Abstract
Acute and chronic neck pain are common medical conditions, and the treatment typically includes physical therapy involving daily exercises. Insufficient motivation of people afflicted with neck pain to adhere to the prescribed exercise regimen may delay their recovery. Accordingly, in this work, we propose a system that motivates the users to perform neck exercises by engaging them in a serious exergame within virtual reality (VR) environment. The system measures the users’ neck movements via a few static and dynamic kinematic tests and a novel VR serious game, tailored to the neck range of motion of each individual user. The game is designed to make the users perform rehabilitative neck movements according to the prescribed exercise regimen while playing. The analysis of acquired data from VR hardware provides insight into flexibility of the neck during head movements and overall neck kinematics, which is valuable for assessment of pain-related stiffness, as well as for progress monitoring. In a user study performed with the proposed system and the Oculus Rift DK2 VR headset, we show that the users find exercising more interesting and engaging when using the proposed system, and that introducing visually rich VR environments makes the users more motivated to continue exercising.
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References
Aiolli F, Ciman M, Donini M, Gaggi O (2014) Climbtheworld: real-time stairstep counting to increase physical activity. Proceedings of the 11th International Conference on Mobile and Ubiquitous Systems: Computing, Networking and Services (Mobiquitous 2014), pp. 218–227
Althoff T, White RW, Horvitz E (2016) Influence of Pokémon go on physical activity: study and implications. J Med Internet Res 18(12):e315. https://doi.org/10.2196/jmir.6759
Bassett SF (2003) The assessment of patient adherence to physiotherapy rehabilitation. N Z J Physiother 31(2):60–66
Blanpied PR, Gross AR, Elliott JM, Devaney LL, Clewley D, Walton DM, Sparks C, Robertson EK (2017) Neck pain: revision 2017: clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther 47(7):A1–A83. https://doi.org/10.2519/jospt.2017.0302
Bronfort G, Evans R, Nelson B, Aker PD, Goldsmith CH, Vernon H (2001) A randomized clinical trial of exercise and spinal manipulation for patients with chronic neck pain. Spine 26(7):788–797
Buckwalter JA (1995) Aging and degeneration of the human intervertebral disc. Spine 20(11):1307–1314
Cameirão MS, Badia SB, Oller ED, Verschure P (2010) Neurorehabilitation using the virtual reality based rehabilitation gaming system: methodology, design, psychometrics, usability and validation. J Neuroeng Rehabil 7:48. Published online 2010 Sep 22. https://doi.org/10.1186/1743-0003-7-48
Chen KB, Sesto ME, Ponto K, Leonard J, Mason A, Vanderheiden G, Williams J, Radwin RG (2016) Use of virtual reality feedback for patients with chronic neck pain and Kinesiophobia, IEEE Trans Neural Syst Rehabil Eng, Issue: 99. https://doi.org/10.1109/TNSRE.2016.2621886
Childs JD, Fritz JM, Piva SP, Whitman JM (2004) Proposal of a classification system for patients with neck pain. J Orthop Sports Phys Ther 34(11):686–700
Childs JD, Cleland JA, Elliott JM, Teyhen DS, Wainner RS, Whitman JM, Sopky BJ, Godges JJ, Flynn TW (2008) Association APT: neck pain: clinical practice guidelines linked to the international classification of functioning, disability, and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther 38(9):A1–A34. https://doi.org/10.2519/jospt.2008.0303
Cohen SP (2015) Epidemiology, diagnosis, and treatment of neck pain. Mayo Clin Proc. Feb; 90 (2):284–299. doi:https://doi.org/10.1016/j.mayocp.2014.09.008
