{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T21:01:51Z","timestamp":1780088511607,"version":"3.54.0"},"reference-count":52,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["DGE-1646713"],"award-info":[{"award-number":["DGE-1646713"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Rehabilitation requires repetitive and coordinated movements for effective treatment, which are contingent on patient compliance and motivation. However, the monotony, intensity, and expense of most therapy routines do not promote engagement. Gesture-controlled rehabilitation has the potential to quantify performance and provide engaging, cost-effective treatment, leading to better compliance and mobility. We present the design and testing of a gesture-controlled rehabilitation robot (GC-Rebot) to assess its potential for monitoring user performance and providing entertainment while conducting physical therapy. Healthy participants (n = 11) completed a maze with GC-Rebot for six trials. User performance was evaluated through quantitative metrics of movement quality and quantity, and participants rated the system usability with a validated survey. For participants with self-reported video-game experience (n = 10), wrist active range of motion across trials (mean \u00b1 standard deviation) was 41.6 \u00b1 13\u00b0 and 76.8 \u00b1 16\u00b0 for pitch and roll, respectively. In the course of conducting a single trial with a time duration of 68.3 \u00b1 19 s, these participants performed 27 \u00b1 8 full wrist motion repetitions (i.e., flexion\/extension), with a dose-rate of 24.2 \u00b1 5 reps\/min. These participants also rated system usability as excellent (score: 86.3 \u00b1 12). Gesture-controlled therapy using the GC-Rebot demonstrated the potential to be an evidence-based rehabilitation tool based on excellent user ratings and the ability to monitor at-home compliance and performance.<\/jats:p>","DOI":"10.3390\/s20154269","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T06:16:47Z","timestamp":1596435407000},"page":"4269","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A Gesture-Controlled Rehabilitation Robot to Improve Engagement and Quantify Movement Performance"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4566-7813","authenticated-orcid":false,"given":"Ava D.","family":"Segal","sequence":"first","affiliation":[{"name":"M3Robotics and Functional Biomechanics Laboratories, Department of Mechanical Engineering Colorado School of Mines, Golden, CO 80401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8655-3196","authenticated-orcid":false,"given":"Mark C.","family":"Lesak","sequence":"additional","affiliation":[{"name":"Army Cyber Institute, West Point, NY 10996, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-4548","authenticated-orcid":false,"given":"Anne K.","family":"Silverman","sequence":"additional","affiliation":[{"name":"M3Robotics and Functional Biomechanics Laboratories, Department of Mechanical Engineering Colorado School of Mines, Golden, CO 80401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-4227","authenticated-orcid":false,"given":"Andrew J.","family":"Petruska","sequence":"additional","affiliation":[{"name":"M3Robotics and Functional Biomechanics Laboratories, Department of Mechanical Engineering Colorado School of Mines, Golden, CO 80401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"33S","DOI":"10.1177\/1545968311410942","article-title":"Neurological principles and rehabilitation of action disorders: Rehabilitation interventions","volume":"25","author":"Pomeroy","year":"2011","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1080\/02640419608727734","article-title":"Threat and coping appraisal as determinants of compliance with sports injury rehabilitation: An application of Protection Motivation Theory","volume":"14","author":"Taylor","year":"1996","journal-title":"J. Sport. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/0738-3991(91)90060-I","article-title":"Patient compliance with exercise: Different theoretical approaches to short-term and long-term compliance","volume":"17","author":"Sluijs","year":"1991","journal-title":"Patient Educ. Couns."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1016\/j.apmr.2009.04.005","article-title":"Observation of amounts of movement practice provided during stroke rehabilitation","volume":"90","author":"Lang","year":"2009","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2522\/ptj.20130579","article-title":"Emergence of virtual reality as a tool for upper limb rehabilitation: Incorporation of motor control and motor learning principles","volume":"95","author":"Levin","year":"2015","journal-title":"Phys. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1080\/096382899297459","article-title":"The long-term outcome of arm function after stroke: Results of a follow-up study","volume":"21","author":"Broeks","year":"1999","journal-title":"Disabil. Rehabil."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2017\/3908135","article-title":"Hand rehabilitation robotics on poststroke motor recovery","volume":"2017","author":"Yue","year":"2017","journal-title":"Behav. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1161\/hs0102.101014","article-title":"Adherence to postacute rehabilitation guidelines is associated with functional recovery in stroke","volume":"33","author":"Duncan","year":"2002","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1743-0003-6-1","article-title":"Technology-assisted training of arm-hand skills in stroke: Concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design","volume":"6","author":"Timmermans","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/NPT.0000000000000017","article-title":"Video games and rehabilitation: Using design principles to enhance engagement in physical therapy","volume":"37","author":"Lohse","year":"2013","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s11517-011-0808-1","article-title":"Quantitative evaluation of upper-limb motor control in robot-aided rehabilitation","volume":"49","author":"Zollo","year":"2011","journal-title":"Med. Biolog. Eng. Comp."