Rehabilitation Robots for Neurorehabilitation in High-, Low-, and Middle-Income Countries

This chapter will first present health statistics for Turkey and describe conventional rehabilitation therapies used to rehabilitate patients with stroke. Next, we will present existing neurorehabilitation robotic centers that treat patients in Turkey and provide information about the upper/lower-extremity robots used in these centers. We will discuss the advantages and shortcomings of these robots and technological advances in neurorehabilitation. Then, we will describe the prototype upper/lower-extremity robots that are not yet used in the clinic but are still being developed in the universities to treat patients in Turkey. Next, we will discuss barriers to effective rehabilitation robotics and give an overview of the policies and legal and ethical issues around rehabilitation robotics in Turkey. Lastly, we will evaluate how rehabilitation has changed or is still changing during the COVID-19 pandemic, whether the need for rehabilitation robots will increase, and our opinions about the future of neurorehabilitation and what can be done further to use rehabilitation robots.

Stress recognition from facial images in children during physiotherapy with serious games

Serious games have emerged as promising tools for physiotherapy, offering an engaging way to motivate patients and improve physical functions. Stress, a common physiological response, can impede patient performance and hinder recovery in physiotherapy. However, there is limited research on stress recognition for children during physiotherapeutic serious games. This study proposes a deep and machine learning based method for stress detection from facial images of children. The contributions include the utilization of a novel dataset comprising videos of 25 children, including children with specific conditions, and the exploration of using adults’ facial images for data augmentation. The proposed method employs a modified deep network architecture, VGG-Face, for facial emotion recognition and utilizes three machine learning models for stress recognition. This study represents the first attempt to recognize stress in children’s facial images during physiotherapy with serious games. The findings hold the potential to optimize patient outcomes and contribute to monitoring patients during home therapy.

A physiological signal database of children with different special needs for stress recognition

This study presents a new dataset AKTIVES for evaluating the methods for stress detection and game reaction using physiological signals. We collected data from 25 children with obstetric brachial plexus injury, dyslexia, and intellectual disabilities, and typically developed children during game therapy. A wristband was used to record physiological data (blood volume pulse (BVP), electrodermal activity (EDA), and skin temperature (ST)). Furthermore, the facial expressions of children were recorded. Three experts watched the children’s videos, and physiological data is labeled “Stress/No Stress” and “Reaction/No Reaction”, according to the videos. The technical validation supported high-quality signals and showed consistency between the experts. Becure CatchAPet and Becure LeapBall serious games were used in this study. First, the child tries to touch the rabbit on the screen in the playground with his hand in the virtual environment in the Becure CatchAPet game. The child earns points for each contact with the rabbit and loses points for each missed rabbit. The child uses his/her wrist flexion/extension movement during the game. The wrist angles are determined by the physical therapists so that each child can virtually touch a rabbit with the correct range of motion. In the Becure LeapBall game, the child tries to drop the ball on the screen into buckets of the same color. The child tries to hold and release the ball with grasping movements. The child directs the ball in the virtual environment, and if the child throws it into the correct bucket, he/she earns scores. The fail score increases when the child throws in the wrong basket. Various measures are recorded at the end of each game on the Becure E-Therapy web portal.

The Effect of leap motion controller based exergame therapy on hand function, cognitive function and qualty of life in older adults. A randomised trial.

Technology and game-based rehabilitation systems such as exergames can contribute to the development of both motor and cognitive functions with task-specific upper extremity exercises, by providing fun and challenging tasks that enable participants to rehabilitate without being aware of it. The leap motion controller (LMC) can be used for hand exercises with advantages like cheap, no sensor needed, portable, safe and inspiratory environment. The LMC based exergame therapy (LMCBET) is widely used, particularly in pediatric rehabilitation, to evaluate hand fine motor function. Although the LMCBET has been applied for a specific disease group in previous studies to our knowledge, there is no study focusing on virtual reality and cognitive function in healthy older adults. This study is intended to be a pioneering study. The aim of this study was to evaluate the effectiveness of the SE and LMCBET in hand function, cognitive function and QoL in older adults.

