Virtual Reality and Serious Games for Simulating Muscle Force and Joint Torque in Upper Limb Prosthesis Training: A Systematic Literature Review
Resumo
This paper presents a systematic literature review on the use of biomechanical models in virtual reality environments, in association with serious games for the training and control of upper-limb prostheses. The review covers studies that integrate musculoskeletal simulations, motion capture, and interaction with virtual systems. The main computational models employed are discussed, along with the motor control strategies adopted. Serious games are considered not only for their motivational role but also as methods for functional assessment in clinical settings. The results indicate a growing interest in the combined use of virtual reality and serious games with biomechanical models, while also revealing a lack of integrated and clinically validated solutions. Notably, no study simultaneously addressed the five criteria defined in this review, namely biomechanical modeling, immersive virtual reality, serious games, force estimation, and joint torque estimation, which highlights a fragmented scenario. This review contributes by presenting an existing gap, as well as proposing a direction for future upper limb prosthesis training systems that are more effective and clinically viable.
Palavras-chave:
Biomechanical models, virtual reality, serious games, upper-limb prosthesis, musculoskeletal models
Referências
World Health Organization. World Report on Disability. [link]
Cordella, F. Ciancio, A. Sacchetti, R. Davalli, A. Cutti, A. Guglielmelli, E. and Zollo, L. Literature review on needs of upper limb prosthesis users. Frontiers in Neuroscience, 10:209, 2016.
Gaballa, A. Cavalcante, R. S. Lamounier, E. A. Soares, A. B. and Cabibihan, J.-J. Extended Reality X-Reality for Prosthesis Training of Upper-Limb Amputees A Review on Current and Future Clinical Potential. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 30:1652–1663, 2022. DOI: 10.1109/TNSRE.2022.3179327.
Marques, I. A. Alves, C. M. Rezende, A. R. Mendes, L. C. Paiva, T. S. de, Cyrino, G. F. Souza, J. T. de, Silva, M. A. M. Souza, L. A. P. S. de, and Naves, E. L. M. Virtual reality and serious game therapy for post-stroke individuals A preliminary study with humanized rehabilitation approach protocol. Heliyon, 9(10):e20285, 2023.
Doumas, G. Everard, S. Dehem, S. and Lejeune, T. Serious games for upper limb rehabilitation after stroke A meta-analysis. Journal of NeuroEngineering and Rehabilitation, 18(1):100, 2021. DOI: 10.1186/s12984-021-00889-1.
Hashim, N. A. Abd Razak, N. A. Shanmuganathan, T. Jaladin, R. A. Gholizadeh, H. and Abu Osman, N. A. On the use of virtual reality for individuals with upper limb loss A systematic scoping review. European Journal of Physical and Rehabilitation Medicine, 58(4):612–620, 2022.
Heerschop, A. van der Sluis, C. K. and Bongers, R. M. Transfer of mode switching performance from training to upper-limb prosthesis use. Journal of NeuroEngineering and Rehabilitation, 18(1):85, 2021.
Maas, B. Wright, Z. A. Lock, B. A. van der Sluis, C. K. and Bongers, R. M. Using serious games to measure upper-limb myoelectric pattern recognition prosthesis control performance in an at-home environment. Journal of Prosthetics and Orthotics, 36(3):153–160, 2024.
Cavalcante, R. Gaballa, A. Cabibihan, J.-J. Soares, A. and Lamounier, E. A VR-Based Serious Game Associated to EMG Signal Processing and Sensory Feedback for Upper Limb Prosthesis Training. Entertainment Computing ICEC 2021, Lecture Notes in Computer Science, 13056:433–440, 2021. DOI: 10.1007/978-3-030-89394-1_3.
Gutierrez, A. Sepulveda-Munoz, D. Gil-Agudo, A. and de los Reyes Guzman, A. Serious game platform with haptic feedback and EMG monitoring for upper limb rehabilitation and smoothness quantification on spinal cord injury patients. Applied Sciences, 10(3):963, 2020. DOI: 10.3390/app10030963.
Blana, D. Chadwell, M. L. Baker, R. and Howard, M. I. M. Model-based control of individual finger movements for prosthetic hand function. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 28(3):612–620, 2020.
