all and is supported by the study by Hashim et al [58].…”

The Role of Fascial Tissue Layer in Electric Signal Transmission from the Forearm Musculature to the Cutaneous Layer as a Possibility for Increased Signal Strength in Myoelectric Forearm Exoprosthesis Development

“…Using a software environment is not singular [ 53 , 54 ] and offers the possibility of testing the subject’s ability to voluntarily control the musculature at the amputation site and, following the series of tests, choosing the subset of sEMG signals most useful in the use of a myoelectric prosthesis. Moreover, using the virtual equivalents of the healthy hand and exoprosthesis allows the subject to become familiar with this type of myoprosthesis and train safely before the prosthesis is purchased.…”

An analysis of clinical outcomes and essential parameters for designing effective games for upper limb rehabilitation: A scoping review

“…Most of the studies were done in Canada (n = 4, 19%) 24,27,31,36 and México (n = 3, 14%), 18,20,29 respectively. Turkey, 19,33 Taiwan, 25,30 Malaysia, 28 and China 34 were the only Asian countries that focused on upper limb disabilities rehabilitation games.…”