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2014 Full Papers ~ Abstracts
and Links to Full Papers
Abstracts are listed in alphabetical order, based
on first author. Click links
below each abstract to view publication.
(Browse Short Paper Abstracts)
User evaluation of a virtual rehabilitation system during reaching exercises: a pilot study, M Al-Amri, D Abásolo, S Ghoussayni, D Ewins, Cardiff University/ University of Surrey/Queen’s Mary Hospital, Roehampton, UK
The aim of this paper was to evaluate the practicality of the Surrey Virtual Rehabilitation System (SVRS) for reaching exercises with children with CP. Five potential users or operators (two children with CP, a physiotherapist, and two clinical engineers) participated in the study. Using 11 closed-ended questions and an open discussion, the feedback collected indicates that the participants were generally positive about the practicality of the SVRS. Outcome measures obtained from data gathered during the session suggest that the SVRS can provide clinically relevant feedback on the performance of patients for themselves and their treating clinicians. In conclusion, the SVRS seems to be practical for rehabilitation purposes and further development and evaluation are warranted.
Cravings in a virtual reality room paired with chocolate predict eating disorder risk, R S Astur, A W Carew, A Palmisano, B E Deaton, F Kuhney, R Niezrecki, M Santos, University of Connecticut/Connecticut Childrens Medical Center, Hartford, USA
Pavlovian conditioning is a major factor in drug and food addictions. Previously, we have shown in humans that we can reliably establish a conditioned place preference to a virtual reality (VR) room that is paired with real life food reward. We examined whether the strength of this conditioned place preference is related to eating disorder risk. 31 food-restricted female undergraduates were recruited and placed into a VR environment consisting of 2 visually distinct rooms connected by a hallway. Participants underwent 6 pairing sessions in which they were locked into one of the two rooms and explored the VR environment. Room A was paired with real-life M&Ms for 3 sessions, and Room B was paired with no food for 3 sessions. After the conditioning, a test session was given in which participants were given free access to the entire VR environment with no food present. Additionally, participants completed a standard assessment of eating disorder risk, the Eating Attitudes Test (EAT-26). We observed a conditioned place preference only for the participants who were in the top 50 percentile for hunger. Self-reported hunger rating was significantly correlated with amount of time in the room paired with food. In regards to the eating attitudes, we observed that the higher the eating disorder risk, as evidenced by higher scores on the dieting subscale, and as evidenced by higher total risk scores, the lower they rated the room paired with no food. This suggests a unique conflict whereby stimuli that are not food associated are rated as less enjoyable, particularly the higher the risk for an eating disorder. Hence, novel measures and associations from a brief conditioning paradigm predict eating disorder risk and may suggest some implicit conflicts and processes involved in people with eating disorders. Future studies will examine people with eating disorders more directly as well as will examine whether these measures can direct treatment strategies and predict treatment success.
Virtual reality system for the enhancement of mobility in patients with chronic back pain, B Bolte, M de Lussanet, M Lappe, University of Münster, GERMANY
Back pain is among the most common health problems in the western world. While surgery can reduce pain and disability for patients with symptoms specific to spinal degeneration, for chronic back pain (CBP) patients exist a variety of therapeutic interventions, which are, unfortunately, not very effective. In addition, CBP patients tend to develop a fear of movement (kinesiophobia) and stiffness of the trunk that probably lead to further problems due to reduced physical activity. To address these problems, we propose a virtual reality system using head-mounted displays for the enhancement of mobility in CBP patients. We manipulate the visual feedback to change the motor behavior of participants by applying gains to alter the weight with which neck, back and hip rotations contribute to the orientation of the virtual camera. Users will not notice the manipulation if the gains are sufficiently small. In an evaluation study we showed that our approach has the potential to increase back movement amplitudes in control and CBP participants. Although we have used a specific task, the big advantage of our method is that any task involving body rotations can be used, thereby providing the opportunity to tailor the task to a patient’s specific preference or need.
