Usage of RePlay as a Take-Home System to Support High-Repetition Motor Rehabilitation After Neurological Injury

David T. Pruitt, Y. Nhy Duong-Nguyen, Eric C. Meyers, Joseph D. Epperson, Joel M. Wright, Rachael A. Hudson, Jane G. Wigginton, Robert L. Rennaker, Seth A. Hays, Michael P. Kilgard

Research output: Contribution to journalArticlepeer-review


Stroke is a leading cause of chronic motor disability. While physical rehabilitation can promote functional recovery, several barriers prevent patients from receiving optimal rehabilitative care. Easy access to at-home rehabilitative tools could increase patients' ability to participate in rehabilitative exercises, which may lead to improved outcomes. Toward achieving this goal, we developed RePlay: a novel system that facilitates unsupervised rehabilitative exercises at home. RePlay leverages available consumer technology to provide a simple tool that allows users to perform common rehabilitative exercises in a gameplay environment. RePlay collects quantitative time series force and movement data from handheld devices, which provide therapists the ability to quantify gains and individualize rehabilitative regimens. RePlay was developed in C# using Visual Studio. In this feasibility study, we assessed whether participants with neurological injury are capable of using the RePlay system in both a supervised in-office setting and an unsupervised at-home setting, and we assessed their adherence to the unsupervised at-home rehabilitation assignment. All participants were assigned a set of 18 games and exercises to play each day. Participants produced on average 698 ± 36 discrete movements during the initial 1 hour in-office visit. A subset of participants who used the system at home produced 1593 ± 197 discrete movements per day. Participants demonstrated a high degree of engagement while using the system at home, typically completing nearly double the number of assigned exercises per day. These findings indicate that the open-source RePlay system may be a feasible tool to facilitate access to rehabilitative exercises and potentially improve overall patient outcomes.

Original languageEnglish (US)
Pages (from-to)73-85
Number of pages13
JournalGames for health journal
Issue number1
StatePublished - Feb 1 2023


  • Games
  • Neurological disorders
  • Recovery
  • Rehabilitation
  • Telehealth systems

ASJC Scopus subject areas

  • Health(social science)
  • Rehabilitation
  • Computer Science Applications
  • Public Health, Environmental and Occupational Health


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