Enhancing the measurement of clinical outcomes using Microsoft Kinect

There is a growing body of applications leveraging Microsoft Kinect and the associated Windows Software Development Kit in health and wellness. In particular, this platform has been valuable in developing interactive solutions for rehabilitation including creating more engaging exercise regimens and ensuring that exercises are performed correctly for optimal outcomes. Clinical trials rely upon robust and validated methodologies to measure health status and to detect treatment-related changes over time to enable the efficacy and safety of new drug treatments to be assessed and measured. In many therapeutic areas, traditional outcome measures rely on subjective investigator and patient ratings. Subjective ratings are not always sensitive to detecting small improvements, are subject to inter- and intra-rater variability and limited in their ability to record detailed or subtle aspects of movement and mobility. For these reasons, objective measurements may provide greater sensitivity to detect treatment-related changes where they exist. In this review paper, we explore the use of the Kinect platform to develop low-cost approaches to objectively measure aspects of movement. We consider published applications that measure aspects of gait and balance, upper extremity movement, chest wall motion and facial analysis. In each case, we explore the utility of the approach for clinical trials, and the precision and accuracy of estimates derived from the Kinect output. We conclude that the use of games platforms such as Microsoft Kinect to measure clinical outcomes offer a versatile, easy to use and low-cost approach that may add significant value and utility to clinical drug development, in particular in replacing conventional subjective measures and providing richer information about movement than previously possible in large scale clinical trials, especially in the measurement of gross spatial movements. Regulatory acceptance of clinical outcomes collected in this way will be subject to comprehensive assessment of validity and clinical relevance, and this will require good quality peer-reviewed publications of scientific evidence

Kinect as an access device for people with cerebral palsy: A preliminary study

Cerebral palsy (CP) describes a group of disorders affecting the development of movement and posture, causingactivity limitation. Access to technology can alleviate some of these limitations. Many studies have used vision- based movement capture systems to overcome problems related to discomfort and fear of wearing devices. Incontrast, there has been no research assessing the behavior of vision-based movement capture systems in peoplewith involuntary movements. In this paper, we look at the potential of the Kinect sensor as an assistive technologyfor people with cerebral palsy. We developed a serious game, called KiSens Números, to study the behavior ofKinect in this context and eighteen subjects with cerebral palsy used it to complete a set of sessions. The resultsof the experiments show that Kinect filters some of peoples involuntary movements, confirming the potential ofKinect as an assistive technology for people with motor disabilities

Implementation of Open Source applications “Serious Game” for rehabilitation

Serious Games and Virtual Reality (VR) are present nowadays as an alternative to traditional rehabilitation therapies. This project describes the workflow to develop videogames for health monitoring as well as a source of entertainment for physiotherapy patients, primarily patients that suffer hemiparesis caused by a neurological disease like a stroke. We propose the last version of Microsoft Kinect sensors as low cost game controller and the software Unity to develop Open Source Rehabilitation Serious Games. These Serious Games try to imitate physiotherapy sessions performed in movement recovery therapies, reducing the waiting list of patients together with time and costs to hospitals. The premise is that the gameplay makes patients execute upper body exercises alongside equilibrium training, meanwhile they are monitored extracting useful data and results for the physicians.Ingeniería Biomédic

Review of the Augmented Reality Systems for Shoulder Rehabilitation

Literature shows an increasing interest for the development of augmented reality (AR) applications in several fields, including rehabilitation. Current studies show the need for new rehabilitation tools for upper extremity, since traditional interventions are less effective than in other body regions. This review aims at: Studying to what extent AR applications are used in shoulder rehabilitation, examining wearable/non-wearable technologies employed, and investigating the evidence supporting AR effectiveness. Nine AR systems were identified and analyzed in terms of: Tracking methods, visualization technologies, integrated feedback, rehabilitation setting, and clinical evaluation. Our findings show that all these systems utilize vision-based registration, mainly with wearable marker-based tracking, and spatial displays. No system uses head-mounted displays, and only one system (11%) integrates a wearable interface (for tactile feedback). Three systems (33%) provide only visual feedback; 66% present visual-audio feedback, and only 33% of these provide visual-audio feedback, 22% visual-audio with biofeedback, and 11% visual-audio with haptic feedback. Moreover, several systems (44%) are designed primarily for home settings. Three systems (33%) have been successfully evaluated in clinical trials with more than 10 patients, showing advantages over traditional rehabilitation methods. Further clinical studies are needed to generalize the obtained findings, supporting the effectiveness of the AR applications