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1123\/jpah.7.3.393","article-title":"The physiological cost and enjoyment of Wii Fit in adolescents, young adults, and older adults","volume":"7","author":"Graves","year":"2010","journal-title":"J. Phys. Act. Health"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Segal, A.D., Lesak, M.C., Suttora, N.E., Silverman, A.K., and Petruska, A.J. (2020, January 20\u201324). iRebot: An interactive rehabilitation robot with gesture control. Proceedings of the IEEE International Confrence Engineering in Medicine and Biology Society (EMBC), Montreal, QC, Canada.","DOI":"10.1109\/EMBC44109.2020.9176696"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1109\/TNSRE.2010.2047608","article-title":"Sensor-based arm skill training in chronic stroke patients: Results on treatment outcome, patient motivation, and system usability","volume":"18","author":"Timmermans","year":"2010","journal-title":"IEEE Trans. Neural. Sys. Rehabil. Eng."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"493","DOI":"10.2340\/16501977-0802","article-title":"Virtual reality for enhancement of robot-assisted gait training in children with neurological gait disorders","volume":"43","author":"Brutsch","year":"2011","journal-title":"J. Rehabil. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Prahm, C., Kayali, F., Vujaklija, I., Sturma, A., and Aszmann, O. (2017, January 19\u201322). Increasing motivation, effort and performance through game-based rehabilitation for upper limb myoelectric prosthesis control. Proceedings of the 2017 International Conference on Virtual Rehabilitation (ICVR), Montreal, QC, Canada.","DOI":"10.1109\/ICVR.2017.8007517"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S208","DOI":"10.1016\/j.pmrj.2010.10.016","article-title":"Neural plasticity: The biological substrate for neurorehabilitation","volume":"2","author":"Warraich","year":"2010","journal-title":"PM&R"},{"key":"ref_18","first-page":"1300","article-title":"Gesture controlled robot for military Purpose","volume":"1","author":"Sathiyanarayanan","year":"2014","journal-title":"Int. J. Technol. Res. Eng."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1007\/s00202-017-0614-3","article-title":"Control of the mobile robot by hand movement measured by inertial sensors","volume":"99","author":"Nemec","year":"2017","journal-title":"Electr. Eng."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Wolf, M.T., Assad, C., Vernacchia, M.T., Fromm, J., and Jethani, H.L. (2013, January 6\u201310). Gesture-based robot control with variable autonomy from the JPL BioSleeve. Proceedings of the 2013 IEEE International Conference on Robotics and Automation, Karlsruhe, Germany.","DOI":"10.1109\/ICRA.2013.6630718"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.cmpb.2013.12.018","article-title":"Hand gesture guided robot-assisted surgery based on a direct augmented reality interface","volume":"116","author":"Wen","year":"2014","journal-title":"Comp. Meth. Prog. Biomed."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yang, G., Lv, H., Chen, F., Pang, Z., Wang, J., Yang, H., and Zhang, J. (2018). A novel gesture recognition system for intelligent interaction with a nursing-care assistant robot. Appl. Sci., 8.","DOI":"10.3390\/app8122349"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S255","DOI":"10.1097\/PHM.0b013e31826bcdc1","article-title":"Robotic assessment of upper limb motor function after stroke","volume":"91","author":"Balasubramanian","year":"2012","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"350","DOI":"10.2522\/ptj.20130564","article-title":"Patients\u2019 use of a home-based virtual reality system to provide rehabilitation of the upper limb following stroke","volume":"95","author":"Standen","year":"2015","journal-title":"Phys. Ther."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3389\/fneur.2018.00212","article-title":"Technological approaches for neurorehabilitation: From robotic devices to brain stimulation and beyond","volume":"9","author":"Semprini","year":"2018","journal-title":"Front. Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1080\/17482798.2011.633404","article-title":"Sleep as a mediator of screen time effects on US children\u2019s health outcomes: A prospective study","volume":"6","author":"Barlett","year":"2012","journal-title":"J. Child. Media"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.envres.2018.01.015","article-title":"Adverse physiological and psychological effects of screen time on children and adolescents: Literature review and case study","volume":"164","author":"Lissak","year":"2018","journal-title":"Environ. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"212","DOI":"10.3200\/JMBR.36.2.212-224","article-title":"Challenge point: A framework for conceptualizing the effects of various practice conditions in motor learning","volume":"36","author":"Guadagnoli","year":"2004","journal-title":"J. Mot. Behav."},{"key":"ref_29","unstructured":"Paulich, M., Schepers, M., Rudigkeit, N., and Bellusci, G. (2018). Xsens MTw Awinda: Miniature Wireless Inertial-Magnetic Motion Tracker for Highly Accurate 3D Kinematic Applications, Xsens."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1037\/h0075814","article-title":"Learning and stability: A psychophysiological analysis of a case of motor learning with clinical applications","volume":"10","author":"Snoddy","year":"1926","journal-title":"J. App. Psyc."