Enciso James, Variya Dhruval, Sunthonlap James, Sarmiento Terrence, Lee Ka Mun, Velasco James, Pebdani Roxanna N, de Leon Ray D, Dy Christine, Keslacy Stefan, Won Deborah Soonmee
Department of Electrical and Computer Engineering, California State University, Los Angeles, Los Angeles, CA, United States.
Rufus Labs, Los Angeles, CA, United States.
JMIR Rehabil Assist Technol. 2021 Jan 19;8(1):e16054. doi: 10.2196/16054.
Implementing exercises in the form of video games, otherwise known as exergaming, has gained recent attention as a way to combat health issues resulting from sedentary lifestyles. However, these exergaming apps have not been developed for exercises that can be performed in wheelchairs, and they tend to rely on whole-body movements.
This study aims to develop a mobile phone app that implements electromyography (EMG)-driven exergaming, to test the feasibility of using this app to enable people in wheelchairs to perform exergames independently and flexibly in their own home, and to assess the perceived usefulness and usability of this mobile health system.
We developed an Android mobile phone app (Workout on Wheels, WOW-Mobile) that senses upper limb muscle activity (EMG) from wireless body-worn sensors to drive 3 different video games that implement upper limb exercises designed for people in wheelchairs. Cloud server recordings of EMG enabled long-term monitoring and feedback as well as multiplayer gaming. Bench testing of data transmission and power consumption were tested. Pilot testing was conducted on 4 individuals with spinal cord injury. Each had a WOW-Mobile system at home for 8 weeks. We measured the minutes for which the app was used and the exergames were played, and we integrated EMG as a measure of energy expended. We also conducted a perceived usefulness and usability questionnaire.
Bench test results revealed that the app meets performance specifications to enable real-time gaming, cloud storage of data, and live cloud server transmission for multiplayer gaming. The EMG sampling rate of 64 samples per second, in combination with zero-loss data communication with the cloud server within a 10-m range, provided seamless control over the app exergames and allowed for offline data analysis. Each participant successfully used the WOW-Mobile system at home for 8 weeks, using the app for an average of 146 (range 89-267) minutes per week with the system, actively exergaming for an average of 53% of that time (39%-59%). Energy expenditure, as measured by integrated EMG, was found to be directly proportional to the time spent on the app (Pearson correlation coefficient, r=0.57-0.86, depending on the game). Of the 4 participants, 2 did not exercise regularly before the study; these 2 participants increased from reportedly exercising close to 0 minutes per week to exergaming 58 and 158 minutes on average using the WOW-Mobile fitness system. The perceived usefulness of WOW-Mobile in motivating participants to exercise averaged 4.5 on a 5-point Likert scale and averaged 5 for the 3 participants with thoracic level injuries. The mean overall ease of use score was 4.25 out of 5.
Mobile app exergames driven by EMG have promising potential for encouraging and facilitating fitness for individuals in wheelchairs who have maintained arm and hand mobility.
以电子游戏形式开展的运动，即健身游戏，作为一种应对久坐生活方式导致的健康问题的方法，近来受到了关注。然而，这些健身游戏应用程序并非针对轮椅上可进行的运动而开发，并且它们往往依赖全身运动。
本研究旨在开发一款实现肌电图（EMG）驱动的健身游戏的手机应用程序，测试使用该应用程序使轮椅使用者能够在自己家中独立灵活地进行健身游戏的可行性，并评估该移动健康系统的感知有用性和易用性。
我们开发了一款安卓手机应用程序（Wheelchair Workout，WOW-Mobile），该程序通过无线可穿戴传感器感知上肢肌肉活动（EMG），以驱动3种不同的视频游戏，这些游戏实现了为轮椅使用者设计的上肢运动。EMG的云服务器记录实现了长期监测和反馈以及多人游戏。对数据传输和功耗进行了台架测试。对4名脊髓损伤患者进行了试点测试。每人在家中使用WOW-Mobile系统8周。我们测量了应用程序使用时间和健身游戏的游玩时间，并将EMG作为能量消耗的一种度量进行整合。我们还进行了感知有用性和易用性问卷调查。
台架测试结果表明，该应用程序符合性能规格，能够实现实时游戏、数据云存储以及多人游戏的实时云服务器传输。每秒64个样本的EMG采样率，结合在10米范围内与云服务器的零损耗数据通信，为应用程序健身游戏提供了无缝控制，并允许进行离线数据分析。每位参与者均在家中成功使用WOW-Mobile系统8周，使用该系统时平均每周使用应用程序146（范围89 - 267）分钟，其中平均53%的时间（39% - 59%）用于积极进行健身游戏。通过整合EMG测量的能量消耗与在应用程序上花费的时间成正比（皮尔逊相关系数，r = 0.57 - 0.86，取决于游戏）。在4名参与者中，2名在研究前未定期锻炼；这2名参与者从据报道每周锻炼接近0分钟增加到使用WOW-Mobile健身系统平均每周健身游戏58分钟和158分钟。WOW-Mobile在激励参与者锻炼方面的感知有用性在5分制李克特量表上平均为4.5分，对于3名胸段损伤的参与者平均为5分。总体易用性平均得分为4.25分（满分5分）。
由EMG驱动的移动应用程序健身游戏在鼓励和促进保持手臂和手部活动能力的轮椅使用者的健身方面具有广阔的潜力。
