Jeffrey C Schneider1, Muzaffer Y Ozsecen2, Nicholas K Muraoka3, Chiara Mancinelli4, Ugo Della Croce5, Colleen M Ryan6, Paolo Bonato7. 1. Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 300 First Ave, Boston, MA 02129(∗). Electronic address: jcschneider@partners.org. 2. Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA(†). 3. Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA(‡). 4. Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA(§). 5. Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA; and Università degli Studi di Sassari, Dipartimento di Scienze Politiche, Scienze della Comunicazione e Ingegneria, Sassari, Italy(¶). 6. Department of Surgery, Massachusetts General Hospital, Harvard Medical School; and Shriners Hospitals for Children, Boston, MA(#). 7. Department of Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA(‖).
Abstract
BACKGROUND: Burn contractures are common and difficult to treat. Measuring continuous joint motion would inform the assessment of contracture interventions; however, it is not standard clinical practice. This study examines use of an interactive gaming system to measure continuous joint motion data. OBJECTIVE: To assess the usability of an exoskeleton-based interactive gaming system in the rehabilitation of upper extremity burn contractures. DESIGN: Feasibility study. SETTING: Eight subjects with a history of burn injury and upper extremity contractures were recruited from the outpatient clinic of a regional inpatient rehabilitation facility. METHODS: Subjects used an exoskeleton-based interactive gaming system to play 4 different video games. Continuous joint motion data were collected at the shoulder and elbow during game play. MAIN OUTCOME MEASURES: Visual analog scale for engagement, difficulty and comfort. Angular range of motion by subject, joint, and game. RESULTS: The study population had an age of 43 ± 16 (mean ± standard deviation) years and total body surface area burned range of 10%-90%. Subjects reported satisfactory levels of enjoyment, comfort, and difficulty. Continuous joint motion data demonstrated variable characteristics by subject, plane of motion, and game. CONCLUSIONS: This study demonstrates the feasibility of use of an exoskeleton-based interactive gaming system in the burn population. Future studies are needed that examine the efficacy of tailoring interactive video games to the specific joint impairments of burn survivors.
BACKGROUND: Burn contractures are common and difficult to treat. Measuring continuous joint motion would inform the assessment of contracture interventions; however, it is not standard clinical practice. This study examines use of an interactive gaming system to measure continuous joint motion data. OBJECTIVE: To assess the usability of an exoskeleton-based interactive gaming system in the rehabilitation of upper extremity burn contractures. DESIGN: Feasibility study. SETTING: Eight subjects with a history of burn injury and upper extremity contractures were recruited from the outpatient clinic of a regional inpatient rehabilitation facility. METHODS: Subjects used an exoskeleton-based interactive gaming system to play 4 different video games. Continuous joint motion data were collected at the shoulder and elbow during game play. MAIN OUTCOME MEASURES: Visual analog scale for engagement, difficulty and comfort. Angular range of motion by subject, joint, and game. RESULTS: The study population had an age of 43 ± 16 (mean ± standard deviation) years and total body surface area burned range of 10%-90%. Subjects reported satisfactory levels of enjoyment, comfort, and difficulty. Continuous joint motion data demonstrated variable characteristics by subject, plane of motion, and game. CONCLUSIONS: This study demonstrates the feasibility of use of an exoskeleton-based interactive gaming system in the burn population. Future studies are needed that examine the efficacy of tailoring interactive video games to the specific joint impairments of burn survivors.
Authors: Tam N Pham; Richard Goldstein; Gretchen J Carrougher; Nicole S Gibran; Jeremy Goverman; Peter C Esselman; Lewis E Kazis; Colleen M Ryan; Jeffrey C Schneider Journal: Burns Date: 2020-02-20 Impact factor: 2.609