Increasing Motor Learning During Hand Rehabilitation Exercises Through the Use of Adaptive Games: A Pilot Study

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English, Brittney A.
Howard, Ayanna M.
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Physical therapy is a common treatment for the rehabilitation of hemiparesis, or the weakness of one side of the body [1]. Unfortunately, a recent study found that about one third of stroke patients who are prescribed rehabilitation in hospital settings are ranked as poor participators in physical therapy [2]. In an attempt to increase morale and participation of stroke survivors in hand function motor therapy, a robotic rehabilitation system is being designed to counteract these hindrances to hand function recovery. For this system, an adaptive game that is only controllable through hand movement has been designed to optimize the challenges and rewards presented to the user. A healthy subjects pilot study was conducted to assess the adaptive game’s ability to increase the motor learning of participants during rehabilitation exercises. During this experiment, participants were asked to wear a robotic wrist sensor that functions as a game controller and play a rehabilitative tablet game that encourages therapeutic motions. To play this game users had to reach various targets in the game scenario by moving their hand in pre-determined ranges of motion. Two game scenarios presented the participant with a constant level of challenge, one of which was an easy scenario and the other a hard scenario, while a third scenario adjusted the game difficulty in order to maintain a constant balance of challenge and reward. When participants were presented with a constant level of challenge, their performance did not increase or decrease linearly during the session. This lack of linear growth or decay suggests that the participants did not experience significant learning and their performances were not hindered by negative emotions such as frustration or boredom. Participants that played the adaptive scenario performed similarly to the fixed difficulty levels when presented with an easy scenario for the beginning portion of the gaming experience and a difficult portion at the end. However, if participants were presented with a difficult scenario at the beginning of their gaming experience and an easy scenario at the end, they performed similarly to the fixed difficulty during the hard portion yet much better than the fixed difficulty during the easy portion. The averages for the easy portion of the adaptive level and the fixed easy level were 90.33% and 82.72%, respectively, and the standard deviations were 10.25% and 17.82%, respectively.
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