IP: 46.148.120.192 On: Tue, 07 May 2019 11:17:50 Copyright: American Scientific Publishers Delivered by Ingenta RESEARCH ARTICLE Copyright © 2018 American Scientific Publishers All rights reserved Printed in the United States of America Journal of Computational and Theoretical Nanoscience Vol. 15, 1445–1451, 2018 Activities of Daily Living Rehab Game Play System with Augmented Reality Based Gamification Therapy for Automation of Post Stroke Upper Limb Rehabilitation S. J. Syed Ali Fathima 1 * , S. Shankar 2 , and A. Ahamed Thajudeen 3 1 Kumaraguru College of Technology, Coimbatore 641049, Tamil Nadu, India 2 Hindusthan College of Engineering and Technology, Coimbatore 641032, Tamil Nadu, India 3 The Oxford College of Physiotheraphy, Bangalore 560068, Karnataka, India The effectiveness of Post Stroke upper limb rehabilitation can be maximized through the patient involvement in the exercise training program regularly with proper motivation and engagement to speed up recovery. The stroke patient suffers from functional disability of independentlyexecuting their activities of daily living (ADL) like reaching, handling, grooming, eating, and dressing etc. In-spite of various external supports, an individual gets recovered only at his/her own pace of confidence. ADL Rehab Game Play System proposes an augmented reality based gamification therapy using Microsoft©Kinect and Unity 3D Gaming Engine Software to create three dimensional (3D) training simulation scenarios to carry out most basic activities of daily living (ADL). Gamification using natural user interface (NUI) enhances the data-driven techniques used by the designers to motivate the patient or the players, so as to engage in the action actively and adds significance to the faster recovery. Keywords: Microsoft©Kinect, Unity 3D Gaming Engine, Rehabilitation, Gamification, Activities of Daily Living (ADL), Natural User Interface (NUI), Range of Motion (ROM), Human Computer Interaction (HCI), Augmented Reality (AR), Three Dimensional (3D). 1. INTRODUCTION Upper Limb refer to hands, are the most important part in most of the human physical actions. According to the reports from the various agencies, the occupationally impaired upper limbs affect one-third functions of the human body. As per the research of American Medical Association, 60% of the mechanisms of the body are lost when one loses his/her arm. Drop of 90% of the arm func- tion equates a hand loss or the entire body mechanism by 54%. Therefore, one cannot ignore having healthy upper limbs. 1 Several studies have been conducted to examine stroke patients on the recovery of the hemiplegic arm. Patients up to 85% show an initial deficit in the arm. Three quarters of strokes happen in the region supplied by the middle cerebral artery. As a consequence, the upper limb will be affected in a large number of patients. 2 In Physical rehabilitation, Activities of Daily Living (ADL) is an axiom concerning human self care routine activities or tasks that is undertaken in their everyday life with no assistance. The six basic ADL’s are bathing, * Author to whom correspondence should be addressed. eating, toileting, transferring, dressing and continence. Research shows that there is a high correlation between ADL of the patients with stroke and their Quality of Life (QOL). 3 The Range of Motion (ROM) activities of upper limb joints are restricted by stroke condition and this lim- itation can have a severe impact on performing ADL by the patient. 4 The rehabilitation of the upper limb is a challenge. Although, many therapeutic approaches are cur- rently available, considerable controversy exists about their effectiveness. There should be appropriate rehabilitation equipment for the patients with dysfunction of upper limb using which it may be trained again and again to recover. Exercise slate of the arm, incline board, care motion exercises, ver- tical tower, stacking cones and exercise skate of the hand are the most frequently used equipment that is used clin- ically in the therapy. There are also different therapeu- tic methods like augmented reality (AR) that improves and integrates the texts, video, sound and other graphics, mechanical arms used to make a positive training of the patient through a mechanical structure and video games are helpful to give the instructions on the screen so that J. Comput. Theor. Nanosci. 2018, Vol. 15, No. 5 1546-1955/2018/15/1445/007 doi:10.1166/jctn.2018.7376 1445