Kineblitz: Microcontroller-based electromyography biofeedback game-based habilitation system for children with cerebral palsy

ABSTRACT: STATEMENT OF THE PROBLEM: Spasticity, or unusually stiff, inflexible, or tight muscles, is one of the hallmark physical signs of Cerebral Palsy (CP). Spasticity interferes with a child’s ability to control muscular movement, particularly in the hips, knees, ankles, shoulders, elbows, and wrists. It can also create increased reflexes, giving the appearance of erratic or jumpy movements, according to an article entitled Rehabilitation of Cerebral Palsy in Children (2022). Although children can be diagnosed with CP as early as months after birth or for more accurate findings, until they are 1 to 2 years of age, there is no cure for it. When the signs and symptoms are minor, the diagnosis may take a little longer. Depending on the severity of the symptoms and the sections of the body affected, a child may require one or several types of treatment. The treatment varies from person to person, depending on their individual needs. However important therapy sessions are, its inconsistency poses an issue to its effectivity. The follow through of physical activities introduced by a physical therapist to a patient is crucial for improving their condition, but it is a fact that most patients are not fully capable of engaging in physical activities in a rehabilitation center, with proper equipment to utilize. It was said that patient retention is one of the difficulties for outpatient therapy clinics, with a 14.1 percent no-show rate in the sector (Medbridge, 2022). It was revealed in an article written by Staff (2022), that “72% of physical therapy patients do not perform their Home Exercise Program (HEP)”. Subsequently, this will hinder the patient’s recovery, and may lead to having little to no improvement at all. It can eventually lead to a cascade of events as patients may ultimately opt to drop out of their habilitation process due to lack of motivation since there are no perceived improvements. RESEARCH METHODOLOGY: SUMMARY OF FINDINGS: Based on the research objectives presented, as well as the methods and results presented on Chapter 3 and Chapter 4, respectively, the following findings and observations are then enumerated: • After calibration of the device to avoid misinterpretation of muscle movements, there was a noticeable change in sEMG readings, indicating success in the calibration process. • The “biofeedback-driven game” selected was “Flappy Bird”, for a variety of reasons: its low degree of complexity, its compatibility with the sEMG device, and its history of being used in past studies, such as in the home rehabilitation research of Janarthana et, al (2020). • The patient, diagnosed with spastic triplegia, was observed to have difficulties in limb movement. Despite that being the case, the left-arm tests of the first two domains of QUEST – dissociated movements and grasps, were still able to be performed as a warm-up exercise for the five-day period. • Taking into account, the construct validity analysis of Thorley et.al (2012), these scores were reported per domain due to their unidimensional nature. The findings during this phase of the study provided valuable insights in the integration of a warm-up exercise for cerebral palsy patients. Past investigations deemed warm-up exercise to be highly recommended and necessary, some even implemented into their actual programs. The results of this research, particularly on its QUEST portions, only further solidified this claim. • The survey findings show that all respondents, professional and student, agreed that sEMG would be useful in deciding and/or performing interventions in Cerebral Palsy (CP) patients rehabilitation/habilitation. There is a general acceptance among professionals and students alike that sEMG has substantial utility and potential. • Based on the survey findings, Kineblitz was deemed to be useful, and they generally have a favorable opinion of it. The majority of them agree that utilizing a game to motivate CP patients to participate in activities is a beneficial tactic. CONCLUSION: In conclusion, the research project entitled “Kineblitz: Microcontroller-Based Electromyography Biofeedback Game-Based Habilitation System for Children with Cerebral Palsy” achieved its overall goal of creating a biofeedback game-based habilitation system specifically for children with spastic cerebral palsy, as well as their unique needs and difficulties are taken into account in the game design, ensuring to create a stimulating and encouraging environment for therapy. Second, a microcontroller-based system that is both affordable and capable of performing surface electromyography (EMG) functions-------measuring muscle activation to analyzing the electric potential of the upper body-----was developed. This system enables accurate muscle activity recording, allowing for real-time feedback and control within the game and at the same time, making it able for low-resource facilities and other settings to acquire. The creation of the Kineblitz system represents, all things considered, a low-cost alternative in habilitation methods for kids with spastic cerebral palsy. One of its strong points is its economic nature. This makes it a promising method for enhancing the effectiveness of therapy, which offers the integration of his biofeedback, microcontroller technology, and game-based features. The system’s accessibility and potential for widespread adoption are further enhanced by its ability to be low cost. RECOMMENDATION: The implications of the results extend beyond the scope of this investigation. Specifically, the knowledge that was gathered here can contribute to areas of further research into the application of electromyography and biofeedback games, even on other neurological conditions. By delving deeper into the complex dynamics of myoelectric signals, future researchers can better address the potential benefits as well as the challenges in neurological research and develop effective strategies. It is crucial to acknowledge the limitations in the study and how future researchers could improve on it. Thus, the researchers have made the following proposals for future development after considering the findings and discussions, particularly the ideas provided by the respondents who answered the Kineblitz questionnaire. Future investigations could attempt not only to increase the number of games available, but also their degree of complexity. When choosing a game to implement, it is always important to think how it could impact the child’s behavior, their frustration tolerance, most notably. Improved habilitation systems could employ activities that will facilitate functional movements for the patient with CP. These include activities that would help in helping the patient perform daily activities, such as walking, feeding, bathing, and the like. In addition, incorporating the lower extremities in the design is also suggested.

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