Virtual reality exposure for trauma and stress-related disorders for city violence crime victims, G Cárdenas-López, A de la Rosa, R Durón, X Durán, National Autonomous University of Mexico, MEXICO
The criminal violence is attached with mental health problems as depression and substance use and abuse. However one of most important psychological problems linked with the victims of violence is Posttraumatic Stress Disorder (PSTD) and Acute Stress Disorder (ASD). In Mexico, according to the ICESI in 2012, 11% (6,800/for each 100 thousands of habitants) of the population over 18 years experienced a crime. One in four of the people victim of violence develops PSTD symptoms. Due to this socially relevant problem and based on the efficacy of Virtual Reality (VR) treatments, it is important to design treatments involving the use of VR because it can help overcome some of the limitations of traditional therapy using exposure. The present study shows preliminary results of efficacy or virtual reality treatment for PTSD and ASD for crime violence. The clinical sample was conformed for 9 participants from city of Mexico, 6 participants with PTSD diagnoses and 3 participants with ASD diagnoses, aged between 18 and 65. All participants gave informed consent to participate. Treatment was delivered in 90 min individual sessions conducted once a week. Three virtual scenarios for PTSD exposure treatment were used. Improvement was seen in measures of stress, anxiety and depression in both treatment groups, which confirms the clinical efficacious for this technique to treat stress-related disorders.
Differences in effects when using virtual reality balance trainer or wobble board in terms of postural responses, I Cikajlo, S Bajuk, University Rehabilitation Institute, Ljubljana, SLOVENIA
The aim of this study was is twofold: firsts to examine whether the choice of balance training device has any influence on overall therapeutic outcome and secondly whether it affects postural strategy in patients with low-back pain. Six patients used Gamma trainer with virtual reality games and five patients used a wobble board. Before and after the treatment the postural responses were tested. 5 out of 11 patients improved their postural responses in terms of latency and stability. Contribution of the balance training to the improvement of postural responses was not statistically significant (ANOVA, p > 0.05), but differences in functional reaching test were statistically significant (p = 0.0215) for each group (p = 0.0419), while differences between the groups were not found significant (p = 0.1257). In spite of small number of participating subjects, we may suggest that balance training improves postural responses and functional reaching in people with low back pain regardless of the choice of the balance training device.
Virtualising the nine hole peg test of finger dexterity, J Collins, S Hoermann, H Regenbrecht, University of Otago, NEW ZEALAND
Using Virtual and Augmented Reality (VR/AR) approaches in physical rehabilitation can lead to better controlled, more client motivating, and more flexible forms of therapy. The Nine Hole Peg Test (NHPT) is a standard instrument in physiotherapy to practice and assess a patient’s hand motor control abilities. A physical, wooden or plastic board with nine holes and cylindrical shaped pegs are used to perform this task. There are only limited ways of varying the degree of difficulty or to precisely measure progress with this physical setup. This study presents the development of a VR/AR version of the NHPT and evaluates the usability of three versions: (1) the real life wooden version, (2) a video-mediated version and (3) a computer-generated AR version built from low-cost off-the-shelf components. Our results show that all three conditions were successfully completed by all participants with the highest measured performance and perceived usability still achieved in the real life situation. This indicates that the implementation of currently available low-cost, off-the-shelf components is not yet reliable enough to suggest its use for therapeutic exercises or assessments that require very fine finger level interaction.
Case study series using brain-training games to treat attention and memory following brain injury, B B Connor, C Shaw, Independent Practice in Neuropsychology, Nevada City/Sierra Nevada Memorial Hospital, Grass Valley, CA, USA
Rehabilitation following acquired brain injury typically focuses on regaining use of the affected lower and upper limbs. Impairment of cognitive processes, however, is predictive of rehabilitation outcomes. Cognitive activities have become more readily accessible to the home user through web-based games that engage brain functions often disrupted by acquired brain injury. With cognitive testing, it is possible to “prescribe” brain training that targets the specific cognitive functions disrupted by an individual’s acquired brain injury. Previous research has shown that individuals with acquired brain injury have difficulty finding the time to train on cognitive tasks at home, and are often confused and overwhelmed when attempting to operate computers without assistance. We asked if computer-based braining training were made available in a structured training format, at no cost to the participant, would acquired brain injury survivors benefit from using commercially available brain training? Three acquired brain injury patients were recruited. Pre and post training psychometric measures of memory and attention were obtained, as well as qualitative evaluation of the user experience.
Effect of the Oculus Rift head mounted display on postural stability, P Epure, C Gheorghe, T Nissen, L O Toader, A N Macovei, S S M Nielsen, D J Rosengren Christensen, A L Brooks, E Petersson Brooks, Aalborg University, Esbjerg, DENMARK
This study explored how a HMD-experienced virtual environment influences physical balance of six balance-impaired adults 59-69 years-of-age, when compared to a control group of eight non-balance-impaired adults, 18-28 years-of-age. The setup included a Microsoft Kinect and a self-created balance board controlling a skiing game. Two tests were conducted: full-vision versus blindfolded and HMD versus monitor display. Results were that five of the six balance-impaired adults and six of the eight non-balance-impaired adults showed higher degree of postural stability while using a monitor display. Conclusions are that HMD, used in this context, leads to postural instability.
