HOME BASE REHABILITATION OF THE UPPER LIMB MOTOR FUNCTION AFTER STROKE USING VIRTUAL REALITY

7/26/2019 HOME BASE REHABILITATION OF THE UPPER LIMB MOTOR FUNCTION AFTER STROKE USING VIRTUAL REALITY

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CHAPTER 1

INTRODUCTION

This chapter consist of four part; problem background, objective, scope and

significance of the study. Problem background explain the severity of stroke.

Objective of this study clarified two objective of the study. Scope of the study describe

the limitation of this study and the contribution of this study is enlighten in part four;

significance of the study.

1.1 Background of the Problem

Stroke is the third largest cause of death and the most common cause of severe

disability in Malaysia. Statistic from National stroke association of Malaysia show

that every year 40,000 people suffer from stroke. Everybody ranging from children to

adult has the potential to get stroke. The mean age of stroke patients in Malaysia is

between 545 and 626 years (Loo & Gan, 2012).

Stroke is a condition whereby blood vessel to the brain is blocked or ruptured,

which will cause brain tissue damaged because of lack of oxygen. When that part of


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brain tissue dies the function of that brain tissue will be lost. Fainting, unconsciousness

and/or weakness of limbs are main stroke symptoms.

The World Health Organization estimates that in 2001 there were over 20.5

million people suffer from strokes worldwide, 5.5 million of these were fatal. (Dr. A.

Khalek Abd. Rahman, 2012). In Kuala Lumpur Hospital, 1000 stroke cases are seen

per year with 30% - 35%, deaths due to stroke (Nurul Aini HM, Aniza I, 2007).

Based on a study comprised of 49 patients (28 men, 21 women) with a mean

age of 60.2 (range 3580) years. The mean total cost for post stroke treatment in

Malaysia was RM 2352.53 (USD 547.10), of which 36.6% was spent on attendant

care, 25.5% on medical aids, 15.1% on travel expenses, 14.1% on medical fees and

8.5% on out-of-pocket expenses (Akhavan Hejazi, Mazlan, Abdullah, & Engkasan,

2015). 60% of Malaysian population monthly gross income raging from RM 1,760 to

7,049. Workers in rural area population received between RM 1,760 to RM 3,729 per

month (Malaysian Economic Planning Unit, 2014). .Taking into consideration that this

amount did not include expenses such as car loan repayment, house loan repayment,

personal expenses and compulsory contribution such KWSP, LHDN etc., net income

will be lower, this situation will increase their burden in order to get proper treatment

in hospital.

Stroke rehabilitation consist of daily routine physical exercise under the

guidance of physiotherapists. Rehabilitation is used to reduce the disability cause by

the stroke. Rehabilitation activity aim is to help the stroke survivors to learn how to

use their affected part of the body through exercise.

The main focus of rehabilitation activity is to improve the stroke survivor

ability to move their affected limbs as fast as the unaffected limbs move. Several

studies show that the recovery speed be can increase by increasing the duration ofrehabilitation activity. Thus there is a necessity for home-based rehabilitation games


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which can help and inspire patients to do exercises related to therapy in the comfort of

their home (Sanjay Saini, Dayang Rohaya Awang Rambli, Suziah Sulaiman, Zakaria,

& Zakaria, 2012).

Cost in this project, referring to the initial cost needed to set up the

rehabilitation system; the computer hardware system.

1.2 Objective of the study

This project objective is

i. To develop a low cost game based rehabilitation system as a tool which

can be used as a part of post stroke rehabilitation activity to help stroke

survivor to regain their hand and arm movement ability.

ii.

To develop a monitoring system that allows the rehabilitation process

to be monitored.

iii. To test the system clinically at Hospital Sultan Ismail.

1.3 Scope of the study

The scope of study is

i. The rehabilitation will be focus on the rehabilitation of the upper limb

movement of patient with stroke.

ii. The system can be executed using computer or laptop and mouse as the

graphical user interface.


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iii. The system will be developed using OpenGL and C++ programming

language.

iv. Clinical testing will be conducted to verify the effectiveness of the

system.

1.4 Significance of the study

Population of people suffering stroke is increasing dramatically every day.

Even though good treatment program will increase the probability of gaining their

normal live back, not all stroke survivor can afford the treatment cost. Inflation has

the decrease the value of money and increasing the cost for stroke rehabilitation

treatment. This situation led to various research on designing a low cost rehabilitation

system which will provide an option to current rehabilitation treatment. The

effectiveness of rehabilitation process not solely depending on physical exercise, the

most important aspect is stroke survivors must have a strong believe that they still have

the ability to recover their movement ability and memory. This software will allow

stroke survivors to monitor their own rehabilitation progress and increasing their

motivation. This software will also provide the therapist with numerical evidence to

evaluate their therapy program effectiveness.


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CHAPTER 2

LITERATURE REVIEW

This section consists of 11 section. This chapter objective is to provide basic

theoretical background underlying behind this project. Section 2.1 contains brief

description of stroke classification, causes and consequences. Section 2.2 describes

the importance of after stroke recovery treatment and factors that affect the rate of

stroke patient recovery speed. Section 2.3 explain several hand and arm disability

cause by stroke. Section 2.4 contains a general description of how recovery after a

stroke can be carried out at home. Section 2.5 describes how computer games can be

used as part of the activities of after stroke recovery. Section 2.6 and 2.7 clarify the

definition of virtual reality and virtual rehabilitation. Section 2.8 and 2.9 contains

basic information related to computer graphics and how the image is produced by a

computer software. Section 2.10 and 2.11 contained basic information on how the

computer mouse can be used to measure distances hand movements.


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2.1 What is stroke?

Stroke is one of the deadly disease in Malaysia; one of top five major causes

of death and one of the top ten causes for hospitalization in Malaysia (Loo & Gan,

2012). Every year 40,000 people diagnosed with this deadly disease (National stroke

association of Malaysia, 2015). Hospital Kuala Lumpur record show that 30% to 35%

from 1000 patient treated for stroke will end with death (Nurul Aini HM, Aniza I,

2007). Even though in Malaysia most of the stroke patient age are between 54 to 65

year (Loo & Gan, 2012); everybody have potential to get stroke, including children

and babies. Considering all this fact, research regarding stroke prevention and

rehabilitation is very crucial.

Stroke occurs when blood flow to the brain is blocked. Blood supply essential

nutrient and oxygen to the brain. Insufficient blood supply will cause brain cell

damages and lead to lose control of human body. Stoke effect varies from one person

to the others depending on the location and degree of brain tissue damage, stroke

survivors are likely to suffer cognitive, visual and motor losses. Stroke is divided into

two type as shown inFigure 2.1:

Ischemic strokes; caused by blood clots.

Haemorrhagic strokes; caused by bleeding in or around the brain.

Figure 2.1: Type of strokes


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Ischemic strokes account for 87 percent of all strokes. Ischemic stroke happen

when there is a blood clot that blocks blood flow to a part of the brain. Ischemic stroke

occur when:

Plaque reduce the blood flow to neck or brain. Plaque is a combination

of fat, cholesterol and other substances that build up in the inner lining

of the artery walls. This condition is often referred to as atherosclerosis,

or "hardening of the arteries."

In some situation the plaque origin is from some other part of the body.

When this plaque breaks, the fragments may travel to the brain and

disrupt the blood flow. This is called embolism.

Haemorrhagic strokes occur when a weakened blood vessel in the brain breaks

and bleeds into surrounding brain tissue. This puts too much pressure on blood cells

in the surrounding tissue, cutting off their blood supply and causing damage. About

13 percent of all strokes are haemorrhagic strokes.

