Koutsiana Elisavet, Ladakis Ioannis, Fotopoulos Dimitris, Chytas Achilleas, Kilintzis Vassilis, Chouvarda Ioanna
Lab of Computing, Medical Informatics, and Biomedical-Imaging Technologies, School of Medicine, Aristotle University, Thessaloniki, Greece.
JMIR Serious Games. 2020 Dec 11;8(4):e19071. doi: 10.2196/19071.
Serious gaming has increasingly gained attention as a potential new component in clinical practice. Specifically, its use in the rehabilitation of motor dysfunctions has been intensively researched during the past three decades.
The aim of this scoping review was to evaluate the current role of serious games in upper extremity rehabilitation, and to identify common methods and practice as well as technology patterns. This objective was approached via the exploration of published research efforts over time.
The literature search, using the PubMed and Scopus databases, included articles published from 1999 to 2019. The eligibility criteria were (i) any form of game-based arm rehabilitation; (ii) published in a peer-reviewed journal or conference; (iii) introduce a game in an electronic format; (iv) published in English; and (v) not a review, meta-analysis, or conference abstract. The search strategy identified 169 relevant articles.
The results indicated an increasing research trend in the domain of serious gaming deployment in upper extremity rehabilitation. Furthermore, differences regarding the number of publications and the game approach were noted between studies that used commercial devices in their rehabilitation systems and those that proposed a custom-made robotic arm, glove, or other devices for the connection and interaction with the game platform. A particularly relevant observation concerns the evaluation of the introduced systems. Although one-third of the studies evaluated their implementations with patients, in most cases, there is the need for a larger number of participants and better testing of the rehabilitation scheme efficiency over time. Most of the studies that included some form of assessment for the introduced rehabilitation game mentioned user experience as one of the factors considered for evaluation of the system. Besides user experience assessment, the most common evaluation method involving patients was the use of standard medical tests. Finally, a few studies attempted to extract game features to introduce quantitative measurements for the evaluation of patient improvement.
This paper presents an overview of a significant research topic and highlights the current state of the field. Despite extensive attempts for the development of gamified rehabilitation systems, there is no definite answer as to whether a serious game is a favorable means for upper extremity functionality improvement; however, this certainly constitutes a supplementary means for motivation. The development of a unified performance quantification framework and more extensive experiments could generate richer evidence and contribute toward this direction.
严肃游戏作为临床实践中一个潜在的新组成部分，越来越受到关注。具体而言，在过去三十年中，其在运动功能障碍康复中的应用受到了深入研究。
本范围综述的目的是评估严肃游戏在上肢康复中的当前作用，并确定常见的方法、实践以及技术模式。通过探索不同时期发表的研究成果来实现这一目标。
利用PubMed和Scopus数据库进行文献检索，纳入1999年至2019年发表的文章。纳入标准为：（i）任何形式的基于游戏的手臂康复；（ii）发表在同行评审期刊或会议上；（iii）以电子格式介绍一款游戏；（iv）英文发表；（v）非综述、元分析或会议摘要。检索策略共识别出169篇相关文章。
结果表明，在上肢康复中部署严肃游戏领域的研究呈上升趋势。此外，在康复系统中使用商业设备的研究与提出定制机器人手臂、手套或其他用于与游戏平台连接和交互的设备的研究之间，在出版物数量和游戏方法上存在差异。一个特别相关的观察涉及对引入系统的评估。尽管三分之一的研究对其在患者中的实施情况进行了评估，但在大多数情况下，需要更多的参与者，并随着时间的推移对康复方案的效率进行更好的测试。大多数对引入的康复游戏进行某种形式评估的研究提到，用户体验是评估系统时考虑的因素之一。除了用户体验评估外，涉及患者的最常见评估方法是使用标准医学测试。最后，一些研究试图提取游戏特征，以引入定量测量来评估患者的改善情况。
本文概述了一个重要的研究课题，并突出了该领域当前的状况。尽管为开发游戏化康复系统进行了大量尝试，但对于严肃游戏是否是改善上肢功能的有利手段尚无定论；然而，这肯定是一种激励的补充手段。开发一个统一的性能量化框架和更广泛的实验可以产生更丰富的证据，并朝着这个方向做出贡献。
