Background: Exercise is emerging as an efficacious therapy to complement the management of motor symptoms in Parkinson's disease (PD) such as poor gait and postural control. Computer based gaming systems can facilitate complex task practice, enhanced sensory feedback and action observation in novel, relevant and motivating modes of exercise which can be difficult to achieve with standard physiotherapy. The appropriateness of current Kinect gaming software for rehabilitation in PD is limited and the accuracy of movement detection has not been established. Aims: Develop a computer game to rehabilitate dynamic postural control in people with Parkinson's disease (PD) using the Xbox Kinect; and assess the feasibility and validity of the Kinect system to provide rehabilitation and symptom monitoring in people with PD. Methods: A rehabilitation game aimed at training dynamic postural control was developed in collaboration with people with PD and their carers. The game consisted of multi-directional reaching and stepping, with increasing cognitive complexity across 11 stages. Nine people with PD played the game for one 30min session. Participant feedback to identify issues relating to acceptability, feasibility and safety of rehabilitation gaming for people with PD were collected using a semi-structured interview. To establish reliability and validity for gaming and monitoring, we recruited nine PD participants and 10 controls to perform a range of movements measured by a 3D motion capture system (VICON) and Kinect system concurrently. Results: People with PD generally enjoyed the game and all felt safe whilst playing the game. Eight out of the nine participants said they would buy the game, especially if they felt it would improve their balance. However, some participants found interacting with game objects appearing to move towards them difficult and some had difficulty combining the stepping and reaching tasks. The Kinect accurately measured gross movements such as multi-directional stepping and reaching, and sit-to-stand, as well as estimated relative timing and amplitude of distal movements such as hand clasping and foot tapping. The Kinect was also able to estimate a consistent pattern of knee flexion when walking. Discussion: Computer based rehabilitation games can be delivered in a safe and enjoyable way using the Xbox Kinect for people with PD. However intervention trials are needed to test the game's efficacy. In addition, the Xbox Kinect can accurately measure the timing and overall pattern of movements used in clinically based tests but not with the same spatial accuracy as the gold standard three-dimensional motion analysis equipment.
|Publication status||Published - 22 Jun 2013|
|Event||ISPGR World Congress 2013 - Akita, Japan|
Duration: 22 Jun 2013 → …
|Conference||ISPGR World Congress 2013|
|Period||22/06/13 → …|