The effects of a stroke depend primarily on the location of the obstruction and

the extent of brain tissue affected. Human brain is divided into two hemisphere; right

brain and left brain. Right brain control the left side of human body and the left brain

is responsible for right side of human body.

As one side of the brain controls the opposite side of the body, a stroke

affecting one side of the brain will result in nerve system problems on the side of the

body it affects. For example, if the stroke occurs in the brain's right side, the left side

of the body and the left side of the face will be affected, which could produce any or

all of the following:

Paralysis or weakness on certain part of the side of the body such as hand, arm

and leg.

Vision problems.

Quick, inquisitive behavioural style.


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Memory loss.

If the stroke occurs in the left side of the brain, the right side of the body will

be affected, producing some or all of the following:

Paralysis on the right side of the body.

Speech/language problems.

Slow, cautious behavioural style.

Memory loss.

Stroke can affect both sides of the body or may leave someone in a locked-in

state. Stroke patient with locked-in state will lost their ability to speak or achieve any

movement below the neck. The effect of stroke varies depending on the severity of

human brain damage.

Certain environmental factors, medical conditions, and lifestyle habits increase

the risk of stroke. Some risk factors can be treated or controlled, while other risk

factors cannot (Lindsey Konkel, 2015). Factors that cannot be changed include:

Family history; Stroke often runs in families. Stroke risk may be higher if a

grandparent, parent, or sibling has suffered a stroke in the past.

Age; stroke is most common in adults over the age of 65. According to the

American Stroke Association (American Stroke Association, n.d.); the chance

of having a stroke doubles for each decade of life after 55.

Gender; women have more strokes than men, and strokes kill more women

than men each year.

Race; African Americans, Hispanics, American Indians, and Alaska Natives

have a higher risk of stroke than non-Hispanic whites or Asians.

Personal history of a previous stroke.


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Stroke risk factors that can be prevented or controlled include:

High blood pressure; high blood pressure is the main risk factor for stroke. It

can damage and weaken arteries throughout the body so that they burst or clog

more easily.

High cholesterol; cholesterol is a fatty substance that contributes to plaques in

the arteries that can block blood flow to the brain.

Heart disease; coronary artery disease, the build-up of plaque in the arteries,

can increase your risk of stroke. So can other heart conditions, including heart

valve defects and irregular heartbeat (atrial fibrillation).

Diabetes; people with diabetes are four times as likely to have a stroke as

people without diabetes.

Certain lifestyle habits and conditions can also increase risk of stroke. These

risk factors include:

Smoking.

Poor diet.

Obesity.

Low physical activity.

Stress and depression.

Heavy alcohol use.

Use of illicit drugs, including cocaine and amphetamines.

Person who survive from stroke known as stroke survivor. Stroke survivor is

classified as disable people. In this study, disability is define as difficulty to perform

something that is a normal part of daily life. Stroke survivors will have difficulty to

perform activities of daily living (ADL) such walking, talking, eating, and taking

care of the daily activity such as using toilet, wearing dress and bathing. Furthermore

they will lost the ability to perform instrumental activities of daily living (IADL),

such as housekeeping, using the telephone, driving, and using computers. Treatment

for stroke complications usually involves a combination of therapy and medication.


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2.2 Stroke Recovery and Rehabilitation

Brain injury due to stroke can change the way people move, feel, think, or

speak. The effects are greatest right after the stroke. Over time, most stroke survivor

will make improvements. Rehabilitation helps stroke survivors relearn skills that are

lost when part of the brain is damaged. The stroke rehabilitation objective are to help

stroke survivors live as independently as possible while adjusting to new limitations.

For example, these skills can include coordinating leg movements in order to walk or

carrying out the steps involved in any complex activity. Rehabilitation also teaches

survivors new ways of performing tasks to circumvent or compensate for any residual

disabilities. Individuals may need to learn how to bath and dress using only one hand,

or how to communicate effectively when their ability to use language has been

compromised. Figure 2.2 show three important element in any rehabilitation program;

carefully directed, well-focused, and repetitive practice, same method used to learn a

new skill, such as playing the piano or pitching a baseball.

Figure 2.2: Stroke rehabilitation program implementation strategy

Carefullydirected

Well-

focused

Repetitivepractice


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Rehabilitation therapy begins in the acute-care hospital after the persons

overall condition has been stabilized, often within 24 to 48 hours after the stroke. The

first steps involve promoting independent movement because many individuals are

paralyzed or seriously weakened. Patients are prompted to change positions frequently

while lying in bed to engage in passive or active range of motion exercises to

strengthen their stroke-impaired limbs. Depending on several factors such as the

extent of the initial injury; patients may progress from sitting up and being moved

between the bed and a chair to standing, bearing their own weight, and walking, with

or without assistance. Rehabilitation nurses and therapists help patients who are able

to perform progressively more complex and demanding tasks, such as bathing,

dressing, and using a toilet, and they will encourage patients to use their stroke-

impaired limbs while engaging in those tasks. Beginning to reacquire the ability to

carry out these basic activities of daily living represents the first stage in a stroke

survivor's return to independence.

For some stroke survivors, rehabilitation will be an ongoing process to

maintain and refine skills and could involve working with specialists for months or

years after the stroke. The types of therapy will depend on which parts of the brain

were damaged. Stroke survivors may require:

Speech therapy.

Physical therapy and strength training.

Occupational therapy (re-learning skills required for daily living).

Psychological counselling.

Physical and occupational therapy involved a structured activity designed to

regain the ability lost due to stroke by encouraging the use of the affected parts of the

body through repeated motion. Conventional therapy require the stroke survivors to

preform repeated motions under the supervision of the therapist in a one on one

session. Therapy activity is design to suit the stroke survivor capability. The goal is

to get the patients to move their affected limbs as easily as they move their unaffected

limbs.


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Recovery of the upper limb such as hand and arm has a slower progression and

is usually gained through outpatient and home therapy (van der Lee et al., 1999).

Upper limb stroke survivor recovery process start with regaining their ability to move

their shoulder, arm, wrist and hand.

2.3 Post stroke upper limb rehabilitation

Most stroke survivor will suffer weakness or lost ability to upper limb or arm.

Arm movements are produce by moving a group of muscle groups together and this

movement is coordinated by brain. Collaboration between muscles is known as

synergies. Stroke will reduce the coordination between the brain and body, as a

result the muscle synergies will move in abnormal patterns. Normally only one side

of the body will be affected. Stroke can affect stroke patient arm in several way:

Weakness.

Stroke survivors may completely paralyzed or their shoulder, elbow wrist

and/or hand may be weak. This condition will lead to difficulty in reaching,

picking things up or holding onto things.

Coordination problems.

Stroke survivor may have difficulty to plan or coordinate the movements of

their arm; arm doesnt move in the way that they want it to.

Changes in muscle tone.

Stroke survivor with high tone known as hypertonia or spasticity will suffer

stiff or tight muscles. Stroke survivor with low tone called hypotonia, will

suffer floppy or loose muscles.

Subluxation.

Weakness or low tone may allow the top of stroke survivor arm to drop out of

the shoulder socket slightly. This makes arm movements difficult and can be

painful.


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Contracture.

Weakness or high tone may make stroke survivor muscles shorter or joints less

flexible. This makes movements difficult and can be painful.

Arm skate, cone stacking and picking marble are equipment which is

frequently use at occupational therapy unit. Stroke survivor has to repeat the same

activity for 15 20 minutes in one session. Normally in one session a therapist is

required to monitor two or three patient at the same time. Study done by a group

researcher from Taiwan reveal that even though these equipment can produce the

expected outcome there are several weakness such as easy to lose focus because of

boredom, no difficulty setting and no movement record (Huang, Lee, Hsieh, & Chen,

2013).

