Executive control in a Mixed Reality exergame for motor-cognitive rehabilitation in multiple sclerosis

Nowadays, rehabilitation procedures for people with multiple sclerosis (MS) are supported by an increasing number of tools. In particular, interactive settings have gained attention in this domain, showing promising effectiveness in motivating patients during repetitive rehabilitative activities. The aim of this work is to enhance traditional exercises through recent innovations in mixed reality (combining real and digital elements in the same setting, making the computer-generated items encrusted in the physical setting). This is achieved by developing an interactive environment where rehabilitation tasks are coupled with game-like features with augmentative audio and video cues. In this paper, the test setting focuses on upper limb rehabilitation, with a grid-like structure where the user must place a virtual cube according to a set of rules and constraints requiring the individual capability to control the execution of repetitive actions without violating specific limitations. This method is used to evaluate the performance and experience of users without MS through a series of playtesting sessions as preliminary tests, before involving people with MS. This study - also based on the comparison of two conditions of executive-inhibitory control - demonstrates how the engaging features of mixed reality can actively reduce the detrimental effects of repetitive exercises, further improving individual adherence to clinical procedures.