Serious Gaming for Upper Limbs Rehabilitation-Game Controllers Features: A Scoping Review

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.