An integrative virtual reality cognitive-motor intervention approach in stroke rehabilitation: a pilot study, A L Faria, A Vourvopoulos, M S Cameirão, J C Fernandes, S Bermúdez i Badia, Universidade da Madeira/ Universidade de Coimbra/Hospital Nélio Mendonça, Funchal, PORTUGAL
Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patient’s capability to live independently. In post-stroke it is imperative to initiate a process of intensive rehabilitation and personalized objectives to maximize functional cognitive and motor recovery. Virtual Reality (VR) technology is being widely applied to rehabilitation of stroke, however, not in an integrative manner. Like traditional rehabilitation, these new tools mostly focus either in the cognitive or in the motor domain, which can take to a reduced impact in the performance of activities of daily living, most of them dual-task. Assuming the existence of cognitive and motor recovery interdependence, RehabNet proposes a holistic approach. Here we present a one-month long pilot study with three stroke patients whose training was a game-like VR version of the Toulouse-Piéron cancellation test, adapted to be performed by repetitive arm reaching movements. A standardized motor and cognitive assessment was performed pre and post intervention. The first results on this intervention support a holistic model for rehabilitation of stroke patients, sustaining interdependence on cognitive and motor recovery. Furthermore, we observed that the impact of the integrative VR approach generalizes to the performance of the activities of daily living.
Virtual reality-augmented rehabilitation for patients in sub-acute phase post stroke: a feasibility study, G G Fluet, A Merians, J Patel, A Van Wingerden, Q Qiu, M Yarossi, E Tunik, S Adamovich, S Massood, Rutgers University/New Jersey Institute of Technology/Saint Joseph’s Wayne Hospital, Wayne, NJ, USA
Upper extremity (UE) rehabilitation is of utmost importance to the achievement of full inclusion and functional independence. Traditionally presented as well as technology-based therapeutic interventions have produced measurable changes in motor function and motor control but fall short of major reductions in disability. Animal models of stroke suggest that the first two weeks to one month post stroke may be a critical time period of increased brain plasticity. This study shows the feasibility of adding one hour of intensive robotic/virtual reality (VR) therapy to on-going rehabilitation in the acute phase of recovery post-stroke. All five of the subjects made substantial improvements in Upper Extremity Fugl-Meyer Assessment (UEFMA) scores (mean improvement = 6 points (SD=2)) as well as improvements in Wolf Motor Function Test (WMFT) time (average decrease = 41% (SD=35) after training with more consistent changes in the proximal arm portions of the WMFT and the UEFMA as well as in upper arm kinematics. Maps of cortical excitability indicate an increase in both the area of activation and the volume of activation of the first dorsal interosseous (FDI) muscle after a two-week training period.
Speech development and therapy using the Kinect, S Frost, R J McCrindle, University of Reading, UK
The use of computers and technology to treat patients with developmental problems or rehabilitation needs is an emerging field. Implementation of such treatment methods however has not traditionally been easy, requiring expensive equipment, significant programming experience and the time of trained medical professionals. The release of gaming systems with natural user interfaces has opened up new possibilities for creating home based therapy and rehabilitation systems that are more engaging, affordable and customisable to individual needs. This project leverages the high quality voice and facial recognition capabilities of the Microsoft Kinect natural user interface, and affordable hardware, to provide an interactive speech therapy application that can be used by patients in their own homes, whilst also collecting metric data for remote monitoring by medical professionals to ensure that engagement with, and appropriate progression of, treatment is occurring.
Cognitive stimulation through mHealth-based program for patients with Alcohol Dependence Syndrome – a randomized controlled study, P Gamito, J Oliveira, P Lopes, R Brito, D Morais, S Rebelo, D Silva, C Caçôete, A Deus, Lusophone University/São João de Deus Institute, Sintra, PORTUGAL
Alcohol abuse can impact on general cognitive functioning and more particularly on frontal lobe functions. One option available to reduce this impact may rest on rehabilitation paradigms that include cognitive stimulation programmes. This paper reports on a randomized controlled study where two sample of patients with alcohol dependence syndrome where enrolled: 1) on a mHealth-based cognitive stimulation program (CSP) within alcohol dependence treatment (experimental group) and 2) on the alcohol dependence treatment without CSP (control group). The CSP mHealth applications consisted on a serial of serious games designed to stimulate frontal lobe functions. Assessment was conducted with the Mini-Mental State Examination and the Frontal Assessment Battery. After 10 stimulation sessions the experimental group evidenced a significant improvement on frontal-lobe functioning when compared with the control group. As expected, no differences on general cognitive functioning were found between groups.
