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Nguyen CM, Uy J, Serrada I, Hordacre B. Quantifying patient experiences with therapeutic neurorehabilitation technologies: a scoping review. Disabil Rehabil 2024; 46:1662-1672. [PMID: 37132669 DOI: 10.1080/09638288.2023.2201514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/06/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Neurorehabilitation technologies are a novel approach to providing rehabilitation for patients with neurological conditions. There is a need to explore patient experiences. This study aimed; 1) To identify available questionnaires that assess patients' experiences with neurorehabilitation technologies, and 2) where reported, to document the psychometric properties of the identified questionnaires. MATERIALS AND METHODS Four databases were searched (Medline, Embase, Emcare and PsycInfo). The inclusion criteria were all types of primary data collection that included neurological patients of all ages who had experienced therapy with neurorehabilitation technologies and completed questionnaires to assess these experiences. RESULTS Eighty-eight publications were included. Fifteen different questionnaires along with many self-developed scales were identified. These were categorised as; 1) self-developed tools, 2) specific questionnaire for a particular technology, and 3) generic questionnaires originally developed for a different purpose. The questionnaires were used to assess various technologies, including virtual reality, robotics, and gaming systems. Most studies did not report any psychometric properties. CONCLUSION Many tools have been used to evaluate patient experiences, but few were specifically developed for neurorehabilitation technologies and psychometric data was limited. A preliminary recommendation would be use of the User Satisfaction Evaluation Questionnaire to evaluate patient experience with virtual reality systems.
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Affiliation(s)
- Chi Mai Nguyen
- University of South Australia, Allied Health and Human Performance, Adelaide, Australia
| | - Jeric Uy
- University of South Australia, Allied Health and Human Performance, Adelaide, Australia
| | - Ines Serrada
- University of South Australia, Allied Health and Human Performance, Adelaide, Australia
| | - Brenton Hordacre
- University of South Australia, Innovation, Implementation and Clinical Translation (IIMPACT), Health Allied Health and Human Performance, Adelaide, Australia
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2
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Gebreheat G, Goman A, Porter-Armstrong A. The use of home-based digital technology to support post-stroke upper limb rehabilitation: A scoping review. Clin Rehabil 2024; 38:60-71. [PMID: 37469176 PMCID: PMC10631286 DOI: 10.1177/02692155231189257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/05/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To identify, map and synthesize the extent and nature of existing studies on the use of home-based digital technology to support post-stroke upper limb rehabilitation. DATA SOURCES A comprehensive literature search was completed between 30 May 2022 and 05 April 2023, from seven online databases (CINAHL, Cochrane Library, PubMed, ScienceDirect, IEEExplore, Web of Science and PEDro), Google Scholar and the reference lists of already identified articles. METHODS A scoping review was conducted according to Arksey and O'Malley (2005), and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. All English-language studies reporting on the use of home-based digital technology to support upper limb post-stroke rehabilitation were eligible for inclusion. RESULTS The search generated a total of 1895 records, of which 76 articles met the inclusion criteria. Of these, 52 were experimental studies and the rest, qualitative, case series and case studies. Of the overall 2149 participants, 2028 were stroke survivors with upper limb impairment. The majority of studies were aimed at developing, designing and/or assessing the feasibility, acceptability and efficacy of a digital system for poststroke upper limb rehabilitation in home settings. The thematic analysis found six major categories: Tele-rehabilitation (n = 29), games (n = 45), virtual reality (n = 26), sensor (n = 22), mobile technology (n = 22), and robotics (n = 8). CONCLUSION The digital technologies used in post-stroke upper limb rehabilitation were multimodal, and system-based comprising telerehabilitation, gamification, virtual reality, mobile technology, sensors and robotics. Furthermore, future research should focus to determine the effectiveness of these modalities.
