Biomedical Serious Game System for Lower Limb Motor Rehabilitation of Hemiparetic Stroke Patients

Hemiparesis resulting from a stroke has a direct impact on patients' daily activities. New approaches for motor rehabilitation include Serious Games (SG) because they include (in a motivating way) the three fundamental elements for rehabilitation: intensive, repetitive and task-oriented training. This study aims to evaluate the therapeutic effects of a biomedical SG and a scoring system developed for lower limb motor rehabilitation of hemiparetic stroke patients. The SG was inspired by the classic videogame called Pong, where the goal is to control a tennis racquet, but using muscular strength. A knee extensor apparatus was adapted with a load cell and mechanical adjustments for measuring the muscular strength of the quadriceps femoris (QFG) and hamstrings (HSG). A scoring system was proposed to evaluate muscular control. Eleven hemiparetic stroke patients participated in an exercise program using the SG twice a week for ten weeks and only the paretic side was trained. Significant Effect Sizes (d) were found for QFG strength (d = 0.5; p = 0.021), QFG control (d = 1.1; p < 0.001), HSG strength (d = 1.1; p = 0.001), HSG control (d = 1.5; p = 0.003), functional mobility (d = 0.3; p < 0.001), gait speed (d = 0.4; p = 0.007) and motor recovery (d = 1.0; p < 0.001). Results indicate that the intervention of a SG with both proper apparatus and evaluation system may effectively promote lower limb motor rehabilitation of hemiparetic stroke patients.