A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review...

of 11 /11
7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 1 Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: [email protected] URL: www.sport.tu-darmstadt.de Intl Workshop on Serious Games @ Multimedia 2014 November 7, 2014 Session 2 (1.45 pm) Orlando, Florida

Embed Size (px)

Transcript of A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review...

  • 7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 1

    Serious Games in Neurorehabilitation

    A Systematic Review of Recent Evidence

    Prof. Dr. Josef Wiemeyer

    eMail: [email protected]

    URL: www.sport.tu-darmstadt.de

    Intl Workshop on Serious Games –

    @ Multimedia 2014

    November 7, 2014 – Session 2 (1.45 pm)

    Orlando, Florida

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.pptmailto:[email protected]:[email protected]:[email protected]://www.sport.tu-darmstadt.de/http://www.sport.tu-darmstadt.de/http://www.sport.tu-darmstadt.de/

  • 7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 2

    Overview

    1. Introduction

    2. Methods

    3. Results

    4. Discussion

    5. Conclusion

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 1. Introduction

    Neurorehabilitation –

    a challenging mission: “…training has to be challenging, repetitive,

    task-specific, motivating, salient, and intensive

    for neuroplasticity to occur”

    (Saposnik & Lewin, 2011, p.1380)

    Serious Games in Neurorehabilitation –

    selected benefits

    − “… they will get better while having fun!“

    (Burdea, 2003, p.520)

    − Motivation & engagement

    − Immediate feedback

    − Rewards

    − Adaptation – personalization

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 3

    Source: http://www.bing.com

    Source: http://www.bing.com

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 1. Introduction

    Serious Games in Neurorehabilitation –

    current state:

    − Many publications

    − Main issues: Quality of SG systems & evidence

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 4

    0 10 72

    244

    11 12

    320

    782

    10 21

    184

    867

    16 46

    380

    998

    0

    200

    400

    600

    800

    1000

    1200

    Pubmed ACM IEEE Googlescholar

    Published papers – Feb 2014

    Serious Games &Neurorehabilitation

    Computer Games &Neurorehabilitation

    Video Games &Neurorehabilitation

    Games &Neurorehabilitation

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 2. Methods – Research questions

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 5

    Aspect Categories

    Study design RCT, pilot, case study, feasibility study

    Hardware Type: robot, PC interface, game interface;

    Category: off the shelf, custom-made, mixed

    Experimental design e.g., pre-post study with control group

    Disease e.g., stroke, multiple sclerosis, morbus

    Parkinson, generic

    Sample Quality: patients, healthy

    Quantity: sample size

    Focus of intervention e.g., upper extremity, lower extremity, gait,

    balance

    Treatment duration, focus

    Effects performance and attitude

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 2. Methods – Literature search

    4 sources:

    PubMed, ACM, IEEE, and

    Google scholar

    4 search terms:

    − Serious Games & Neurorehabilitation

    − Computer Games & Neurorehabilitation

    − Video Games & Neurorehabilitation

    − Games & Neurorehabilitation

    Date: February 28, 2014

    Inclusion criteria:

    − Publication year: 2013 and 2014

    − Empirical study relevant to

    neurorehabilitation

    Papers included: 30 (plus 4 RCT)

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 6

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 3. Results

    4 RCT studies (published before 2013)

    − Preliminary positive evidence

    − Quality issues:

    multiple testing

    considerable dropout rates

    small sample size

    30 further studies

    − Design

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 8

    Source: http://www.bing.com

    Feasibility 50%

    Pilot 27%

    Case 10%

    Other 13%

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 3. Results

    (30 further studies - continued)

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 10

    Source: http://www.bing.com

    Game 46%

    PC 17%

    Robot 27%

    Other 10%

    Interface

    Upper extremity 60%

    Lower extremity 7%

    Perceptual/ cognitive

    functions & balance

    10%

    Other 23%

    Focus of intervention

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 3. Results

    (30 further studies - continued)

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 12

    Source: Vandermaesen et al. (2013, p.2)

    Positive 44%

    Mixed 10%

    No effect 3%

    No report 43%

    Performance effects

    Positive 33%

    Mixed 10%

    No report 57%

    Attitude effects

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 4. Discussion

    Evidence − Positive trends – strong bias

    − Quality of evidence: poor

    − Shortcomings:

    Research design

    Dependent variables

    Sample size and recruitment

    Dominant research designs:

    − Feasibility, pilot, case

    − No recent RCT

    Hardware: OTS dominating

    Trends:

    − Individualization & adaptation

    [email protected]

    − Brain-game interfaces

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 13

    Source: http://www.bing.com

    Source: Hocine et al. (2014, p. 120)

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt

  • 5. Conclusion

    Further studies needed

    Improved quality

    Reminder: “double mission” of Serious Games

    7. November 2014 | Fachbereich Humanwissenschaften | Institut für Sportwissenschaft | Prof. Dr. Josef Wiemeyer | 14

    Task difficulty

    Skill

    level

    low high

    low

    high Boredom

    No improvement

    Deterioration

    Anxiety

    Failure

    Maldadaptation

    Source: Wiemeyer (2014, p.178)

    (Translation)

    Source: http://www.bing.com

    ../../Lehre/Lehrmaterialien für Biomechanik_Physiologie_etc/Lehrmedien_neuesCD.ppt