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Affiliation(s)
- Gdiom Gebreheat
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Adele Goman
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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Lakshminarayanan K, Shah R, Daulat SR, Moodley V, Yao Y, Ezhil SL, Ramu V, Sengupta P, Madathil D. Feasibility and usability of a virtual-reality-based sensorimotor activation apparatus for carpal tunnel syndrome patients. PLoS One 2023; 18:e0292494. [PMID: 37819927 PMCID: PMC10566719 DOI: 10.1371/journal.pone.0292494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/15/2023] [Indexed: 10/13/2023] Open
Abstract
PURPOSE This study aimed to assess the usability of a virtual reality-assisted sensorimotor activation (VRSMA) apparatus for individual digit rehabilitation. The study had two main objectives: Firstly, to collect preliminary data on the expectations and preferences of patients with carpal tunnel syndrome (CTS) regarding virtual reality (VR) and an apparatus-assisted therapy for their affected digits. Secondly, to evaluate the usability of the VRSMA apparatus that was developed. METHODS The VRSMA system consists of an apparatus that provides sensory and motor stimulation via a vibratory motor and pressure sensor attached to a button, and a virtual reality-based visual cue provided by texts overlaid on top of a 3D model of a hand. The study involved 10 CTS patients who completed five blocks of VRSMA with their affected hand, with each block corresponding to the five digits. The patients were asked to complete a user expectations questionnaire before experiencing the VRSMA, and a user evaluation questionnaire after completing the VRSMA. Expectations for VRSMA were obtained from the questionnaire results using a House of Quality (HoQ) analysis. RESULTS In the survey for expectations, participants rated certain attributes as important for a rehabilitation device for CTS, with mean ratings above 4 for attributes such as ease of use, ease of understanding, motivation, and improvement of hand function based on clinical evidence. The level of immersion and an interesting rehabilitation regime received lower ratings, with mean ratings above 3.5. The survey evaluating VRSMA showed that the current prototype was overall satisfactory with a mean rating of 3.9 out of 5. Based on the HoQ matrix, the highest priority for development of the VRSMA was to enhance device comfort and usage time. This was followed by the need to perform more clinical studies to provide evidence of the efficacy of the VRSMA. Other technical characteristics, such as VRSMA content and device reliability, had lower priority scores. CONCLUSION The current study presents a potential for an individual digit sensorimotor rehabilitation device that is well-liked by CTS patients.
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Affiliation(s)
- Kishor Lakshminarayanan
- Neuro-rehabilitation Lab, Department of Sensors and Biomedical Engineering, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Rakshit Shah
- Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, United States of America
| | - Sohail R. Daulat
- University of Arizona College of Medicine–Tucson, Tucson, AZ, United States of America
| | - Viashen Moodley
- Arizona Center for Hand to Shoulder Surgery, Phoenix, AZ, United States of America
| | - Yifei Yao
- Soft Tissue Biomechanics Laboratory, Med-X Research Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Srignana Lokesh Ezhil
- Neuro-rehabilitation Lab, Department of Sensors and Biomedical Engineering, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Vadivelan Ramu
- Neuro-rehabilitation Lab, Department of Sensors and Biomedical Engineering, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Puja Sengupta
- Neuro-rehabilitation Lab, Department of Sensors and Biomedical Engineering, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Deepa Madathil
- Jindal Institute of Behavioural Sciences, O. P. Jindal Global University, Sonipat, Haryana, India
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Vibhuti, Kumar N, Kataria C. Efficacy assessment of virtual reality therapy for neuromotor rehabilitation in home environment: a systematic review. Disabil Rehabil Assist Technol 2023; 18:1200-1220. [PMID: 34761705 DOI: 10.1080/17483107.2021.1998674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Neuromotor impairments can affect any part of the body. It leads to many disorders, injuries, or disabilities, conventional rehabilitation is a long, rigorous, and tedious process. There is a need to inculcate new and innovative techniques in rehabilitation processes, to increase individuals' interest and overall performance with such therapies. Virtual Reality is considered a new technology that has the potential to be a useful aid in overcoming therapeutic problems in clinical and home-based environments. However, providing home-based rehabilitation is more practicable, cost-effective, and even safer than in-hospital rehabilitation. In addition, the need for home-based rehabilitation is growing as the number of neuromotor disorders rises and the capacity of acute inpatient rehabilitation decreases. Therefore, the main objective of this study was to assess the efficacy of a home-based Virtual Reality exercise treatment to identify the areas for future rehabilitation research. MATERIALS AND METHODS Data Extraction of 24,257 articles from seven databases were identified and the review is narrowed down and only 45 studies were focussed on efficacy assessment of Virtual Reality in the home environment. RESULTS The significant outcome of the effective home-based therapy system for the exercise improved functional ability, increasing range of motion, and motivation through Virtual reality-based rehabilitation is inferred. CONCLUSION Unlike clinical settings, a home-based system provides efficacious therapy with a controlled environment. This survey facilitates bettering methods and devices for neuromotor disorders. It is a good living long-term problem-solving approach and investigates awareness, needs, and a preferred component of home-based rehabilitation services.IMPLICATIONS FOR REHABILITATIONVR-based rehabilitation in the home environment has many physical and mental benefits in persons with neuromotor disorders.The most commonly neuromotor disorders considered in the study were Stroke, Spinal Cord Injury, Parkinson's disease, and Cerebral Palsy.Assistive technologies in home environments can compensate for long-term disorders or be used in rehabilitation as an addition to conventional therapy.The study gives an overview of current interventions and how they can be of benefit for a person suffering from neuromotor disorders in the home environment.
