Enhancing Robotic-Assisted Lower Limb Rehabilitation Using Augmented Reality and Serious Gaming
Source abstract
Abstract
Stroke, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease are some of the conditions that can lead to neuromotor disabilities requiring rehabilitation. To address the socio-economic burden that is amplified by the rapidly increasing elderly population, traditional rehabilitation techniques have recently been complemented by technological advancements, particularly Robot-Assisted Therapy (RAT). RAT enhances motor learning by improving both accuracy and consistency. This study proposes an innovative rehabilitation system that combines serious gaming and augmented reality (AR) with the LegUp parallel robot, developed for the spatial rehabilitation of the hip, knee, and ankle in bed-ridden patients. The system aims to improve patient outcomes and actively involve patients in their therapy. Electro-goniometers and a HoloLens 2 device are used to provide immediate feedback about the position of the patient’s joints, forming the basis of an interactive game in which the patient moves their leg to reach various targets. Two game modes were developed, each targeting different aspects of neuromotor rehabilitation, such as coordination, strength, and flexibility. Preliminary findings suggest that combining RAT with augmented reality-based serious gaming can increase patient motivation and engagement. Furthermore, the personalized and interactive nature of the therapy holds the potential to improve rehabilitation outcomes by fostering sustained engagement and effort.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Stroke Rehabilitation and Recovery · Prosthetics and Rehabilitation Robotics · Muscle activation and electromyography studies
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
CESTER—Research Center for Industrial Robots Simulation and Testing, Technical University of Cluj-Napoca, 400114 Cluj-Napoca, Romania
Campus of Azurem, Universidade do Minho, 4800-058 Guimarães, Portugal
Technical Sciences Academy of Romania, B-dul Dacia, 26, 030167 Bucharest, Romania
Funding
European Union—NextGenerationEU and the Romanian Government
References (41)
Show source-provided references
1. World Health Organization—Disability and Health (2024, August 01). WPR-2017-DNH-005-Factsheet. [Online]. Available online: https://iris.who.int/bitstream/handle/10665/279966/WPR-2017-DNH-005-factsheet-01-disability-eng.pdf.
2. World Health Organization (2024, November 20). ‘Stroke, Cerebrovascular Accident’ [Online]. Available online: https://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/index.html#:~:text=Annually%2C%2015%20million%20people%20worldwide%20suffer%20a%20stroke.,ocur%2C%20the%20main%20cause%20is%20high%20blood%20pressure.
3. World Health Organization (2024, April 20). Parkinson Disease. [Online]. Available online: https://www.who.int/news-room/fact-sheets/detail/parkinson-disease.
4. Smukowski, S.N., Maioli, H., Latimer, C.S., Bird, T.D., Jayadev, S., and Valdmanis, P.N. (2022). Progress in Amyotrophic Lateral Sclerosis Gene Discovery: Reflecting on Classic Approaches and Leveraging Emerging Technologies, Lippincott Williams and Wilkins.10.1212/NXG.0000000000000669 ↗
5. Epidemiology of neurological diseases in older adults10.1016/j.neurol.2020.01.356 ↗
6. Pisla, D., Nadas, I., Tucan, P., Albert, S., Carbone, G., Antal, T., Banica, A., and Gherman, B. (2021). Development of a Control System and Functional Validation of a Parallel Robot for Lower Limb Rehabilitation. Actuators, 10.10.3390/act10100277 ↗
7. Robotic assistive and rehabilitation devices leading to motor recovery in upper limb: A systematic review10.1080/17483107.2021.1906960 ↗
8. Robot-assisted rehabilitation for total knee or hip replacement surgery patients: A systematic review and meta-analysis10.1097/MD.0000000000030852 ↗
9. Payedimarri, A.B., Ratti, M., Rescinito, R., Vanhaecht, K., and Panella, M. (2022). Effectiveness of Platform-Based Robot-Assisted Rehabilitation for Musculoskeletal or Neurologic Injuries: A Systematic Review. Bioengineering, 9.10.3390/bioengineering9040129 ↗
10. Robotic Orthosis Lokomat: A Rehabilitation and Research Tool10.1046/j.1525-1403.2003.03017.x ↗
11. (2024, July 29). Life Science Robotics, Robert®—The Robotic Co-Therapist. [Online]. Available online: https://www.lifescience-robotics.com/solutions/lower-extremities/.
