Projected AR Serious Game "Painting Discovery" for Shoulder Rehabilitation: Assessment With Technicians, Physiotherapists, and Patients

• Published in: IEEE journal of translational engineering in health and medicine Vol. 13; pp. 149 - 157
• Main Authors: Turini, Giuseppe, Carbone, Marina, Condino, Sara, Gallone, Donato, Ferrari, Vincenzo, Gesi, Marco, Scaglione, Michelangelo, Parchi, Paolo, Maria Viglialoro, Rosanna
• Format: Journal Article
• Language: English
• Published: United States IEEE 2025; The Institute of Electrical and Electronics Engineers, Inc. (IEEE)
• Subjects: Acceleration; Adult; Augmented reality; Completion time; Computer & video games; Ergonomics; Female; Games; Hand-finger tracking; Hands; Humans; Limbs; making rehabilitation more accessible and enhancing overall effectiveness; Male; Middle Aged; Motors; Pathology; Performance evaluation; Physical Therapists; Physical therapy; Physical Therapy Modalities; projected augmented reality; Rehabilitation; serious game; Shoulder; Shoulder - physiology; Shoulder - physiopathology; shoulder disorders. Clinical Impact: “Painting Discovery” could significantly impact clinical practice by improving patient adherence through increased engagement and motivation. This may reduce the need for supervised sessions; Shoulder Pain - rehabilitation; Surgery; Tracking; Trajectory; Video Games; shoulder disorders. Clinical Impact: “Painting Discovery” could significantly impact clinical practice by improving patient adherence through increased engagement and motivation. This may reduce the need for supervised sessions; making rehabilitation more accessible and enhancing overall effectiveness; Hand-finger tracking; projected augmented reality; rehabilitation; serious game
• ISSN: 2168-2372; 2168-2372
• DOI: 10.1109/JTEHM.2025.3557250

Objective: Motivation and adherence are crucial for effective rehabilitation, yet engagement remains a challenge in upper limb physiotherapy. Serious Games (SGs) have emerged as a promising tool to enhance patient motivation. This study evaluates Painting Discovery, a projected augmented reality (AR) SG for shoulder rehabilitation, assessing engagement, ergonomics, and its potential to differentiate motor performance between healthy and those with rheumatoid arthritis, bursitis, subacromial impingement, rotator cuff tear, or calcific tendinopathy. Additionally, it examines improvements in pathological subjects following physiotherapy. Method: Sixteen healthy and seven pathological subjects participated. Engagement, ergonomics, and satisfaction were assessed using Likert-scale questionnaires. Motor performance was evaluated through completion time, speed, acceleration, and normalized jerk. Four pathological subjects underwent pre- and post-physiotherapy assessments over six weeks. Results: SG was highly engaging and ergonomic, with no significant differences based on prior video game or AR experience. The pathological group had longer completion times (<inline-formula> <tex-math notation="LaTeX">56.49~\pm ~37.85 </tex-math></inline-formula>s vs. <inline-formula> <tex-math notation="LaTeX">39.02~\pm ~24.21 </tex-math></inline-formula>s, p < 0.001), lower acceleration (<inline-formula> <tex-math notation="LaTeX">1.11~\pm ~0.92 </tex-math></inline-formula> m/s2 vs. <inline-formula> <tex-math notation="LaTeX">0.79~\pm ~0.56 </tex-math></inline-formula> m/s2, p < 0.001), and higher jerk (<inline-formula> <tex-math notation="LaTeX">6.68\times 107~\pm ~1.37\times 108 </tex-math></inline-formula> m/s3 vs. <inline-formula> <tex-math notation="LaTeX">9.22\times 106~\pm ~2.51\times 107 </tex-math></inline-formula> m/s3, p = 0.025) then healthy subjects. After physiotherapy, completion time and normalized jerk indicated enhanced efficiency and control. Conclusions: Painting Discovery shows strong potential as an engaging, accessible rehabilitation tool. While effective in differentiating motor impairments, its small sample size and horizontal-plane movement focus limit broader conclusions. Future studies should expand participation, incorporate vertical-plane movements, and refine performance metrics for clinical validation.