2.4 Home base rehabilitation

Home based rehabilitation is special therapy program design to suit the stroke

survivor needs. Rehabilitation process will be carry out at the patient house. In current

practice a special team will be form to monitor this program. Home based

rehabilitation objective is to improve the ability of the stroke survivor to carry out daily

living activity such as grooming, toileting, and other forms of self-care, household

and other day-to-day tasks, as well as leisure activities.

Home based rehabilitation will reduce the frequency of visit to the clinics, this

approach will help stroke survivor reduce their expenses. Due to the low-cost and

availability of the rehabilitation, the therapy could continue until the individual was

satisfied with their ability to independently perform activities of daily living. The

home-based rehabilitation would include an engaging interaction, such as a game, to

maintain the individual's interest (Reed, Ismet Handzic, & Samuel McAmis, 2014).


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Movement activity can be recorded using video or log file. These data can be used by

therapist to evaluate the stroke survivor achievement and can be used to plan further

rehabilitation activity.

2.5 Game based rehabilitation

Combination of conventional rehabilitation and games based activity has

shown significant effect in improving stroke survivor rehabilitation performance.

Various games has been integrated into stroke rehabilitation activity ranging from a

simple card and board game, commercial computer base game, and customised

computer games. Matching the game to the specific deficit is a key to rebuilding lost

skills. Game is use to reduce stroke survivor weakness and increase their confident

level. Crossword puzzle game can be used to overcome memory deficit. Jigsaw

puzzle can increase memory and motor skill ability.

Beside conventional therapy, some therapist include commercial activity

promoting gaming systems as a part of their rehabilitation programs. Commercial

activity promoting gaming systems provide a potentially attractive means to facilitate

exercise and rehabilitation (Matthew J. D. Taylor, McCormick & Teshk Shawis,

Rebecca Impson, 2011). The Nintendo Wii, Sony Eye Toy, Dance Dance Revolution,

and Xbox Kinect are examples of gaming systems that use the movement of the player

to control gameplay.


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2.6 Virtual reality technology

Virtual reality was first introduced by Jaron Lanier in 1987. Virtual reality also

known as Synthetic Experience, Virtual Worlds, Artificial Worlds or Artificial Reality.

Different name propose different definition, but all researcher agree that VR is an

interactive and immersive experience in a simulated world (Mazuryk & Gervautz,

1996).

Virtual reality allow user to explore a three-dimensional (3D) world produced

by computer system. 3D Images will change continuously depending on the

orientation and input provided by the user (Wiederhold, 2006). Virtual reality

experience varies from non-immersive to fully immersive depending on the degree to

which the user is isolated from the physical surroundings when interacting with the

virtual environment (Saposnik & Levin, 2011). Visual in immerse virtual reality is

supply through head-mounted display. Their view of the virtual world is controlled

through head movements. The virtual environment is seen at full-scale. Non-immerse

virtual reality refers to all systems that do not involve the use of head-mounted displays

to control the user's view of the virtual environment. Instead, users view the virtual

environment on a two-dimensional flat screen, and interact with it through a variety of

motion-detecting interfaces.

Virtual reality experience consist of four key element virtual world, immersion,

sensory feedback and interactivity. A virtual environment is a real world environment

simulation created using computer software and is experienced by the user through a

human machine interface. In the real world human use eyes, nose, ears and skin to

detect changes in their environment, same principle applied in virtual world,

information about environmental changes in virtual world is send to the user senses

using human machine interface such as head mounted display (HMD) and data glove.

Virtual reality device create a feeling of being inside and a part of virtual world, this

experience is known as immersion. Sensory feedback refers to the ability of virtual


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reality system to react to user movement. Interaction is defined as the ability of the

user to move and interact with object in virtual world.

Virtual reality has a wide range of application in various field such as military,

education, entertainment, fashion and engineering. Virtual reality has become an

important tools in medical training and treatment process. Virtual reality allow

medical student to perform virtual surgery and reduce the effect of trial and error

during learning process.

Limited number of rehabilitation centre and high treatment cost has motivated

many researcher to develop game based rehabilitation. Games based rehabilitation

offer a cheaper rehabilitation therapy for stroke survivors. Virtual reality can also be

integrate with robotic technology to perform robotic surgery. This surgery will be

controlled by human surgeon but the surgery is done by robotic arm to reduce error.

2.7 Virtual rehabilitation

Rehabilitate is originate from Latin word "habilitas", means to make able

again. Rehabilitation does not reverse or undo the damage caused by an injury or

illness, but rather helps restore the individual to optimal health, functioning, and well-

being. Virtual rehabilitation is a process which combining virtual reality (VR)

hardware and simulation in improving the effect of rehabilitation process (Burdea,

2002). Virtual reality provide interactive simulation which the users has the

opportunities to engage in environments that appear and feel similar to real world

objects and events (Sheridan, 1992). VR allows the Users to interact with displayed

images, move and manipulate virtual objects and perform other actions in a way that

attempts to immerse them within the simulated environment thereby engendering afeeling of presence in the virtual world (Weiss, Kizony, Feintuch, & Katz, 2006).


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Rate of success in virtual rehabilitation is affected by three fundamental factor

as shown in Figure 2.3; repetition, feedback and motivation (Maureen K. Holden,

2005). Repetition play important role in rehabilitation process. Repeating the same

movement for several time will increase the movement speed. Repetition drawbacks

is unmotivated, when same movement is repeated for a long time, it will cause

boredom. Repetition must accompanied with motivation. The repeated practice must

be linked to incremental success at some task or goal. This can be achieved by setting

different level of difficulty and feedback system.

Figure 2.3: Virtual rehabilitation success factor

The use virtual rehabilitation as a part of stroke survivor rehabilitation program

has positive impact in improving the stroke survivor upper limb and ADL function.

Virtual rehabilitation provide an enjoyable rehabilitation tool and has the ability to

increase stroke survivor confidence to regain the hand arm movement ability (Laver,

George, Thomas, Deutsch, & Crotty, 2015).

Most researcher use haptic equipment such as data glove to simulate 3D

environment. Virtual person known as avatar or virtual person is used to represent

user in the virtual world. Several game based on daily activities such as pick and place,

bowling game and water pipeline fixing has been simulated. Table 2.1 listed several

research on virtual rehabilitation.

Succes virtualrehabilitation

Repitition

Feedback

Motivation


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Table 2.1: Previous virtual rehabilitation research

Title Year Detection Method Researcher

A Virtual Reality Based

Exercise System for

Hand Rehabilitation

Post-Stroke

2004 CyberGlove and a

Rutgers Master

II-ND haptic

glove.

Adamovich, Merians,

Boian,Tremaine, Burdea,

Recce and Poizner

The Rehabilitation

Gaming System: a

Review

2009 Vision based

tracking system

Mnica, Bermde, Esther

and Paul.

A study to evaluate a

low cost virtual reality

system for home based

rehabilitation of the

upper limb following

stroke

2010 Virtual glove Penny, David, Steven,

Marion, Louise, Andy,

Fran, Kate and Andy

Interactive

Virtual Reality Gamebased Rehabilitation

for Stroke Patients

2013 Microsoft

Kinectcamera

Nahid, Mindy, Joyce and

Philippe.

Glove Based Virtual

Reality (VR)

Interaction for the

Purpose of

Rehabilitation

2014 Data glove Aswad , Khairunizam,

Nazrul, Shahriman, Hazry

and Zuradzman

Game-based virtual

rehabilitation system

for upper extremityusing low-cost camera

2015 Low cost camera Ngoc Bien Pham

Two major obstacle in implementing virtual rehabilitation is high cost and

require high technical skills (Jonathan Halton, 2008). To overcome this limitation,

low cost home base virtual rehabilitation system has become a popular topic in virtual

rehabilitation research, the aim of this system is to design a low cost rehabilitation

games which will allow stroke survivors to practice their rehabilitation activity in

comfort of their home. In early stage, most of virtual rehabilitation game use data

glove as input devices, data glove allow the program to record the hand movement and

finger flexure effectively. As the cost of glove is expensive, researcher seek a lower

cost alternative. Nowadays, many researcher use low cost camera to detect hand

movement. This project will use an optical mouse as input device.