The validity of an objective measurement method using the Leap Motion Controller for fingers wrist, and forearm ranges of motion.

The present study aimed to validate the Leap Motion Controller (LMC)-based Fizyosoft HandROM System developed by our team to evaluate range of motion (ROM) for fingers, wrist, and forearm in a new clinical setting. Thirty-five healthy individuals participated in the study (all right-handed, 20–30 years old). The LMC-based Fizyosoft HandROM System is a licensed software ROM-measurement developed by our team. Pronation/supination, wrist flexion/extension, ulnar/radial deviation and metacarpopha- langeal (MCP) flexion/extension of all fingers were measured with both the Fizyosoft HandROM System and a universal goniometer. The present study results indicated that the LMC-based Fizyosoft HandROM System could sensitively track changes in the active motion of the thumb, wrist, and forearm. It is a viable alternative for assessing ROMs of the forearm, wrist, and thumb in patient follow-up.

Comparing body posture and postural control in children with intellectual disability and dyslexia to typically developing children using technology‑based assessments

The aim of this study was to investigate body posture and postural control in children with intellectual disability and dyslexia compared to typically developing children using technology‑based assessments.

The Effects of Proprioceptive Neuromuscular Facilitation Vs Virtual Reality Exercise on Shoulder Muscle Activation

The purpose of this study is to compare the effects of Proprioceptive Neuromuscular Facilitation (PNF) exercises and Virtual Reality Therapy (VR) to see which treatment yields the greatest shoulder musculature activation in a healthy population..VR exercise was performed playing the U-Ball game which closely mimics a D2 PNF pattern via an X-box (BeCure software system).

Evaluation of Balance Functions in Early Multiple Sclerosis Patients with Technological System

The purpose of this study is to investigate balance disorder in the early stage of MS disease, to examine its demographic and clinical relationships, and to direct appropriate treatment in the early period. Balance assessment was done with the “Becure Balance System“.

Comparison of Static Balance in University Students with and without Smartphone Addiction-Pilot Study

The aim of this study was to compare the static balance in university students with and without smartphone addiction. Static balance was evaluated with “Becure BalanceSystem”.

The Effect of Technology Assisted Rehabilitation Practices on Postural Control, Activity and Participation in Children with Cerebral Palsy

In this study, trunk control ‘Trunk Control Measurement Scale’, selective movement ‘Selective Control Assessment of Lower Extremity’, spasticity ‘Modified Ashworth Scale’, balance ‘BeCure Balance Assessment Systems’, activity-participation ‘Pediatric Evaluation of Disability Inventory’, quality of life were evaluated with ‘Pediatric Quality of Life Inventory-CP Module’.They used Nintendo WiiFit’s balance bord for balance system measuring.

Investigation on the Efficiency of the Closed Kinetic Chain and Video-Based Game Exercise Programs in the Rotator Cuff Rupture: A Randomized Trial

The ROM of the joint and joint position sense of the individuals participating in the study were evaluated using Fizyosoft Extremity ROM. Fizyosoft Balance System was used to evaluate shoulder approxima- tion force. Video-Based Games Exercise Program in Rotator Cuff in this study: Uball, ArmRotate, BalanceSurf, BalanceAdvanture

Development Process of Rehabilitative Games

Development Process of Rehabilitative Games

Development of a Balance System Including Virtual Reality Applications for the Evaluation and Improvement of Balance: Physiotherapy–Engineering Cooperation

In the study, software was developed to evaluate balance and make exercise applications by using the balance platform of the Nintendo Wii game console available in the market. Worked has been done for the “Balance System”

Investigation of the Effectiveness of Rebound Therapy with Back Walking Exercises in Cerebral Palsy Rehabilitation

In study, they used Gross Motor Function Measurement (GMFM-88) scale and Lower Extremity Function Test (LEFT) for determining the level of functionality, manual goniometre for determining Range of motion (ROM) ( ankle dorsiflexion and popliteal angle), Becure Balance System (BBS) for determining the balance, ultrasonographic measurement of the medial gastrocnemius (m-gcm) for determining the changes in muscle thickness (MT) before and after the treatment. They used Nintendo WiiFit’s balance bord for balance system measuring.

