Physioland – A serious game for physical rehabilitation of patients with neurological diseases
Introduction
Genetic, congenital or acquired factors can cause lesions in the neurons. Whenever this happens, the transmission of information is compromised, leading to neuronal death and causing a neurological disease [1]. When the lesions occur in the region of the Nervous System responsible for the movements, the neurons in that region lose their ability to transmit the nervous stimuli, the transmission of the electrical signals to the muscles is ceasing, atrophying them and affecting mobility [2].
There is an increasing number of victims of neurological disease, with reduced mobility, leading to a need for physical therapy. The therapeutic procedures prescribed are generally traditional physical therapy programs that must be practiced over a long period of time. These programs consist of repetitive, boring and sometimes painful exercises, causing the demotivation and disinterest of the patients and leading them to prematurely abandon treatments [3], [4].
However, as a result of the technological evolution, new support tools are emerging, where serious games are playing an important role, bringing the playful aspect to the ability of solving problems [5]. Serious pioneering games revealed a predominance of educational games, but in recent years, the health area has been booming, particularly in the fields of physical therapy and rehabilitation [6]. In fact, its use in the field of physical therapy can modify the way patients face their treatments. Considering the results of several studies, it was possible to recognize that serious games, when used in physical therapy, can create flexible, dynamic and interesting environments, and have elements that motivate patients and lead them to forget about their treatments [7], [8].
There are several serious games directed to the practice of physical therapy that have shown positive effects during their experiments. However, almost all serious games used are generic games that have been adapted to different situations, and only few, in their conception, are based on specific exercises of traditional physical therapy [9]. Besides that, these games are mainly aimed at a small set of specific diseases, noting that there is a gap regarding games directed to a broad spectrum of neurological diseases, which Physioland comes to fill.
Thus, Physioland stands out from the others, as it aims to monitor patients with neurological diseases to practice physical therapy, through a friendly and motivating environment (electronic game).
Section snippets
Materials and methods
After an analysis performed with health professionals (physiatrists, physiotherapists and physiotherapy technicians), six exercises with different dynamics were chosen, which are of technological and physiotherapeutic interest that is, which are susceptible to be adapted to electronic game situations and which are transversal to a higher number of neurological diseases. (Fig. 1): glenohumeral joint abduction/adduction (1), flexion/extension of the radioumeral joint (2), pulleys (3),
Results – analysis and discussion
In order to avoid an overly long text, it was decided to present in this paper the results obtained by the patients who obtained the best and the worst performance, thus demonstrating the divergence of results and the extremes of the results obtained during the experiment. This does not mean that a patient with the best performance has the best score. In fact, some patients sacrifice their performance, that is, they make compensations, misalignments and sudden variations of speed, in order to
Conclusions
This paper presented Physioland, a serious game based on image processing techniques to promote and monitor the physical therapy practice of patients with reduced mobility as a consequence of neurological disease.
The storyboard includes a family (father, mother and son) living in a medieval village. To support his family, the father has to face challenges in order to collect as many coins as possible. The challenges are overcome by performing movements of the upper and lower limbs.
The game was
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Acknowledgments
This work has been supported by national funds through FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/2019. The authors are also grateful to the Portuguese Foundation (FCT) for funding through SFRH/BD/74852/2010 Ph.D. scholarship.
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