Utilising the Intel RealSense camera for measuring health outcomes in clinical research

Applications utilising 3D Camera technologies for the measurement of health outcomes in the health and wellness sector continues to expand. The Intel® RealSense™ is one of the leading 3D depth sensing cameras currently available on the market and aligns itself for use in many applications, including robotics, automation, and medical systems. One of the most prominent areas is the production of interactive solutions for rehabilitation which includes gait analysis and facial tracking. Advancements in depth camera technology has resulted in a noticeable increase in the integration of these technologies into portable platforms, suggesting significant future potential for pervasive in-clinic and field based health assessment solutions. This paper reviews the Intel RealSense technology’s technical capabilities and discusses its application to clinical research and includes examples where the Intel RealSense camera range has been used for the measurement of health outcomes. This review supports the use of the technology to develop robust, objective movement and mobility-based endpoints to enable accurate tracking of the effects of treatment interventions in clinical trials

Motion Capture for Telemedicine: A Review of Nintendo Wii, Microsoft Kinect, and PlayStation Move

Access to healthcare has been and continues to be difficult for many around the world. With the introduction of telemedicine, this impediment to attaining medical care has been lifted. Although many avenues of telemedicine exist (and have yet to exist), the use of home video game consoles such as the Nintendo Wii®, Microsoft Kinect®, and PlayStation Move® can be used to measure patient progress outside of the office. Due to the nature of each individual console/system, some unique characteristics exist that allow each system to provide its own clinical potential. A comparative analysis of the clinical implications of the Nintendo Wii®, Microsoft Kinect®, and PlayStation Move® showed that with its ease of use and dynamic accuracy, the Microsoft Kinect® offered the most benefit. With further exploration, using the Microsoft Kinect® for telemedicine will be able to improve medical efficiency and hopefully health outcomes

Home-based rehabilitation of the shoulder using auxiliary systems and artificial intelligence: an overview

Advancements in modern medicine have bolstered the usage of home-based rehabilitation services for patients, particularly those recovering from diseases or conditions that necessitate a structured rehabilitation process. Understanding the technological factors that can influence the efficacy of home-based rehabilitation is crucial for optimizing patient outcomes. As technologies continue to evolve rapidly, it is imperative to document the current state of the art and elucidate the key features of the hardware and software employed in these rehabilitation systems. This narrative review aims to provide a summary of the modern technological trends and advancements in home-based shoulder rehabilitation scenarios. It specifically focuses on wearable devices, robots, exoskeletons, machine learning, virtual and augmented reality, and serious games. Through an in-depth analysis of existing literature and research, this review presents the state of the art in home-based rehabilitation systems, highlighting their strengths and limitations. Furthermore, this review proposes hypotheses and potential directions for future upgrades and enhancements in these technologies. By exploring the integration of these technologies into home-based rehabilitation, this review aims to shed light on the current landscape and offer insights into the future possibilities for improving patient outcomes and optimizing the effectiveness of home-based rehabilitation programs.info:eu-repo/semantics/publishedVersio

Development and Usability Evaluation of Low-cost Virtual Reality Rehabilitation Games for Patients with Upper Limb Impairment