Effect of Kinesio taping on wrist kinematics and functional performance: A randomized controlled trial

The participants of the study dominant wrist kinematics during DTM was evaluated by a Leap motion controller and wrist functional performance was evaluated by Minnesota Manual Dexterity Test. Played the Fizyosoft Pong game by participants.

The Validity of an Objective Measurement Method Using the Leap Motion Controller for Fingers Wrist, and Forearm Ranges of Motion

The present study, they aimed to validate the Leap Motion Controller (LMC)-based Fizyosoft HandROM System developed by our team to evaluate range of motion (ROM) for fingers, wrist, and forearm in a new clinical setting.

The Effect of Video-Based Games on Hand Functions and Cognitive Functions in Cerebral Palsy

The purpose of this study is to investigate the effect of Leap Motion Based Exergame Therapy (LMBET) on upper limb gross grip strength (GGS), pinch forces, hand functions, gross motor function, and cognitive functions in patients with cerebral palsy (CP). Two games called “Fizyosoft CatchAPet” and “Fizyosoft Leapball” were developed using Leap Motion. In this study, they talked about “Fizyosoft CatchAPet” and “Fizyosoft Leapball” games.

Investigation of the Effectiveness of Structured Closed Kinetic Chain and Video-Based Game Exercise Programme in Rotator Cuff Lesion

In this study, the effectiveness of video-based game exercise and structured closed kinetic chain exercises in individuals with rotator cuff rupture was investigated. Normal joint movement and proprioception of all individuals were evaluated with Fizyosoft Extremity ROM, and approximation strength was evaluated with Fizyosoft Balance System.

The Effect of High Speed Lowamplitude Manipulation on Balance and Proprioception in Amateur Footballers

After the sociodemographic information of all participants was recorded, dynamic balance Y test, static balance stork test, and proprioception were evaluated with the Fizyosoft Balance System.

Investigation of Foot-Ankle Characteristics, Balance, Functional Activity and Quality of Life in Children with Idiopathic Pes Equinovarus

In this study, foot characteristics were evaluated with foot anthropometric measurements, posture with FPI-6, balance-proprioception with Fizyosoft Balance System, functional activity with Functional Activity and Skill Form, disability with OxAFQ-C and OxAFQ-P, and quality of life with KINDL.

Does Hip Circumference Muscle Strength Affect Balance and Function?

The participants’s muscle strength were evaluated using Myometry; balance assessment was evaluated using the Fizyosoft Balance Board of Nintendo Wii; lower extremity functionality was evaluated using the Lower Extremity Functional Scale; the physical activity status was evaluated with the International Physical Activity Questionnaire (IPAQ).

Upper Extremity Rehabilitation Using Video Games in Cerebral Palsy: a Randomized Clinical Trial

Compared the efects of neurodevelopmental therapy (NDT)-based upper extremity rehabilitation and video game-based therapy (VGBT) using Nintendo® wii and leap motion controller (LMC) games on upper extremity function in patients with cerebral palsy (CP).

Video Game-Based Therapy For The Non-Dominant Hand Improves Manual Skills And Grip Strength

In this study, used the leapmotion sensor with ErgoActive games of Fizyosoft software. The participants of the studys hand function hand function was evaluated using the Jebsen Taylor Hand Function Test (JTHFT), while grip strength was evaluated with a Jamar Hand Dynamometer and Pinchmeter.

Efficacy Of A Video-Based Physical Therapy And Rehabilitation System in Patients wıth Post-Stroke Hemiplegia: A Randomized, Controlled, Pilot Study

VR exercises for the upper extremity (speed, difficulty, duration, etc.) were implemented for the experimental group using a developed software. In recent years, it has become possible to track hand movements in space using cameras with the LeapMotion® device. (LeapBall and Pong game with Fizyosoft)

Investigation of the Effect of Hand Exercises with Video Based Games on Motor Functions in Stroke Rehabilitation

The aim of is to compare the effects of upper extremity rehabilitation with the upper extremity rehabilitation done by video based games on motor development level, muscle tone and functional abilities in neurodevelopmental therapy (NGT) based adult stroke patients. In this study, Fizyosoft LeapBall and CatchApet games were applied with leap motion sensor.