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Affiliation(s)
- Vibhuti
- Academy of Scientific and Innovative Research, Ghaziabad, India
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh, India
| | - Neelesh Kumar
- Academy of Scientific and Innovative Research, Ghaziabad, India
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh, India
| | - Chitra Kataria
- Department of Rehabilitation Services, Indian Spinal Injuries Center, New Delhi, India
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Young R, Sage K, Broom D, Hext A, Snowdon N, Smith C. Evaluating the usability of a co-designed power assisted exercise graphical user interface for people with stroke. J Neuroeng Rehabil 2023; 20:95. [PMID: 37488564 PMCID: PMC10364422 DOI: 10.1186/s12984-023-01207-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 06/19/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Digital advancement of power assisted exercise equipment will advance exercise prescription for people with stroke (PwS). This article reports on the remote usability evaluation of a co-designed graphical user interface (GUI) and denotes an example of how video-conference software can increase reach to participants in the testing of rehabilitation technologies. The aim of this study was to evaluate the usability of two sequential versions of the GUI. METHODS We adopted a mixed methods approach. Ten professional user (PU) (2M/8F) and 10 expert user (EU) participants (2M/8F) were recruited. Data collection included a usability observation, a 'think aloud' walk through, task completion, task duration and user satisfaction as indicated by the Post Study System Usability Questionnaire (PSSUQ). Identification of usability issues informed the design of version 2 which included an additional submenu. Descriptive analysis was conducted upon usability issues and number of occurrences detected on both versions of the GUI. Inferential analysis enabled comparison of task duration and PSSUQ data between the PU and EU groups. RESULTS Analysis of the 'think aloud' walkthrough data enabled identification of 22 usability issues on version 1 from a total of 100 usability occurrences. Task completion for all tasks was 100%. Eight usability issues were directly addressed in the development of version 2. Two recurrent and 24 new usability issues were detected in version 2 with a total of 86 usability occurrences. Paired two tailed T-tests on task duration data indicated a significant decrease amongst the EU group for task 1.1 on version 2 (P = 0.03). The mean PSSUQ scores for version 1 was 1.44 (EU group) and 1.63 (PU group) compared with 1.40 (EU group) and 1.41 (PU group) for version 2. CONCLUSIONS The usability evaluation enabled identification of usability issues on version 1 of the GUI which were effectively addressed on the iteration of version 2. Testing of version 2 identified usability issues within the new submenu. Application of multiple usability evaluation methods was effective in identifying and addressing usability issues in the GUI to improve the experience of PAE for PwS. The use of video-conference software to conduct synchronous, remote usability testing is an effective alternative to face to face testing methods.
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Affiliation(s)
- Rachel Young
- Department of Allied Health Professions, Advanced Wellbeing Research Centre, Sheffield Hallam University, 2 Old Hall Road, Sheffield, S9 3TU UK
| | - Karen Sage
- Faculty of Health and Education, Manchester Metropolitan University, Manchester Brooks Building, 53 Bonsall Street, Manchester, M15 6GX UK
| | - David Broom
- Centre for Sport Exercise and Life Sciences, Institute of Health and Well-Being, Coventry University, Coventry, CV1 2DS UK
| | - Andrew Hext
- Sports Engineering Research Group, Advanced Wellbeing Research Centre, Sheffield Hallam University, 2 Old Hall Road, Sheffield, S9 3TU UK
| | - Nicky Snowdon
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
| | - Christine Smith
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Collegiate Crescent Campus, Sheffield, S10 2BP UK
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Abbas JR, O'Connor A, Ganapathy E, Isba R, Payton A, McGrath B, Tolley N, Bruce IA. What is Virtual Reality? A healthcare-focused systematic review of definitions. HEALTH POLICY AND TECHNOLOGY 2023. [DOI: 10.1016/j.hlpt.2023.100741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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7
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Lv L, Yang J, Gu F, Fan J, Zhu Q, Liu X. Precision and accuracy of measuring finger motion with a depth camera: a cross-sectional study of healthy participants. J Hand Surg Eur Vol 2022; 48:453-458. [PMID: 36420794 DOI: 10.1177/17531934221138924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The purpose of this cross-sectional study was to determine the precision and accuracy of the measurement of finger motion with a depth camera. Fifty-five healthy adult hands were included. Measurements were done with a depth camera and compared with traditional manual goniometer measurements. Repeated measuring showed that the overall repeatability and reproducibility of extension measured with the depth camera were within 3° and 4° and that of flexion were within 13° and 14°. Compared with traditional manual goniometry, biases of extension of all finger joints and flexion of metacarpophalangeal joints were less than 5°, and the average bias of flexion of proximal and distal interphalangeal joints was 29°. We conclude that the measurement of finger extension and flexion of the metacarpophalangeal joints with a depth camera was reliable, but improvement is required in the precision and accuracy of interphalangeal joint flexion.
