Development of Functional Electrical Stimulation Rehabilitation

System Integrated with Game

Chanil Kim, Moon-young Lee,

Jong-ha Lee, Hee-jun Park and Jeong-hun Ku

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

Keywords: Gamification, Upper Limb Rehabilitation, FES.

Abstract: Stroke is the main cause of chronic movement disorder as the aftereffect. Clearly, active participation for

patients is critical to increase the motor ability. In this paper, we propose the virtual-reality based

rehabilitation gaming system to increase the rehabilitation participation of stroke patients. The proposed

system consists of Functional Electrical Stimulation (FES) device, webcam, and game. The webcam tracks

the movement of patient’s hand when the FES stimulates. The patients rehabilitate with the game which is

operated by the hand movements and feels interest in rehabilitation. This work is the initial step towards

achieving the stroke rehabilitation gaming system to maximize the patient participation.

1 INTRODUCTION

Stroke damages the nervous system and muscular

system, and these damages engender aftereffects

such as chronic movement disorder. Upper and

lower limb movement disorder causes hemiplegia,

balance disorder and difficulty in walking.

Rehabilitation processes recover lower limb

movement, but the majority of patients have

insuperable difficulty with recovering the upper limb

movement. Currently used treatments of upper limb

paralysis are constraint induced movement therapy

(CIMT), functional electrical stimulation (FES),

joint tracking training, bio feedback, mirror therapy,

robot-assisted therapy and virtual reality therapy.(

Chung, JW, 2002) One of the most general and

effectual clinical treatments for upper limb recovery

is FES.

Neurons are electrically active cells. Presence of

electric field in nervous tissue leads to the

depolarization of neuronal lipid membranes and

induces firing of action potential. FES takes

advantage of this property of nerve cells. Passing of

electric current through nervous tissue can lead to

adverse effects such as decrease in excitability or

cell death due to thermal damage, electroporation,

toxic products from electrochemical reactions or

overexcitation of neurons.

The use of FES for the treatment of upper limbs

paralysis has increased recently and many studies of

its effectiveness are currently being conducted.

(Eom, GM, 2003)

According to the study by Park and Oh,

environmental factors in addition to patient’s

voluntary and active participation in the treatment

are critical for the stroke patient’s improvement in

movement. (Cho, IS., 2009), (Park, RJ., 2002),

(Bolton, D.A., 2004). However, there are limits to

inducing such participation from the patients with

the current FES-based rehabilitation treatments,

which do not provide any visuals but simple patterns

of electrical stimulation.

In this study, a gamified FES treatment system

that encourages more active participation from the

patients was developed.

2 METHODS

Wrists were the target areas for this rehabilitation

system. The system is consisted of two parts: FES

and data collection. According to the provided game

scenario by the system, electrical stimulation will be

applied to the target area. The patient’s

performances will be monitored by cameras and the

collected data will be provided to the system as a

feedback to the system’s performance. Patients

during the treatment will constantly receive instant

visual feedback as they accomplish the assignments

given in the game.

Kim C., Lee M., Lee J., Park H. and Ku J..

Development of Functional Electrical Stimulation Rehabilitation System Integrated with Game.

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

Figure 1: The Hardware (a) FES Controller, (b) Webcam,

As shown in Picture 1, the hardware is consisted

of FES device, FES Controller and webcam. The

FES device used is Microstim of MED-EL GmbH.

The FES controller was used to control the FES

device from the work station. And the webcam was

used in order to measure the angle of wrists.

Figure 2: Diagram of system.

3 RESULTS

There are two separate game contents; one for the

permanently paralyzed patient and another for the

partly paralyzed. For the permanently paralyzed, the

system visualizes the timing of FES, regardless of

the patient’s movement in the wrists, so that patients

are aware of when they will receive stimulations.

For the partly paralyzed, their movement will be

monitored, and the FES will be applied when their

movement is deemed inadequate.

4 CONCLUSIONS

In this paper, a new rehabilitation system for the

upper limbs of stroke patients was introduced. This

system seeks to supplement the existing treatments

of which simple FES patterns lead to passive

participation of patients. The new system expects to

promote voluntary and active participation, which

are crucial for successful treatment of post-stroke

paralysis.

Figure 3: The Scene for Setting (L), Playing Scene (R).

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)

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