Intensive language-action therapy in virtual reality for a rehabilitation gaming system, K Grechuta, B Rubio, A Duff, E Duarte Oller, P Verschure, Pompeu Fabra University/Hospital del Mar i l’Esperanza, Barcelona/CREA – Institució Catalana de Recerca i Estudis Avançats, SPAIN
One third of stroke patients suffer from language disorders. These disorders severely impair individuals’ communication abilities, which impacts on their quality of life. Recently, the Intensive Language Action Therapy (ILAT) emerged as a novel paradigm for aphasia rehabilitation. ILAT is grounded in three main principles: intense practice, overcoming the learned non-use, and an individualized training. In the present study we designed and developed a VR based language rehabilitation tool by integrating ILAT’s object request LAG in RGS, a novel paradigm for the rehabilitation of motor deficits after lesions to the central nervous system. RGS is a gaming environment that provides a multimodal, task specific training in virtual reality scenarios. Its special design consists of an intelligent motion detection system that monitors the users’ movements. This allows for an active interaction as well as continuous evaluation of the affected limbs. We addressed the question whether aphasia rehabilitation designed within the VR environment of RGS can be an effective tool. The principal purpose of the initial pilot study was to validate the system and to learn whether a virtual adaptation of the ILAT into RGS can trigger positive changes in the linguistic behavior of Broca’s aphasia patients. We report the results of a double-case initial pilot study where one acute and one chronic aphasic patient followed five RGS-ILAT therapy sessions. Before and after the treatment we evaluated their language skills using the Communication Activity Log (CAL) and Western Aphasia Battery (WAB) scales. Results show that the patients learnt how to interact within the VR system. The CAL performance suggests that both patients and their therapist perceived improvements in the communication skills after the therapy. Additionally, the approval and acceptance of the system were high. Based on this initial outcome we will further provide the present RGS-ILAT with substantive technological advancements and evaluate the system to reliably replicate the original ILAT, in order to better understand the potential of the virtual reality based language rehabilitation therapies.
Arm prosthesis simulation on a virtual reality L-shaped workbench display system using a brain computer interface, G Heisenberg, Y A Rezaei, T Rothdeutsch, W Heiden, Bonn-Rhein-Sieg University of Applied Sciences/RheinMain University of Applied Sciences, GERMANY
The work being described in this paper is the result of a cooperation project between the Institute of Visual Computing at the Bonn-Rhein-Sieg University of Applied Sciences, Germany and the Laboratory of Biomedical Engineering at the Federal University of Uberlândia, Brazil. The aim of the project is the development of a virtual environment based training simulator which enables for better and faster learning the control of upper limb prostheses. The focus of the paper is the description of the technical setup since learning tutorials still need to be developed as well as a comprehensive evaluation still needs to be carried out.
A serious-gaming alternative to pen-and-paper cognitive scoring – a pilot study, G House, G Burdea, K Polistico, J Ross, M Leibick, Bright Cloud International Corp, Highland Park/Memory Enhancement Center of America, Inc., Eatontown, NJ, USA
The majority of cognitive virtual reality (VR) applications have been for therapy, not cognitive stratification/scoring. This paper describes the BrightScreener™ and its first pilot feasibility study for evaluating elderly with various degrees of cognitive impairment. BrightScreener is a portable (laptop-based) serious-gaming system which incorporates a bimanual game interface for more ecological interaction with virtual worlds. A pilot study was undertaken to determine if BrightScreener is able to differentiate levels of cognitive impairment based on game performance, as well as to evaluate the technology acceptance by the target population. 11 elderly subjects were recruited by the Clinical Coordinator at the Memory Enhancement Center of America (MECA, Eatontown, NJ) site. They had an average age of 73.6 years, and averaged 14.5 years of education. Subjects first underwent clinical scoring with the standardised Mini Mental State Exam (MMSE). During the same visit they underwent a familiarization session and then an evaluation session on the BrightScreener. At the end of their visit, each subject filled a subjective evaluation exit form. Technologists were blinded to MMSE scores. Subsequent group analysis of the Pearson correlation coefficient showed a high degree of correlation between the subjects’ MMSE scores and their Composite Game Scores (0.90, |P| < 0.01). Despite the small sample size, results suggest that serious-gaming strategies can be used as a digital technique to stratify levels of Cognitive Impairment. This may be an alternative to conventional standardised scoring for Mild Cognitive Impairment and Dementia.
