{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:29:50Z","timestamp":1789788590166,"version":"4.0.1"},"reference-count":35,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017170","name":"Thailand Science Research and Innovation","doi-asserted-by":"crossref","award":["4821366"],"award-info":[{"award-number":["4821366"]}],"id":[{"id":"10.13039\/501100017170","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>This paper presents RehabHub, a home-based exergaming system that integrates standardized physical assessment directly into gameplay by using a common webcam and MediaPipe for real-time pose estimation. The system quantifies upper-limb movement quality, specifically abduction, shoulder flexion, and elbow flexion based on FMA-UE guidelines, by applying Dynamic Time Warping (DTW) together with a Z-score-based scoring model that relies on data from non-clinical adult participants. A pilot study, which included movements simulated with a 5-kg resistance band, evaluated three feature-extraction methods. The findings indicate that the single-angle method provides the clearest distinction between normal and abnormal movements, particularly for abduction and elbow flexion. In the case of shoulder flexion, the score separation was less distinct because of movement variability and posture-related angle fluctuations, which suggests that further refinement of feature design is needed. The cloud-based platform supports remote monitoring and gives caregivers access to both performance scores and recorded exercise videos. Overall, the results demonstrate the feasibility of a low-cost webcam-based assessment integrated into exergaming, and they highlight important trends for improving abnormal-movement detection in home rehabilitation systems.<\/jats:p>","DOI":"10.3390\/s26041219","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:52:21Z","timestamp":1770979941000},"page":"1219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Webcam-Based Exergame for Motor Recovery with Physical Assessment via DTW"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8924-2175","authenticated-orcid":false,"given":"Norapat","family":"Labchurat","sequence":"first","affiliation":[{"name":"School of Information Technology and Innovation, Bangkok University, Pathum Thani 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3100-3469","authenticated-orcid":false,"given":"Kingkarn","family":"Sookhanaphibarn","sequence":"additional","affiliation":[{"name":"Center of Specialty Innovation, Bangkok University, Pathum Thani 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-0953","authenticated-orcid":false,"given":"Worawat","family":"Choensawat","sequence":"additional","affiliation":[{"name":"Center of Specialty Innovation, Bangkok University, Pathum Thani 12120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2141-9746","authenticated-orcid":false,"given":"Pujana","family":"Paliyawan","sequence":"additional","affiliation":[{"name":"Center of Specialty Innovation, Bangkok University, Pathum Thani 12120, Thailand"},{"name":"Ritsumeikan University Research Organization, Ritsumeikan University, Ibaraki, Osaka 567-8570, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"ref_1","unstructured":"World Stroke Organization (2023, February 21). Learn About Stroke. Available online: https:\/\/www.world-stroke.org\/world-stroke-day-campaign\/about-stroke\/impact-of-stroke."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.jpsychires.2022.09.040","article-title":"Association between adhesive capsulitis and depression: A five-year retrospective cohort study including 58,516 adults from Germany","volume":"155","author":"Jacob","year":"2022","journal-title":"J. Psychiatr. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/ijs.12041","article-title":"Approaches to economic evaluations of stroke rehabilitation","volume":"9","author":"Craig","year":"2014","journal-title":"Int. J. Stroke"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"99","DOI":"10.3233\/NRE-172408","article-title":"The use of robots in stroke rehabilitation: A narrative review","volume":"43","author":"Weber","year":"2018","journal-title":"NeuroRehabilitation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.ijmedinf.2018.12.001","article-title":"Home-based technologies for stroke rehabilitation: A systematic review","volume":"123","author":"Chen","year":"2019","journal-title":"Int. J. Med. Inform."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"112826","DOI":"10.1016\/j.measurement.2023.112826","article-title":"Reliability and validity analysis of MediaPipe-based measurement system for some human rehabilitation motions","volume":"214","author":"Latreche","year":"2023","journal-title":"Measurement"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kim, J.W., Choi, J.Y., Ha, E.J., and Choi, J.H. (2023). Human pose estimation using mediapipe pose and optimization method based on a humanoid model. Appl. Sci., 13.","DOI":"10.3390\/app13042700"},{"key":"ref_8","first-page":"153","article-title":"A scoping review of health game research: Past, present, and future","volume":"1","author":"Kharrazi","year":"2012","journal-title":"Games Health Res. Dev. Clin. Appl."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s00371-009-0387-4","article-title":"Optimising engagement for stroke rehabilitation using serious games","volume":"25","author":"Burke","year":"2009","journal-title":"Vis. Comput."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2340\/1650197771331","article-title":"A method for evaluation of physical performance","volume":"7","author":"Leyman","year":"1975","journal-title":"Scand. J. Rehabil. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.apmr.2007.12.041","article-title":"Longitudinal stability of the Fugl-Meyer Assessment of the upper extremity","volume":"89","author":"Woodbury","year":"2008","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/NPT.0000000000000318","article-title":"Barriers and facilitators to aerobic exercise implementation in stroke rehabilitation: A scoping review","volume":"44","author":"Moncion","year":"2020","journal-title":"J. Neurol. Phys. Ther."},{"key":"ref_13","first-page":"3738219","article-title":"Effectiveness of a Soft Robotic Glove to Assist Hand Function in Stroke Patients: A Cross-Sectional Pilot Study","volume":"2022","author":"Thimabut","year":"2022","journal-title":"Rehabil. Res. