The Rehabilitation Gaming System
The Rehabilitation Gaming System is a novel technology for Neuro-Rehabilitation that assists in the recovery of function after brain damage. RGS is based on concrete neuroscientific principles of brain function in health and disease. RGS was initially developed via the EU project http://www.aal-europe.eu/projects/rgs/
The motivation behind the development of a neurorehabilitation system such as RGS was driven by the intuition that combining interaction technology, in particular, virtual reality, with the DAC theory of mind and brain would make an impact on the recovery of brain function at the clinical level. This decision was a key step in the realization of RGS since it made choices on the content of non-arbitrary treatment protocols and every intervention became a well-defined interaction with a user, which in turn would provide an immediate feedback on the system in terms of its usability, and effectiveness. By now RGS incorporates about 20 specific DAC derived principles that range from the key role of sensori-motor contingencies in organizing cognition and action (see Prochnow, D. et al., Eur. J. of Neurosc. 2013) to the importance of goal-oriented and error-driven intervention. (see Belen Rubio Ballestr et al., J. NeuroEng. Rehab. 2015)
Image: [left] Extension of brain damage after stroke. Stroke can cause brain damage with loss of motor and cognitive functions. [right] A stroke patient training with RGS under the supervision of her physician/physioterapist at Val d’Hebron Hospital in Barcelona. The efficacy of RGS in the recovery of these functions has been clinically tested with hundreds of patients. RGS is based on the neurobiological considerations that plasticity of the brain remains throughout life and therefore can be utilized to achieve functional reorganization of the brain areas affected by stroke. RGS in the News – http://www.euronews.com/2016/02/15/takeaway-train-your-brain – http://www.euronews.com/2016/02/15/a-virtual-reality-game-to-help-stroke-patients
RGS has advanced over the last decade with an extensive experimental agenda realized with dedicated partners in Barcelona
To support our experimental studies we have installed RGS therapy-stations in several hospitals (see collaborators below). As a result, RGS has built up an unprecedented empirical track record (see key references below) having been tested with over 800 patients at the acute and chronic stages of stroke, including at home settings. Building on these results, together with our clinical partners, we are now validating the generalization of RGS to other neuropathologies such as Parkinson’s disease, Cerebral Palsy, Traumatic Brain Injury and Spinal Cord Lesions and the initial analysis looks very encouraging.
Stroke patients want to continue using RGS after participanting in clinical trials.
This demand combined with the clinical results that show that RGS is more effective than any other intervention available today has led us to the creation of the spin-off company Eodyne.com Eodyne’s goal is to make RGS available to as many people as possible for a minimum cost.
Schematic representation of the RGS platform: from the laboratory to the patient @clinic and @home
SPECS_lab collaborates with Hospital la Esperanza, in particular with Dr Ester Duarte and “TiC Salut Foundation” a Catalan agency that is part of the Ministry of Health.
The RGS platform
- Rehabilitation Gaming System set up
- Virtual Reality tools (graphics, game design, game engine Unity…)
- Custom made gloves
- Physiological measuring devices
- Haptic interfaces (GRAB)
- Eye tracker (TOBII)
- Wearable devices
Other tools used to investigate the impact of RGS on motor function and recovery
The Passive exoskeletons (ARMEO) provides support against gravity and allows the capture of different arm joint angles that are translated to the virtual world. The GRAB haptic interface system provides force-feedback to the user by means of two mechanical arms that detect collisions in the virtual environment.
- Hospital Universitari de la Vall d’Hebron (HUVH)
- Parc Salut de Mar (Hospital del Mar i de l’Esperança)
- Heinrich Heine Universität
- Fundació Tic Salut
- Institut Municipal d’Assistència Sanitària (IMAS)
- Hospital Clinic
- (see also AAL project http://rgs-project.upf.edu/home and project SANaR http://sanar.project.upf.edu/)
find all articles at http://specs.upf.edu/biblio
 Belén Rubio Ballester, Martina Maier, Rosa María San Segundo Mozo, Victoria Castañeda, Armin Duff and Paul F. M. J. Verschure (2016), “Counteracting learned non-use in chronic stroke patients with reinforcement-induced movement therapy”, Journal of NeuroEngineering and Rehabilitation. DOI: 10.1186/s12984-016-0178-x
 Belén Rubio Ballester, Jens Nirme, Esther Duarte, Ampar Cuxart, Susana Rodriguez, Paul Verschure and Armin Duff (2015), “The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patients”, Journal of NeuroEngineering and Rehabilitation, 12:50 ; doi 10.1186/s12984-015-0039-z.
