JMIR Publications

ABSTRACT

Background:

Prepared residual muscles and induced specific brain plasticity are very important before wearing a myoelectric prosthetic hand. They can be achieved through exhausting and tedious muscle training. Conservative physiotherapeutic exercise often results in significant reduction in patient motivation. Motivation is a key factor for effective rehabilitation and is frequently used to determine rehabilitation outcome. While a few systems for upper limb amputee rehabilitation are available, playful concept in rehabilitation that usually increase patient engagement and perseverance through the use of video games is often unanalyzed in the upper limb amputee population.

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 before wearing myoelectric prosthesis, coordination and patient motivation.

Methods:

Ten participants, 5 amputee and 5 able-bodied, enrolled in ten 1-hour sessions within a 4-week rehabilitation program. In order to investigate the effect of the rehabilitation protocol used in this study, a virtual reality box and block test and electromyography assessment was performed. Maximum voluntary contraction was measured before, after, and two days after interacting with four different EMG-controlled computer games. Participants completed user evaluation survey and their motivation was assessed using the Intrinsic Motivation Inventory (IMI) questionnaire.

Results:

Muscle strength and coordination increased at the end of training for all the participants. The result of the Pearson correlation indicated that there was a significant positive association between the training period and the Box and Block Test score (r(8): 0.95, p < 0.001). The percentage of Maximum Voluntary Contraction increment value is greater before training (6.84%) and in follow up session (7.14%) but was very small (2.11%) shortly after the training was conducted. The IMI assessed showed high scores for subscales of interest, perceived competence, choice and usefulness but low values for pressure and tension.

Conclusions:

This study demonstrates that videogames enhance motivation and adherence in upper limb amputee rehabilitation programs. The use of videogames could be seen as complementary methods for physical training in upper limb amputee rehabilitation. Clinical Trial: The test was approved by the Medical Research Ethics Committee (MREC) and the Ministry of Health (MOH) Malaysia, Approval ID: NMRR-16-2106-32880.