The use of exergames in the rehabilitation of patients with upper limb dysfunctions has increased significantly. This scoping review aimed to investigate the game controllers (GCs) employed in exergame systems used for rehabilitation, offering insights into the platforms, sensors, and techniques used in their development, implementation, and utilization. We conducted a comprehensive search of Scopus and PubMed databases, encompassing articles published between February 2013 and February 2023. The eligibility criteria included studies on upper limbs (UL) rehabilitation using exergames published in English-language journals, resulting in the identification of 175 pertinent articles. Seven key categories were identified: pathology, participants' conditions, dosage of sessions, GCs, sensors, specific part of the UL rehabilitated, and ergonomics. Stroke (55.4%) and cerebral palsy (6.3%) were the most frequently addressed medical conditions in the exergame-based rehabilitation. The number of participants in the reviewed articles was from one to several hundred. Three types of participants were identified: patients, specialists, and volunteers. Randomized controlled trial (RCT) studies consistently featured a controlled number of sessions (ranging from 6 to 40) lasting an average of 20 minutes, while non-RCT studies displayed more variability. Commercial platforms were favored, accounting for 74.3% of GCs, with physical controllers (57.1%) surpassing virtual ones. Cameras were the predominant sensors (50.3%), although a wide array of sensor types including IMUs, push buttons, and force sensors were also used. Rehabilitation focuses 68% on general UL, 20.6% on hands, 4% on elbows, and 3.4% on arms and shoulders. Notably, only 26.3% of the studies considered ergonomics in the rehabilitation system. Although exergame systems are advancing rehabilitation treatments, there remains a need for further development and research on various aspects, such as ergonomics, controller design, and sensor integration, to enhance their suitability for patient use.

This work presents the design of a new game controller device and the development of two exergames (Peter Jumper and Andromeda) for upper limb rehabilitation. The eJamar controller is a novel electromechanical device designed to measure wrist and hand movements, such as pronation/supination, flexion/extension, and ulnar/radial deviation, enabling users to perform control actions in the exergames. One of eJamar’s most significant features is its ability to measure hand grip strength, a function not available in commercial gaming controllers. The exergame Peter Jumper involves a character jumping over obstacles in various environments, promoting hand grip exercises. The exergame Andromeda involves shooting enemy ships, promoting coordination between hand movements and grip strength, making it suitable for different rehabilitation techniques. A testing protocol was applied with eight healthy participants (5F and 3M), who completed a survey evaluating gameplay, usability, and satisfaction of the system. The results demonstrated that the developed exergames are intuitive and easy to play, with participants reporting that a therapist’s presence is not required for gameplay. Hence, it suggests that the developed system can improve the rehabilitation process, promoting wrist–arm movements and grasping actions.

Hand and wrist rehabilitation is essential for restoring function in patients affected by neurological, traumatic, or degenerative conditions. In recent years, rehabilitation strategies incorporating exergames and specialized controllers have emerged as supportive tools to enhance conventional therapies. This study presents the results of a case series involving four female patients, aiming to explore the effects of a combined treatment protocol that integrates conventional hand rehabilitation with the use of the eJamar game controller and three exergames: Peter Jumper, Andromeda, and KARS. The participants presented hand and wrist impairments due to arthritis, arthrosis, or fractures. Each patient underwent a three-week intervention consisting of 15 one-hour sessions (five per week). Functional assessments were conducted before and after the intervention using several tools: range of motion, hand grip strength, Visual Analog Scale, Medical Research Council Scale for hand, a Nine-Hole Peg Test based, and the Duruöz Hand Index questionnaire. All participants showed general improvement in the measured parameters. Major improvement was observed particularly in grip strength and range of motion, especially in pronation, supination, and wrist deviation. One patient also reported a marked reduction in hand pain. Despite the small and heterogeneous sample, the results suggest a positive impact of the eJamar system on the hand motor function based on the evaluated metrics. These findings support the potential of combined therapy to improve rehabilitation outcomes. A follow-up study involving a larger sample and a control group is planned to further validate these preliminary findings.

A system for making remote two- and three-dimensional reconstructions from computerized tomography images has been developed in order to improve medical teleteaching. It allows the automatic two- and three-dimensional remote visualization of the anatomical structure of interest. As a part of this system, software has been developed which allows many visual operations or transformations on a remote three-dimensional model. It permits the remote workstation and the local workstation to visualize every transformation simultaneously. It allows a doctor to interact virtually and remotely with the anatomical structure. The software enables examination of the anatomical model from all angles, even from inside (including planar and three-dimensional presentations).

BACKGROUND Background: Hand rehabilitation is essential for restoring autonomy and daily functioning in patients with neurological, traumatic, and rheumatic conditions. Sensor-based exergame systems may complement conventional rehabilitation by promoting engagement and providing objective motor performance feedbaForty-two participants were allocated to a control group (CG; n=21) or experimental group (EG; n=21). Both groups were scheduled to receive a two-week rehabilitation program (five sessions/week). The CG received conventional therapy, whereas the EG additionally performed 15–20 minutes of eJamar-based exergames per session. Assessments were conducted at baseline (t₀), postintervention (t₁), and one-month follow-up (t₂). Outcomes included manual dexterity, grip and muscle strength, range of motion (ROM), pain, and hand function. Longitudinal changes were assessed using mixed-design repeated-measures ANOVA, and between-group differences at follow-up were evaluated using baseline-adjusted ANCOVA.ck. OBJECTIVE To compare conventional hand rehabilitation with a combined intervention incorporating an eJamar-based exergame system. METHODS Forty-two participants were allocated to a control group (CG; n=21) or experimental group (EG; n=21). Both groups were scheduled to receive a two-week rehabilitation program (five sessions/week). The CG received conventional therapy, whereas the EG additionally performed 15–20 minutes of eJamar-based exergames per session. Assessments were conducted at baseline (t₀), postintervention (t₁), and one-month follow-up (t₂). Outcomes included manual dexterity, grip and muscle strength, range of motion (ROM), pain, and hand function. Longitudinal changes were assessed using mixed-design repeated-measures ANOVA, and between-group differences at follow-up were evaluated using baseline-adjusted ANCOVA. RESULTS Thirty-three participants completed t₂ (CG=16; EG=17). Significant Time effects were observed for 10 of 15 clinical outcomes. The Box and Block Test for the more affected side (BBT-MAS) was the only outcome showing a significant Time × Group interaction (P=.04). Baseline-adjusted analyses showed a significant between-group difference for wrist ROM-MAS at t₂ (P=.02). Medical Research Council scale scores for the MAS (MRC-MAS) showed a significant conditional between-group difference at t₁ (P<.001), which was not maintained at t₂ (P=.40). Most other between-group comparisons were not significant CONCLUSIONS The addition of eJamar-based exergames to conventional hand rehabilitation was feasible in this clinical setting and was associated with significant between-group differences only for selected outcomes and assessment points. No consistent additional benefit over conventional rehabilitation was demonstrated across the assessed clinical outcomes. Given the nonrandomized design, baseline group differences, small and heterogeneous sample, and greater therapeutic exposure in the EG, these findings should be interpreted cautiously. Larger randomized controlled studies are needed to determine whether eJamar-based exergames provide clinically meaningful benefits beyond conventional rehabilitation CLINICALTRIAL Not applicable