Computerised help information and interaction project for people with memory loss and mild dementia, S Jawaid, R J McCrindle, University of Reading, UK
People have to perform many tasks and remember many different things during the course of their daily lives. Remembering them all is a challenge for everyone and especially so if a person has age associated memory impairment or some form of dementia. As technologies such as RFID (Radio Frequency Identification) and Near Field Communication (NFC) tags become more cheaply available and more seamlessly integrated into our lives as the Internet of Things (IoT), it makes sense to use these technologies to help people remember information or automate tasks. The CHIIP (Computerised Help Information and Interaction Project) project has created a framework that uses smartphones and sensor technologies to help people perform tasks that are relevant or specific to them quickly and efficiently within their homes or local environment.
Development of a real world simulation to study cognitive, locomotor and metabolic processes in older adults, R Kizony, G Zeilig, PL Weiss, I Baum-Cohen, Y Bahat, E Kodesh, M Bondi, I Mintz, M Kafri, Sheba Medical Center, Tel Hashomer/University of Haifa/Tel Aviv University, ISRAEL
The purpose of this paper was to demonstrate a proof of concept concerning the design and implementation of a simulation that replicates a real world environment in order to evaluate a complex task of shopping within a mall while measuring cognitive, motor and metabolic aspects of the task. The paper presents the experimental protocol and results from four young healthy and two elderly adults who performed the Multiple Errands Test in both simulated and real world settings. These initial findings show the feasibility of the protocol in both environments.
Spatial working memory performance in real museum environment vs. computer simulation: a comparison between healthy elderly and young adults, M Korman, R Kizony, M Hochhauser, T Kuflik, AJ Wecker, PL Weiss, University of Haifa/Sheba Medical Center, Tel Hashomer, ISRAEL
In recognition of the limited ecological validity of testing in a laboratory setting, we compared spatial memory performance of healthy young and older adults in a real museum setting and on a computer simulation. In the museum, participants physically moved between display stations to locate hidden tokens; an ongoing representation of previous searches had to be remembered. A comparable task was implemented via mouse actions on a computer simulation. Nine older (60-80 years) and 20 younger (20-45 years) adults performed both tasks. The younger group was superior to the older group in terms of success and time, and all participants were more efficient within the simulated task. The feasibility of using realistic tasks in a physical location to study spatial memory is discussed.
Functional improvement of hemiparetic upper limb after a virtual reality-based intervention with a tabletop system and tangible objects, R Lloréns, C Colomer, E Noé, M Ortega, M Alcañiz, Universitat Politècnica de València/Fundación Hospitales NISA/Univesity of Jaume I, SPAIN
Rehabilitation of the hemiparetic upper limb after stroke is a common challenge for neurorehabilitation units. Recent advances in behavioural neuroscience and neuroimaging techniques have provided current insights of brain plasticity mechanisms that support the functional improvement after an injury to the brain. Different interventions have provided evidence of improvement associated to cortical reorganization. Initial studies report the benefits of virtual reality interventions to recreate enriched and controlled environments that promote brain plasticity mechanisms. This paper presents a novel virtual reality-based tabletop system that focuses on the motor learning principles to promote functional improvement of the hemiparetic upper limb in chronic individuals with stroke. The system allows users to perform a set of exercises that train different movements and skills interacting with or without tangible objects. A preliminary study to determine the clinical effectiveness and acceptance of a virtual reality-based intervention is provided.
Subjective perceptions when using motion tracking systems – a comparison among healthy subjects, individuals post-stroke, and therapists, R Lloréns, A Borrego, E Parra, V Naranjo, E Noé, M Alcañiz, Universitat Politècnica de València/Fundación Hospitales NISA, Valencia/Univesity of Jaume I, SPAIN
Different tracking technologies allow users to interact with virtual reality environments. Most research regarding tracking systems has focused on studying their performance parameters, mainly accuracy. However, even though subjective parameters also determine the responses evoked by the virtual reality experience, least efforts have been made to study their influence. The subjective perceptions of healthy subjects, individuals post-stroke, and physical therapists after using three tracking technologies (optical, electromagnetic, and skeleton tracking) to interact with a virtual rehabilitation exercise were collected via questionnaire. Results showed that subjective perceptions and preferences are far from being constant among different populations, thus suggesting that these considerations, together with the performance parameters, should be taken into account when designing a rehabilitation system.