Connolly TM, Boyle EA, MacArthur E, Hainey T, Boyle JM (2012) A systematic literature review of empirical evidence on computer games and serious games. Comput Educ 59(2):661–686
Cosic K, Slamic M, Popovic S, Rac Z (2002) VR based adaptive stimulation in estimation of whiplash injuries. Proceedings Vision, Modeling and visualization 2002, Erlangen, Germany, November 2002, pp 35–42
Dall’Alba P, Sterling M, Trealeven J, Edwards S, Jull G (2001) Cervical range of motion discriminates between asymptomatic and whiplash subjects. Spine 26(19):2090–2094
DeFrate LE, Sakai JL, Gilbertson LG, Moon SH, Nishida K, Donaldson WF, Kang JD, Woo SLY (1999) Magnetic tracking/virtual reality based system for comprehensive kinematic assessment of the cervical spine. ASME Summer Bioengineering Conference, 1999
Deponti D, Maggiorini D, Palazzi CE (2011) Smartphone's physiatric serious game. Proceedings of the IEEE International Conference on Serious Games and Applications for Health (SeGAH 2011)
Ding M, Fan G (2016) Articulated and generalized Gaussian kernel correlation for human pose estimation. IEEE Trans Image Process 25(2):776–789. https://doi.org/10.1109/TIP.2015.2507445
Escolar-Reina P, Medina-Mirapeix F, Gascón-Cánovas JJ, Montilla-Herrador J, Jimeno-Serrano FJ, de Oliveira Sousa SL, del Baño-Aledo ME, Lomas-Vega R (2010) How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: a qualitative study. BMC Health Serv Res 10:60. https://doi.org/10.1186/1472-6963-10-60
Eubanks JD (2010) Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician 81(1):33–40
Falla D (2013) Neck pain: combining exercise and manual therapy for your neck and upper back leads to quicker reductions in pain. J Orthop Sports Phys Ther 43(3):128. https://doi.org/10.2519/jospt.2013.0502
Gaggi O, Ciman M (2016) The use of games to help children eyes testing. Multimed Tools Appl 75(6):3453–3478
Gormley J (2005) Adherence to exercise. In: exercise therapy: prevention and treatment of disease. Edited by John Gormley, Juliette Hussey. Blackwell Publishing Ltd; 2005. pp 228–239
Hakala PT, Rimpela AH, Saarni LA, Salminen JJ (2006) Frequent computer-related activities increase the risk of neck–shoulder and low back pain in adolescents. Eur J Pub Health 16(5):536–541
Haneline MT (2009) The notion of a “whiplash culture”: a review of the evidence. Journal of Chiropractic Medicine 8(3):119–124
Hurwitz EL, Carragee EJ, Van der Velde G, Carroll LJ, Nordin M, Guzman J, Peloso PM, Holm LW, Côté P, Hogg-Johnson S, Cassidy JD, Haldeman S (2009) Treatment of neck pain: noninvasive interventions: results of the bone and joint decade 2000–2010 task force on neck pain and its associated disorders. J Manip Physiol Ther 32(2):S141–S175 Neck Pain Task Force Special Supplement
Kasch H, Bach FW, Jensen TS (2001) Handicap after acute whiplash injury: a 1-year prospective study of risk factors. Neurology 56(12):1637–1643
Keilhauer E (1998) Therapeutic sleeping pillow. United States patent, patent number: 5,727,267. Date of Patent: Mar. 17. 1998
Kim H, Shin S-H, Kim J-K, Park Y-J, Oh H-S, Park Y-B (2013) Cervical coupling motion characteristics in healthy people using a wireless inertial measurement unit. Evid Based Complement Alternat Med 2013:570428. Published online 2013 Jul 9. https://doi.org/10.1155/2013/570428
Kramer M et al. (2008) Reliability of a new virtual reality test to measure cervicocephalic kinaesthesia. J Electromyogr Kinesiol. https://doi.org/10.1016/jelekin.2008.05.005
Kristjansson E, Hardardottir L, Asmundardottir M, Gudmundson K (2004) A new clinical test for cervicocephalic kinesthetic sensibility: “the fly”. Arch Phys Med Rehabil 85(3):490–495
