Desenvolvimento e testes de funcionalidades do instrumento de reabilitação da força labial utilizando jogos digitais.

Abstract

The proposed project aimed the creation of a new method, with the development of an anatomical and functional instrument for lip strength therapy, with a focus on facilitating, inciting, making Speech Therapy exercises more pleasant and stimulating. A "Serious Game" was developed with this purpose as a therapeutic tool, and an interactive game for rehabilitation of the lip was associated with the new device, with the objective of increasing the patient's adherence to the treatment. The game was designed for children and teenagers, who are in a period of extensive orofacial development, in addition to being in a phase of a great interest in digital games. This game uses development software for Unity environments in its free version. Four Flexiforce® sensors were used that separately capture the strength of different lip points (upper right, upper left, lower right and lower left) to highlight possible differences between the forces of the upper and lower orbicular oris muscle, and changes in strength between the left and the right side. These sensors, when compressed by the lips, produce analog voltage signals, which are treated, transmitted, processed and stored in digital media. The forces measured by the device are converted into movements in the computer game. The objective of the game is that the user, in addition to reaching strength levels (isotonic muscle contraction), also sustains the forces for certain periods (isometric muscle contraction). It also allows biofeedback to the player, who visualizes if the force used in the instrument is enough to reach the desired level, or if s/he is managing to maintain the strength correctly for the predetermined period. The scores achieved in the game, the maximum, average, minimum forces, the period of sustained muscle contraction, and the configuration parameters planned by the Speech Therapist are stored together with the patient's information. Thus, lip therapy generates data and graphics that are stored and allow analysis of the patient's evolution in his/her rehabilitation. A performance report, using this data, was developed. Functionality tests were carried out to adapt the device, analyze of the shape and ergonomics of the device and adapt the games. The new device was presented to five Speech-Language Pathology professionals to analyze the applicability, usability and acceptability of the lip rehabilitation instrument and to validate the content of the patient's performance report. Then, tests were conducted with 11 adults without problems with lip occlusion and nine children, aged 8 to 12 years, attended at Hospital das Clínicas, UFMG, who tested a game in three attempts, with a 2-minute rest period between attempts. The instrument presented good usability and acceptability in the opinion of speech therapists with experience in Orofacial Myology and Dysphagia, as well as in the opinion of adults who tested the equipment. The patient’s performance report was validated in terms of its content. The average of the scores in the game, obtained by the adults who used the instrument, were higher in the third attempt. The same occurred with children without changes in lip tension, but not with children with changes in lip tension.