JMIR Publications

ABSTRACT

Background:

Upper limb functional deficits are common after stroke and result from motor weakness, ataxia, spasticity, special neglect and poor stamina. Past studies employing a range of commercial gaming systems to deliver rehabilitation to stroke patients provided short-term efficacy, but have not yet demonstrated whether or not those games are acceptable for long-term use, that is, motivational, comfortable, and engaging, all necessary for their long-term adoption and use by patients.

Objective:

To assess the acceptability of a cell-phone based augmented reality (AR) game as a means of delivering stroke rehabilitation for patients with upper limb motor function loss.

Methods:

Five patients ages 50–70, all of whom experienced motor deficits after acute ischemic stroke, participated in three optional therapy sessions using augmented reality therapeutic gaming over the course of one week targeting deficits in upper extremity strength and range of motion. After completion of the game we administered a questionnaire that assessed the game acceptability for the patient.

Results:

Five out of five acute stroke patients completed a total of 23 out of 45 scheduled AR game sessions, with patient fatigue the primary factor for uncompleted sessions. Four out of five patients completed a 16-question questionnaire at the end of their final gaming session with one patient lost to early discharge. An average score of 4.25/5 for motivation to follow the instructions and finish the AR experience to the end of a given gaming session, 3.75/5 for motivation to try other game-based therapies, 3.5/5 for desire to do another session, and 3.25/5 for motivation to perform other exercises in support of their daily rehabilitation. In addition, average scores of 4/5 was given for the overall experience, 4.25/5 for comfort, 3.25/5 for finding the study fun, enjoyable, and/or engaging, and 3.5/5 for believing this technology could help them reach their rehabilitation goals. For each of the four patients, their reported scores were statistically significantly higher in value than that generated by a random sampling of values, with an average of P=.037.

Conclusions:

Based on the questionnaire scores, patients with upper limb motor deficits following stroke found our AR game motivating, comfortable, engaging and well tolerated. Anticipated improvements in AR technology may allow patients to work with improved versions of the presently tested therapy, independently, in their own home. We therefore anticipate that cell-phone based AR gaming systems may one day provide useful self-treatment of stroke patients with upper limb deficiencies post discharge as a supplement to professional therapy.