Download - A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: [email protected]

Transcript
Page 1: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 2: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@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

Page 3: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 4: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 5: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 6: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 7: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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%

Page 8: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 9: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

Page 10: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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

− RehaGames@home

− 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)

Page 11: A Systematic Review of Recent Evidence · Serious Games in Neurorehabilitation A Systematic Review of Recent Evidence Prof. Dr. Josef Wiemeyer eMail: wiemeyer@sport.tu-darmstadt.de

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