Giuseppe Turini;Marina Carbone;Sara Condino;Donato Gallone;Vincenzo Ferrari;Marco Gesi;Michelangelo Scaglione;Paolo Parchi;Rosanna Maria Viglialoro
{"title":"Projected AR Serious Game “Painting Discovery” for Shoulder Rehabilitation: Assessment With Technicians, Physiotherapists, and Patients","authors":"Giuseppe Turini;Marina Carbone;Sara Condino;Donato Gallone;Vincenzo Ferrari;Marco Gesi;Michelangelo Scaglione;Paolo Parchi;Rosanna Maria Viglialoro","doi":"10.1109/JTEHM.2025.3557250","DOIUrl":null,"url":null,"abstract":"Objective: Motivation and adherence are crucial for effective rehabilitation, yet engagement remains a challenge in upper limb physiotherapy. Serious Games (SGs) have emerged as a promising tool to enhance patient motivation. This study evaluates Painting Discovery, a projected augmented reality (AR) SG for shoulder rehabilitation, assessing engagement, ergonomics, and its potential to differentiate motor performance between healthy and those with rheumatoid arthritis, bursitis, subacromial impingement, rotator cuff tear, or calcific tendinopathy. Additionally, it examines improvements in pathological subjects following physiotherapy. Method: Sixteen healthy and seven pathological subjects participated. Engagement, ergonomics, and satisfaction were assessed using Likert-scale questionnaires. Motor performance was evaluated through completion time, speed, acceleration, and normalized jerk. Four pathological subjects underwent pre- and post-physiotherapy assessments over six weeks. Results: SG was highly engaging and ergonomic, with no significant differences based on prior video game or AR experience. The pathological group had longer completion times (<inline-formula> <tex-math>$56.49~\\pm ~37.85$ </tex-math></inline-formula>s vs. <inline-formula> <tex-math>$39.02~\\pm ~24.21$ </tex-math></inline-formula>s, p < 0.001), lower acceleration (<inline-formula> <tex-math>$1.11~\\pm ~0.92$ </tex-math></inline-formula> m/s2 vs. <inline-formula> <tex-math>$0.79~\\pm ~0.56$ </tex-math></inline-formula> m/s2, p < 0.001), and higher jerk (<inline-formula> <tex-math>$6.68\\times 107~\\pm ~1.37\\times 108$ </tex-math></inline-formula> m/s3 vs. <inline-formula> <tex-math>$9.22\\times 106~\\pm ~2.51\\times 107$ </tex-math></inline-formula> m/s3, p = 0.025) then healthy subjects. After physiotherapy, completion time and normalized jerk indicated enhanced efficiency and control. Conclusions: Painting Discovery shows strong potential as an engaging, accessible rehabilitation tool. While effective in differentiating motor impairments, its small sample size and horizontal-plane movement focus limit broader conclusions. Future studies should expand participation, incorporate vertical-plane movements, and refine performance metrics for clinical validation.","PeriodicalId":54255,"journal":{"name":"IEEE Journal of Translational Engineering in Health and Medicine-Jtehm","volume":"13 ","pages":"149-157"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=10947717","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"IEEE Journal of Translational Engineering in Health and Medicine-Jtehm","FirstCategoryId":"5","ListUrlMain":"https://ieeexplore.ieee.org/document/10947717/","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENGINEERING, BIOMEDICAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Motivation and adherence are crucial for effective rehabilitation, yet engagement remains a challenge in upper limb physiotherapy. Serious Games (SGs) have emerged as a promising tool to enhance patient motivation. This study evaluates Painting Discovery, a projected augmented reality (AR) SG for shoulder rehabilitation, assessing engagement, ergonomics, and its potential to differentiate motor performance between healthy and those with rheumatoid arthritis, bursitis, subacromial impingement, rotator cuff tear, or calcific tendinopathy. Additionally, it examines improvements in pathological subjects following physiotherapy. Method: Sixteen healthy and seven pathological subjects participated. Engagement, ergonomics, and satisfaction were assessed using Likert-scale questionnaires. Motor performance was evaluated through completion time, speed, acceleration, and normalized jerk. Four pathological subjects underwent pre- and post-physiotherapy assessments over six weeks. Results: SG was highly engaging and ergonomic, with no significant differences based on prior video game or AR experience. The pathological group had longer completion times ($56.49~\pm ~37.85$ s vs. $39.02~\pm ~24.21$ s, p < 0.001), lower acceleration ($1.11~\pm ~0.92$ m/s2 vs. $0.79~\pm ~0.56$ m/s2, p < 0.001), and higher jerk ($6.68\times 107~\pm ~1.37\times 108$ m/s3 vs. $9.22\times 106~\pm ~2.51\times 107$ m/s3, p = 0.025) then healthy subjects. After physiotherapy, completion time and normalized jerk indicated enhanced efficiency and control. Conclusions: Painting Discovery shows strong potential as an engaging, accessible rehabilitation tool. While effective in differentiating motor impairments, its small sample size and horizontal-plane movement focus limit broader conclusions. Future studies should expand participation, incorporate vertical-plane movements, and refine performance metrics for clinical validation.
期刊介绍:
The IEEE Journal of Translational Engineering in Health and Medicine is an open access product that bridges the engineering and clinical worlds, focusing on detailed descriptions of advanced technical solutions to a clinical need along with clinical results and healthcare relevance. The journal provides a platform for state-of-the-art technology directions in the interdisciplinary field of biomedical engineering, embracing engineering, life sciences and medicine. A unique aspect of the journal is its ability to foster a collaboration between physicians and engineers for presenting broad and compelling real world technological and engineering solutions that can be implemented in the interest of improving quality of patient care and treatment outcomes, thereby reducing costs and improving efficiency. The journal provides an active forum for clinical research and relevant state-of the-art technology for members of all the IEEE societies that have an interest in biomedical engineering as well as reaching out directly to physicians and the medical community through the American Medical Association (AMA) and other clinical societies. The scope of the journal includes, but is not limited, to topics on: Medical devices, healthcare delivery systems, global healthcare initiatives, and ICT based services; Technological relevance to healthcare cost reduction; Technology affecting healthcare management, decision-making, and policy; Advanced technical work that is applied to solving specific clinical needs.