Development of a new scoring system for bilateral upper limb function and performance in children with cerebral palsy using the MIRA interactive video games and the Kinect sensor, I M Moldovan, A D Călin, A C Cantea, L A Dascălu, C A Mihaiu, O Ghircău, S Onac, O Rîză, R A Moldovan, L V Pop, Socio-medical services complex “Maria Beatrice”/ University of Medicine and Pharmacy, Cluj-Napoca/Alba-Iulia Emergency County Hospital, ROMANIA/MIRA REHAB LIMITED, London, UK
The aim of the study is to develop a reliable and valid occupational therapy scoring system for the assessment of bilateral upper limb function and performance in children with cerebral palsy (CP) using adapted MIRA (Medical Interactive Rehabilitation Assistant) interactive video games and the Kinect 360 Xbox sensor. MIRA is a software platform that uses the Kinect 360 motion sensor to interact with several video games adapted for children with cerebral palsy. 16 healthy children and 11 children diagnosed with cerebral palsy played four MIRA games that generate three performance quantifiers: distance (m), average acceleration (m/s2) and score (points). The reliability and the validity tests performed suggest that the scoring of the MIRA testing schedule is a reliable and valid occupational therapy tool for the assessment of bilateral upper limb function and performance in children with cerebral palsy.
The application of enhanced virtual environments for co-located childhood movement disorder rehabilitation, N H Mumford, J Duckworth, P H Wilson, Australian Catholic University/RMIT University, AUSTRALIA
In this paper we discuss potential benefits and future directions in virtual reality rehabilitation for co-located motor training in children with developmental movement disorders. We discuss the potential for co-located VR to promote participation using cooperative virtual environments, facilitate social learning, and quantify levels of social interaction. We pay particular attention to the capacity of co-located systems to enhance levels of participation and the psychosocial outcomes of VR therapy. Finally, we offer directions for future research.
Web accessibility by Morse Code modulated haptics for deaf-blind, L Norberg, T Westin, P Mozelius, M Wiklund, Stockholm University, SWEDEN
Providing information using a modality that is both non-visual and non-auditory such as haptic feedback, may be a viable approach regarding web accessibility for deaf-blind. Haptic navigation systems have been shown to be easy to learn (Venesvirta, 2008), and modulating navigation related information as patterns of vibrations has been shown to be perceived as natural and non-intrusive (Szymzcak, Magnusson and Rassmus-Gröhn, 2012). To minimise the bandwidth needed, a varying length encoding scheme such as Morse code may be considered. A prototype Morse code vibration modulated system for web page navigation was developed, using a standard game controller as a means of output. Results show that simulated deaf-blind test subjects using the system were able to navigate a web site successfully in three cases out of four, and that in some situations a version of the system with a higher degree of manual interaction performed better.
Assessment of convalescent brain-damaged patients using a virtual shopping test with different task difficulties, S Okahashi, H Mizumoto, A Komae, K Ueno, M Yokoyama, A Nagano, K Seki, T Futaki, Z W Luo, Kyoto University/Nishi Memorial Port Island Rehabilitation Hospital, Kobe/ Ritsumeikan University, JAPAN
We developed a Virtual Shopping Test for realistic cognitive assessment using virtual reality technology. The objective of this study was to investigate differences in task performance, brain activation, and subjective assessments in relation to the task difficulty level. Subjects were asked to buy two specific items in Task 1, four items in Task 2, and six items in Task 3 at a virtual mall. The tasks and questionnaires were conducted by convalescent brain-damaged patients and healthy adults. Hemodynamic changes in the prefrontal cortex (PFC) during activation due to the tasks were examined using functional near-infrared spectroscopy. The mean total time was longer for the patients than for the healthy subjects in all tasks. PFC responses in the patients were greater in Task 2 than in Task 1. The patients subjectively evaluated these tasks as more difficult than healthy adults. Although task performance as well as PFC responses were not significantly changed in the healthy adults, they could subjectively evaluate differences between the three task levels, whereas the patients could not, which indicated that patients could not clearly distinguish between differences in the difficulty of the tasks performed. Taken together, the results suggest that the difficulty of the 4-item shopping task may have been sufficient to cause brain activation in the brain-damaged patients.
Locating objects in virtual reality – the effect of visual properties on target acquisition in unrestrained reaching, V Powell, W A Powell, University of Portsmouth, UK
Locating objects in virtual space is not the same as locating them in physical space. The visual properties of the virtual object can affect the perception of its spatial location, and hence the ability to accurately co- locate the hand and the object. This paper presents an investigation into the effects of object geometry and proximity brightness cues on the time-to-target of a virtual reality reaching and grasping task. Time-to-target was significantly affected by object geometry, but not by brightness cues. We conclude that object geometry needs to be carefully considered for applications where accurate co-location of hand and object are important.
