The Knee Biofeedback Rehabilitation Interface for Game-based Home Therapy (KneeBRIGHT) system combines electromyography (EMG) biofeedback with video game therapy (VGT) to provide knee osteoarthritis (OA) patients with an engaging, effective tool for conducting rehabilitation exercises at home. KneeBRIGHT aims to motivate patients with knee OA to conduct regular muscle strengthening exercise through an engaging, EMG-driven video game therapy. The system combines wireless EMG electrodes that are convenient for patients to use in a home setting with software that provides automated guidance through targeted and progressive exercise routines. Importantly, these exercises are presented to the patient in the form of fun and engaging games to promote a positive experience and encourage continued adherence. Problem to be Addressed: OA is the leading cause of disability in the U.S. Rehabilitation through quadriceps strengthening is a well-established treatment for patients with OA of the knee, but necessities of cost containment and lack of access to rehabilitation centers result in many patients being advised to perform these exercises at home. When left unsupervised, patients are faced with two challenges: (1) lack of guidance of trained clinicians who, in the clinic, optimally adjust protocols and resistance levels for functional improvement, and (2) lack of engagement during repetitive exercises that most individuals find boring. Long-Term Goal: Improve knee OA rehabilitation outcomes through effective and efficient delivery of care. Phase I Hypotheses: The STTR Phase I program will test the hypotheses that patients performing exercise routines using KneeBRIGHT will: (1) achieve equivalent muscle activations compared to a conventional EMG biofeedback system; and (2) exhibit increased engagement compared to the conventional system. Phase I Summary: Barron Associates, Inc. (award-winning innovators in video game therapy) has partnered with the University of Virginia for this STTR Phase I program to demonstrate feasibility and usability of the KneeBRIGHT system. The specific objectives of the Phase I program are to: (1) develop the Phase I prototype KneeBRIGHT EMG modules; (2) develop the Phase I KneeBRIGHT game software; (3) perform pilot testing of muscle activation and engagement levels (when compared to a conventional system) with knee OA patients in a laboratory environment; and (4) analyze the results of the pilot study. Successful prototype development along with the pilot study in Phase I will lay the foundation for the Phase II effort, which will include development of a commercial product including an interactive patient-clinician interface and formal evaluation of the KneeBRIGHT system's efficacy for improving adherence and clinical outcomes. Impact: The system will have a significant overall impact on public health by increasing patient adherence to home exercise routines and thereby reducing pain symptoms, restoring physical function, and ultimately improving quality of life for patients with knee OA.
The proposed Knee Biofeedback Rehabilitation Interface for Game-based Home Therapy ('KneeBRIGHT') system aims to motivate patients with knee osteoarthritis to conduct regular muscle strengthening exercise through an engaging, EMG-driven video game therapy. KneeBRIGHT promises to enhance rehabilitation by: (1) increasing functional recovery through physical practice of evidence-based exercise routines; (2) promoting adherence through fun games and performance feedback; (3) providing a low-cost option for at-home therapy; (4) creating reliable tracking mechanisms for patient activity and functional status; and (5) increasing access to care in remote, underserved areas.
