TrunkyXL: Sixpack for everybody!

Carmen Ensink MSc(1), Lise Wilders(2), Kim Vereijken(3), Desirée Struijk – Vlaswinkel(2), Fanny Schils MSc(2), Gert-Jan Brok Ing(4), Kiki Coppelmans(4), Colin Rosen Ing(4), Noël Keijsers PhD(1)

(1)Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands.
(2)Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, the Netherlands. (3)Bedrijfsbureau, Sint Maartenskliniek, Nijmegen, The Netherlands,
(4)Motion VR, ‘s Hertogenbosch, the Netherlands.

Introduction

A significant proportion of stroke patients experience poor trunk control (1), which is highly associated with decreased gait ability and difficulty with activities of daily living (2). Moreover, impaired trunk stability and sitting balance affects the safety of performing daily life activities. Trunk stability is therefore an important goal in functional rehabilitation care (3). However, trunk control training is perceived as uninteresting accompanied by reduced therapy compliance (4). Virtual Reality (VR) has been mentioned to increase motivation and may increase exercise dosage (5).

An important step of using VR in trunk training is that the trunk movements are captured when playing a VR game. Trunk control performance is frequently assessed by a pressure mat or forceplate (5). Although it provides information on someone’s trunk control, it describes the velocity of the center of pressure rather than how movements are executed. Inertial measurement units (IMU)s can provide a more direct measure of 3D trunk orientation and movement execution and as such be used as input signals for controlling VR games. Based on this idea, the purpose of the TrunkyXL project is to develop a VR game in which patients use their trunk as the controller of the game.

The scientific aim of the first study within the TrunkyXL project is to evaluate the validity and feasibility of the TrunkyXL VR-training.

Methods

The TrunkyXL VR-training simulates an underwater world, in which the patient moves a manta ray along a certain route through the VR underwater world. The patient can earn point by picking up coins or open treasure boxes. The performance of each session can be stored in terms of the achieved range of motion, used settings in order to set the difficulty, training time, but also high scores. The TrunkyXL VR-training can be used at in-clinic rehabilitation settings, but patients could take the system with them to train at home as well. The validity and feasibility of the TrunkyXL VR-training game will be tested in healthy participants and patients with stroke. Trunk movements recorded with the sensors will be compared to the trunk movements recorded with a 3D optical motion system (gold standard).

Results and discussion

The first impression of the TrunkyXL VR-training shows that trunk movements are indeed provoked in an enjoyable game. The next step after these promising results, is to test the system in a lab setting with healthy participants and patients with stroke.

Conclusions

Trunk control training is one of the most important aspects of rehabilitation training but it tends to be one of the most boring parts. TrunkyXL is going to change this and make trunk training fun and exciting!

References

1. Tyson SF, et al., Phys Ther, 2006.

2. Verheyden G, et al., Clin Rehab, 2007.

3. Verheyden G, et al., Clin Rehabil. 2006.

4. Thornton M, et al., Brain Inj. 2005.

5. Sheehy L, et al., BMC Neurol. 2016.