| 제목 |
Effect of EMG biofeedback-based mobile game for upper limb rehabilitation in stroke patients |
| 소속 |
Eulji Hospital, Eulji University, Department of Rehabilitation Medicine1, College of medicine, Keimyung University, Department of Biomedical Engineering2 |
| 저자 |
Hyoseon Choi1, Joon Woo Kim1*, Seung Eui Lim2, Hyunmi Lim2, Jeonghun Ku2, Youn Joo Kang 1† |
Introduction: Electromyographic (EMG) biofeedback induces the motions necessary for rehabilitation through the feedback of the EMG signal. However, the rehabilitation program using EMG biofeedback has limitations in utilizing and attracting the interest of stroke patients. Therefore, a new EMG biofeedback rehabilitation program is needed, which is more therapeutically accessible and increases patient's interest and participation. The purpose of this study was to investigate the effects of a new rehabilitative program, integrating a mobile game and a wearable device based on EMG biofeedback and motion sensing, on the recovery of upper limb function in stroke patients.
Methods: The mobile game was designed to enable rehabilitative training through games reflective of flexion, extension, abduction, and adduction identified by motion sensors along with grasping motions recognized by EMG signals measured by the wearable device. Twenty-two participants with upper extremity motor impairment within 3months after stroke were included in this study. Participants were randomized to either the intervention group or the control group. The intervention group (n=12) received 30 min of conventional occupational therapy (OT) and 30 min of the EMG biofeedback-based mobile game training. The control group (n=10) received conventional OT alone for 1 h per day. Rehabilitation consisted of 10 sessions of therapy, 5 days per week, for 2 weeks. The outcome measures were Manual Function Test (MFT), Fugl−Meyer Assessment (FMA), Box and block test (BBT), Manual Muscle Testing (MMT), and modifed Barthel index (MBI). Participants were assessed before treatment (pre), after 2 weeks of treatment (post), and at 1 month (2 weeks after the end of treatment, 1mo). Statistical analysis was performed using independent sample t-tests and repeated measures ANOVA.
Results: The baseline characteristics showed no significant differences between the two groups. Both groups showed significant within-group improvement in the MFT, BBT, MMT and MBI after treatment and at 1month (p<0.05). The FMA scores increased significantly in the intervention group after treatment and at 1month (p<0.05), but not in the control group. There was a significant interaction effect in MFT (p<0.05), but not in other measures. Changes in the MFT (pre vs. 1 mo and post vs. 1 mo) were significantly greater in the intervention group than in the control group (p<0.05).
Conclusion: This EMG biofeedback-based mobile game was more effective in improving upper limb function than the conventional OT in the stroke patients. This game appears to be feasible and can be used as an alternative to standard rehabilitation. |
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Table 1. Baseline characteristics of the participants
Fig 1. Change in the MFT, FMA, and BBT
Fig 2. Change in the MMT (shoulder, elbow, wrist) and MBI
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