Abdelbaset, R. Mohamed, B. and Afify, H. A 3-D biomechanical model for enhancing the performance of artificial hand. Proceedings of the 4th Middle East Conference on Biomedical Engineering (MECBME), 2018.
Garcia-Rosas, R. Tan, Y. Oetomo, D. Manzie, C. and Choong, P. Personalized online adaptation of kinematic synergies for human-prosthesis interfaces. IEEE Transactions on Cybernetics, 51(2):1070–1084, 2021. DOI: 10.1109/TCYB.2019.2920376.
Knight, A. Carey, S. and Dubey, R. Transradial prosthesis performance enhanced with the use of a computer assisted rehabilitation environment. Proceedings of the 10th ACM International Conference on PErvasive Technologies Related to Assistive Environments (PETRA), Rhodes, Greece, 2017.
Cavalcante, R. Lima, F. and Souza, D. C. A virtual reality game-based system with EMG signal control and sensory feedback for upper-limb prosthesis training. Proceedings of the 23rd Symposium on Virtual and Augmented Reality (SVR), 2021.
He, Y. Sawada, I. Fukuda, O. Shima, R. Yamaguchi, N. and Okumura, H. Development of an evaluation system for upper limb function using AR technology. Proceedings of GECCO 2018 Companion, Kyoto, Japan, 2018.
Seth, A. Sherman, M. Reinbolt, J. Habib, E. and Delp, S. OpenSim Simulating musculoskeletal dynamics and neuromuscular control to study human and animal movement. PLOS Computational Biology, 14(7):e1006223, 2018.
Delp, S. L. Anderson, F. C. Arnold, A. S. Loan, P. Habib, A. John, C. T. Guendelman, E. and Thelen, D. G. OpenSim Open-source software to create and analyze dynamic simulations of movement. IEEE Transactions on Biomedical Engineering, 54(11):1940–1950, 2007.
Laver, K. George, S. Thomas, S. Deutsch, J. and Crotty, M. Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews, 11:CD008349, 2017. DOI: 10.1002/14651858.CD008349.pub4.
Williamson, T. Kenney, L. Barker, A. T. Cooper, G. Good, T. Healey, J. Heller, B. Howard, D. Matthews, M. Prenton, S. Ryan, J. and Smith, C. Enhancing public involvement in assistive technology design research. Disability and Rehabilitation Assistive Technology, 10(3):258–265, 2015. DOI: 10.3109/17483107.2014.908247.
Quintero, C. A review Accessible technology through participatory design. Disability and Rehabilitation Assistive Technology, 17(4):369–375, 2022. DOI: 10.1080/17483107.2020.1785564.
Lima, D. A. C. Soares, A. B. Lamounier, E. A. Silva, A. C. Melo, B. G. R. V. and Cardoso, A. A markerless augmented reality application for training upper limb amputees. Anais Estendidos do XXIV Simposio de Realidade Virtual e Aumentada (SVR), XR Experience, 1–8, 2022. DOI: 10.5753/svr_estendido.2022.227935.
Fernandes, D. P. Adiers, D. O. Silva, F. B. da, Migliorini, B. P. Goi, A. P. C. Milanese, J. L. Siqueira, L. O. Mendes, N. B. S. Zanatta, A. L. and Rieder, R. DPOC-VR um VR-serious game para apoio ao ensino de doenca pulmonar obstrutiva cronica. Anais Estendidos do XXV Simposio de Realidade Virtual e Aumentada (SVR), Workshop de Iniciacao Cientifica, 1–4, 2023. DOI: 10.5753/svr_estendido.2023.235985.
Amaral, L. Santos, J. Soares, F. Felix, J. Cardoso, L. and Nascimento, T. H. Interactive educational game for chemistry in virtual reality with user gesture interactions via smartwatches. Anais do XXVI Simposio de Realidade Virtual e Aumentada (SVR), Manaus, 2024. DOI: 10.5753/svr.2024.30566.
Hamner, S. R. Seth, A. and Delp, S. L. Muscle contributions to propulsion and support during running. Journal of Biomechanics, 43(14):2709–2716, 2010. DOI: 10.1016/j.jbiomech.2010.06.025.
