Abstract
Purpose
This study consists of a systematic review that aims to identify and evaluate the scenario of the use of serious games in the rehabilitation of individuals with Parkinson’s disease.
Methods
Web searches were conducted on Web of Science, Scopus, PubMed, Bireme, ScienceDirect, IEEE Digital Library, ACM Digital Library, and Google Scholar databases, using the keywords “serious game” and “Parkinson”. The following variables were evaluated: type of game, interface, device, protocol used for rehabilitation, method used for assessing the effectiveness of the game, symptoms treated, and application in real patients. A total of 169 studies were identified and 38 were selected.
Results
The majority of studies propose the development of exergames, used virtual reality as the interface technology, used Leap Motion and Microsoft Kinect to capture body movements, included a doctor or therapist to accompany the serious games development, used more than one tool to evaluate the game and patient outcomes, treated bradykinesia and gait impairments, and took into account experiments with patients.
Conclusion
The results suggest that it is important that the solutions developed have high methodological rigor and that they extend the instrument to a clinical practice. Serious games for individuals with Parkinson’s disease must be customizable, simple, and smart.
Graphical abstract
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References
Abdi H, Williams LJ. Principal component analysis. Wiley Interdiscip Rev Comput Stat. 2010;2:433–59. https://doi.org/10.1002/wics.101.
Alves G, Forsaa EB, Pedersen KF, et al. Epidemiology of Parkinson’s disease. In: Journal of Neurology. 2008;18–32.
Andrade Ferreira LD, Ferreira H, Cavaco S, et al. User experience of interactive technologies for people with dementia: comparative observational study. JMIR Serious Games 8. 2020. https://doi.org/10.2196/17565.
Annetta L. The “I’s” have it: a framework for serious educational game design. 2010. https://doi.org/10.1037/a0018985.
Assad O, Hermann R, Lilla D, et al. Motion-based games for Parkinson’s disease patients. In: Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics). Springer, Berlin, Heidelberg. 2011;47–58.
Avola D, Cinque L, Foresti GL, et al. VRheab: a fully immersive motor rehabilitation system based on recurrent neural network. Multimed Tools Appl. 2018;77:24955–82. https://doi.org/10.1007/s11042-018-5730-1.
Ayed I, Ghazel A, Jaume-i-Capó A, et al. Vision-based serious games and virtual reality systems for motor rehabilitation: a review geared toward a research methodology. Int. J. Med. Inform. 2019; 131.
Baranyi R, Willinger R, Lederer N, et al. Chances for serious games in rehabilitation of stroke patients on the example of utilizing the Wii Fit Balance Board. In: SeGAH 2013 - IEEE 2nd International Conference on Serious Games and Applications for Health, Book of Proceedings. IEEE Computer Society. 2013.
Bégel V, Di Loreto I, Seilles A, Dalla Bella S. Music games: Potential application and considerations for rhythmic training. Front. Hum. Neurosci. 2017;11.
Bruin E, Schoene D, Pichierri G, Smith S. Use of virtual reality technique for the training of motor control in the elderly. Z Gerontol Geriat. 2010;43:229–34. https://doi.org/10.1007/s00391-010-0124-7.
Burdea G. Virtual rehabilitation-benefits and challenges. Methods Inf Med. 2003;42:519–23. https://doi.org/10.1267/METH03050519.
Cai H, Lin T, Chen L, et al. Evaluating the effect of immersive virtual reality technology on gait rehabilitation in stroke patients: a study protocol for a randomized controlled trial. Trials. 2021;22:91. https://doi.org/10.1186/s13063-021-05031-z.
Chen W, Bang M, Krivonos D, et al. An immersive virtual reality exergame for people with Parkinson’s disease. In: International Conference on Computers Hel** People with Special Needs. Springer Science and Business Media Deutschland GmbH. 2020;138–145.
Da Silva ICS, Nesi LC, De Andrade Werly J, Murillo LR. Ludic game approach as assistive technology for activities of daily living training. In: ACM International Conference Proceeding Series. Association for Computing Machinery, New York, New York, USA. 2017;1–10.
