Cerebrovascular accident (CVA) is the medical emergency that kills the most in Brazil and causes disability in the world. Stroke results from a change in blood flow in the brain, caused by an obstruction of blood vessels (ischemic stroke) or by a rupture of the vessels (hemorrhagic stroke). 

Seeking to help in the effective recovery of limbs that had their movements compromised by the pathology, researchers from the Federal University of Uberlândia (UFU), in Minas Gerais, developed a system based on virtual reality. 

It is a “serious game” – those in which the main purpose is not purely for fun – for rehabilitation, with customizable levels and tasks, which can be configured according to the needs of each patient. Interaction with the system takes place through a robotic platform, which can be adapted to stimulate or restrict the execution of movements. 

According to the professor of Electrical Engineering at UFU, Alexandre Cardoso, the use of serious games for physical therapy and rehabilitation treatments has proved to be effective. 

Game Development 

The game, named Harpy Game, was developed in 2019 by researchers from the Faculty of Electrical Engineering (Feelt) – then masters students Gabriel Cyrino and Júlia Tannús, doctoral student Leandro Mattioli and professors Eduardo Naves and Edgard Lamounier. 

According to Cyrino, there are already serious games aimed at recovery of this type, but most of them were limited to 2D environments or 3D environments of low graphic quality, which could affect patient engagement. In addition, most games in the same segment do not detect compensatory movements, which confounded the diagnosis of recovery. 

Thus, the Harpy Game was developed so that, through a playful and realistic environment, the physical therapist can customize the levels and tasks for the patient through a control panel. 

The project is now carried out in partnership with physical therapists and has the support of the Coordination for the Improvement of Higher Education Personnel (Capes), the Virtual and Augmented Reality Group (GRVA) and the Biomedical Engineering Laboratory (BioLab) at UFU. 

How it works? 

The patient needs to control a bird of prey to hunt and escape predators, fulfilling different goals and challenges. For this, he uses 3D motion trackers in the points of the arm affected by the stroke. 

Rainforest game was developed at the Computer Graphics Laboratory at UFU. Reproduction: Alexandre Costa 

As already mentioned, the difference in this serious game is precisely the identification of compensatory movements. This is because it is common for patients who have had a stroke to use the trunk to compensate for the loss of motor function in the arm and, thus, make it difficult to fully rehabilitate movements. This possibility of “compensation” is not allowed in the game. 

The system also has a control panel that can be accessed and changed by the therapist, depending on the patient’s specifications. With this, it is possible to analyze the evolution and results of the treatment. 

Patient information can be saved in the game’s control panel. Reproduction: Alexandre Costa 

The researchers point out that the main challenge is the treatment of the captured data and its relations with the movements, for practical use by health specialists. 

“This way, it will be possible to identify, for example, which muscle groups were activated and which were not, so that the physical therapist can feed back the treatment with such information”, said Gabriel Cyrino, in an interview with CNN. 

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