Effects of Virtual Reality Training Program and Functional Balance Training Program on Balance in Healthy Young Adults

Investigated the effects of functional balance training (FBT) and VRT programs on static and dynamic balance performance in healthy young adults (with BalanceMaze-BalanceSurf )

Evaluation of Plantar Foot Sensation, Balance, Physical Performance and Fear of Movement in Substance Use Disorders

Fizyosoft BalanceSystem , measured by using the Wii Balance Board, Time Up and Go (TUG) Test

Leap Motion Controllere based training for upper extremity rehabilitation in children and adolescents with physical disabilities: A randomized controlled trial

“Leapball” was designed to focus on the development of grasping and individuating motor skills of hand; the improvement of the dexterity and coordination of the digits; the improvement of the ability to flex and extend the hand, the increase in the joint range of motion of the wrist and digits; the improvement of the movement speed, muscle strength, and motor control. -In the “CatchAPet” game, it is aimed to touch the rabbits coming out of the holes with repetitive wrist flexion/extension movements.

Investigation of the Effect of Hand Exercises with Video Based Games on Motor Functions in Stroke Rehabilitation

The aim of is to compare the effects of upper extremity rehabilitation with the upper extremity rehabilitation done by video based games on motor development level, muscle tone and functional abilities in neurodevelopmental therapy (NGT) based adult stroke patients. In this study, Fizyosoft LeapBall and CatchApet games were applied with leap motion sensor.

Effects of Video Games–Based Task-Oriented Activity Training (Xbox 360 Kinect) on Activity Performance and Participation in Patients With Juvenile Idiopathic Arthritis

The aim of the study was to compare the effects of two different task-oriented activity training programs on activity performance and participation in children/adolescents with juvenile idiopathic arthritis. Used the Kinect-based rehabilitation systems in this study.

The Correlation Between Gravity Center And Waist/Hip Circumference Ratio

The aim of this study was to determine if there is correlation between Gravity Center (GC) and Waist- Hip Circumference Ratio. The evaluations were made with Fizyosoft Balance System.

Technological Approaches for Joint Rehabilitation

With inertia sensors and camera based technologies, planned tele-rehabilitation approaches performed by collecting data, analyzing and reorienting the patient, adding new exercises or levels to the treatment program

Hand Rehabilitation with Virtual Reality Games: Fizyosoft™ LeapBall

This study presents a new virtual reality hand rehabilitation game named Fizyosoft™ LeapBall. The game is played with the developed software and a Leap Motion Controller.

Investigation of Posture Balance and Upper Extremity Functionality in Individuals with Intellectual Disability

The aim of study is to assess the posture, balance and grip strength in children with Specific Learning Difficulties and Intellectual Disability who continue their therapy at special education and rehabilitation centers. In order to evaluate the posture, PostureScreen Mobile and New York Posture Analysis were applied. Fizyosoft Balance System is used to measure the balance and postural control.

Investigation of the Effectiveness of Video-Based Games on Upper Extremity Functions in Cerebral Palsy Patients

The aim of our study was to investigate the effects of NGT based upper extremity rehabilitation and upper extremity rehabilitation with video-based games on range of motion (ROM), muscle tonus, grip and pinch strengths and functional abilities in children with Cerebral Palsy (CP). Fizyosoft applications used: Fizyosoft Leapball game, CatchApet game with Leap Motion sensor.

Development of a Measurement Method with Leap Motion Sensor for Objective Measurement of Hand and Wrist Range of Motion: Validity and Reliability Study

A leap motion sensor-based EHA measurement method called HandROM has been developed.The wrist flexion/extension, radial/ulnar deviation, supinatio /pronation, 1.-5. fingers MCP flexion/ extension ROM measurements were performed with a universal goniometer and HandROM and the data obtained by these two methods were analyzed by SPSS 22.0 statistical program.

Augmented Reality Based Wrist Rehabilitation System

A solution has been produced on the computer screen based on the marker symbol (marker) using the Leap motion sensor. A new mirror-based method has been introduced for real-world measurement.

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