INTRODUCTION: Physical disability is a fact of some neurologic disorders, such as multiple sclerosis. One of the treatments for such disability is routine physical exercises, or rehabilitation. However, rehabilitation in hospitals is often unattractive to patients. Another difficulty is objectively assessing the final effect of rehabilitation on disabilities, as assessment often depends on the subjective opinion of the physician. In the present study, we offer exergaming rehabilitation at home (telerehabilitation) and an objective method for measuring the physical performance of people with multiple sclerosis using a virtual reality tool to assist the decision of whether improvement, no change, or deterioration in the patients health status has occurred.
METHODS: Telerehabilitation is provided by custom-made exergames specifically designed for patients with upper extremity disabilities. Our performance measurement method records the time taken by a patient to finish a physical test and measures the angles of interest between predetermined upper extremities. The measurements are recorded and saved for future determinations of patient progress. Thus, improvement-deterioration-no change decisions can depend less on subjective opinions. Preliminary performance experimentation was conducted before and after participants played our virtual reality exergames.
RESULTS: The results reveal that our method is capable of measuring angles with an error margin of 6.44%. The accuracy of our method is 86.00%. The sensitivity, i.e., ability to detect improvements in patient performance, of our method is higher at 88.24%. The specificity, i.e., correct determination of no change in performance, is lower at 82.25%. The time taken to finish a physical test could not be evaluated due to a lack of real patients in our engineering laboratories.
DISCUSSION AND CONCLUSION: The impact of our telerehabilitation exergaming solution on patient performance requires prolonged use by patients and future analysis of accumulated medical opinions. Our proposal is the first step toward exergaming and digital performance determination.