Publication: Development and impact of customised serious game system in stable-sitting trunk control exercises among stroke survivors
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Date
2024-08-01
Authors
Tan, Alexander Wai Teng
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Abstract
This study presents a custom Serious Game (SG) system designed for stable sitting trunk exercises. The system incorporates three key features: (1) measurement
of the Centre of Pressure (CoP) using a custom force plate, (2) real-time translation of
CoP shifts into game avatar control, and (3) recording of CoP trajectories during
gameplay. This approach provides an engaging game-based rehabilitation therapy that
offers valuable insights into users' functional movements. The study assesses the
impact of this SG system on trunk rehabilitation in stroke survivors through a two phase approach. Initially, a within-participant, repeated measures pilot study involved
12 stroke subjects who undertook both conventional trunk exercises (CTE) and SG based trunk exercises (SGTE) in a stable-sitting posture was carried out, aiming to
compare the physiological and postural responses. ANOVA results revealed low
muscle activity and light-intensity cardiovascular responses across exercises, with
game-paced SGTE yielding marginally higher CoP velocity in Anterior-Posterior (AP)
and Medio-Lateral (ML) axes compared to CTE (AP: 4.40 ± 1.80 vs. 4.02 ± 1.20 cm/s;
ML: 6.40 ± 2.54 vs. 5.42 ± 2.21 cm/s). However, self-paced SGTE had a lesser impact
on postural control. Subsequently, a larger cohort of 25 stroke subjects participated in
SGTE to explore the relationship between in-game CoP measures and clinical
assessment outcomes. Spearman correlation analysis found significant correlations,
particularly in the ML axis, with the TIS2.0 score showing a strong association with
CoP range (ρ = 0.78; p < 0.001) and mean CoP velocity (ρ = 0.75; p < 0.001). The novelty of this thesis lies in developing a custom SG system specifically designed for
trunk rehabilitation in a sitting position for stroke survivors, combining the
motivational aspects of games with the clinical relevance of force plate measurements.
This study compares the impacts of SGTE on physiological and postural responses
with those of CTE in stroke survivors. Additionally, it establishes correlations between
in-game CoP measures and clinical assessments among stroke survivors. The findings
indicate that the SG system provides impacts comparable to CTE and shows potential
as an adjunct to existing rehabilitation protocols and assessment tools for stroke
survivors, suggesting further investigation into its utility.