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Affiliation(s)
- Lulu Lv
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jiantao Yang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Fanbin Gu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingyuan Fan
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, China
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8
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Eckert M, Aglio A, Martín-Ruiz ML, Osma-Ruiz V. A New Architecture for Customizable Exergames: User Evaluation for Different Neuromuscular Disorders. Healthcare (Basel) 2022; 10:healthcare10102115. [PMID: 36292562 PMCID: PMC9602287 DOI: 10.3390/healthcare10102115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 11/04/2022] Open
Abstract
This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to different diseases and states of disease. The game is based on motion capturing and integrates four example exercises that can be configured via our therapeutic web platform “Blexer-med”. To prove the feasibility for a wide range of different users, evaluation tests were performed on 14 patients with various types and degrees of neuromuscular disorders, classified into three groups based on strength and autonomy. The users were free to choose their schedule and frequency. The game scores and three surveys (before, during, and after the intervention) showed similar experiences for all groups, with the most vulnerable having the most fun and satisfaction. The players were motivated by the story and by achieving high scores. The average usage time was 2.5 times per week, 20 min per session. The pure exercise time was about half of the game time. The concept has proven feasible and forms a reasonable basis for further developments. The full 3D exercise needs further fine-tuning to enhance the fun and motivation.
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Affiliation(s)
- Martina Eckert
- Group on Acoustics and MultiMedia Applications (GAMMA), Centro de Investigación en Tecnologías Software y Sistemas Multimedia Para la Sostenibilidad (CITSEM), Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
- Correspondence:
| | - Alicia Aglio
- Group on Acoustics and MultiMedia Applications (GAMMA), Centro de Investigación en Tecnologías Software y Sistemas Multimedia Para la Sostenibilidad (CITSEM), Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
| | - María-Luisa Martín-Ruiz
- InnoTep Research Group, ETSIS de Telecomunicación, Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
| | - Víctor Osma-Ruiz
- Group on Acoustics and MultiMedia Applications (GAMMA), Centro de Investigación en Tecnologías Software y Sistemas Multimedia Para la Sostenibilidad (CITSEM), Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
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Lv L, Yang J, Gu F, Fan J, Zhu Q, Liu X. Validity and Reliability of a Depth Camera-Based Quantitative Measurement for Joint Motion of the Hand. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2022; 5:39-47. [PMID: 36704372 PMCID: PMC9870814 DOI: 10.1016/j.jhsg.2022.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 08/23/2022] [Indexed: 01/18/2023] Open
Abstract
Purpose Quantitative measurement of hand motion is essential in evaluating hand function. This study aimed to investigate the validity and reliability of a novel depth camera-based contactless automatic measurement system to assess hand range of motion and its potential benefits in clinical applications. Methods Five hand gestures were designed to evaluate the hand range of motion using a depth camera-based measurement system. Seventy-one volunteers were enrolled in performing the designed hand gestures. Then, the hand range of motion was measured with the depth camera and manual procedures. System validity was evaluated based on 3 dimensions: repeatability, within-laboratory precision, and reproducibility. For system reliability, linear evaluation, the intraclass correlation coefficient, paired t -test and bias were employed to test the consistency and difference between the depth camera and manual procedures. Results When measuring phalangeal length, repeatability, within-laboratory precision, and reproducibility were 2.63%, 12.87%, and 27.15%, respectively. When measuring angles of hand motion, the mean repeatability and within-laboratory precision were 1.2° and 3.3° for extension of 5 digits, 2.7° and 10.2° for flexion of 4 fingers, and 3.1° and 5.3° for abduction of 4 metacarpophalangeal joints, respectively. For system reliability, the results showed excellent consistency (intraclass correlation coefficient = 0.823; P < .05) and good linearity with the manual procedures (r = 0.909-0.982, approximately; P < .001). Besides, 78.3% of the measurements were clinically acceptable. Conclusions Our depth camera-based evaluation system provides acceptable validity and reliability in measuring hand range of motion and offers potential benefits for clinical care and research in hand surgery. However, further studies are required before clinical application. Clinical relevance This study suggests a depth camera-based contactless automatic measurement system holds promise for assessing hand range of motion in hand function evaluation, diagnosis, and rehabilitation for medical staff. However, it is currently not adequate for all clinical applications.