Farina, D. Jiang, N. Rehbaum, H. Holobar, A. Graimann, B. Dietl, H. and Aszmann, O. C. The extraction of neural information from the surface EMG for the control of upper-limb prostheses Emerging avenues and challenges. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 22(4):797–809, 2014. DOI: 10.1109/TNSRE.2014.2305111.
Cordella, F. Ciancio, A. Sacchetti, R. Davalli, A. Cutti, A. Guglielmelli, E. and Zollo, L. Literature review on needs of upper limb prosthesis users. Frontiers in Neuroscience, 10:209, 2016.
Gaballa, A. Cavalcante, R. S. Lamounier, E. A. Soares, A. B. and Cabibihan, J.-J. Extended Reality X-Reality for Prosthesis Training of Upper-Limb Amputees A Review on Current and Future Clinical Potential. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 30:1652–1663, 2022. DOI: 10.1109/TNSRE.2022.3179327.
Marques, I. A. Alves, C. M. Rezende, A. R. Mendes, L. C. Paiva, T. S. de, Cyrino, G. F. Souza, J. T. de, Silva, M. A. M. Souza, L. A. P. S. de, and Naves, E. L. M. Virtual reality and serious game therapy for post-stroke individuals A preliminary study with humanized rehabilitation approach protocol. Heliyon, 9(10):e20285, 2023.
Doumas, G. Everard, S. Dehem, S. and Lejeune, T. Serious games for upper limb rehabilitation after stroke A meta-analysis. Journal of NeuroEngineering and Rehabilitation, 18(1):100, 2021. DOI: 10.1186/s12984-021-00889-1.
Hashim, N. A. Abd Razak, N. A. Shanmuganathan, T. Jaladin, R. A. Gholizadeh, H. and Abu Osman, N. A. On the use of virtual reality for individuals with upper limb loss A systematic scoping review. European Journal of Physical and Rehabilitation Medicine, 58(4):612–620, 2022.
Heerschop, A. van der Sluis, C. K. and Bongers, R. M. Transfer of mode switching performance from training to upper-limb prosthesis use. Journal of NeuroEngineering and Rehabilitation, 18(1):85, 2021.
Maas, B. Wright, Z. A. Lock, B. A. van der Sluis, C. K. and Bongers, R. M. Using serious games to measure upper-limb myoelectric pattern recognition prosthesis control performance in an at-home environment. Journal of Prosthetics and Orthotics, 36(3):153–160, 2024.
Cavalcante, R. Gaballa, A. Cabibihan, J.-J. Soares, A. and Lamounier, E. A VR-Based Serious Game Associated to EMG Signal Processing and Sensory Feedback for Upper Limb Prosthesis Training. Entertainment Computing ICEC 2021, Lecture Notes in Computer Science, 13056:433–440, 2021. DOI: 10.1007/978-3-030-89394-1_3.
Gutierrez, A. Sepulveda-Munoz, D. Gil-Agudo, A. and de los Reyes Guzman, A. Serious game platform with haptic feedback and EMG monitoring for upper limb rehabilitation and smoothness quantification on spinal cord injury patients. Applied Sciences, 10(3):963, 2020. DOI: 10.3390/app10030963.
Blana, D. Chadwell, M. L. Baker, R. and Howard, M. I. M. Model-based control of individual finger movements for prosthetic hand function. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 28(3):612–620, 2020.
Abdelbaset, R. Mohamed, B. and Afify, H. A 3-D biomechanical model for enhancing the performance of artificial hand. Proceedings of the 4th Middle East Conference on Biomedical Engineering (MECBME), 2018.
Garcia-Rosas, R. Tan, Y. Oetomo, D. Manzie, C. and Choong, P. Personalized online adaptation of kinematic synergies for human-prosthesis interfaces. IEEE Transactions on Cybernetics, 51(2):1070–1084, 2021. DOI: 10.1109/TCYB.2019.2920376.
Knight, A. Carey, S. and Dubey, R. Transradial prosthesis performance enhanced with the use of a computer assisted rehabilitation environment. Proceedings of the 10th ACM International Conference on PErvasive Technologies Related to Assistive Environments (PETRA), Rhodes, Greece, 2017.