Detection and computational analysis of psychological signals using a virtual human interviewing agent, A A Rizzo, S Scherer, D Devault, J Gratch, R Artstein, A Hartholt, G Lucas, S Marsella, F Morbini, A Nazarian, G Stratou, D Traum, R Wood, J Boberg, L-P Morency, Institute for Creative Technologies, University of Southern California, USA
It has long been recognized that facial expressions, body gestures and vocal features/prosody play an important role in human communication signaling. Recent advances in low cost computer vision and sensing technologies can now be applied to the process of sensing such behavioral signals and from them, making meaningful inferences as to user state when a person interacts with a computational device. Effective use of this additive information could serve to enhance human interaction with virtual human (VH) agents and for improving engagement in Telehealth/Teletherapy approaches between remote patients and care providers. This paper will focus on our current research in these areas within the DARPA-funded “Detection and Computational Analysis of Psychological Signals” project, with specific attention to our SimSensei application use case. SimSensei is a virtual human platform able to sense real-time audio-visual signals from users interacting with the system. It is specifically designed for health care support and is based on years of expertise at ICT with virtual human research and development. The platform enables an engaging face-to-face interaction where the virtual human automatically reacts to the estimated user state and intent of the user through vocal parameters and gestures. Much like non-verbal behavioral signals have an impact on human to human interaction and communication, SimSensei aims to capture and infer from user’s non-verbal communication to improve engagement between a VH-human and a user. The system can also quantify sensed signals over time that could inform diagnostic assessment within a clinical context.
Design and usability evaluation of an audio-based college entrance exam for students with visual disabilities, J Sánchez, M Espinoza, M de Borba Campos, University of Chile, Santiago, CHILE/Pontifical Catholic University of Rio Grande do Sul – PUCRS, BRAZIL
The purpose of this research was to design, implement and evaluate the usability of a digital pilot system that adapts the Language and Communication subject section of the PSU (Chilean college entry exam), allowing for equal and autonomous participation by learners with visual disabilities in the college selection process. The study was carried out in two stages during the years 2010 and 2012. The pilot project was carried out in December of 2010 in three different regions of Chile, at the same time as the regular process for taking the PSU. Based on the initial results from 2010, the system was redesigned, implemented and evaluated in order to create the final version. The results for the final version of the tool designed demonstrate a high level of usability. This work provides a detailed analysis and discussion of the results obtained in 2012, as well as future directions regarding the issue at hand.
Towards a mobile exercise application to prevent falls: a participatory design process, M Sandlund, H Lindgren, P Pohl, A Melander-Wikman, B Bergvall-Kåreborn, L Lundin-Olsson, Umeå University/Luleå University of Technology, SWEDEN
In this cross-disciplinary project senior citizens and researchers participated in the collaborative design and development of a mobile exercise application to prevent falls. The methods Form-IT and Participatory and Appreciative Action and Reflection were applied in a series of workshops, facilitating the creation of new knowledge and a socio-technical platform for an end-user development process. The participation of the older adults was key to understanding the broad range of preferences and motivational aspects. The outcomes emerged into prototypes, which were composed using the ACKTUS platform for end-user development, resulting in a dynamic application, easily adaptable to future needs and studies.
Evaluating the Microsoft Kinect for use in upper extremity rehabilitation following stroke as a commercial off the shelf gaming system, L Shires, D J Brown, N Sherkat, J Lewis, P J Standen, Nottingham Trent University/University of Nottingham, UK
Motion controlled video games have been shown to have a positive effect for physical rehabilitation on the upper extremity in stroke survivors when combined with conventional physical therapy. While much research in this area has worked with bespoke systems and games, some research has been done into using commercial off the shelf gaming systems (COTS) for use in upper extremity stroke rehabilitation. As COTS systems are designed to be used in the home they offer the possibility of providing survivors with low cost systems that they can use to carry out rehabilitation at home. The Microsoft Kinect for the Xbox360 is a multimodal gaming peripheral used to drive a full body skeletal pose estimation system. This allows users to interact with games using bodily motions and gestures. Unlike other current motion controlled gaming systems the Kinect is marker-less so does not require the user to hold or wear any peripherals. A list of important joint motions and movement synergies were identified by looking at leading stroke motor function tests for the upper limb. These have been verified by working with Occupational Therapists. A study group of Occupational and Physiotherapists were asked to record their experience of playing three Kinect mini-games from the Kinect Sports title and evaluate them with respect to their motor function requirements and exertion for each identified joint motion. Quality information was also gathered relating to the perceived usability and safety issues that could arise by presenting the device to a stroke survivor. Kinect provides opportunities for gross arm movement exercise, while the requirement for highly raised arm movements will present a potential barrier for stroke users. Fine motor control movements of the hand and fingers are not tracked sufficiently for effective rehabilitation of the hand. A probable risk of falling while using the Kinect, and potential injury from overexerting the impaired limb while playing existing games were also identified. We conclude that as the experience have been designed for able bodied users the games present significant barriers for using Kinect as a COTS system for stroke rehabilitation.
