For the estimated three million upper-arm amputees in the world, adjusting to life without a limb can be arduous. While prosthetic arms help to give back some normality, a majority of amputees report discontent with their prosthesis and difficulty using it for everyday tasks.
A new study, published in Hindawi’s open access Journal of Healthcare Engineering, may improve the rehabilitation of amputees with a prosthetic arm. The answer, it seems, may be found in dance.
Rehabilitation – slow, poorly assessed, and demotivating
Depending on the amputation and the amputee’s health, it can take around six months between losing a limb and starting rehabilitation.
“Prosthetic arms are heavy to wear and the fitting is often uncomfortable,” says Marina Melero, who authored the study with colleagues at University College London. “It also takes a long time between the moment of trauma and the time the prosthesis can be fitted to the amputee.”
Doctors tracking patients’ progress often find it difficult to objectively assess their patients’ recovery. The repetitiveness of rehabilitation also means that patients lack motivation to do the exercises.
“During this time the muscles are not being used and this leads to poorer rehabilitation results afterwards,” explains Melero.
To address these challenges, the team developed Upbeat, a pop dance game to help recent amputees strengthen their muscles. Patients follow an on-screen dance instructor while a Microsoft Kinect camera records their dance moves. The game uses augmented reality to show patients a digital prosthetic arm attached to their body on-screen.
“By using an augmented reality prosthetic arm, the amputee can start rehabilitation before the actual prosthetic arm has been fitted,” says Melero.
Patients also wear an armband on their forearm which senses their muscle activity and hand gestures. While they follow the dance instructor, icons tell the patients which hand gestures to use. These gestures are based on ones used in daily life – for example, a fist gesture to replicate grabbing an object.
Afterwards, patients can see their score and the activity of each muscle in their prosthetic arm. This information also gives rehabilitation professionals a better understanding of their patients’ progress.
The system was used on three subjects who each performed ten trials of the game while researchers monitored how many gestures were detected and classified by the system. Crucially, the video game proved popular with the patients. “The subjects who tested the system found the game entertaining and enjoyable,” Melero confirms.
For now, the Upbeat prototype has shown that a dance-based game is suitable for clinical use. Reassuringly, people also enjoy the exercises that help their rehabilitation. Researchers now hope to do a full group clinical study to see how Upbeat affects patients’ progress over time compared to just regular therapy alone.
Adding different songs and improving the game design is another focus. “I would say it’s crucial to include a more comprehensive set of hand gestures in the current game setup,” says Melero. “This would enable the amputee to practise a broader range of movements.”
Adjusting to a new life without a limb can be a long journey. By giving patients a more engaging form of rehabilitation, alongside providing professionals with more information about their progress, Upbeat may just make that journey easier.
Marina Melero, Annie Hou, Emily Cheng, et al., “Upbeat: Augmented Reality-Guided Dancing for Prosthetic Rehabilitation of Upper Limb Amputees”, Journal of Healthcare Engineering, vol. 2019, Article ID 2163705, 9 pages, 2019. https://doi.org/10.1155/2019/2163705.
This blog post is distributed under the Creative Commons Attribution License (CC-BY). The illustration is by Hindawi and is also CC-BY.