title: Retraining function in people with Parkinson's disease using the Microsoft kinect: game design and pilot testing.
abstract: BACKGROUND
  Computer based gaming systems, such as the Microsoft Kinect (Kinect), can facilitate complex task practice, enhance sensory feedback and action observation in novel, relevant and motivating modes of exercise which can be difficult to achieve with standard physiotherapy for people with Parkinson's disease (PD). However, there is a current need for safe, feasible and effective exercise games that are appropriate for PD rehabilitation. The aims of this study were to i) develop a computer game to rehabilitate dynamic postural control for people with PD using the Kinect; and ii) pilot test the game's safety and feasibility in a group of people with PD.
  
  
  METHODS
  A rehabilitation game aimed at training dynamic postural control was developed through an iterative process with input from a design workshop of people with PD. The game trains dynamic postural control through multi-directional reaching and stepping tasks, with increasing complexity across 12 levels of difficulty. Nine people with PD pilot tested the game for one session. Participant feedback to identify issues relating to safety and feasibility were collected using semi-structured interviews.
  
  
  RESULTS
  Participants reported that they felt safe whilst playing the game. In addition, there were no adverse events whilst playing. In general, the participants stated that they enjoyed the game and seven of the nine participants said they could imagine themselves using the game at home, especially if they felt it would improve their balance. The Flow State Scale indicated participants were immersed in the gameplay and enjoyed the experience. However, some participants reported that they found it difficult to discriminate between different types and orientations of visual objects in the game and some also had difficulty with the stepping tasks, especially when performed at the same time as the reaching tasks.
  
  
  CONCLUSIONS
  Computer-based rehabilitation games using the Kinect are safe and feasible for people with PD although intervention trials are needed to test their safety, feasibility and efficacy in the home.
authors.forename: Brook
authors.initials: B
authors.lastname: Galna
authors.forename: Dan
authors.initials: D
authors.lastname: Jackson
authors.forename: Guy
authors.initials: G
authors.lastname: Schofield
authors.forename: Roisin
authors.initials: R
authors.lastname: McNaney
authors.forename: Mary
authors.initials: M
authors.lastname: Webster
authors.forename: Gillian
authors.initials: G
authors.lastname: Barry
authors.forename: Dadirayi
authors.initials: D
authors.lastname: Mhiripiri
authors.forename: Madeline
authors.initials: M
authors.lastname: Balaam
authors.forename: Patrick
authors.initials: P
authors.lastname: Olivier
authors.affiliation: Clinical Ageing Research Unit, Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne NE4 5PL, UK. lynn.rochester@ncl.ac.uk.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000534:rehabilitation*; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D018910:Video Games / Q000009:adverse effects
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