Stroke is one of the primary causes of long-term disability in adults in the United States which leads to mild to severe sensorimotor impairments. Long-term continuous rehabilitation therapies are needed to facilitate sensorimotor recovery and empower patients in performing daily living activities. Currently, the opportunity of receiving post stroke rehabilitation in the chronic stage (\u3e 6 months post stroke) is limited due to a lack of insurance and the high cost of therapy. Low-cost virtual rehabilitation games with motion tracking devices have tremendous potential to assist physical rehabilitation. Motion tracking devices such as Kinect (Microsoft, Redmond, CA; $100) and P5 Glove (Essential Reality, LLC, NY;$40) have become available to enable development of low-cost virtual rehabilitation games. Such low-cost games may encourage continuous, repeated, and intensive rehabilitation therapies thereby enhancing recovery post stroke. However, current virtual rehabilitation games emphasize on gross arm movements using Kinect or fine finger movements using P5 Glove, but not both at the same time. Since most daily living activities require coordination of the gross shoulder/elbow movement and fine finger movement such as reaching to grasp and transferring a jar to a shelf, effective upper limb rehabilitation must involve coordination of the arm and finger movements. In addition, many virtual rehabilitation games have been developed without user input and feedback, which may be the primary reason why virtual rehabilitation games are not prominently used at home by patients. This thesis presents the development and usability evaluation of low-cost virtual rehabilitation games. In addition to the archery and puzzle games previously developed in the laboratory, a low-cost rehabilitation kitchen game was developed to encourage patients to practice various functional tasks involving coordinated arm and finger movements that were detected by using Kinect and P5 Glove, respectively. Usability of the three games was assessed with ten chronic stroke survivors using pre-game and post-game surveys. The games met patients\u27 expectations of providing challenging movements. The House of Quality analysis revealed that technical characteristic needing the most improvement was device reliability. The future research should address device reliability by developing a better instruction manual to facilitate device set-up and use. In addition, filtering data can also improve quality of virtual arm movements in future versions of the games. In summary, this thesis presents promising evidence for low-cost rehabilitation games using commercially available motion tracking devices of Kinect and P5 Glove together with free Blender software

An Overview of Self-Adaptive Technologies Within Virtual Reality Training

This overview presents the current state-of-the-art of self-adaptive technologies within virtual reality (VR) training. Virtual reality training and assessment is increasingly used for five key areas: medical, industrial & commercial training, serious games, rehabilitation and remote training such as Massive Open Online Courses (MOOCs). Adaptation can be applied to five core technologies of VR including haptic devices, stereo graphics, adaptive content, assessment and autonomous agents. Automation of VR training can contribute to automation of actual procedures including remote and robotic assisted surgery which reduces injury and improves accuracy of the procedure. Automated haptic interaction can enable tele-presence and virtual artefact tactile interaction from either remote or simulated environments. Automation, machine learning and data driven features play an important role in providing trainee-specific individual adaptive training content. Data from trainee assessment can form an input to autonomous systems for customised training and automated difficulty levels to match individual requirements. Self-adaptive technology has been developed previously within individual technologies of VR training. One of the conclusions of this research is that while it does not exist, an enhanced portable framework is needed and it would be beneficial to combine automation of core technologies, producing a reusable automation framework for VR training

Kires: a data-centric telerehabilitation system based on kinect

185 p.It is widely accepted that the worldwide demand for rehabilitation services. To meet these needs, there will have to be developed systems of telerehabilitation that will bring services to even the most remote locations, through Internet and related technologies.This thesis is addressing the area of remote health care delivery, in particular telerehabilitation. We present KiReS; a Kinect based telerehabilitation system which covers the needs of physiotherapists in the process of designing, managing and evaluating physiotherapy protocols and sessions and also covers the needs of the users providing them an intuitive and encouraging interface and giving useful feedback to enhance the rehabilitation process. As required for multi-disciplinary projects, physiotherapists were consulted and feedback from patients was incorporated at different development stages.KiReS aims to outcome limitations of other telerehabilitation systems and bring some novel features: 1) A friendly and helpful interaction with the system using Kinect and motivational interfaces based on avatars. 2) Provision of smart data that supports physiotherapists in the therapy design process by: assuring the maintenance of appropriate constraints and selecting for them a set of exercises that are recommended for the user. 3) Monitoring of rehabilitation sessions through an algorithm that evaluates online performed exercises and sets if they have been properly executed. 4) Extensibility, KiReS is designed to be loaded with a broad spectrum of exercises and protocols