Punching ducks for post-stroke neurorehabilitation: System design and initial exploratory feasibility study

Each year 795,000 people in the U.S. have a stroke and the majority cannot resume daily activity because of persistent upper extremity (UE) motor impairment. Research in rehabilitation science has demonstrated that movement recovery is facilitated by extended task practice. However, 75% of stroke survivors are unable to successfully practice reaching tasks, due to the severity of the impairment of elbow and wrist movements. We hypothesize that expert action observation-observing normal avatar movement in response to impaired UE movement-may promote greater brain learning and contribute to greater UE movement recovery for patients with severe limitations of elbow and wrist movement. To incorporate extended task practice and expert action observation into current therapy, we have developed and begun initial exploratory testing of Duck Duck Punch, a 3D serious game for stroke neurorehabilitation. A Microsoft Kinect motion tracking sensor allows a stroke survivor to interact with the virtual game by moving their impaired arm. The visual display of a corresponding avatar arm enables a patient with impaired movement in the real world to appear to have normal movement in the virtual game environment. Data from a preliminary study suggests that our system may be effective in aiding in rehabilitation, especially in improving reaching efficiency and reducing abnormal movements.