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2.8 Computer graphics system

A computer graphics system consist of six main element as shown in Figure

2.4.

1. Input devices.

2.

Central Processing Unit.

3. Graphics Processing Unit.

4. Memory.

5. Frame buffer.

6. Output devices.

Most graphics systems contain a keyboard and a pointing device. The most

common pointing devices are the mouse, joystick and data tablet. Each pointing

device equipped with one or more buttons. Pointing device provide positional

information to the processor.

Central

processor

Graphic

processor

Frame

buffer

CPU

Memory

CPU

Memory

Figure 2.4: Computer graphic elements

Before optical mouse was invented, mechanical mouse is use as a pointing

device. A mechanical mouse is a computer hardware input device comprised of a


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metal or rubber ball in its underside. Moving the mouse causes the ball to roll, and

sensors inside the mouse detect the movement of the ball and consequently send

signals to the cursor on the screen. Mechanical mouse use a pair of encoders to send

two orthogonal direction information to processor. Central processing unit (CPU) will

convert this information into a convenient coordinate system and use it to produce

graphics or execute specified action define by the computer program.

Graphics processing unit (GPU) is used to produce 3D image. Graphic system

produce of a group of picture elements, or pixels know as image. Pixel are stored in a

frame buffer; a part of computer memory. Computer memory act as a brain in

computer system. Frame buffer is an area of computer memory used to hold the frame

of data that is continuously being sent to the screen. Each pixel corresponds to a

location or small area, in the image. Pixel or picture element as shown inFigure 2.5

is one coloured dot on the screen.

Figure 2.5: Computer graphic pixel

Resolution refer to number of pixel in the frame buffer, resolution determines

the detail of an image display on screen. Computer display resolution refers to the

number of pixels that can be displayed on a computer screen, computer display

resolution is expressed in terms of the number of pixels on the horizontal axis and the

number of pixel in vertical axis. For example, monitor with 1366 x 768 resolution,

width is 1366 pixel and height is 768 pixel. Dots per inch (dpi) or maximum number

of dot in one inch is a measure of the sharpness or the density of illuminated points on

a display screen. Most computer screen have a resolution of 72 or 96 pixels per inch.


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Processor function is to assign values to the pixels in the frame buffer that best

represent the entities based on the specifications of graphical primitives such as lines,

circles, and polygons, generated by application programs. For example, a triangle is

specified by three vertices, but to display a triangle is outline by the three line segments

connecting the vertices, the graphics system must generate a set of pixels that appear

as line segments to the viewer. The actual drawing or filling in of the pixels between

each vertex to make the lines is called rasterization or scan conversion.

In early graphics systems, the frame buffer was part of the standard memory

that could be directly addressed by the CPU. Today, virtually all graphics systems are

characterized by special-purpose graphics processing units (GPUs), custom-tailored

processing unit to carry out specific graphics functions. The GPU can be embedded

either on the mother board of the system or on a graphics card. The frame buffer is

accessed through the graphics processing unit and usually is on the same circuit board

as the GPU.

2.9 Interactive computer graphic

Interactive computer graphic can be define as a computer system that allows

user to interact with the graphical information presented on the display using one or

more input devices. Interactive computer graphic was introduced by Ivan Sutherland.

Figure 2.6, summarized the basic concept of interactive computer graphic. Human

machine interaction in computer system is done using the input device. In programmer

view, input device can be divided into two categories; physical and logical device.


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User sees an

image on the

display

User react using

interactive device

Images change

according to

users input

Figure 2.6: Interactive computer graphic concept

Physical device is computer hardware such as keyboard and mouse, on the

other hand logical device is computer software. Logical device is a statements line

such as printf and scanf in C programming language and cin and cout in C++

programing language. All these statement is use by the programmer to get response

from the user.

Physical and logical input device send input to an application program in two

steps; measure process and device trigger. The measure process is how the device

respond based on the user action. The trigger of a device is a physical input on the

device with which the user can signal the computer. For example, the measure of akeyboard contains a group of character such as hello world!, and the trigger can be

the return or enter key. For a pointing device such as optical mouse, the measure

includes the position, and the associated trigger can be a button on the pointing device.

In an environment with multiple input devices, each device has its own trigger and

each device will run a measure process. Each time that a device is triggered, an event

is generated. The device measure, with the identifier for the device, is placed in an

event queue. This process of placing events in the event queue is completely

independent of what the application program does with these events. This process is

shown inFigure2.7

Trigger

processTrigger

Measure

process

Event

queueMeasure ProgramAwait event

Figure 2.7: Interactive computer graphic measure process


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2.10 Mouse as tracking device

Nowadays computer mouse has become a standard device for all personal

computer. Computer mouse was invented by Douglas Engelbart of Stanford Research

Centre in 1963. The mouse was officially called an X-Y Position Indicator for a

Display System (Mueller, 2011). Traditional mouse consist of a small rubber ball

which will rolls when the mouse is move across the table top. Information regarding

this ball movement will be converted into electrical signals and transmitted to the

computer across the cable.

The standard mouse consists of several components:

A housing that user hold in their hand and move around on table top.

A method of transmitting movement to the system; either ball/roller or

optical sensors.

Buttons (two or more, and often a wheel or toggle switch) for making

selections.

Wheel for vertical scrolling. Some wheels tilt for horizontal scrolling

or can be pressed to act as a button.

An interface for connecting the mouse to the system. Conventional

mice use a wire and connector, whereas wireless mice use a radio

frequency (RF) or infrared (IR) transceiver in both the mouse and a

separate unit connected to the computer to

Interface the mouse to the computer.

Even though ball type mouse as illustrated in Figure 2.8 are considered

obsolete, understanding their working principle will provide the basic understanding

on how mouse can be used as a tracking device. Figure 2.9 show basic construction

of a ball mouse. A ball mouse consist of a rubber ball mounted on two rollers; one for

x-axis movement detection and the other one for detecting up and down movement

changes in y-axis direction. As the mouse move, rubber ball will move the roller which


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will cause either one or both wheel to rotate. When mouse is move in side by side

direction only x axis wheel will turn. On the other hand when mouse is move in

upward or downward direction y axis wheel will turn. When the mouse is move in an

angle both wheel will move. These rollers are typically connected to small disks with

shutters that alternately block and allow the passage of light produce by the led. Small

optical sensors detect movement of the wheels by watching an internal IR light blink

on and off as the shutter wheel rotates and chops the light. These blinks are

translated into movement along the axes.

Figure 2.8: Ball mouse

Figure 2.9: A Typical mechanical mouse with ball and shafts

Adapted from (Ian McLoughlin, 2011)

Roller ball mouse required frequent maintenance as it will trap dust as it is

moving. To overcome this problem, optical mouse is introduced by Agilent


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Technologies in 1999. The first generation optical mouse actually uses a tiny camera

to take thousands of pictures every second. Some of the early mouse used a sensor

that required a special grid-marked pad. Although these mice were accurate, the need

to use them with a pad caused them to fall out of favour. Recently, mouse use optical

technology to detect change in movement and they have no moving parts of their own

(except for the scroll wheel and buttons on top). Todays optical mice need no pad;

they can work on virtually any surface. This is done by upgrading the optical sensor

from the simple type used in older optical mice to a more advanced CCD (charge

coupled device. This essentially is a crude version of a video camera sensor that

detects movement by seeing the surface move under the mouse. An LED or diode

laser provides light for the sensor.