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Celesti, A., Cimino, V., Naro, A., Portaro, S., Fazio, M., Villari, M., and Calabr\u00f3, R.S. (2022). Recent considerations on gaming console based training for multiple sclerosis rehabilitation. Med. Sci., 10.","DOI":"10.3390\/medsci10010013"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Robinson, J., Dixon, J., Macsween, A., Van Schaik, P., and Martin, D. (2015). The effects of exergaming on balance, gait, technology acceptance and flow experience in people with multiple sclerosis: A randomized controlled trial. BMC Sports Sci. Med. Rehabil., 7.","DOI":"10.1186\/s13102-015-0001-1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.cmpb.2017.08.008","article-title":"Motion Rehab AVE 3D: A VR-based exergame for post-stroke rehabilitation","volume":"151","author":"Trombetta","year":"2017","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1186\/s12984-016-0185-y","article-title":"Effects of a balance-based exergaming intervention using the Kinect sensor on posture stability in individuals with Parkinson\u2019s disease: A single-blinded randomized controlled trial","volume":"13","author":"Shih","year":"2016","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.aott.2017.03.008","article-title":"Comparison of virtual reality exergaming and home exercise programs in patients with subacromial impingement syndrome and scapular dyskinesis: Short term effect","volume":"51","author":"Pekyavas","year":"2017","journal-title":"Acta Orthop. Traumatol. Turc."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ferraris, C., Ronga, I., Pratola, R., Coppo, G., Bosso, T., Falco, S., Amprimo, G., Pettiti, G., Lo Priore, S., and Priano, L. (2022). Usability of the REHOME solution for the telerehabilitation in neurological diseases: Preliminary results on motor and cognitive platforms. Sensors, 22.","DOI":"10.3390\/s22239467"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e26153","DOI":"10.2196\/26153","article-title":"A personalized home-based rehabilitation program using exergames combined with a telerehabilitation app in a chronic stroke survivor: Mixed methods case study","volume":"9","author":"Allegue","year":"2021","journal-title":"JMIR Serious Games"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s13755-022-00189-5","article-title":"Design and evaluation of an exergame system to assist knee disorders patients\u2019 rehabilitation based on gesture interaction","volume":"10","author":"Wang","year":"2022","journal-title":"Health Inf. Sci. Syst."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Rosique, F., Losilla, F., and Navarro, P.J. (2021). Applying vision-based pose estimation in a telerehabilitation application. Appl. Sci., 11.","DOI":"10.3390\/app11199132"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1053\/apmr.2001.23183","article-title":"The reliability of the wolf motor function test for assessing upper extremity function after stroke","volume":"82","author":"Morris","year":"2001","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Oliveira, C.S., Almeida, C.S., Freias, L.C., Santana, R., Fernandes, G., Fonseca Junior, P.R., and Moura, R.C.F. (2016). Use of the Box and Block Test for the evaluation of manual dexterity in individuals with central nervous system disorders: A systematic review. Man. Ther. Posturology Rehabil. J., 1\u20137.","DOI":"10.17784\/mtprehabjournal.2016.14.436"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2179","DOI":"10.1109\/TNSRE.2018.2876670","article-title":"Biomedical serious game system for balance rehabilitation of hemiparetic stroke patients","volume":"26","author":"Noveletto","year":"2018","journal-title":"IEEE Trans. Neural Syst. Rehabil. Eng."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1093\/ptj\/73.7.447","article-title":"Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke","volume":"73","author":"Sanford","year":"1993","journal-title":"Phys. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Yu, X., and Xiong, S. (2019). A dynamic time warping based algorithm to evaluate kinect-enabled home-based physical rehabilitation exercises for older people. Sensors, 19.","DOI":"10.3390\/s19132882"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"13","DOI":"10.20965\/jaciii.2012.p0013","article-title":"Similarity retrieval of motion capture data based on derivative features","volume":"16","author":"Choensawat","year":"2012","journal-title":"J. Adv. Comput. Intell. Intell. Inform."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Schneider, P., Memmesheimer, R., Kramer, I., and Paulus, D. (2019). Gesture recognition in RGB videos using human body keypoints and dynamic time warping. RoboCup 2019: Robot World Cup XXIII 23, Sydney, NSW, Australia, 8 July 2019, Springer.","DOI":"10.1007\/978-3-030-35699-6_22"},{"key":"ref_30","unstructured":"Google Developers (2025, July 17). ML Kit|Google for Developers. Available online: https:\/\/developers.google.com\/ml-kit."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Jia, W., Wang, H., Chen, Q., Bao, T., and Sun, Y. (2025). Analysis of Kinect-Based Human Motion Capture Accuracy Using Skeletal Cosine Similarity Metrics. Sensors, 25.","DOI":"10.3390\/s25041047"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1016\/j.jneumeth.2003.10.013","article-title":"The dynamics of spatial behavior: How can robust smoothing techniques help?","volume":"133","author":"Hen","year":"2004","journal-title":"J. Neurosci. Methods"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Labchurat, N., Khumthong, A., Choensawat, W., and Sookhanaphibarn, K. (2023). Leveraging Exergaming and Standard Webcams for Stroke Rehabilitation. 2023 IEEE 12th Global Conference on Consumer Electronics (GCCE), Nara, Japan, 10\u201313 October 2023, IEEE.","DOI":"10.1109\/GCCE59613.2023.10315630"},{"key":"ref_34","unstructured":"Labchurat, N. (2025, October 20). Motion Segmentation Source Code. GitHub Repository. Available online: https:\/\/github.com\/ArmNorapat\/norapat-motion-segmentation."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Buehler, C., Koller, W., De Comtes, F., and Kainz, H. (2021). Quantifying muscle forces and joint loading during hip exercises performed with and without an elastic resistance band. Front. Sports Act. Living, 3.","DOI":"10.3389\/fspor.2021.695383"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/4\/1219\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T05:20:42Z","timestamp":1771132842000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/26\/4\/1219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":35,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["s26041219"],"URL":"https:\/\/doi.org\/10.3390\/s26041219","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]}}}