Use of exergames for upper extremity rehabilitation in stroke patients
Dr Philippe ARCHAMBAULTa, Mrs Nahid NOROUZI-GHEIDARIa, Mr Gordon TAOa, Dr John M. SOLOMONb, Dr Dahlia KAIRYc, Dr Mindy F. LEVINa
a École de physiothérapie et d’ergothérapie, Université McGill, Canada, b Université de Manipal, Département de physiothérapie, Manipal, Inde, c École de réadaptation, Université de Montréal, Canada
Introduction: Virtual reality (VR) can promote functional rehabilitation of arm movements through environments allowing the practice of a variety of tasks while providing feedback . We evaluated an affordable VR system for arm rehabilitation, developed by Jintronix Inc and based on the Microsoft Kinect, that provides three unilateral and two bilateral activities, each with ten difficulty levels.
Objectives: Our objectives were to 1) determine which activities and levels of difficulty are appropriate for rehabilitation of arm movements in stroke patients with different degrees of motor impairment; and 2) determine the ease of use and subjective experience of patients using the VR arm rehabilitation system.
Methods: Clinicians each supervised two to four stroke patients who participated in three 20-minute sessions with the Jintronix system. We determined the highest level of difficulty attained by patients in each activity with a performance score of at least 50%. Arm impairment was assessed using the upper extremity section of the Chedoke-McMaster Scale (CM) . Patients and clinicians completed a questionnaire on the usability of the Jintronix system, based on the technology acceptance model (FD Davis ).
Results: Fifteen clinicians supervised a total of 40 stroke patients. Over 80% of the clinicians and patients provided positive feedback in terms of ease of use and VR experience. For each activity of the Jintronix system, results indicated a positive correlation between the CM score and the maximal difficulty level reached by stroke patients.
Discussion: Our data demonstrate the feasibility of using an affordable VR arm rehabilitation system in a clinical setting and provide clinical guidelines for the selection of impairment-specific difficulty levels.
 M.K. Holden: "Virtual environments for motor rehabilitation: review", Cyberpsychol Behav, 2005, 8, pp. 187-211
 C. Gowland, P. Stratford, M. Ward, J. et al.: "Measuring physical impairment and disability with the Chedoke-McMaster Stroke Assessment", Stroke, 1993, 24, pp. 58-63
 F.D. Davis: "User acceptance of information technology: system charcteristics, user perceptions and behavioural impacts", International Journal of Man-Machine Studies, 1993, 38, pp. 475-487
Keywords : rehabilitation, upper extremity, stroke, video games, exercises, Kinect