Beside the normal use such as selecting, dragging, hovering, and clicking.

Several research such as listed inTable 2.2 has been done to seek the possibilities to

use mouse as motion sensor. The motivation of this study is mouse provide an accurate

position measurement with a lower cost, compare to industrial sensor.

Table 2.2: List of research using mouse as tracking sensor

Title Year Application Researcher

The optical mouse

as a two-

dimensional

displacement

sensor

2002 Optical mouse as a two

axes displacement sensor.

T.W. Ng

The optical mouse

for vibratory

motion sensing

2003 Optical mouse as

vibratory displacement

sensor

Ng and Ang

Digital readout

manometer using

an

optical mouse

2003 Automated data

acquisition from a simple

U-tube manometer using

an optical mouse.

Ng, Cheong and

Sheridan

Using optical

mouse sensors for

2007 Optical mouse sensors as

contactless

W.P.H. Kamphuis


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sheet position

measurement

sheet displacement

sensors

2D position

measurement with

optical laser

mouse sensor

2010 Study the effect of mouse

sensor accuracy to

position measurement

Michal and Milan

Long range

measurements

using a

contactless

low cost optical

sensor

2013 Optical mouse sensors ascontactless optical

measurement device.

Paulo, Higinio,

Julia and Pedro

2.11 Mouse resolution and hand movement distance

Optical mouse detect movement using Complementary Metal Oxide Silicon

(CMOS) sensors. CMOS in mouse will take an image of the pixel and determine the

size of that pixel. CMOS sensor operate by comparing images and computer use this

information to determine the mouse movement direction and distance. CMOS sensor

can capture up to 12000 frames per second. Image processing feature in mouse

software enable the CMOS sensor to see less than one pixel. This process in known

as fractions of pixels, where a pixel is divided into a smaller size.

Mouse resolution is the number of pixels per inch that the optical sensor and

focusing lens see when the mouse move. Mouse resolution is measured using Dot

per Inch (DPI). Franois Morier, Logitech Senior Engineer define mouse resolution

as the translation between hand movement and the distance covered on the screen. It

is just a factor of relation between, I move one inch, how many pixels I have covered

on the screen. This is the resolution (Wes Fenlon, 2015). In theory, if a mouse has


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1000 DPI, then, if the mouse move one inch (2.54 cm), the mouse cursor will move

1000 pixels. Higher resolution cause the mouse moves faster and requires less effort

to get across the screen. Low resolution make a mouse moves slower and requires

more effort to get across the screen, but offers better precision. Higher resolution

displays may require higher resolution or higher mouse DPI to attain the same amount

of on-screen movement.

There are two way to change a mouse resolution; using Window mouse

properties setting and in game sensitivity setting function. In Windows, mouse settings

are controlled using the mouse properties dialog box as shown inFigure 2.10.The

Window mouse properties setting is actually a multiplier, when the slider is set at 6/11

it will keep a 1:1 ratio; for each mouse count, the cursor will move by 1 pixel. If the

slider is set higher, the pixel will skipping since window will try to move the cursor

faster than sensor's count.

Figure 2.10: Mouse properties dialog box

As shown inFigure 2.10,Windows mouse properties provide Enhance Pointer

Precision (EPP) option. EPP function is to smoothen the movement of the mouse

pointer. When EPP is enabled, the pointer moves smoothly without any visible breaks

in motion. When EPP is disabled, the pointer move a bit jerkily. For example, when

the mouse sends data that it has been moved one unit to the right, without the enhanced


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pointer precision and the pointer speed slider located at 6/11 (= no scaling) the pointer

will also move one unit to the right. This could be called as "one-to-one" or 100%

speed. Lower pointer speeds is achieved by delaying the pointer movement until the

mouse has sent enough units to the given direction. At 50% speed the mouse has to

send 2 counts to the right before the pointer moves one count.

Mouse DPI refers to a mouses hardware capabilities, while sensitivity is

software setting. Default value for Windows mouse sensitivity is 6/11. Mouse

sensitivity setting can be adjusted by changing the in-game mouse sensitivity value or

by selecting a higher or lower mouse DPI value.


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CHAPTER 3

RESEARCH METHODOLOGY

This section described the research methodology implemented in this project.

This project implementation is divided into two part; software development and

system verification. Software development is carry out in three step system problem

definition, problem solving and testing and verification. System verification is done

in three ways; discussion with expert, user feedback and observation. This program is

develop in three different version, after every version is completed program will tested

and verified. After completing the final version, three experiment has been conducted,

this experiment is carried out to determine the relationship between mouse hardware

with hand movement distance required to move cursor from one to another point,

comparing the accuracy of single DPI mouse with multi DPI mouse and study the

effect of in game sensitivity setting to hand movement distance while playing with the

JDS rehabilitation games. Result of this experiment is discuss in chapter 4.


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3.1 Research methodology

This project objective is to develop a system with the ability to record stroke

survivor hand arm movement information while they are practicing their hand and arm

rehabilitation to regain their upper limb movement ability. This system is named as

JDS (Jamal Dan Shokor) rehabilitation games. JDS rehabilitation games is inspired

by arm skating exercise. In this exercise stroke survivor is required to move their arm

and hand with the assistance of arm skate as shown inFigure 3.3.

Flow chart in Figure 3.1 explain the process of developing the JDS

rehabilitation games. This process is started by defining the problem. Once the

problem has been identified a flow chart which represent the solution will be produced,

later this flowchart known as pseudocode will be transferred into programming

language such as C++ to develop the solution to the problem.

JDS rehabilitation games is develop in several version. Once the program has

successfully develop, this program will be test and verify. Verification is done by

obtaining feedback either from expert, user or observation. Once the verification has

been done, improvement will be conducted based on expert or users input.


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Start

Define the problem

Design algorithm to solve problem

Test and verify the program

Working correctly?

Yes

No

End

Figure 3.1: Software development process

3.2 Problem definition

Stroke survivor will suffer several disability such as memory loss, loss ability

to communicate and paralyzed some part of their body. Stoke effect is different from

one patient to the other, this study will focus on developing a home based rehabilitation

games to help the stroke survivor to regain their upper limb movement activity. Based

on observation made at Hospital Sultan Ismail rehabilitation unit, activity such as cone

stacking (Figure 3.2), picking up small objects such as marbles and transferring it into

to another place and arm skating (Figure 3.3); moving the affected arm on table top

using the affected arm is used to help stroke survivor to regain their hand and arm

movement ability. In order to get the benefit of this exercise, stroke survivor has to


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repeat this exercise for several time, this will lead to boredom and motivation lost.

Another disadvantage is there is no indicator for showing degree of the rehabilitation.

Figure 3.2: Cone stacking Figure 3.3: Arm skating

Research done by several researcher in several part of the world has proven

that computer games can be used as a tool in stroke rehabilitation. Computer

program will allow different set of difficulty to be set, to suit the user requirement.

Computer program can also be used to record the rehabilitation progress. Therapist

can used the recorded data to monitor their rehabilitation activity effectiveness.

These data can be converted into graphical chart and can be display at certain place

which can be seen by the stroke survivor so that they can monitor their own

rehabilitation progress.

3.3 Rehabilitation games (version 1)

This version serve as the basic foundation of this project. This game is develop

base on object matching games. The objective of this games is to detect the hand

movement location based on the mouse cursor position coordinate. Cursor location

will be shown on the console window as shown inFigure 3.4. Besides moving the

cursor to specific location, user must match the object shape and colour to get the

correct match. Objective of this activity is to improve the user motor and cognitive


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skill. Figure 3.5 show the snapshot of the program. Before terminating the program,

user need to copy the coordinate location recorded on the console windows and paste

it into a notepad file. Then therapist can used formula shown inFigure 3.6 to calculate

the hand movement distance. Figure 3.7 show the pseudocode of this program.