},{"key":"ref_31","unstructured":"(2020, June 21). Renewal Lodge.com. Available online: https:\/\/www.renewallodge.com\/5-ways-quitting-drinking-affects-your-brain\/."},{"key":"ref_32","first-page":"4","article-title":"SUS: A Quick and Dirty usability scale","volume":"189","author":"Brooke","year":"1996","journal-title":"Usability Eval. Ind."},{"key":"ref_33","first-page":"1","article-title":"A technique for the measurement of attitudes","volume":"140","author":"Likert","year":"1932","journal-title":"Arch. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2126","DOI":"10.1109\/TBME.2011.2179545","article-title":"A robust and sensitive metric for quantifying movement smoothness","volume":"59","author":"Balasubramanian","year":"2012","journal-title":"IEEE Trans. Biomed. Eng."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1523\/JNEUROSCI.05-07-01688.1985","article-title":"The coordination of arm movements: An experimentally confirmed mathematical model","volume":"5","author":"Flash","year":"1985","journal-title":"J. Neurosci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"59","DOI":"10.2307\/2685263","article-title":"Thirteen ways to look at the correlation coefficient","volume":"42","author":"Rodgers","year":"1988","journal-title":"Am. Stat."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1177\/875647939000600106","article-title":"Interpretation of the correlation coefficient: A basic review","volume":"6","author":"Taylor","year":"1990","journal-title":"J. Diagnos. Med. Sonogr."},{"key":"ref_38","first-page":"29","article-title":"SUS: A Retrospective","volume":"8","author":"Brooke","year":"2013","journal-title":"J. Usability Stud."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1007\/978-3-642-02806-9_12","article-title":"The factor structure of the System Usability Scale","volume":"Volume 5619","author":"Kurosu","year":"2009","journal-title":"International Conference on Human Centered Design"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s10339-009-0268-9","article-title":"On the dimensionality of the System Usability Scale: A test of alternative measurement models","volume":"10","author":"Borsci","year":"2009","journal-title":"Cog. Process."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1177\/1545968310361957","article-title":"Translating animal doses of task-specific training to people with chronic stroke in 1-hour therapy sessions: A proof-of-concept study","volume":"24","author":"Birkenmeier","year":"2010","journal-title":"Neurorehabil. Neural Rep."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1109\/TNSRE.2005.848352","article-title":"Robotic techniques for upper limb evaluation and rehabilitation of stroke patients","volume":"13","author":"Colombo","year":"2005","journal-title":"IEEE Trans. Neural Sys. Rehabil. Eng."},{"key":"ref_43","first-page":"317","article-title":"A computational framework for quantitative evaluation of movement during rehabilitation","volume":"1371","author":"Chen","year":"2011","journal-title":"AIP Conf. Proc. Am. Inst. Phys"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s00221-010-2210-x","article-title":"The curvature and variability of wrist and arm movements","volume":"203","author":"Charles","year":"2010","journal-title":"Exp. Brain Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1310\/tsr1406-22","article-title":"Poststroke upper extremity rehabilitation: A review of robotic systems and clinical results","volume":"14","author":"Brewer","year":"2007","journal-title":"Top. Stroke Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.physio.2006.08.005","article-title":"Self-controlled practice enhances motor learning: Implications for physiotherapy","volume":"93","author":"Wulf","year":"2007","journal-title":"Physiotherapy"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.math.2009.05.011","article-title":"Real-time feedback improves accuracy of manually applied forces during cervical spine mobilisation","volume":"15","author":"Snodgrass","year":"2010","journal-title":"Man. Ther."},{"key":"ref_48","first-page":"13","article-title":"Putting fun into video games for older adults","volume":"20","author":"McLaughlin","year":"2012","journal-title":"Ergon. Des."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1161\/01.STR.29.4.785","article-title":"Effect of a therapeutic intervention for the hemiplegic upper limb in the acute phase after stroke: A single-blind, randomized, controlled multicenter trial","volume":"29","author":"Feys","year":"1998","journal-title":"Stroke"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.apmr.2007.05.012","article-title":"Kinematic and clinical analyses of upper-extremity movements after constraint-induced movement therapy in patients with stroke: A randomized controlled trial","volume":"88","author":"Wu","year":"2007","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3758\/s13423-012-0333-8","article-title":"Augmented visual, auditory, haptic, and multimodal feedback in motor learning: A review","volume":"20","author":"Sigrist","year":"2013","journal-title":"Psychon. Bull. Rev."},{"key":"ref_52","unstructured":"Patel, K., Bailenson, J.N., Hack-Jung, S., Diankov, R., and Bajcsy, R. (2006, January 24\u201326). The effects of fully immersive virtual reality on the learning of physical tasks. Proceedings of the 9th Annual International Workshop on Presence, Cleveland, OH, USA."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/15\/4269\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:53:16Z","timestamp":1760176396000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/15\/4269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,31]]},"references-count":52,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2020,8]]}},"alternative-id":["s20154269"],"URL":"https:\/\/doi.org\/10.3390\/s20154269","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,31]]}}}