KneeBRIGHT: Knee Biofeedback Rehabilitation Game for Osteoarthritis Therapy

Barron Associates has developed the “Knee Biofeedback Rehabilitation Interface for Game-based Home Therapy (KneeBRIGHT)” system that combines electromyography (EMG) biofeedback with video game therapy to provide knee osteoarthritis (OA) patients with an engaging, effective tool for conducting rehabilitation exercises at home. KneeBRIGHT aims to motivate knee OA patients to conduct regular muscle strengthening exercise through an engaging, EMG-driven video game therapy (VGT). The system combines wireless EMG sensors that are specifically optimized for patient use in a home setting with software that provides automated guidance through targeted and progressive exercise routines. Importantly, these exercises are presented to the patient in the form of fun and engaging games to promote a positive experience and encourage continued adherence.KneeBRIGHT rehabilitation video game screen capture.

The KneeBRIGHT system was developed to offer a novel solution to the rehabilitation of OA, which is the leading cause of disability in the United States. Rehabilitation through quadriceps strengthening is a well-established treatment for knee OA patients, but to be successful, patients must integrate regular, repetitive exercise into their daily routines. When unsupervised, patients are faced with two challenges: (1) lack of guidance from trained clinicians; and (2) lack of engagement during repetitive exercises that patients find boring. These challenges are compounded by pain, a key symptom of the disorder that leads patients to avoid activity, despite being advised that exercise can in fact reduce pain. As such, patient adherence to home exercise routines is poor. KneeBRIGHT is the first system to offer automated, adaptive OA rehabilitation exercises that can be performed in a home environment, while also engaging the user through use of fun games and integrated performance feedback to increase motivation.

Development of the KneeBRIGHT system has been supported by the National Institutes of Health (NIH) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

Barron Associates, along with project collaborators at the University of Virginia, completed pilot testing of the prototype KneeBRIGHT system with 19 knee OA patients. The KneeBRIGHT system demonstrated statistically significant increases in three key metrics:

  • knee extension torque generated during exercise;
  • patient engagement and motivation measured via the Technology Acceptance Model; and
  • duration of voluntary exercise.