Figure 3.4: Cursor location information

Figure 3.5: Version 1 snapshot

= + Where: , = , =

Figure 3.6: Distance formula


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Start

Draw 8 different shape with 4

different color at 8 different location

Place the cursor at the screen center as the

starting point

Use keyboard button to change

the cursor shape and colour

Correct match?

End

Once user move the mouse to new location record the

new cursor location coordinate

Display

Congratulation

Display Sorry no

match foundYes No

Esc button

press

Figure 3.7: Rehabilitation game version 1 pseudocode

This version verification is done by conducting a presentation to Dr Sharon

Khor, rehabilitation physician at Hospital Sultan Ismail, Johor Bahru. From the

discussion following weaknesses has been identified:

It is difficult to measure motor and cognitive skills improvement at the same

time. This project should focus on how to measure the motor skill because

there a lot of application available in the market to measure cognitive skill.

This application will be more effective if the point is arrange in circular

shape, same like a dart board.


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The data collection and analysing method must be simplified.

User must be motivated to move their hand as fast and as far as they can

while doing this activity.

This point has been used as a guideline to create rehabilitation games version 2.


Rehabilitation game version 2 is an upgrade version of rehabilitation games 1.

This version arrange the point in circular shape as shown inFigure 3.8. Objective of

this game is to provide a tools that can be use by therapist to calculate the hand

movement speed. This application is build using four circle with four different radius.

Circle in this application is develop using formula shown inFigure 3.9. In this formula

i represent the point location and j represent the maximum number of points. For

example circle 1 radius in Figure 3.8 is 50 and the maximum number of point is 8.

The weakness of this application is there is a gap between points. The other weakness

is when centre point is moved to another location it will leave a blank space. It will

cause difficulty to the user to locate the centre point. To overcome the gap problem

the maximum number of point is increase and new circle as shown in Figure 3.10 is

produced, in this version the maximum number of point for circle 1 is increase from 8

to 240. Even though this method has create a better circle shape the circle is not

smooth because the rectangle shape point is used. As a solution rectangle shape point

is change to a round point shape and the result is shown in Figure 3.11.


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Figure 3.8: Dart board point arrangement

= + cos (360 ) 180

= + sin (360 ) 180

:= = , = = , = Figure 3.9: Circle coordinate calculation formula


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Figure 3.10: Circle with rectangle point shape

Figure 3.11: Circle with round point shape

Rehabilitation games version 2 is also equip with instruction to guide the user

how to use this program effectively. Hand movement data in this program is recorded

into a log file located outside of the program. This program also has a calibration

option which will allow user to set the hand movement distance required to move from

one end to the other end. Figure 3.12 show the snapshot of the console windows.


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As shown in Figure 3.12, log file name is given based on the user name specified by

the user, console will also provide information on the log file location. Mouse speed

will determine the amount of hand movement required to move from one end to other

end, smaller number of mouse speed will produce a longer hand movement distance.

Figure 3.13 show the rehabilitation games version 2 pseudocode.

Figure 3.12: Rehabilitation games version 2 console output.


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Start

Request user name

Create log file base on user name input

Display instruction

End

Create 5 circle with different radius and color

Record hand movement coordinate in log file

Esc button press

Figure 3.13: Rehabilitation games version 2 pseudocode

This version verification is done by conducting a discussion by having a

discussion with my supervisor Dr Jamaludin Mohd. Taib. From the discussion

following the following weaknesses has been identified:

This program still used manual calculation, as this program will be used by

various education background, the distance calculation should be made by the

program.

This program can only use to measure the hand movement distance only,

additional features must be added to create a rehabilitation tools.


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Rehabilitation game version 3 is develop in several version. This section will

only discuss about the final version of this project, this version is named as JDS

rehabilitation games. This game package consist of four set of application; JDS Pong,

JDS bouncing ball, JDS connecting the dot and JDS hand movement speed calculation

tools. Each program except JDS pong is attach with a log file.

Based on feedback obtain from Hospital Sultan Ismail, Rehabilitation Unit

staff and observation on patient rehabilitation activity, these strategy are embedded to

create the final version this project:

Clear instruction must be provided.

Several difficulty level must be set from easy to hard.

User must be inform about their achievement at the end of every session.

A control feature must be included to make sure that user follow the given

instruction and stay focus on their activity.

3.5.1 JDS pong

JDS pong is inspired by from the table tennis games. The aim of this games is

to provide an activity which will help stoke survivor to regain vertical hand and arm

movement ability. This games allow the user to the hand movement distance to move

from one end to the other end based on their hand movement ability. Similar to original

table tennis game, the player will play this games with computer as their opponent.

The window border will act as the wall, each time the ball hit the wall and ball will

change its direction. The objective of this game is to prevent the ball from hitting the

bottom wall. If the ball hit the bottom wall, the computer will get a point and the ball


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speed will increase, if the player manage to obstruct the ball movement using his bat

he will get points. Point is assign randomly by the computer based the ball location

on the bat. To play this game, user only need to put his hand and move the mouse to

the left or right side of the screen. Axis align bounding box method is used to carry

out collision detection test. Mouse movement will cause the bat to move according to

the hand movement direction. Once the user press S key to stop the game, program

will show the user achievement; either he win or lost. If the user score is higher than

computer score. Figure 3.15 toFigure 3.17 show a screen shot of this game. Figure

3.18 show the pseudocode.

Figure 3.14: JDS pong console windows


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Figure 3.15: JDS pong games screen shot

Figure 3.16: Player win statement

Figure 3.17: Player lose statement


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Start

Right value entered?

Set cursor speed

Ball hit the wall

True

Ball hit the bat

End

Create application windows

Change the ball

movement direction

Select difficulty level

False

Esc button pressed

Increase player

score

Increase computer score and ball speed

Ball hit the bottom wall

True

True

False

Move the ball

Figure 3.18: JDS pong games pseudocode

3.5.2 JDS bouncing ball

JDS bouncing ball objective is to provide a vertical and horizontal hand

movement therapy using 2D game. JDS bouncing ball demonstrate the application ofcollision detection principle and counter controlled repetition loop in creating an


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animation. In this game, ball will bounce from wall to wall. Ball is drawn using

counter repetition control loop. Every time the ball hit the wall, the ball will change

its direction and speed is increase. The games objective is to encourage the player to

move his hand according to ball movement pattern. Player can stop the ball movement

by clicking the left mouse button. The target is to place the cursor on the ball area to

pause the ball movement. When the ball movement is stopped, program will compare

current pixel with specified pixel. Ball movement can be resume by clicking the

mouse button once again. This game will endure until the player press S to stop the

ball movement or press X to exit the game. This game involved two type of

movement: hand and arm movement, and finger movement. Hand and arm movement

is required to move cursor across the screen. Finger movement is needed to press the

mouse button to stop and resume the ball movement. Figure 3.19 show the JDS

bouncing ball screenshot andFigure 3.20 show the pseudocode of JDS pong games.

Radius 1 Radius 2 Radius 3

Figure 3.19: JDS bouncing ball screen shot


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Start


Set cursor speed

Ball hit the wall

True

End

Create application

windows

Change the

ball movement

direction

Select

difficulty

level False

Esc button pressed

Move the ball

True

Mouse button

pressed (1)

Stop ball

movement

Cursor located

on the ball?