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Affiliation(s)
- Lulu Lv
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiantao Yang
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, Guangdong, China
| | - Fanbin Gu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jingyuan Fan
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qingtang Zhu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, Guangdong, China
| | - Xiaolin Liu
- Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Province Engineering Laboratory for Soft Tissue Biofabrication, Sun Yat-sen University, Guangzhou, Guangdong, China,Guangdong Provincial Key Laboratory for Orthopaedics and Traumatology, Guangzhou, Guangdong, China,Corresponding author: Xiaolin Liu, MD, Department of Microsurgery, Orthopaedic Trauma and Hand Surgery, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhong Shan Er Lu, Guangzhou, Guangdong 510080, China.
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10
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Zanatta F, Giardini A, Pierobon A, D'Addario M, Steca P. A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients' and healthcare professionals' perspective. BMC Health Serv Res 2022; 22:523. [PMID: 35443710 PMCID: PMC9020115 DOI: 10.1186/s12913-022-07821-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The application of virtual reality (VR) and robotic devices in neuromotor rehabilitation has provided promising evidence in terms of efficacy, so far. Usability evaluations of these technologies have been conducted extensively, but no overviews on this topic have been reported yet. METHODS A systematic review of the studies on patients' and healthcare professionals' perspective through searching of PubMed, Medline, Scopus, Web of Science, CINAHL, and PsychINFO (2000 to 2021) was conducted. Descriptive data regarding the study design, participants, technological devices, interventions, and quantitative and qualitative usability evaluations were extracted and meta-synthetized. RESULTS Sixty-eight studies were included. VR devices were perceived as having good usability and as a tool promoting patients' engagement and motivation during the treatment, as well as providing strong potential for customized rehabilitation sessions. By contrast, they suffered from the effect of learnability and were judged as potentially requiring more mental effort. Robotics implementation received positive feedback along with high satisfaction and perceived safety throughout the treatment. Robot-assisted rehabilitation was considered useful as it supported increased treatment intensity and contributed to improved patients' physical independence and psychosocial well-being. Technical and design-related issues may limit the applicability making the treatment difficult and physically straining. Moreover, cognitive and communication deficits were remarked as potential barriers. CONCLUSIONS Overall, VR and robotic devices have been perceived usable so far, reflecting good acceptance in neuromotor rehabilitation programs. The limitations raised by the participants should be considered to further improve devices applicability and maximise technological rehabilitation effectiveness. TRIAL REGISTRATION PROSPERO registration ref. CRD42021224141 .
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy.
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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11
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Seo NJ, Ramakrishnan V, Woodbury ML, Bonilha L, Finetto C, Schranz C, Scronce G, Coupland K, Blaschke J, Baker A, Howard K, Meinzer C, Velozo CA, Adams RJ. Concomitant sensory stimulation during therapy to enhance hand functional recovery post stroke. Trials 2022; 23:262. [PMID: 35382902 PMCID: PMC8981199 DOI: 10.1186/s13063-022-06241-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background Post-stroke hand impairment is prevalent and persistent even after a full course of rehabilitation. Hand diminishes stroke survivors’ abilities for activities of daily living and independence. One way to improve treatment efficacy is to augment therapy with peripheral sensory stimulation. Recently, a novel sensory stimulation, TheraBracelet, has been developed in which imperceptible vibration is applied during task practice through a wrist-worn device. The objective of this trial is to determine if combining TheraBracelet with hand task practice is superior to hand task practice alone. Methods A double-blind randomized controlled trial will be used. Chronic stroke survivors will undergo a standardized hand task practice therapy program (3 days/week for 6 weeks) while wearing a device on the paretic wrist. The device will deliver TheraBracelet vibration for the treatment group and no vibration for the control group. The primary outcome is hand function measured by the Wolf Motor Function Test. Other outcomes include the Box and Block Test, Action Research Arm Test, upper extremity use in daily living, biomechanical measure of the sensorimotor grip control, and EEG-based neural communication. Discussion This research will determine clinical utility of TheraBracelet to guide future translation. The TheraBracelet stimulation is delivered via a wrist-worn device, does not interfere with hand motion, and can be easily integrated into clinical practice. Enhancing hand function should substantially increase stroke survivors' independence and quality of life and reduce caregiver burden. Trial registration NCT04569123. Registered on September 29, 2020
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Affiliation(s)
- Na Jin Seo
- Department of Rehabilitation Sciences, Department of Health Science and Research, Medical University of South Carolina, 151B Rutledge Ave, MSC 962, Charleston, SC, 29425, USA. .,Ralph H. Johnson VA Medical Center, Charleston, SC, USA. .,Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA.