12. Clinical Effects of MOTOmed Intelligent Exercise Training Combined with Intensive Walking Training on the Rehabilitation of Walking, Nerve and Lower Limb Functions among Patients with Hemiplegia after Stroke10.12669/pjms.38.5.5259 ↗
13. Development of a novel cable-driven parallel robot for full-cycle ankle rehabilitation10.1016/j.mechatronics.2024.103210 ↗
14. Development and Evaluation of a Wearable Lower Limb Rehabilitation Robot10.1007/s42235-022-00172-6 ↗
15. Vaida, C., Birlescu, I., Pisla, A., Carbone, G., Plitea, N., Ulinici, I., Gherman, B., Puskas, F., Tucan, P., and Pisla, D. (2019). RAISE—An Innovative Parallel Robotic System for Lower Limb Rehabilitation. New Trends in Medical and Service Robotics. Mechanisms and Machine Science, Springer.10.1007/978-3-030-00329-6_33 ↗
16. Extended reality in musculoskeletal rehabilitation and injury prevention—A systematic review10.1016/j.ptsp.2022.04.011 ↗
17. Gupta, M., Bhatia, D., and Kumar, P. (2023). Virtual reality, augmented reality technologies, and rehabilitation. Modern Intervention Tools for Rehabilitation, Elsevier.10.1016/B978-0-323-99124-7.00001-8 ↗
18. Innocente, C., Ulrich, L., Moos, S., and Vezzetti, E. (2021). Augmented Reality: Mapping Methods and Tools for Enhancing the Human Role in Healthcare HMI. Appl. Sci., 12.10.3390/app12094295 ↗
19. Phan, H.L., Le, T.H., Lim, J.M., Hwang, C.H., and Koo, K. (2021). Effectiveness of Augmented Reality in Stroke Rehabilitation: A Meta-Analysis. Appl. Sci., 12.10.3390/app12041848 ↗
20. Three-Dimensional Augmented Reality System for Balance and Mobility Rehabilitation in the Elderly: A Randomized Controlled Trial10.1089/cyber.2018.0261 ↗
21. Damaševičius, R., Maskeliūnas, R., and Blažauskas, T. (2023). Serious Games and Gamification in Healthcare: A Meta-Review. Information, 14.10.3390/info14020105 ↗
22. Serious Games for Stroke Telerehabilitation of Upper Limb—A Review for Future Research10.5195/ijt.2020.6326 ↗
23. Robotic arm training in neurorehabilitation enhanced by augmented reality—A usability and feasibility study10.1186/s12984-023-01225-5 ↗
24. Rodriguez-De-Pablo, C., Balasubramanian, S., Savic, A., Tomic, T.D., Konstantinovic, L., and Keller, T. (2015, January 25–29). Validating ArmAssist Assessment as outcome measure in upper-limb post-stroke telerehabilitation. Proceedings of the 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), Milan, Italy.10.1109/EMBC.2015.7319424 ↗
25. Pisla, D., Birlescu, I., Vaida, C., Tucan, P., Gherman, B., and Machado, J. (2024). Parallel Robot for Lower Limb Joint Rehabilitation in Two Planes. (No. OSIM A 00116), Patent.10.1007/978-3-031-59888-3_21 ↗
26. Innovative Approaches and Therapies to Enhance Neuroplasticity and Promote Recovery in Patients with Neurological Disorders: A Narrative Review
27. Wareham, L.K., Liddelow, S.A., Temple, S., Benowitz, L.I., Di Polo, A., Wellington, C., Goldberg, J.L., He, Z., Duan, X., and Bu, G. (2022). Solving Neurodegeneration: Common Mechanisms and Strategies for New Treatments, BioMed Central Ltd.10.1186/s13024-022-00524-0 ↗
28. Modeling and analysis of a parallel robotic system for lower limb rehabilitation with predefined operational workspace10.1016/j.mechmachtheory.2024.105674 ↗
29. Afyouni, I., Murad, A., and Einea, A. (2020). Adaptive Rehabilitation Bots in Serious Games. Sensors, 20.10.3390/s20247037 ↗
30. Alarcón-Aldana, A.C., Callejas-Cuervo, M., and Bo, A.P.L. (2020). Upper Limb Physical Rehabilitation Using Serious Videogames and Motion Capture Systems: A Systematic Review. Sensors, 20.10.3390/s20215989 ↗
31. (2024, July 31). Biometrics Ltd.’s Twin-axis Goniometers [Online]. Available online: https://www.biometricsltd.com/blog/electronic-goniometers.htm.
32. Microsoft (2024, July 31). HoloLens 2. Microsoft. [Online]. Available online: https://www.microsoft.com/en-us/hololens/buy?msockid=1d8aaf670ae2690e3d42bcff0b3b6880.
33. Palumbo, A. (2022). Microsoft HoloLens 2 in Medical and Healthcare Context: State of the Art and Future Prospects. Sensors, 22.10.3390/s22207709 ↗
34. (2024, August 27). Biometrics Ltd. [Online]. Available online: https://www.biometricsltd.com/system-integrations.htm.
35. DeapSea: Workflow-Supported Serious Game Design for Stroke Rehabilitation10.1155/2023/3169262 ↗
36. Game-Based Learning in Neuroscience10.1212/NE9.0000000000200103 ↗
37. Tucan, P., Vaida, C., Ulinici, I., Banica, A., Burz, A., Pop, N., Birlescu, I., Gherman, B., Plitea, N., and Antal, T. (2021). Optimization of the aspire spherical parallel rehabilitation robot based on its clinical evaluation. Int. J. Environ. Res. Public Health, 18.10.3390/ijerph18063281 ↗
38. Systematic Review of Augmented Reality Training Systems10.1109/TVCG.2022.3201120 ↗
39. Schrepp, M. (2024, July 30). User Experience Questionnaire Handbook. Available online: https://www.researchgate.net/publication/281973617_User_Experience_Questionnaire_Handbook.
40. Gerbino, S., Lanzotti, A., Martorelli, M., Mirálbes Buil, R., Rizzi, C., and Roucoules, L. (2022). Mixed Reality-Based Support for Total Hip Arthroplasty Assessment. Advances on Mechanics, Design Engineering and Manufacturing IV, Springer. JCM. Lecture Notes in Mechanical Engineering.10.1007/978-3-031-15928-2 ↗
41. Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis10.2196/30985 ↗