False

Print You

missed, try

again

Print You hit the

ball

Mouse buttonpressed (2)

True

Figure 3.20: JDS bouncing ball game pseudocode


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3.5.3 JDS connect the dot

JDS connect the dot is develop based on kids dot connecting activity. The

objective of this game is to enhance hand movement in various direction while the user

use the mouse to connect a set of dot to create certain shape. Five shape with different

level of difficulty has been selected for this activity. Figure 3.21 andFigure 3.22 show

the JDS connecting the dot screenshot.

Figure 3.21: JDS connect the dot games

Beside enhancing the user hand movement, while playing this games user need

to adhere certain rules; user cannot quit the game before all the dot is connected, on

the other hand user must comply the maximum number of mouse click to complete

this game. Error message as shown inFigure 3.23 andFigure 3.24 will be display if

the user fail to comply the rules. Message inFigure 3.25 will be display if the user

manage to complete the given task. Figure 3.26 show the pseudocode.


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Figure 3.22: JDS Connecting the dot console display

Figure 3.23: Uncomplete task message


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Figure 3.24: User exceed the maximum attempt allow

Figure 3.25: User successfully complete the game


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Start


Set cursor speed

True

End

Draw line

from position

1 to position 2

Select hand

movement

ability level False

Esc button pressed

Display

window anddraw shape

Select objectshape


True

Player click mouse

button (position 1)

Player click mouse

button (position 2)

False

Figure 3.26: JDS connect the dot pseudocode


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3.5.4 JDS hand movement speed calculation tool

JDS hand movement speed calculation tool as shown inFigure 3.27 is design

to provide tools to measure hand movement speed. User can use information from this

application to compare the hand movement speed between the affected limbs and the

unaffected limbs, the rehabilitation goal is to train the affected limb so it can move as

fast as the unaffected limb.

In this application mouse click location is used to determine the distance

between two points. New location will be recorded based on mouse button state (up

or down). Every state will produce a new location. Figure 3.28 show the JDS hand

movement speed calculation tool pseudocode.

Figure 3.27: JDS hand movement speed calculation tools snap shot


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Start

Log file created?

End

Correct value entered?

Request user name

Print greeting

Create log file based on user name

Print file name and location

True

Enter hand movement ability

Perform hand movement

distance calibration

True

False

Record start time

Create console and application

windowMouse button press

Record time and location

Mouse button release

Record time and location

Esc button pressed

False

Perform hand movement speed

calculation

Figure 3.28: JDS hand movement speed calculation tools pseudocode


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JDS hand movement speed calculation tool application windows size is set to

700 x 700 pixel. This create a coordinate system ranging from 0 to 700 inxaxis and

0 to 700 inyaxis. All mouse click location detected by JDS hand movement speed

calculation tool will be recorded in log a file. Besides recording the cursor location,

this program also record the time duration taken to move for initial point to end point.

This data will use by the program to calculate the hand movement speed using the

formula shown inFigure 3.29. Output of the program is shown inFigure 3.30.

,=

: = Figure 3.29: Hand movement speed calculation formula

Figure 3.30: JDS HMCT speed calculation output


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3.6 Effect of mouse hardware to DPI to hand movement distance validation

Introduction:

Optical mice contain a light emitting diode (LED) and a little camera. As the

mouse move around, the light shines on the surface below the mouse and the camera

takes hundreds of pictures per second. The mouse compares the pictures and

determines the direction which the mouse is moving. The mouse then sends this

movement data to the computer as mouse input, and the computer moves the cursor

across the screen.

The pixel is originated from the word picture element; is the basic unit of

programmable colour on a computer display or in a computer image. The physical

size of a pixel depends on the resolution for the display screen. Display screen

resolution is the number of pixels or individual points of colour contained on a display

monitor. If the display screen display resolution is set to its maximum resolution, the

physical size of a pixel will equal the physical size of the dot pitch or the dot size of

the display. The dot pitch is measured in millimetres (mm) and a smaller number

means a sharper image. In desktop monitors, common dot pitches are .31mm, .28mm,

.27mm, .26mm, and .25mm. Personal computer users will usually use .28mm or finer.

Optical sensor resolution number of pixel that can be fitted into one inch. For

example if the pixel size 0.03 mm or 30 micron, the mouse DPI is 840 DPI. Dots per

inch (DPI) refer to the number of image that a mouse sensor can take for every inch it

is moved. The higher a mouses DPI, the farther the cursor will move on screen when

the mouse is move. A mouse with a higher DPI setting detects and reacts to smaller

movements. Some mouse models include dedicated buttons (DPI on-the-fly buttons)

which can be used to instantly adjust the mouse sensitivity (DPI).


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Experiment objective:

Objective of this study is to validate the effect of mouse hardware DPI to hand

movement distance to move computer cursor using JDS hand movement speed

calculation tools.

Equipment:

1. Complete set of computer.

2. JDS hand movement speed calculation tools software.

3. Graph paper.

4. Ruler

5.

Cellulose tape.

6. Logitech G502 Proteus Core Tuneable Gaming Mouse (Figure 3.31).

Figure 3.31: Logitech G502 Proteus Core Tuneable Gaming Mouse

Experiment procedure:

1. Launch JDS hand movement speed calculation tools software.

2. Stick a graph paper on flat surface.

3. Set Logitech G502 DPI to 1200 DPI.

4. Follow instruction given in the JDS hand movement calculation tools to

record the hand movement distance required to movement the cursor 50 pixel

from the centre of the screen. Use the graph paper to measure the hand

distance and record the result. Repeat this each measurement for 3 times.


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5.

Repeat step 4 to measure the hand movement distance of 100, 200 and 300

pixel from the centre of the screen.

6. Record the result.

Result of this experiment will be discuss in chapter 4.

3.7 Comparison between normal and gaming mouse to hand movement

distance

Introduction:

Gaming mouse is a special mouse design to use with computer games. Gaming

mouse typically employ a wide array of controls and buttons and have designs that

differ radically from traditional mice. Gaming mouse is equip with DPI switch known

as on the fly DPI whichenables user to adjust the mouse's sensitivity to a faster or

slower pointer speed. In gaming mouse, DPI increment is produce by subdividing

those pixels into smaller increments, this is done using sensor algorithm. Changes in

DPI value will affect the accuracy, but it will produce a much more sensitive system;

reduce the distance to produce a single count.

DPI is defined as the number of pixel that a mouse can count in one inch. For

example, to move 1000 pixel on screen will required the user to move their hand for 1

inch. Using this relationship formula as shown inFigure 3.32 is develop.

=( 2.54 ): = . = Figure 3.32: Hand movement distance calculation formula


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Objective this study is investigate the effect of mouse sensor DPI to hand movement

distance required to move the cursor from one point to other point. This study will

compare the hand movement distance required to movement cursor from the centre

of the screen to specific location using Logitech M325 mouse and Logitech M502

mouse.

Equipment:


2. JDS hand movement speed calculation tools software.

3.

Graph paper.

4. Ruler

5. Cellulose tape.

6. Logitech G502 Proteus Core Tuneable Gaming Mouse.

7. Logitech M325 mouse (Figure 3.33).

Figure 3.33: Logitech M325 mouse




3. Set Logitech G502 DPI to 1000 DPI.

4.

Follow instruction given in the JDS hand movement calculation tools torecord the hand movement distance required to movement the cursor 50 pixel


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5. Repeat step 4 to measure the hand movement distance of 100, 200 and 300


6. Repeat step 4 and 5 using Logitech M325 mouse.



3.8 Effect of mouse sensitivity to hand movement distance validation

Introduction:

Mouse sensitivity determine the speed or how fast the cursor will move across

the computer screen. Higher mouse sensitivity will produce a quick response and

reduce the hand movement distance to move the cursor across the computer screen.