Dauvergne C, Bégel V, Gény C, et al. Home-based training of rhythmic skills with a serious game in Parkinson’s disease: Usability and acceptability. Ann Phys Rehabil Med. 2018;61:380–5. https://doi.org/10.1016/j.rehab.2018.08.002.
Dias SB, Diniz J, Trivedi D, et al. On exploring design elements in assistive serious games for Parkinson’s disease patients: the i-PROGNOSIS exergames paradigm. In: TISHW 2018 - 2nd International Conference on Technology and Innovation in Sports, Health and Wellbeing, Proceedings. Institute of Electrical and Electronics Engineers Inc. 2018.
Dybå T, Dingsøyr T. Empirical studies of agile software development: a systematic review. Inf Softw Technol. 2008;50:833–59.
Elor A, Teodorescu M, Kurniawan S. Project Star Catcher: a novel immersive virtual reality experience for upper limb rehabilitation. ACM Trans Access Comput 11. 2018. https://doi.org/10.1145/3265755.
Fernández-González P, Carratalá-Tejada M, Monge-Pereira E, et al. Leap Motion controlled video game-based therapy for upper limb rehabilitation in patients with Parkinson’s disease: a feasibility study. J Neuroeng Rehabil. 2019;16:133. https://doi.org/10.1186/s12984-019-0593-x.
Foletto AA, D’Ornellas MC, Prado AL. Serious games for Parkinson’s disease fine motor skills rehabilitation using natural interfaces. 2017;74–78.
Garcia-Agundez A, Folkerts AK, Konrad R, et al. Recent advances in rehabilitation for Parkinson’s disease with exergames: a systematic review. J Neuroeng Rehabil. 2019;16:17.
Holden M. Virtual environments for motor rehabilitation: review. Cyberpsychology Behav. 2005;8:187–211.
Imbeault-Nepton T, Otis MJD. Synchronized walking cadence for TUG in perturbed environments: using earcon or tacton cues? In: 2014 IEEE International Symposium on Haptic, Audio and Visual Environments and Games, HAVE 2014 - Proceedings. Institute of Electrical and Electronics Engineers Inc. 2014;41–46.
Kitchenham B. Guidelines for performing systematic literature reviews in software engineering. 2007.
Koster R. Theory of fun for game design, O’Reilly M. San Diego, CA. 2013.
Krause M, Smeddinck J, Meyer R. A digital game to support voice treatment for Parkinson’s disease. In: Conference on Human Factors in Computing Systems - Proceedings. Association for Computing Machinery. 2013;445–450.
Leblong E, Fraudet B, Dandois M, et al. A 4 weeks home training program using a biofeedback serious game and sensors for Parkinson’s disease: a pilot study on a new and completely autonomous solution. In: International Conference on Virtual Rehabilitation, ICVR. Institute of Electrical and Electronics Engineers Inc. 2017.
Lê S, Josse J, Husson F. FactoMineR : An R Package for Multivariate Analysis. J Stat Softw. 2008;25:1–18. https://doi.org/10.18637/jss.v025.i01.
Mendes FA, dos S, Pompeu JE, Lobo AM, et al. Motor learning, retention and transfer after virtual-reality-based training in Parkinson’s disease - effect of motor and cognitive demands of games: A longitudinal, controlled clinical study. Physiother (United Kingdom). 2012;98:217–23. https://doi.org/10.1016/j.physio.2012.06.001.
Mirelman A, Maidan I, Herman T, et al. Virtual reality for gait training: can it induce motor learning to enhance complex walking and reduce fall risk in patients with Parkinson’s disease? J Gerontol - Med Sci. 2011;66A:234–40. https://doi.org/10.1093/gerona/glq201.
Mitgutsch K, Alvarado N. Purposeful by design?: A serious game design assessment framework. In: Foundations of Digital Games 2012, FDG 2012 - Conference Program. 2012; 121–128.
Mitrousia V, Giotakos O. Virtual reality therapy in anxiety disorders. Psychiatriki. 2016;27:276–86. https://doi.org/10.22365/jpsych.2016.274.276.
