Evaluating the Microsoft Kinect for use in upper extremity rehabilitation following stroke as a commercial off the shelf gaming system

Motion controlled video games have been shown to have a positive effect for physical rehabilitation on the upper extremity in stroke survivors when combined with conventional physical therapy. While much research in this area has worked with bespoke systems and games, some research has been done into using commercial off the shelf gaming systems (COTS) for use in upper extremity stroke rehabilitation. As COTS systems are designed to be used in the home they offer the possibility of providing survivors with low cost systems that they can use to carry out rehabilitation at home. The Microsoft Kinect for the Xbox360 is a multimodal gaming peripheral used to drive a full body skeletal pose estimation system. This allows users to interact with games using bodily motions and gestures. Unlike other current motion controlled gaming systems the Kinect is marker-less so does not require the user to hold or wear any peripherals. A list of important joint motions and movement synergies were identified by looking at leading stroke motor function tests for the upper limb. These have been verified by working with Occupational Therapists. A study group of Occupational and Physiotherapists were asked to record their experience of playing three Kinect mini-games from the Kinect Sports title and evaluate them with respect to their motor function requirements and exertion for each identified joint motion. Quality information was also gathered relating to the perceived usability and safety issues that could arise by presenting the device to a stroke survivor. Kinect provides opportunities for gross arm movement exercise, while the requirement for highly raised arm movements will present a potential barrier for stroke users. Fine motor control movements of the hand and fingers are not tracked sufficiently for effective rehabilitation of the hand. A probable risk of falling while using the Kinect, and potential injury from overexerting the impaired limb while playing existing games were also identified. We conclude that as the experience have been designed for able bodied users the games present significant barriers for using Kinect as a COTS system for stroke rehabilitation.