Design and Development of an Interactive Proportional Myoelectric-Controlled Biofeedback Video Game for Knee Osteoarthritis Rehabilitation

This study introduces the design and development of an interactive biofeedback video game system to support knee osteoarthritis (KOA) rehabilitation. The system features a low-cost, portable multichannel surface electromyography (sEMG) device integrated with customizable biofeedback software to enhance patient engagement and accessibility. The video game, SpaceGame, utilizes proportional myoelectric signals from the vastus medialis (VM) muscle, allowing users to control vertical movements (up-down) of an in-game character based on their muscle contraction levels. To evaluate the system's effectiveness, correlation coefficients were calculated at varying muscle contraction levels, revealing strong correlations-approximately 0.8497, 0.8723, and 0.8849 for 20%, 40%, and 60% contraction levels, respectively-demonstrating accurate control over character movement. Feedback from participants indicated general satisfaction with the system but also highlighted areas for improvement, particularly in control simplicity and session length.