Study for the Clinical Evaluation of the Effectiveness of the Mobile

Game based Upper Extremity Rehabilitation Program for Patients

with Upper Extremity Hemiplegia after Stroke

Hyunmi Lim

, Minah Kim

, Nam Jong Paik

, Jongha Lee

and Jeonghun Ku

Department of Biomedical Engineering, College of Medicine, Keimyung University, Daegu, Korea

Department of Rehabilitation Medicine, Seoul National University College of Medicine,

Seoul National University Bundang Hospital, Seongnam, Korea

Keywords: Game, Upper Rehabilitation, Mobile.

Abstract: In the paper, we developed the mobile based rehabilitation system for patients with upper extremity

hemiplegia after stroke and evaluated clinical usefulness and effectiveness of the system. The sensors built

in the mobile device were used to track patients' upper limb motion and the movements was transferred to

the mobile device through bluetooth connection so that the game contents could be interact with the

movements. For the clinical evaluation of the effectiveness, 12 patients were recruited and make them

perform an exercise of their wrist, shoulder, and forearm using the system for two weeks. The results

showed significant improvement in upper limb function, quality of life and depression. Given the fact that

our experiment, we verified mobile based rehabilitation program could be useful and effective for the

clinical use.

1 INTRODUCTION

Stroke patients suffer from sensory impairment and

motor disorder which cause problems in upper limb

functions, lower limb functions and activities of

daily living (J.H. Carr and R.B Shephered, 2003).

Recently, for the rehabilitaion, various mobile

systems have been introduced to make rehabilitation

easy at home, and our previous study for evaluation

of the mobile based upper extremity rehabilitation

showed that the mobile based rehabilitation have

positive effects on the therapy and the motivation

(Hyunmi Lim and Jeonghun Ku, 2013).

Therefore, in this paper, we aimed to conduct a

clinical evaluation for the effectiveness of the

mobile game based upper extremity rehabilitation

program

2 METHODS

The system of the mobile based rehabilitation

program is shown below in Figure 1. The gyro and

accelerator sensors built in device cellular phone

were used to track patients' upper limb motion and

are attached on a part of upper limbs, such as wrist,

shoulder, and forearm to rehabilitate. The

movements was transferred to a tablet PC through

bluetooth connection so that the game contents could

be interact with the movements.

Figure 1: System.

The rehabilitation game contents were developed

according to the B-stage based exercising. There

were four game contents developed for the

rehabilitation.

For the clinical evaluation of the effectiveness of

the mobile based rehabilitation program, the

program was conducted with 12 patients with upper

extremity hemiplegia after stroke in Seoul National

Lim H., Kim M., Jong Paik N., Lee J. and Ku J..

Study for the Clinical Evaluation of the Effectiveness of the Mobile Game based Upper Extremity Rehabilitation Program for Patients with Upper

Extremity Hemiplegia after Stroke.

 2014 SCITEPRESS (Science and Technology Publications, Lda.)

University Bundang Hospital. And then, we

measured upper limb functions at pre, post and 1

month after the training.

The experiment was conducted with 10 times for

two weeks, and it was composed of an exercise of

their wrist, shoulder, and forearm using the mobile

game based rehabilitation program for 30 minutes

plus occupational therapy for 30 minutes.

For the evaluation of upper limb function, we

measured FMA-upper, B-Stage of hand and upper

arm, EQ-5D and BDI (Beck’s depression inventory).

Figure 2: The scene for a training with mobile

rehabilitation program.

3 RESULTS

3.1 Enhancement of Upper Extremity

Function

The upper extremity FMA scores showed a

significant increase from 24.5 to 43.5 just after the

training [F=22.925, p<0.001], and also did after 1

month of training 53.7 [F=22.811, p<0.001]. The

average of B-stage(arm) increase from 1.9 to 3.9 just

after the training [F=24.000, p<0.001], and also did

after 1 month of training 4.9 [F=15.000, p<0.004].

The average of B-stage(hand) showd a significant

increase from 1.92 to 3.75 just after the training

[F=32.463, p<0.001], and also did after 1 month of

training 4.7 [f=16.000, p<0.003].

3.2 Enhancement of Quality of Life

The average of the EQ-5D(Index) showed a

significant increase from 0.56 to 0.80 just after 1

month of training [F=13.516, p<0.005] and the

average of the EQ-5D(VAS) increase from 52.5 to

77.5 after 1 month of training [F=29.663, p<0.001].

the average of the BDI showed a significant

decrease from 12.42 to 3.4 just after 1 month of

training [F=6.069, p<0.036]. that showed that EQ-

5D(Index) and EQ-5D(VAS) enhanced. Also BDI

was decreased.

Figure 3: Training effect on the measurements. *, ** and

*** represents a significant value of p<0.05, p<0.01 and

p<0.001 respectively.

4 CONCLUSIONS

We developed the mobile based upper extremity

rehabilitation program for patients with upper

extremity hemiplegia after stroke and evaluated the

clinical effectiveness of the program. Experimental

results showed improvement in 12 patients’ upper

extremity function, b-stage and quality of life. And

that showed significant decrease of depression.

The results confirmed that the developed mobile

based rehabilitation program could be effective to

the patients with upper extremity hemiplegia after

stroke by conducting experimentation.

Therefore, the mobile rehabilitation program could

be useful tools for the rehabilitation which could be

used more conveniently.

ACKNOWLEDGEMENTS

This research was supported by Basic Science

Research Program through the National Research

Foundation of Korea(NRF) (2013R1A1A2060973)

and the "Leaders Industry-university Cooperation"

Project, funded by the Ministry of Education(MOE)

REFERENCES

J.H. Carr and R.B Shephered, 2003.Stroke Rehabilitation,

Butterworth-Hemiplegic, London.

Hyunmi Lim, Jeonghun Ku et al, 2013. Preliminary study

for the evaluation of the usefulness of the mobile game

based upper extremity rehabilitation program. Annual

Conference on Biological Engineering.