The Implementation of Action Observation Therapy in Virtual Worlds

Upper limb rehabilitation after stroke is vital to the recovery of a patient’s range of motion, dexterity and strength (Jauch et al, 2010, p. 824). Rehabilitative practises are diverse and met with varying levels of success (Brewer et al, 2012, p. 11). This research is concerned with action observation therapy and its potential for neural reorganization through consistent repetition of prescribed physiotherapy exercises. Action observation utilizes mirror neurons to stimulate neural strengthening and recovery (Ertelt et al, 2007, p. 172). The observation of an expert completion of an action by either the patient, a representation of the patient or someone else fires the corresponding mirror neuron (Fogassi et al, 2005, p. 662). Mirror neurons’ ability to be fired under multiple conditions allow a patient who is unable to complete an action, in this case a physiotherapy exercise, to still receive the neural benefit just by observing the action (Ertelt et al, 2007, p. 165). In collaboration with sensory devices in a virtual medium, action observation will be used to create a dynamic and engaging simulation with the intent of providing a physiotherapy experience that progresses in difficulty. Incremental difficulty will ensure patients are being pushed to their limits in a controlled and monitored environment (IJsselsteijn, 2007, p. 27). Neural reorganization requires a large number of repetitions of exercises over extended periods of time creating rehabilitative experiences that have traditionally been tedious and mundane (Merians et al, 2002, p. 898; O’Dell, Lin & Harrison, 2009, p. 55). Gamification of traditional methods can engage the patient over an extended period of time By masking the repetitive nature of the exercises with a fun experience, patients can receive the full benefit of the treatment while performing enjoyable tasks (Muzzaffa et al, 2013, p. 69).