Voice-Operated Exergame with Motion Feedback for After-Stroke Hand Rehabilitation

Several after-stroke patients suffer loss, weakness or dysfunction of functional abilities in Upper Limbs (ULs), specifically in either hand. This requires studied and intensive rehabilitation programs that are mainly based on exercising to allow patients regain lost hand abilities. Factors affecting the success of the rehabilitation process include, severity level of the stroke, immediate start of the rehabilitation program, intensity of the program, patient psychological state and motivation. To guarantee effective results with traditional rehabilitation approaches, a lot of challenges are posed on patients, therapists, health service providers and caregivers. Recently, exergaming has been accepted amongst therapists and rehabilitation centres as an effective alternative approach that bypasses many of the aforementioned challenges. In this paper, a voice-operated exergame with a modified joystick that produces motion feedback is presented. The purpose of adding motion feedback is to activate the neuroplasticity for more effective and faster recovery of patients suffering from loss of hand abilities. The system development includes the exergame environment developed using Unity Game Engine and GAVPI software for voice recognition. Furthermore, the modified joystick hardware is presented, which allows for both ordinary operation and motion feedback from the exergame based on voice commands. The initial tests of the developed exergame system are presented with prospects given on potential future developments. The paper also gives a review of studies reporting use of exergaming for after-stroke ULs rehabilitation purposes.