The Mobile RehApp™: an AR-based mobile game
for ankle sprain rehabilitation
Jaime Andres Garcia
mHealth Laboratory, iNEXT
University of Technology Sydney, FEIT
Sydney, Australia
Jaime.A.GarciaMarin@student.uts.edu.au
Karla Felix Navarro
mHealth Laboratory, iNEXT
University of Technology Sydney, FEIT
Sydney, Australia
Karla.FelixNavarro@uts.edu.au
Abstract—People struggle to recover from injuries due to the
lack of commitment to their rehabilitation exercises as they are
often boring. Recent approaches that involve the use of
interactive video games have shown positive results in exercising
as users engage in physical activity while playing a game. For
example Nintendo Wii and Microsoft Kinect based games have
shown to be effective in the treatment of post stroke patients. Yet,
there are not tools in the market that offer portable rehabilitation
exercises in the form of interactive games. The work presented in
this paper focuses on the development of the Mobile RehApp™,
an augmented reality based application for mobile devices
designed for therapeutic support that aims to assist
physiotherapists and patients on ankle sprain rehabilitation.
Keywords—augmented reality, mobile augmented reality, ankle
sprain rehabilitation, exergames, mobile games, serious games for
health, gamification, games for rehabilitation, lower limbs.
I. INTRODUCTION
Physical exercise has shown to be one of the most effective
ways to improve well-being and quality of life. Working out is
becoming a must in the modern society not only because of the
health improvement benefits but also as a means to rehabilitate
from injuries [1-3]. Similarly, passive and active exercises are
beneficial for the development of muscles, tissues and a strong
skeletal structure [4]. More importantly, regular physical
activity has shown to dramatically reduce the risk of diseases
such as diabetes, high blood pressure and stroke [3].
There are however some risks inherent in the practicing of a
sport that could lead to suffering injuries such as contusions,
sprains or even fractures [1-3]. In a comprehensive study
conducted by the School of Medicine at the University of
Rochester, Football was shown to be the most common sport of
injury with 1185 out of 4551 cases of injuries surveyed over a
7 year period [5]. This is 12 times the number of injuries seen
in the next most common sport of injury, which is basketball
with 126 cases. More importantly, it was found that the most
common areas injured were the knee and ankle, where sprains
and strains were shown to be the most common injury with 949
cases for males and 194 for females. These injuries can become
problematic and recurrent if not treated correctly [3].
Despite the fact that physical rehabilitation can help to
recover from injuries, it can also be tedious and boring. This is
mainly attributed to the exercises not appealing to most
patients, and the inconvenience of having to keep their health
constantly monitored and reassessed through periodical visits
to the specialist. More importantly the inappropriate execution
of the prescribed exercises may affect negatively the
rehabilitation process.
One of the ways through which this can be improved is the
use of technology that provides appropriate visual feedback
allowing the patient to perform the exercises adequately [6].
For instance, the work of to Shull et al [7], use visual clues to
provide accurate biomechanical feedback on user’s
performance during gait retaining therapy. Similarly, the use of
virtual reality technology in lower limbs rehabilitation showed
positive results in delivering training exercises as well as
measuring the effectiveness of the treatment [8].
These new rehabilitation technologies can bring new
aspects and elements on diagnosis and treatment in order to
cooperate with other disciplines and enhance the benefits for
the parties [9]. However to facilitate this type of feedback,
specialized equipment and trained personnel are often required,
hence limiting its use in a laboratory or clinical settings [6].
In this paper we describe the development of the Mobile
RehApp™, a game application for mobile devices that aims to
assist physiotherapists and patients on ankle sprain
rehabilitation in a portable and cost-efficient manner. The
Mobile RehaApp uses Mobile Augmented Reality (MAR) to
deliver range of motion (ROM) exercises as well as monitor
the user’s performance in a form of a game. The rest of the
paper is structured as follows: Section 2 presents a brief
summary of related work in the field of augmented reality
applications for health and rehabilitation. In Section 3, the
methodology of this study is presented. Section 4 describes the
design process and the aspects that were considered throughout
the development process. Finally, the discussion and
conclusions can be found in Section 5 and 6.
II. RELATED WORK
Augmented Reality (AR) and Mobile Augmented Reality
(MAR) are fast growing technologies that are being applied to
different fields including, business, marketing and gamming. It
can be described as an augmented virtualization of the real
world or environment by over imposing computer-generated
inputs such as graphics, video, sound and GPS information. AR
and MAR technologies are being adopted and used for a whole
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