Cavalcante, R. Lima, F. and Souza, D. C. A virtual reality game-based system with EMG signal control and sensory feedback for upper-limb prosthesis training. Proceedings of the 23rd Symposium on Virtual and Augmented Reality (SVR), 2021.
He, Y. Sawada, I. Fukuda, O. Shima, R. Yamaguchi, N. and Okumura, H. Development of an evaluation system for upper limb function using AR technology. Proceedings of GECCO 2018 Companion, Kyoto, Japan, 2018.
Seth, A. Sherman, M. Reinbolt, J. Habib, E. and Delp, S. OpenSim Simulating musculoskeletal dynamics and neuromuscular control to study human and animal movement. PLOS Computational Biology, 14(7):e1006223, 2018.
Delp, S. L. Anderson, F. C. Arnold, A. S. Loan, P. Habib, A. John, C. T. Guendelman, E. and Thelen, D. G. OpenSim Open-source software to create and analyze dynamic simulations of movement. IEEE Transactions on Biomedical Engineering, 54(11):1940–1950, 2007.
Laver, K. George, S. Thomas, S. Deutsch, J. and Crotty, M. Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews, 11:CD008349, 2017. DOI: 10.1002/14651858.CD008349.pub4.
Williamson, T. Kenney, L. Barker, A. T. Cooper, G. Good, T. Healey, J. Heller, B. Howard, D. Matthews, M. Prenton, S. Ryan, J. and Smith, C. Enhancing public involvement in assistive technology design research. Disability and Rehabilitation Assistive Technology, 10(3):258–265, 2015. DOI: 10.3109/17483107.2014.908247.
Quintero, C. A review Accessible technology through participatory design. Disability and Rehabilitation Assistive Technology, 17(4):369–375, 2022. DOI: 10.1080/17483107.2020.1785564.
Lima, D. A. C. Soares, A. B. Lamounier, E. A. Silva, A. C. Melo, B. G. R. V. and Cardoso, A. A markerless augmented reality application for training upper limb amputees. Anais Estendidos do XXIV Simposio de Realidade Virtual e Aumentada (SVR), XR Experience, 1–8, 2022. DOI: 10.5753/svr_estendido.2022.227935.
Fernandes, D. P. Adiers, D. O. Silva, F. B. da, Migliorini, B. P. Goi, A. P. C. Milanese, J. L. Siqueira, L. O. Mendes, N. B. S. Zanatta, A. L. and Rieder, R. DPOC-VR um VR-serious game para apoio ao ensino de doenca pulmonar obstrutiva cronica. Anais Estendidos do XXV Simposio de Realidade Virtual e Aumentada (SVR), Workshop de Iniciacao Cientifica, 1–4, 2023. DOI: 10.5753/svr_estendido.2023.235985.
Amaral, L. Santos, J. Soares, F. Felix, J. Cardoso, L. and Nascimento, T. H. Interactive educational game for chemistry in virtual reality with user gesture interactions via smartwatches. Anais do XXVI Simposio de Realidade Virtual e Aumentada (SVR), Manaus, 2024. DOI: 10.5753/svr.2024.30566.
Hamner, S. R. Seth, A. and Delp, S. L. Muscle contributions to propulsion and support during running. Journal of Biomechanics, 43(14):2709–2716, 2010. DOI: 10.1016/j.jbiomech.2010.06.025.
Farina, D. Jiang, N. Rehbaum, H. Holobar, A. Graimann, B. Dietl, H. and Aszmann, O. C. The extraction of neural information from the surface EMG for the control of upper-limb prostheses Emerging avenues and challenges. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 22(4):797–809, 2014. DOI: 10.1109/TNSRE.2014.2305111.
Publicado
30/09/2025
Como Citar
CAMARGO, Lisias Carneiro; LAMOUNIER JUNIOR, Edgard Afonso; SOARES, Alcimar Barbosa.
Virtual Reality and Serious Games for Simulating Muscle Force and Joint Torque in Upper Limb Prosthesis Training: A Systematic Literature Review. In: SIMPÓSIO DE REALIDADE VIRTUAL E AUMENTADA (SVR), 27. , 2025, Salvador/BA.
Anais [...].
Porto Alegre: Sociedade Brasileira de Computação,
2025
.
p. 389-395.