Morando M, Ponte S, Femara E, Dellepiane S. Biophysical and motion features extraction for an effective home-based rehabilitation. In: ACM International Conference Proceeding Series. Association for Computing Machinery. 2017;79–85.
Noveletto F, Soares A, Mello BA, et al. Biomedical serious game system for balance rehabilitation of hemiparetic stroke patients. IEEE Trans Neural Syst Rehabil Eng. 2018;26:2179–88. https://doi.org/10.1109/TNSRE.2018.2876670.
Oña ED, Balaguer C, Cano-de la Cuerda R, et al. Effectiveness of serious games for Leap Motion on the functionality of the upper limb in Parkinson’s disease: a feasibility study. Comput Intell Neurosci. 2018. https://doi.org/10.1155/2018/7148427.
Oña ED, Cuesta-Gomez A, Garcia JA, et al. Evaluating a VR-based box and blocks test for automatic assessment of manual dexterity: a preliminary study in Parkinson’s disease. In: 2019 IEEE 7th International Conference on Serious Games and Applications for Health, SeGAH 2019. Institute of Electrical and Electronics Engineers Inc. 2019.
Opara JA, Brola W, Leonardi M, Błaszczyk B. Quality of life in Parkinson’s disease. J Med Life. 2012;5:375–81.
Pachoulakis I, Papadopoulos N. Exergames for Parkinson’s disease patients: the balloon goon game. In: 2016 International Conference on Telecommunications and Multimedia, TEMU 2016. Institute of Electrical and Electronics Engineers Inc. 2016;12–17.
Palacios-Navarro G, Albiol-Pérez S, Gil-Gómez JA, et al. Working alliance and virtual motor rehabilitation in Parkinson patients. In: Proceedings - REHAB 2014. ICST. 2014;274–277.
Paraskevopoulos I, Tsekleves E, Craig C, et al. Design guidelines for develo** customised serious games for Parkinson’s disease rehabilitation using bespoke game sensors. Entertain Comput. 2014;5:413–24. https://doi.org/10.1016/j.entcom.2014.10.006.
Pompeu JE, Arduini LA, Botelho AR, et al. Feasibility, safety and outcomes of playing Kinect Adventures!TM for people with Parkinson’s disease: a pilot study. Physiother (united Kingdom). 2014;100:162–8. https://doi.org/10.1016/j.physio.2013.10.003.
Ramji V, Hssayeni M, Burack MA, Ghoraani B. Parkinson’s disease medication state management using data fusion of wearable sensors. In: 2017 IEEE EMBS International Conference on Biomedical and Health Informatics, BHI 2017. Institute of Electrical and Electronics Engineers Inc. 2017;193–196.
Robert P, Manera V, Derreumaux A, et al. Efficacy of a web app for cognitive training (MEMO) regarding cognitive and behavioral performance in people with neurocognitive disorders: randomized controlled trial. J Med Internet Res 22. 2020. https://doi.org/10.2196/17167.
Rocca WA. The burden of Parkinson’s disease: a worldwide perspective. Lancet Neurol. 2018;11:928–9. https://doi.org/10.1016/S1474-4422(18)30355-7.
Sáenz-De-urturi Z, Zapirain BG, Zorrilla AM. Kinect-based virtual game for motor and cognitive rehabilitation: a pilot study for older adults. In: Proceedings - REHAB 2014. ICST. 2014;262–265.
Sánchez-Herrera-Baeza P, Cano-de-la-Cuerda R, Oña-Simbaña ED, et al. The impact of a novel immersive virtual reality technology associated with serious games in Parkinson’s disease patients on upper limb rehabilitation: a mixed methods intervention study. Sensors. 2020;20:2168. https://doi.org/10.3390/s20082168.
Shah V, Cuen M, McDaniel T, Tadayon R. A rhythm-based serious game for fine motor rehabilitation using Leap Motion. In: 2019 58th Annual Conference of the Society of Instrument and Control Engineers of Japan, SICE 2019. Institute of Electrical and Electronics Engineers Inc. 2019;737–742.
Siegel S, Smeddinck J. Adaptive difficulty with dynamic range of motion adjustments in exergames for Parkinson’s disease patients. In: Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics). Springer, Berlin, Heidelberg. 2012;429–432.
