Kinematics of Movements Provoked by an Augmented Reality App

Kinematics of Upper Limb Movements Provoked by an Augmented Reality App in Comparison to Therapy Exercises.

Introduction: Home-based rehabilitation has the potential to reduce healthcare costs. However, due to less supervision in the home situation, it is possible that movements are made incorrectly. Therefore it is important to gain insight in which movements are made with a home-based rehabilitation system and what effects instructions could have on these movements. The current study investigated these movements made by the Rehabilitation Gaming System (RGS) app, this app uses augmented reality to provoke upper limb movements.

Methods: 16 healthy elderly and 16 stroke survivors participate in this study. Each participant was invited to the rehabilitation clinic for a one time measurement of 1.5 hours. During this measurement, four therapy exercises and four games on the RGS-app are performed. Each game should provoke a similar movement as one of the therapy exercises. Participants start with performing the therapy exercises for two minutes each. Thereafter they receive a video instruction on how to perform one of the games of the RGS-app, and they will play this game for 2 minutes. Thereafter the group is randomized into two conditions. The first group receives the same video instruction, while the second group receives a personalized live instruction based on the first two minutes of playing. After the new instruction, participants will play the game for two minutes again. This is repeated for all four games. Both the order of the therapy exercises and RGS-app games are randomized. During the study, participants wear Inertial Measurement Units (IMU's).

Study Overview

• Status: Completed
• Conditions: Stroke; Healthy Aging
• Intervention / Treatment: Behavioral: RGS-app

• Study Type: Observational
• Enrollment (Actual): 28

Contacts and Locations

Study Locations

• Netherlands
  • Gelderland
    • Ubbergen, Gelderland, Netherlands, 6574 NA
      • Sint Maartenskliniek

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Stroke survivors will be recruited through a Rehabilitation physician at the Sint Maartenskliniek and if needed through social media.

Healthy elderly will be recruited using social media.

Description

Inclusion Criteria stroke survivors:

• People who suffered from a stroke at least 2 months ago.
• Smartphone users
• Mild to moderate upper limb impairment (Medical Research Council Scale for Muscle Strength (MRC) ≥ 2)

Exclusion Criteria stroke survivors:

• Severe cognitive impairment
• Visual impairments (which cannot be corrected with glasses)
• Upper limb impairments not caused by the stroke

Inclusion Criteria healthy elderly:

• 60 years or older
• Smartphone users

Exclusion Criteria healthy elderly:

• Visual impairments (which cannot be corrected with glasses)
• Upper limb impairments which can affect smartphone use

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Healthy elderly; Group of participants who have no prior history of stroke	Behavioral: RGS-app; Participants use the RGS-app on a smartwatch once for 1.5 hours during the measurement. The RGS-app consists of augmented reality games to provoke upper limb movement.
Stroke survivor; Group of participants who have been through a stroke	Behavioral: RGS-app; Participants use the RGS-app on a smartwatch once for 1.5 hours during the measurement. The RGS-app consists of augmented reality games to provoke upper limb movement.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Average movement velocity	Average velocity of every 2-minute session. Velocity is measured at the hand relative to the sternum.	Measured when using the RGS-app during the one-time measurement of 1.5 hours

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Elbow Range of motion	Range of motion in degrees of the elbow joint (0 degrees being fully stretched)	Measured when using the RGS-app during the one-time measurement of 1.5 hours
Pelvis range of motion	Range of motion in degrees of the elbow joint (0 degrees meaning vertical)	Measured when using the RGS-app during the one-time measurement of 1.5 hours
Peak velocity	The maximum velocity measured at the hand	Measured when using the RGS-app during the one-time measurement of 1.5 hours
Hand distance	Distance covered by the hand corrected by the sternum movements	Measured when using the RGS-app during the one-time measurement of 1.5 hours

Collaborators and Investigators

• Sponsor: Sint Maartenskliniek
• Collaborators: Eodyne Systems SL
• Investigators: Principal Investigator: Noël Keijsers, Prof., Donders Institute for Brain, Cognition and Behavior, Radboud University

Study record dates

Study Major Dates

• Study Start (Actual): May 13, 2023
• Primary Completion (Actual): October 1, 2025
• Study Completion (Actual): October 1, 2025

Study Registration Dates

• First Submitted: March 6, 2024
• First Submitted That Met QC Criteria: July 17, 2024
• First Posted (Actual): July 23, 2024

Study Record Updates

• Last Update Posted (Actual): May 7, 2026
• Last Update Submitted That Met QC Criteria: April 30, 2026
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Keywords: Upper limb; Augmented reality; Home-based rehabilitation
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: 1103

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No