Linton SJ, van Tulder MW (2001) Preventive interventions for back and neck pain problems what is the evidence? Spine 26(7):778–787
Love S, Gringmuth RH, Kazemi M, Cornacchia P, Schmolke M (1998) Interexaminer and intraexaminer reliability of cervical passive range of motion using the CROM and Cybex 320 EDI. J Can Chiropr Assoc 42(4):222–228
Mihajlović Ž, Čupić M (2012) Software environment for learning and knowledge assessment based on graphical gadgets. Int J Eng Educ 28(5):1127–1140
Mihajlović Ž, Popović S, Ćosić K (2015) Interactive scenario control in virtual environments. Int J Comput Appl 37(2):53–59
Murphy S, Buckle P, Stubbs D (2004) Classroom posture and self-reported back and neck pain in schoolchildren. Appl Ergon 35(2):113–120
Sakakibara H, Miyao M, Kondo TA, Yamada S (1995) Overhead work and shoulder-neck pain in orchard farmers harvesting pears and apples. Ergonomics 38(4):700–706
Sarig Bahat H, Weiss PL, Laufer Y (2010) The effect of neck pain on cervical kinematics, as assessed in a virtual environment. Arch Phys Med Rehabil 91(12):1884–1890
Sarig Bahat H, Chenb X, Reznika D, Kodesha E, Treleavenbet J (2014) Interactive cervical motion kinematics: sensitivity, specificity and clinically significant values for identifying kinematic impairments in patients with chronic neck pain. Man Ther. https://doi.org/10.1016/j.math.2014.10.002
Sarig-Bahat H (2003) Evidence for exercise therapy in mechanical neck disorders. Man Ther 8(1):10–20
Schonauer C, Pintaric T, Kaufmann H, Kosterink SJ, Vollenbroek-Hutten M (2011) Chronic pain rehabilitation with a serious game using multimodal input. International conference on virtual rehabilitation (ICVR), 2011. ICVR, pp 1–8
Sial AB, Kumar V, Lal R, Reeta KU, Shamsi II, Puri J, Kumar K (2016) Effectiveness of physical therapy in postural neck pain with and without home based management. J Sports and Phys Educ 3(4):66–87. https://doi.org/10.9790/6737-03046687
Sjölander P et al (2008) Sensorimotor disturbances in chronic neck pain - range of motion, peak velocity, smoothness of movement, and repositioning acuity. Man Ther 13:122–131. https://doi.org/10.1016/j.math.2006.10.002
Sterling M, Jull G, Vicenzino B, Kenardy J, Darnell R (2003) Development of motor system dysfunction following whiplash injury. Pain 103(1–2):65–73
Sucar LE, Orihuela-Espina F, Velazquez RL, Reinkensmeyer DJ, Leder R, Hernández-Franco J (2014) Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform. IEEE Trans Neural Syst Rehabil Eng 22(3):634–643
WebMD. Neck pain – cause. http://www.webmd.com/a-to-z-guides/tc/neck-pain-cause
Xu X, Chen KB, Lin J-H, Radwin RG (2015) The accuracy of the oculus rift virtual reality head-mounted display during cervical spine mobility measurement. J Biomech 48(4):721–724
Ylinen J (2007) Physical exercises and functional rehabilitation for the management of chronic neck pain. Eura Medicophys 43(1):119–132
Ylinen J, Kautiainen H, Wirén K, Häkkinen A (2007) Stretching exercises vs manual therapy in treatment of chronic neck pain: a randomized, controlled cross-over trial. J Rehabil Med 39(2):126–132
Acknowledgements
We would like to thank several students who participated in the realization of the basic framework in this project, especially Ivan Hakštok, Bruno Pregun and Renato Zaneto Lukež.
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Mihajlovic, Z., Popovic, S., Brkic, K. et al. A system for head-neck rehabilitation exercises based on serious gaming and virtual reality. Multimed Tools Appl 77, 19113–19137 (2018). https://doi.org/10.1007/s11042-017-5328-z
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DOI: https://doi.org/10.1007/s11042-017-5328-z