Exergames in Multiple Sclerosis: Exploring the Integration of Physical Objects in Mixed Reality for Engaging Patients in Rehabilitative Tasks

The disease named Multiple Sclerosis (MS) is characterized by an autoimmune response resulting in the progressive degeneration of nerve cells. Their ability to transmit electrical signals becomes impaired, leading to disruptions in communication between components within the Central Nervous System (CNS). The manifestation and severity of MS symptoms exhibit substantial heterogeneity across individuals. Notably, the impairments in motor functions and cognitive abilities impact significantly on daily activities. As a result, prioritizing rehabilitation is crucial for effectively managing MS and improving the well-being of individuals living with the condition. The purpose of this thesis is to develop a Mixed Reality system for the rehabilitation of cognitive and motor functions through activities involving the upper limb. We envision interactive games, commonly referred to as exergames, engaging people with MS in rehabilitative tasks. The developed game involves the use of some real objects that must interact with virtual elements. These objects are intended to be grasped by the patient and manipulated in accordance with the game’s rules. The game is organized into sessions, in each session the goal is to manipulate the physical objects while keeping in balance a virtual object placed on top of it. The game provides two modes. The first mode includes a series of mini-games that patients need to complete, whereas the second mode focuses on repetitive movements towards specific target positions; this latter mode has two variations, one involving the use of a single arm and the other requiring coordination of both arms. During gameplay, some data, such as eye movement, hand movements, and execution time are collected to analyze the performance of the patients. The system underwent testing with healthy individuals and subsequently with patients diagnosed with Multiple Sclerosis (PwMS) in order to gather data for evaluating user experience.