| | - Viswanathan Ramakrishnan
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St, Charleston, SC, 29425, USA
| | - Michelle L Woodbury
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 606, Charleston, SC, 29425, USA
| | - Christian Finetto
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Christian Schranz
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Gabrielle Scronce
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Kristen Coupland
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Jenna Blaschke
- Department of Rehabilitation Sciences, Department of Health Science and Research, Medical University of South Carolina, 151B Rutledge Ave, MSC 962, Charleston, SC, 29425, USA
| | - Adam Baker
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Keith Howard
- Department of Health Science and Research, Medical University of South Carolina, 77 President St, MSC 700, Charleston, SC, 29425, USA
| | - Caitlyn Meinzer
- Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon St, Charleston, SC, 29425, USA
| | - Craig A Velozo
- Department of Rehabilitation Sciences, Department of Health Science and Research, Medical University of South Carolina, 151B Rutledge Ave, MSC 962, Charleston, SC, 29425, USA
| | - Robert J Adams
- Department of Neurology, Medical University of South Carolina, 96 Jonathan Lucas St, MSC 606, Charleston, SC, 29425, USA
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12
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Kamińska D, Zwoliński G, Laska-Leśniewicz A. Usability Testing of Virtual Reality Applications-The Pilot Study. SENSORS 2022; 22:s22041342. [PMID: 35214246 PMCID: PMC8963057 DOI: 10.3390/s22041342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/16/2022]
Abstract
The need for objective data-driven usability testing of VR applications is becoming more tangible with the rapid development of numerous VR applications and their increased accessibility. Traditional methods of testing are too time and resource consuming and might provide results that are highly subjective. Thus, the aim of this article is to explore the possibility of automation of usability testing of VR applications by using objective features such as HMD built-in head and hands tracking, EEG sensor, video recording, and other measurable parameters in addition to automated analysis of subjective data provided in questionnaires. For this purpose, a simple VR application was created which comprised relatively easy tasks that did not generate stress for the users. Fourteen volunteers took part in the study and their signals were monitored to acquire objective automated data. At the same time the observer was taking notes of subjects’ behaviour, and their subjective opinions about the experience were recorded in a post-experiment questionnaire. The results acquired from signal monitoring and questionnaires were juxtaposed with observation and post-interview results to confirm the validity and efficacy of automated usability testing. The results were very promising, proving that automated usability testing of VR applications is potentially achievable.
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13
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Goyal C, Vardhan V, Naqvi W. Virtual Reality-Based Intervention for Enhancing Upper Extremity Function in Children With Hemiplegic Cerebral Palsy: A Literature Review. Cureus 2022; 14:e21693. [PMID: 35237486 PMCID: PMC8882342 DOI: 10.7759/cureus.21693] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/25/2022] Open
Abstract
Cerebral palsy (CP) is the most common cause of motor disability in the pediatric population, with hemiplegia as one of the most widely seen subtypes of spastic CP. Although most of the children with hemiplegic CP are independent ambulators, deficits in hand function of the affected side remain a major concern of caregivers and children themselves. Children use the unaffected upper extremity to compensate for the weakness in the affected one, which consequently leads to the disuse of the hemiparetic upper extremity. Interactive virtual environments can enhance the activation of brain areas during training by providing feedback that can catalyze neuroplastic changes for improved function. Although numerous studies have been conducted on the impact of virtual reality (VR)-based rehabilitation in adults with stroke, studies on its use in the pediatric population are scarce. The three broad categories of VR systems based on the type of human-computer interactions are feedback-focused, gesture-based, and haptic-based. Preliminary studies have shown promising results of VR intervention in improving motor function, including upper extremity function, in children with hemiplegic CP. It is an engaging and entertaining intervention that adds an advantage of high compliance due to motivation. The current literature consists of studies with highly heterogeneous groups of participants and small sample sizes. Further investigation on children with a specific type of CP with advanced VR systems technology is warranted.