On the other hand, low sensitivity will reduce the cursor movement speed and increase

the hand movement distance to move the cursor across the screen.

Window operating system provide mouse properties dialog box as shown in

Figure 3.34 which provide pointer speed adjustment option that allow user to change

the mouse cursor speed. In JDS rehabilitation games, mouse sensitivity is change by

changing the in game sensitivity value. Relationship between hand movement distance

and in games mouse sensitivity setting is given by formula inFigure 3.35.


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Figure 3.34: Mouse properties dialog box

=( 2.54 ): = . = =

2.54 = .Figure 3.35: In games sensitivity setting effect calculation formula


Objective of this experiment is to validate the effect of in game sensitivity setting to

hand movement distance to move computer cursor in JDS rehabilitation games. In


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games sensitivity setting can be adjusted using the hand ability movement option in

JDS rehabilitation games.

Equipment:


2.

JDS hand movement speed calculation tools software.

3. Graph paper.

4. Ruler

5. Cellulose tape.

6. Logitech M325 mouse




3. Set the hand ability value to 1.

4. Follow instruction given in the JDS hand movement calculation tools to

record the hand movement distance required to movement the cursor 50 pixel



5. Repeat step 4 to measure the hand movement distance of 100, 200 and 300


6. Repeat step 4 and 5 with the hand ability setting is change to 2, 3 and 4.




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3.9 JDS hand movement speed calculation tools calibration

The accuracy of hand movement distance calculation in JDS hand movement

speed calculation tools is influenced by the mouse hardware DPI value. JDS hand

movement speed calculation is equipped with calibration option as shown inFigure

3.36 which will allow user to set the mouse DPI value.

Figure 3.36: JDS hand movement speed calculation tools calibration option


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3.10 Hand movement chart

Every game except JDS Pong is equip with a log file. Log file will record

information such as user name, program start time, program stop time, hand movement

start time, hand movement stop time and cursor location. Cursor location referring to

the distance measured in pixel from screen center to the destination.

Log file content is different based on the games objective. JDS bouncing ball

game log file as shown inTable 3.1 will record the mouse click location made by the

user and determine whether the user manage to hit the ball or not. Table 3.2 show

connect the dot log file content this log file only record the coordinate location and

time duration.

JDS hand movement speed calculation tools log file as shown inTable 3.2 will

record the hand movement coordinate and calculate the hand movement speed. The

JDS log file will record the hand movement coordinate (pixel), hand movement

duration (seconds), hand movement distance (cm) and hand movement speed (cm/sec).

All calculation is done automatically by the program. Data recorded by the log file

can be use by the therapist and stroke survivors to monitor their rehabilitation progress

Table 3.1: JDS bouncing ball log file content

User name: test1

Begin date : 17/03/2016 Begin time: 13:28:48

Point X Y

1 505 389 Hit target


3 344 218 Missed target

4 154 176 Missed target


End date : 17/03/2016 End time: 13:29:15


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Table 3.2: JDS connecting the dot log file content

User name: test1

Begin date : 17/03/2016

Begin

time: 12:30:00

Shape: Square

Point X Y

1 70 70

2 69 629

3 628 630

4 69 71

5 631 71

End date : 17/03/2016 End time: 12:30:16

Time taken

to complete: 0 Hours 0 Minutes 16 Seconds

Table 3.3: JDS hand movement speed calculation tools log file

User name: test1Begin date

:

18/03/2016 Begin time: 13:00:43

Point X Y Distance

(Cm)

Duration

(Second)

Speed

(Cm/Second)

Location

1 350 348

2 130 628 2.2512 1 2.2512 Zone 5

3 350 349

4 34 14 2.92894 2 1.46447 Zone 5

5 349 351

6 675 16 2.95927 2 1.47964 Zone 5

End date : 18/03/2016 End time: 13:01:07

Chart inFigure 3.37 is produce by plotting the coordinate value from the JDS

bouncing ball games log file. Plotting the coordinate value from JDS connecting the

dot log file will produce hand movement chart as shown inFigure 3.38.


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Figure 3.37: JDS bouncing ball hand movement pattern chart

Figure 3.38: JDS connecting the dot hand movement pattern chart

0

100

200

300

400

500

600

0 100 200 300 400 500 600

Y

coordinate

X coordinate

JDS connecting the dot hand movement chart


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3.11 Conclusion

JDS rehabilitation games is design to produce a rehabilitation activity using

computer games with the ability to record the user hand movement ability. Several

factor such as the user hand movement distance ability, level of difficulty and

motivation is considered in developing this games. JDS hand movement speed

calculation tools is design to compare the hand movement speed of the affected and

non-affected hand. Therapist can used this data to plot a hand movement chart to

record the rehabilitation activity progress.

Repetition and high motivation is the most important factor in increasing the

rehabilitation activity success. Repetition will cause boredom. In this game different

level of difficulty is used to reduce the boredom effect. This system will also provide

feedback in term of score to increase the user motivation.

In general this project has achieve its objective to produce a system which has

the ability to help stroke survivors to regain their upper limb movement ability, but the

effectiveness of the system can only be measured when the stroke survivor and

rehabilitation unit staff has the desire to use this system as a part of their rehabilitation

activity. Wise man says you can lead a horse to water, but you cannot make it drink.


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CHAPTER 4

RESULT AND DISCUSSION

This chapter will discuss the result and finding from experiment describe in chapter 3.

Experiment result show that mouse hardware DPI and in games sensitivity setting

value in JDS rehabilitation games has direct influenced to hand movement distance to

move cursor from one point to the other point.

4.1 Relationship between mouse hardware DPI and hand movement distance

This test is done using Logitech G502 Proteus Core Tuneable Gaming Mouse,

this mouse has the pointer setting option as shown inFigure 4.1which allow user to

change the mouse DPI setting from 200 DPI to 12 000 DPI. The objective of this

experiment is to validate the effect of different mouse DPI to the hand movement

distance required to move from one point to other point. In this experiment the hand

movement distance to move from the centre of the screen to certain location is

recorded in Table 4.1. Relationship between mouse hardware DPI and hand

movement distance can be represented as; higher mouse DPI will decrease the hand

distance required to move from one to another point, lower mouse DPI with lead to

higher effort to move cursor from one to another point.


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Table 4.1: Mouse DPI Vs Hand movement distance

Mouse model: Logitech Proteus core G502

Distance from centre of the screen (pixel)

Mouse DPI 50 100 200 300

1200 4 8 16 24

1000 5 10 20 30

800 6 12 24 36

600 8 16 32 48

400 12 24 48 72

200 27 54 108 162

Figure 4.1: Logitech G502 pointer setting application.

Chart inFigure 4.2 illustrate the relationship between the mouse DPI and hand

movement distance. Using the chart, we can conclude that user has to move his hand

further to move from one point to other point when using a mouse with lower DPI for

example to move 300 pixel on computer screen with 200 DPI mouse the user must

move his hand for 162 mm, on the other hand the user only need to move 28 mm to

move the same distance on screen with 1000 DPI mouse. Relationship between hand

movement distance and cursor movement distance is govern by equation inFigure 4.3.

This study show that mouse hardware DPI value will influence the hand movement

distance to move cursor from one to another point.


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Figure 4.2: Mouse DPI vs hand movement distance

1200 = 0.081000 := 0.1800 := 0.12600 := 0.16400 := 0.24200 := 0.24Figure 4.3: Relationship between mouse DPI and hand movement distance

4.2 Effect of single DPI mouse and multiple DPI mouse to hand movement

distance

This section will study the effect of single DPI and multi DPI mouse to the

accuracy of hand movement distance calculation using JDS hand movement

calculation tools. Objective of thi

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