[Smart Rehab: App-based rehabilitation training for upper extremity amputees - Case Report]

Control of a myoelectric prostheses entails rehabilitative training, based on repetitive exercises with a physiotherapist. However, many patients lack the motivation to continue the exercises in their home environment. Mobile games on the smartphone can provide patients with long-term motivation to continue the repetitive exercises that prepare the muscles for controlling a prosthesis at home. The aim of this study was to confirm the feasibility of a myoelectrical controlled mobile application and the impact of this game-based rehabilitation on the patient's maximum voluntary contraction strength, proportionally activated muscle contraction and ability to separate muscle groups.

We developed a training system that consisted of a game-based mobile rehabilitation application that is controlled by the patient's muscle signal, a tablet to play on, an electrode armband and a manual. So far two patients have participated in this study. They were asked to use the app for 4 weeks at home, 5 times a week, for 10 to 15 minutes. The intervention was designed in a randomised controlled pre-test/post-test design and patients were measured for neuromuscular parameters before the intervention and afterwards. Evaluated parameters included maximum voluntary contraction force, muscle separation, proportional control and muscle endurance, as well as user statistics.

After training with the app, a significant improvement (p < .01) in all examined clinical parameters for myoelectric control of a prosthesis could be achieved. The user statistics showed a high motivation to play the game and ran an additional diagnostic EMG-Test on one patient; the other participating patient, however, had played the game but neglected the EMG test and only completed half of it.

The training app not only provides instruction and feedback on the correct execution of myoelectric commands, but also maintains patient motivation through various game modes and feedback elements. The rehabilitation process could be monitored and compared through an overview of training progress in the form of user statistics and high scores. It could be shown that patients with upper extremity amputation could significantly improve their neuromuscular control, strength and coordination after using the game-based app so that they can fully benefit from the potential of a myoelectric prosthesis.