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Affiliation(s)
- Chanan Goyal
- Pediatric Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.,Pediatric Physiotherapy, Government Physiotherapy College, Raipur, IND
| | - Vishnu Vardhan
- Cardiorespiratory Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Waqar Naqvi
- Community Physiotherapy, N.K.P. Salve Institute of Medical Sciences, Nagpur, IND
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14
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Malone LA, Davlyatov GK, Padalabalanarayanan S, Thirumalai M. Active Video Gaming Using an Adapted Gaming Mat in Youth and Adults With Physical Disabilities: Observational Study. JMIR Serious Games 2021; 9:e30672. [PMID: 34435962 PMCID: PMC8430845 DOI: 10.2196/30672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 11/23/2022] Open
Abstract
Background A common leisure-time activity amongst youth and adults in the United States is video gameplay. Playing video games is typically a sedentary endeavor; however, to encourage an increased level of physical activity in an engaging and enjoyable way, active video gaming has become popular. Unfortunately, the accessibility of gaming controllers is often an issue for persons with disabilities. A commercial off-the-shelf (OTS) gaming mat was adapted to facilitate use by individuals with mobility impairments to address this issue. Objective Our study aimed to examine energy expenditure, enjoyment, and gameplay experience in youth and adults with mobility impairment during active video gaming using an OTS and adapted versions of a gaming mat. Methods The study used an observational design. During visit 1, physical function was assessed, and participants were given a familiarization period with the gaming system. For visit 2, based on observation during the physical function tests and discussion with the participant, it was decided whether the participant would play in a standing or seated position. For standing gameplay, the mat was placed on the floor, and for seated play, the mat was placed on a height-adjustable and tilt-adjustable tabletop. Metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus gameplay, with 2 bouts on each of the mats (adapted and OTS). During gameplay, the research staff observed and rated participants’ ability to use the game controller (mat) and the quality of gameplay. At the end of each game set, participants reported their rating of perceived exertion on a scale from 0 to 10. During rest, participants completed the physical activity enjoyment scale. Participants also answered additional questions regarding the system's usability with each controller (adapted mat and OTS mat). Statistical analyses were computed using Stata 16 (version 16.1; StataCorp). Linear mixed-effects maximum likelihood regression was performed separately for individuals who could play standing and for those who played seated. Results A convenience sample of 78 individuals with mobility impairments between the ages of 12 and 60 years (mean 39.6, SD 15.8) participated in the study. Of the sample, 48 participants played the video games in a seated position, while 30 played the games standing. Energy expenditure and heart rate tended to be higher in the OTS mat condition for seated players, while values were similar for both conditions among standing players. However, seated participants reported greater gameplay experience, and both groups exhibited a higher quality of gameplay during the adapted mat condition. Conclusions Active video gaming using an adapted gaming mat provided an enjoyable exercise activity for individuals with mobility impairments. The use of the adapted controller provides a means by which this population can engage in light to moderate intensity active video gaming, thereby reducing sedentary leisure time. Trial Registration ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199
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Affiliation(s)
- Laurie A Malone
- University of Alabama at Birmingham/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ganisher K Davlyatov
- Department of Health Administration and Policy, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Sangeetha Padalabalanarayanan
- University of Alabama at Birmingham/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mohanraj Thirumalai
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, AL, United States
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15
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Saab MM, Landers M, Murphy D, O'Mahony B, Cooke E, O'Driscoll M, Hegarty J. Nursing students' views of using virtual reality in healthcare: A qualitative study. J Clin Nurs 2021; 31:1228-1242. [PMID: 34296483 DOI: 10.1111/jocn.15978] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This study explored nursing students' views of using virtual reality in healthcare. BACKGROUND The popularity and use of virtual reality in healthcare delivery and education is on the rise. Yet, the views of future nurses regarding this technology remain underexplored. DESIGN This is a qualitative descriptive study guided by a naturalistic inquiry and reported using the Standards for Reporting Qualitative Research checklist. METHODS Nursing students (n = 26) were recruited using convenience and snowball sampling. They were first exposed to a virtual reality intervention aimed to enhance men's awareness of testicular diseases. This was attempted to familiarise participants with the technology and initiate conversations around its use in healthcare. Participants were then interviewed face-to-face, either individually or within focus groups. Data were analysed using thematic analysis. RESULTS Four themes were identified: (i) positive experiences of virtual reality; (ii) challenges to using virtual reality; (iii) settings where virtual reality can be implemented; and (iv) blue-sky and future applications of virtual reality. Participants described this technology as novel, enjoyable, immersive, memorable and inclusive. They questioned, however, the suitability of virtual reality for older adults, reported minor technical difficulties and stressed the importance of prior preparation in the use of the technology. Virtual reality was recommended for use in outpatient healthcare settings, schools and the community. Participants suggested using virtual reality in health promotion, disease prevention and management, and to promote nurses' empathy towards patients. CONCLUSIONS Findings highlight the potential role of virtual reality in assisting nurses in promoting health and managing disease. Future research is needed to establish the long-term effect of virtual reality interventions among more diverse participants. RELEVANCE TO CLINICAL PRACTICE Virtual reality can be implemented in outpatient, educational and community settings in order to promote health, prevent disease, enhance disease and self-management, and increase nurses' empathy towards patients.
