{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:29:51Z","timestamp":1792675791813,"version":"4.5.0"},"reference-count":48,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prosthetic motor rehabilitation usually relies on the highly repetitive training of movements. Patients might drop out of training because the rehabilitation process is long and often discouraging. Game\u2010based interventions provide a potentially useful alternative to standard myoelectric (electromyographic [EMG]) training and can increase engagement with training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the short\u2010term impact of a game\u2010based rehabilitation protocol on parameters for EMG control, evaluate how game\u2010based interventions affect patient motivation, performance, and effort, and compare the game\u2010based intervention with a standard tool in rehabilitation (MyoBoy).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This randomized controlled trial included 2 patient groups and 1 control group. After establishing a baseline, the 2 patient groups received different interventions that were compared with each other and with the able\u2010bodied control group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>University hospital\u2010based study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Fourteen patients with traumatic transradial or transhumeral upper extremity amputation and 10 able\u2010bodied participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For the game\u2010based intervention, EMG proficiency was assessed before and after playing the games and 2 days later as follow\u2010up to measure retention rate. EMG proficiency was measured using maximum voluntary contraction, proportional precision control, signal separation, and muscle endurance. Questionnaires for rating the game\u2010based intervention and intrinsic motivation were provided after the intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes<\/jats:title><jats:p>Outcome measures for EMG proficiency were provisional maximum voluntary muscle contraction, precise proportional control, electrode separation, and muscle endurance. Quantitative outcome measures for participant experience were intrinsic motivation, enjoyment, pressure, exerted effort, and usefulness of the intervention. The qualitative outcome measure was the surveyed attitude toward the game\u2010based intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Results showed an overall improvement in EMG control, fine muscle activation, and electrode separation. Patients stated that racing games provided slightly more fun, but rhythm\u2010based games were considered to provide better challenges for EMG control.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Game\u2010based interventions provide a useful addition to standard EMG training and can achieve better results in clinical outcome measures. The racing and music game genres provide solid starting points for interventions. Further studies can look at a wider range of genres and identify more specific game mechanics suitable for training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>I<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2018.09.027","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T08:29:54Z","timestamp":1543480194000},"page":"1252-1260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":51,"title":["PlayBionic: Game\u2010Based Interventions to Encourage Patient Engagement and Performance in Prosthetic Motor Rehabilitation"],"prefix":"10.1002","volume":"10","author":[{"given":"Cosima","family":"Prahm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fares","family":"Kayali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes","family":"Sturma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Aszmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638280410001645094"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/03093640600994581"},{"key":"e_1_2_8_4_1","first-page":"169","volume-title":"Advanced rehabilitation for amputees after selective nerve transfers: EMG\u2010guided training and testing","author":"Sturma A.","year":"2014"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1197\/j.jht.2007.09.006","article-title":"Managing the upper extremity amputee: A protocol for success","volume":"21","author":"Smurr L.M.","year":"2008","journal-title":"J Hand Ther"},{"key":"e_1_2_8_6_1","first-page":"775","volume-title":"Rehabilitation following targeted muscle reinnervation in Amputees","author":"Sturma A.","year":"2014"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1586\/erd.11.23","article-title":"Myoelectric training systems","volume":"8","author":"Dawson M.R.","year":"2011","journal-title":"Expert Rev Med Devices"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40137-013-0044-8"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1515\/bmt-2014-0022","article-title":"A surface EMG test tool to measure proportional prosthetic control","volume":"60","author":"Sturma A.","year":"2015","journal-title":"Biomed Tech (Berl)"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00132-015-3113-0"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2008.06.001"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2196\/games.3401"},{"key":"e_1_2_8_13_1","first-page":"381","volume-title":"Improving patient motivation in game development for motor deficit rehabilitation Proceedings of the 2008 International Conference on Advances in Computer Entertainment Technology","author":"Flores E.","year":"2008"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.1016\/j.rehab.2014.03.417","article-title":"Virtual reality and serious games for rehabilitation","volume":"57","author":"Abellard P.","year":"2014","journal-title":"Annals of Physical and Rehabilitation Medicine, Elsevier Masson"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0000000000000017"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/1743-0003-8-30","article-title":"Effectiveness of a Wii balance board\u2010based system (eBaViR) for balance rehabilitation: A pilot randomized clinical trial in patients with acquired brain injury","volume":"8","author":"Llor\u00e9ns R.","year":"2011","journal-title":"J Neuroeng Rehabil"},{"key":"e_1_2_8_17_1","first-page":"44","volume-title":"\u201cIf I can\u2019t do it once, why do it a hundred times?\u201d: Connecting volition to movement success in a virtual environment motivates people to exercise the arm after stroke 2007 Virtual Rehabilitation","author":"Reinkensmeyer D.J.","year":"2007"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2013.07.014"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","unstructured":"Annett M Anderson F Bischof WF. Activities and evaluations for technology\u2010based upper extremity rehabilitation. In: Hu F Lu J Zhang T eds. Virtual Reality Enhanced Robotic Systems for Disability Rehabilitation. 