Adapting a humanoid robot for use with children with profound and multiple disabilities, P J Standen, D J Brown, J Hedgecock, J Roscoe, M J Galvez Trigo, E Elgajiji, University of Nottingham/Nottingham Trent University, UK
With all the developments in IT for people with disabilities, few interventions have been designed for people with profound and multiple disabilities as there is little incentive for companies to design and manufacture technology purely for a group of consumers without much buying power. A possible solution is therefore to identify mainstream technology that, with adaptation, could serve the purposes required by those with profound and multiple disabilities. Because of its ability to engage the attention of young children with autism, the role of a humanoid robot was investigated. After viewing a demonstration, teachers of pupils with profound and multiple disabilities described actions they wished the robot to make in order to help nominated pupils to achieve learning objectives. They proposed a much wider range of suggestions for using the robot than it could currently provide. Adaptations they required fell into two groups: either increasing the methods through which the robot could be controlled or increasing the range of behaviours that the robot emitted. These were met in a variety of ways but most would require a degree of programming expertise above that possessed by most schoolteachers.
Usability assessment of natural user interfaces during serious games: adjustments for dementia intervention, V Vallejo, I Tarnanas, T Yamaguchi, T Tsukagoshi, R Yasuda, R Müri, U P Mosimann, T Nef, University of Bern/University Hospital, Bern/ University Hospital of Psychiatry, Bern, SWITZERLAND/Tokyo University of Science, JAPAN
Serious games based rehabilitation program needs a comprehensive and people-centred design for a better efficacy. In most studies benchmarking the computer-interaction interfaces is a prerequisite for adjusting the most appropriate user input for the rehabilitation application. The present study examines a comparison between three natural user interfaces and two standard computer interfaces in two different virtual reality tasks. The results illustrate that the acceptance and user-friendliness of a device regarding the completion of a specific task strongly depends on the task itself and on the abilities of the users.
Quantifying cognitive-motor interference in virtual reality training after stroke: the role of interfaces, A Vourvopoulos, A L Faria, M S Cameirão, S Bermúdez i Badia, Universidade da Madeira/Universidade de Coimbra, PORTUGAL
Globally, stroke is the second leading cause of death above the age of 60 years, with the actual number of strokes to increase because of the ageing population. Stroke results into chronic conditions, loss of independence, affecting both the families of stroke survivors but also public health systems. Virtual Reality (VR) for rehabilitation is considered a novel and effective low-cost approach to re-train motor and cognitive function through strictly defined training tasks in a safe simulated environment. However, little is known about how the choice of VR interfacing technology affects motor and cognitive performance, or what the most cost-effective rehabilitation approach for patients with different prognostics is. In this paper we assessed the effect of four different interfaces in the training of the motor and cognitive domains within a VR neurorehabilitation task. In this study we have evaluated the effect of training using 2-dimensional and 3-dimensional as well as traditional and natural user interfaces with both stroke survivors and healthy participants. Results indicate that 3-dimensional interfaces contribute towards better results in the motor domain at the cost of lower performance in the cognitive domain, suggesting the use 2-dimensional natural user interfaces as a trade-off. Our results provide useful pointers for future directions towards a cost-effective and meaningful interaction in virtual rehabilitation tasks in both motor and cognitive domains.
Analysis of arm movement strategy in virtual catching task, T Yamaguchi, N Ishiura, P Richard, D A Foloppe, F Veaux, M Dinomais, S Nguyen, Tokyo University of Science, JAPAN/Université d’Angers, FRANCE
In this paper, we explored how the arm movement pattern as well as the related strategy of the children with Cerebral Palsy (CP) and the healthy children can be changed in the virtual catching task on a previously proposed rehabilitation system. We recruited 50 healthy children from elementary school, and 3 children with CP as subjects to classify their arm movement pattern/strategy. As a result of the classification, we identified three arm movement stages: Initial position, Reaching path, and Waving form, as well as movement pattern strategy under each movement stage. Based on the classified pattern, we compared the differences in the time series changes of movement strategy between healthy children and the children with CP. The results show there is a significant difference in the strategy of arm movements in the Initial position between healthy and CP children.
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