text: This paper describes an avenue for artificial and computational intelligence techniques applied within games research to be deployed for purposes of physical therapy. We provide an overview of prototypical research focussed on the application of motion sensor input devices and virtual reality equipment for rehabilitation of motor impairment: an issue typical of patients of traumatic brain injuries. We highlight how advances in procedural content generation and player modelling can stimulate development in this area by improving quality of rehabilitation programmes and measuring patient performance.
  @cite_15: Abstract Objective: The aim of this article is to describe a game engine that has all the characteristics needed to support rehabilitation at home. The low-cost tracking devices recently introduced in the entertainment market allow measuring reliably at home, in real time, players' motion with a hands-free approach. Such systems have also become a source of inspiration for researchers working in rehabilitation. Computer games appear suited to guide rehabilitation because of their ability to engage the users. However, commercial videogames and game engines lack the peculiar functionalities required in rehabilitation: Games should be adapted to each patient's functional status, and monitoring the patient's motion is mandatory to avoid maladaptation. Feedback on performance and progression of the exercises should be provided. Lastly, several tracking devices should be considered, according to the patient's pathology and rehabilitation aims. Subjects and Methods: We have analyzed the needs of the clinicians a...
  @cite_7: Effective stroke rehabilitation must be early, intensive and repetitive, which can lead to problems with patient motivation and engagement. The design of video games, often associated with good user engagement, may offer insights into how more effective systems for stroke rehabilitation can be developed. In this paper we identify game design principles for upper limb stroke rehabilitation and present several games developed using these principles. The games use low-cost video-capture technology which may make them suitable for deployment at home. Results from evaluating the games with both healthy subjects and people with stroke in their home are encouraging.
  @cite_11: Computer games are a promising tool to support rehabilitation at home. It is widely recognized that rehabilitation games should (i) be nicely integrated in general-purpose rehabilitation stations, (ii) adhere to the constraints posed by the clinical protocols, (iii) involve movements that are functional to reach the rehabilitation goal, and (iv) adapt to the patients' current status and progress. However, the vast majority of existing rehabilitation games are stand-alone applications (not integrated in a patient station), that rarely adapt to the patients' condition. In this paper, we present the first prototype of the patient rehabilitation station we developed that integrates video games for rehabilitation with methods of computational intelligence both for on-line monitoring the movements' execution during the games and for adapting the gameplay to the patients' status. The station employs a fuzzy system to monitor the exercises execution, on-line, according to the clinical constraints defined by the therapist at configuration time, and to provide direct feedback to the patients. At the same time, it applies real-time adaptation (using the Quest Bayesian adaptive approach) to modify the gameplay according both (i) to the patient current performance and progress and (ii) to the exercise plan specified by the therapist. Finally, we present one of the games available in our patient stations (designed in tight cooperation with therapists) that integrates monitoring functionalities with in-game self-adaptation to provide the best support possible to patients during their routine.
summary: In many respects the ideas of rehabilitation-driven games share similarities with that of dynamic difficulty adjustment. However, as noted in the likes of @cite_7 , the challenges faced are more nuanced given the physical challenges faced by patients. A notable example can be found in the Intelligence Game Engine for Rehabilitation (IGER) detailed in @cite_11 @cite_15 which is focussed on the recording and management of physiotherapy for stroke patients. This system adopts an adaptive fuzzy-driven approach to catering for the patients rehabilitation process. This is achieved while working with a variety of small mini-games that utilise peripherals such as the Microsoft Kinect and Nintendo Wii Fit board. This system places emphasis on ensuring that the parameters of the current game are such that it should not result in activities that player might find painful.