2016 307.","DOI":"10.4018\/978-1-4666-9740-9.ch015"},{"key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1515\/ijdhd-2014-0327","article-title":"Augmented reality improves myoelectric prosthesis training","volume":"13","author":"Anderson F.","year":"2014","journal-title":"Int J Disabil Hum Dev"},{"key":"e_1_2_8_21_1","first-page":"957","volume-title":"WiiEMG: A real\u2010time environment for control of the Wii with surface electromyography Proceedings of 2010 IEEE International Symposium on Circuits and Systems (ISCAS)","author":"Oppenheim H.","year":"2010"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1109\/TNSRE.2015.2502424","article-title":"Task\u2010oriented gaming for transfer to prosthesis use","volume":"99","author":"Van Dijk L.","year":"2016","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","first-page":"e98301","DOI":"10.1371\/journal.pone.0098301","article-title":"Effect of feedback during virtual training of grip force control with a myoelectric prosthesis","volume":"9","author":"Bouwsema H.","year":"2014","journal-title":"PLoS One"},{"key":"e_1_2_8_24_1","first-page":"121","volume-title":"Air\u2010Guitar Hero: A real\u2010time video game interface for training and evaluation of dexterous upper\u2010extremity neuroprosthetic control algorithms 2008 IEEE Biomedical Circuits and Systems Conference","author":"Armiger R.S.","year":"2008"},{"key":"e_1_2_8_25_1","first-page":"582","volume-title":"Electromyogram (EMG) driven system based virtual reality for prosthetic and rehabilitation devices Proceedings of the 11th International Conference on Information Integration and Web\u2010Based Applications & Services. iiWAS \u201809","author":"Al\u2010Jumaily A.","year":"2009"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/g4h.2017.0054"},{"key":"e_1_2_8_27_1","series-title":"2008 Virtual Rehabilitation","first-page":"61","volume-title":"Myo\u2010Pong: A neuromuscular game for the UVa\u2010Neuromuscular training system platform","author":"Rosa R.","year":"2008"},{"key":"e_1_2_8_28_1","unstructured":"Gramatke C Gramatke S. Pospos\u2014Im Land der Chukchuks. 2015."},{"key":"e_1_2_8_29_1","unstructured":"Henrichs J Gagnon M Munoz E Baker S. Super Tux Kart.\u00a02015."},{"key":"e_1_2_8_30_1","unstructured":"Danford C Maynard G. Step Mania 5.\u00a02015."},{"key":"e_1_2_8_31_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12984-016-0183-0","article-title":"Role of muscle synergies in real\u2010time classification of upper limb motions using extreme learning machines","volume":"13","author":"Antuvan C.W.","year":"2016","journal-title":"J Neuroeng Rehabil"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.43.3.450"},{"key":"e_1_2_8_33_1","first-page":"685","volume-title":"Control your game\u2010self: Effects of controller type on enjoyment, motivation, and personality in game Proceedings of the SIGCHI conference on human factors in computing systems CHI Conference","author":"Birk M.","year":"2013"},{"key":"e_1_2_8_34_1","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1016\/j.apmr.2007.12.046","article-title":"The role of order of practice in learning to handle an upper\u2010limb prosthesis","volume":"89","author":"Bouwsema H.","year":"2008","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_8_35_1","doi-asserted-by":"crossref","first-page":"e0137161","DOI":"10.1371\/journal.pone.0137161","article-title":"Virtual training of the myosignal","volume":"10","author":"Terlaak B.","year":"2015","journal-title":"PLoS One"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1162\/PRES_a_00078"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-11-64"},{"key":"e_1_2_8_38_1","unstructured":"Burke JW McNeill MDJ Charles DK Morrow PJ Crosbie JH McDonough SM. Designing engaging playable games for rehabilitation. 8th Int Conf Disabil Virtual Real Assoc Technol. 2010."},{"key":"e_1_2_8_39_1","first-page":"195","volume-title":"Increasing motivation, effort and performance through game\u2010based rehabilitation for upper limb myoelectric prosthesis control","author":"Prahm C.","year":"2010"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0000000000000017"},{"key":"e_1_2_8_41_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.pmr.2013.09.012","article-title":"Prosthetic training: Upper limb","volume":"25","author":"Johnson S.S.","year":"2014","journal-title":"Phys Med Rehabil Clin North Am"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1089\/g4h.2012.0011"},{"key":"e_1_2_8_43_1","unstructured":"S.McCallum.Gamification and serious games for personalized health.pHealth2012;85\u201396 Available at:www.miro.ing.unitn.it\/download\/Didactics\/Misure2\/2012%20pHealth%20\u2010%20Gamification.pdf Accessed November 15 2018"},{"key":"e_1_2_8_44_1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1089\/g4h.2016.0102","article-title":"Gaming your way to health: A systematic review of exergaming programs to increase health and exercise behaviors in adults","volume":"6","author":"Street T.D.","year":"2017","journal-title":"Games Health J"},{"key":"e_1_2_8_45_1","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1186\/s13104-016-2232-y","article-title":"Combining two open source tools for neural computation (BioPatRec and Netlab) improves movement classification for prosthetic control","volume":"9","author":"Prahm C.","year":"2016","journal-title":"BMC Res Notes"},{"key":"e_1_2_8_46_1","first-page":"150","article-title":"Myoelectric control of artificial limbs: Is there a need to change focus?","volume":"29","author":"Jiang N.","year":"2012","journal-title":"IEEE Signal Process Mag"},{"key":"e_1_2_8_47_1","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1109\/TNSRE.2015.2454240","article-title":"Context\u2010dependent upper limb prosthesis control for natural and robust use","volume":"24","author":"Amsuess S.","year":"2015","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2014.2305111"},{"key":"e_1_2_8_49_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1109\/ICVR.2015.7358588","volume-title":"Home\u2010based self\u2010training using video\u2010games: Preliminary data from a randomised controlled trial 2015 International Conference on Virtual Rehabilitation (ICVR)","author":"Rand D.","year":"2015"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148218309274?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148218309274?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2018.09.027","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.pmrj.2018.09.027","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2018.09.027","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T13:25:06Z","timestamp":1694784306000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2018.09.027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":48,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1016\/j.pmrj.2018.09.027"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2018.09.027","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]},"assertion":[{"value":"2018-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-09-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}