Silva KG, De Freitas TB, Doná F, et al. Effects of virtual rehabilitation versus conventional physical therapy on postural control, gait, and cognition of patients with Parkinson’s disease: study protocol for a randomized controlled feasibility trial. Pilot Feasibility Stud. 2017;3:68. https://doi.org/10.1186/s40814-017-0210-3.
Solachidis V, Paliokas I, Vretos N, et al. Two examples of online eHealth platforms for supporting people living with cognitive impairments and their caregivers. In: ACM International Conference Proceeding Series. Association for Computing Machinery. 2018;449–454.
Tannous H, Grebonval C, Istrate D, et al. Cognitive and functional rehabilitation using serious games and a system of systems approach. In: 2018 13th System of Systems Engineering Conference, SoSE 2018. Institute of Electrical and Electronics Engineers Inc. 2018;189–194.
Teive H, Bertucci Filho D, Munhoz R. Sintomas e sinais motores e não motores pouco comuns na fase inicial da doença de Parkinson. Arq Neuropsiquiatr. 2016;74:781–4. https://doi.org/10.1590/0004-282X20160126.
Valladares-Rodríguez S, Pérez-Rodríguez R, Anido-Rifón L, Fernández-Iglesias M. Trends on the application of serious games to neuropsychological evaluation: a sco** review. J Biomed Inform. 2016;64:296–319.
van de Weijer S, Kuijf M, de Vries N, et al. Do-it-yourself gamified cognitive training: viewpoint. JMIR Serious Games. 2019;7:e12130. https://doi.org/10.2196/12130.
Van Der Meulen E, Cidota MA, Lukosch SG, et al. A haptic serious augmented reality game for motor assessment of Parkinson’s disease patients. In: Adjunct Proceedings of the 2016 IEEE International Symposium on Mixed and Augmented Reality, ISMAR-Adjunct 2016. Institute of Electrical and Electronics Engineers Inc. 2017;102–104.
de Paula Vieira G, de Souza MN, Orsini M, et al. Virtual reality for upper limbs in patients with Parkinson’s disease: protocol study. EC Neurol. 2017;6:204–15.
Wattanasoontorn V, Boada I, García R, Sbert M. Serious Games for Health. Entertain Comput. 2013;4:231–47. https://doi.org/10.1016/j.entcom.2013.09.002.
Yuan RY, Chen SC, Peng CW, et al. Effects of interactive video-game-based exercise on balance in older adults with mild-to-moderate Parkinson’s disease. J Neuroeng Rehabil. 2020;17. https://doi.org/10.1186/s12984-020-00725-y.
Funding
The present study was carried out with the support the National Council for Scientific and Technological Development (CNPq), Coordination of Improvement of Higher-Level Personnel (CAPES—Program CAPES/DFATD-88887.159028/2017–00, Program CAPES/COFECUB-88881.370894/2019–01), Foundation for Research Support of the State of Minas Gerais (FAPEMIG -APQ-00942–642 17). A. O. Andrade is a Fellow of CNPq (305223/2014–3 and 304818/2018–6).
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Luciene C. de Oliveira: Conceptualization, methodology, investigation, writing—original draft preparation. Luanne C. Mendes: Methodology; investigation; writing, original draft preparation; writing, reviewing and editing. Renato de A. Lopes: Methodology, investigation, and writing—original draft preparation. José A. S. Carneiro: Writing—reviewing and editing. Alexandre Cardoso: Conceptualization. Edgard A. L. Júnior: Conceptualization, writing—reviewing and editing. Adriano de O. Andrade: PCA analysis in R. Writing—reviewing and editing. Supervision of Luciene C. de Oliveira and Luanne C. Mendes.
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de Oliveira, L.C., Mendes, L.C., de Lopes, R.A. et al. A systematic review of serious games used for rehabilitation of individuals with Parkinson’s disease. Res. Biomed. Eng. 37, 849–865 (2021). https://doi.org/10.1007/s42600-021-00162-3
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DOI: https://doi.org/10.1007/s42600-021-00162-3