Interactive Gait Rehabilitation Through Gamified Real-Time Biofeedback and Adaptive Hip Exoskeleton Assistance: A Preliminary Evaluation

This paper presents the design and functional evaluation of an interactive rehabilitation system that integrates a hip exoskeleton with a game-based environment for targeted gait rehabilitation. The system offers real-time visualization of full-body motion tracking and biofeedback, including electromyography (EMG) based muscle activation feedback. Users control an anatomical avatar within a task-based gameplay interface, where the avatar mirrors their motion and displays muscle activation through dynamic, red-shaded overlays corresponding to real-time EMG signals. To assess the system's functionality, a healthy subject participated in a study involving treadmill walking at $0.25 ~\mathrm{m} / \mathrm{s}$ slower than their selfselected speed. The subject navigated a forest environment to collect virtual apples while using two stiffness-based hip control modes: an in-phase assistive mode and an out-of-phase resistive mode. The assistive mode reduced muscle activation, while the resistive mode increased muscle activation for strength training. Additionally, the system supports post-processing of collected data for further analysis, enabling visualization of kinematics, exoskeleton torques, and EMG patterns. Users can customize rehabilitation parameters to tailor the experience to their needs. The results demonstrate the system's potential as an interactive, feedback-driven rehabilitation platform, showcasing its biofeedback capabilities and adaptability.