 Grechuta, K, Rubio, B, Duff, A, Duarte Oller, E, and Verschure, P (2014), “Intensive language-action therapy in virtual reality for a rehabilitation gaming system“, Proc. 10th Intl Conf. on Disability, Virtual Reality and Assoc. Technologies, PM Sharkey, L Pareto, J Broeren, M Rydmark (Eds), pp. 265-273, Gothenburg, Sweden, 2-4 Sept. 2014
 Rubio, B., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Duff, A., & Verschure, P. F. M. J. (2013). Virtual Reality Based Tool for Motor Function Assessment in Stroke Survivors. In J. L. Pons, D. Torricelli & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation (Vol. 1, pp. 1037-1041): Springer Berlin Heidelberg.
 Maier, M., Rubio Ballester, B., Duarte, E., Duff, A. and Verschure, Paul F.M.J. (2012). “Social Integration of Stroke Patients through the Multiplayer Rehabilitation Gaming System“. Games for Training, Education, Health and Sports. Lecture Notes in Computer Science Volume 8395, 2014, pp 100-114.
 Rodriguez, S., Bermudez i Badia, S., Cameirão, M. S., Fina, A. C., Duarte, E., Duff, A., Verschure, P. F. M. J., et al. (2011). “Effects of Virtual Reality Upper Limb Based Training (Rehabilitation Gaming System) on Spasticity, Shoulder Pain, and Depression After Stroke”. 2011 AAPM&R annual assembly (Vol. 3, p. S160). Elsevier Inc. doi:10.1016/j.pmrj.2011.08.013.
 Nirme, J., A. Duff, and P.F.M.J. Verschure. “Adaptive rehabilitation gaming system: On-line individualization of stroke rehabilitation”. in Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE. 2011. IEEE.
 Verschure, P. F. M. J. (2011). “Neuroscience, virtual reality and neurorehabilitation: brain repair as a validation of brain theory”. Conference proceedings for the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. (Vol. 2011, pp. 2254–7). IEEE.
 Rubio, B., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Duff, A., & Verschure, P. F. M. J. (2013). “Virtual Reality Based Tool for Motor Function Assessment in Stroke Survivors”. In J. L. Pons, D. Torricelli & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation (Vol. 1, pp. 1037-1041): Springer Berlin Heidelberg.
 Nirme, J., Rubio, B., Duff, A., Duarte, E., Rodriguez, S., Cuxart, A., & Verschure, P. F. M. J. (2013). “At Home Motor Rehabilitation in the Chronic Phase of Stroke Using the Rehabilitation Gaming System”. In J. L. Pons, D. Torricelli, & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation SE – 151 (Vol. 1, pp. 931–935). Berlin: Springer Berlin Heidelberg.
 Duff, J. Nirme, B.Rubio, E. Duarte, A. Cuxart, S. Rodríguez, P.F.M.J. Verschure “The optimal dosage of the Rehabilitation Gaming System: The impact of a longer period of virtual reality based and standard occupational training on upper limb recovery in the acute phase of stroke”. Abstract presented during the 22nd European Stroke Conference 2013, LONDON, UK.
 Ballester, B. R., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Verschure, P., & Duff, A. (2015). “The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patients“. Journal of neuroengineering and rehabilitation, 12(1), 50.
 Prochnow, D., Bermudez I Badia, S., Schmidt, J., Duff, A., Brunheim, S., Kleiser, R., Seitz, R., et al. “A functional magnetic resonance imaging study of visuomotor processing in a virtual reality-based paradigm: Rehabilitation Gaming System“. The European journal of neuroscience, (January), 1–7, 2013.
 M. S. Cameirao, et al., “Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation“, J Neuroeng Rehabil, vol. 7, p. 48, 2010.
 M. S. Cameirao, et al., “Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: A randomized controlled pilot study in the acute phase of stroke using the Rehabilitation Gaming System“, Restor Neurol Neurosci, vol. 29, pp. 287-98, 2011
 Mónica S. Cameirão, Sergi Bermúdez i Badia, Esther Duarte, Antonio Frisoli, and Paul F.M.J. Verschure. The combined impact of Virtual Reality Neurorehabilitation and its interfaces on upper extremity functional recovery in patients with chronic stroke. “Stroke”, vol. 43 (10) 2720-2728, 2012