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Affiliation(s)
- Mohamad M Saab
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - Margaret Landers
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - David Murphy
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Billy O'Mahony
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.,School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Eoghan Cooke
- School of Computer Science and Information Technology, University College Cork, Cork, Ireland
| | - Michelle O'Driscoll
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.,School of Pharmacy, University College Cork, Cork, Ireland
| | - Josephine Hegarty
- Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland
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16
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Monardo G, Pavese C, Giorgi I, Godi M, Colombo R. Evaluation of Patient Motivation and Satisfaction During Technology-Assisted Rehabilitation: An Experiential Review. Games Health J 2021; 10:13-27. [DOI: 10.1089/g4h.2020.0024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Giulia Monardo
- Service of Psychology and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Chiara Pavese
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ines Giorgi
- Service of Psychology and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Marco Godi
- Division of Physical Medicine and Rehabilitation and Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
| | - Roberto Colombo
- Service of Bioengineering, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
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17
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Klaic M, Galea MP. Using the Technology Acceptance Model to Identify Factors That Predict Likelihood to Adopt Tele-Neurorehabilitation. Front Neurol 2020; 11:580832. [PMID: 33343488 PMCID: PMC7738474 DOI: 10.3389/fneur.2020.580832] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022] Open
Abstract
Tele-neurorehabilitation has the potential to reduce accessibility barriers and enhance patient outcomes through a more seamless continuum of care. A growing number of studies have found that tele-neurorehabilitation produces equivalent results to usual care for a variety of outcomes including activities of daily living and health related quality of life. Despite the potential of tele-neurorehabilitation, this model of care has failed to achieve mainstream adoption. Little is known about feasibility and acceptability of tele-neurorehabilitation and most published studies do not use a validated model to guide and evaluate implementation. The technology acceptance model (TAM) was developed 20 years ago and is one of the most widely used theoretical frameworks for predicting an individual's likelihood to adopt and use new technology. The TAM3 further built on the original model by incorporating additional elements from human decision making such as computer anxiety. In this perspective, we utilize the TAM3 to systematically map the findings from existing published studies, in order to explore the determinants of adoption of tele-neurorehabilitation by both stroke survivors and prescribing clinicians. We present evidence suggesting that computer self-efficacy and computer anxiety are significant predictors of an individual's likelihood to use tele-neurorehabilitation. Understanding what factors support or hinder uptake of tele-neurorehabilitation can assist in translatability and sustainable adoption of this technology. If we are to shift tele-neurorehabilitation from the research domain to become a mainstream health sector activity, key stakeholders must address the barriers that have consistently hindered adoption.
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Affiliation(s)
- Marlena Klaic
- Allied Health Department, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Mary P Galea
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
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18
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Signal NEJ, McLaren R, Rashid U, Vandal A, King M, Almesfer F, Henderson J, Taylor D. Haptic Nudges Increase Affected Upper Limb Movement During Inpatient Stroke Rehabilitation: Multiple-Period Randomized Crossover Study. JMIR Mhealth Uhealth 2020; 8:e17036. [PMID: 32723718 PMCID: PMC7424469 DOI: 10.2196/17036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/15/2020] [Accepted: 05/13/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND As many as 80% of stroke survivors experience upper limb (UL) disability. The strong relationships between disability, lost productivity, and ongoing health care costs mean reducing disability after stroke is critical at both individual and society levels. Unfortunately, the amount of UL-focused rehabilitation received by people with stroke is extremely low. Activity monitoring and promotion using wearable devices offer a potential technology-based solution to address this gap. Commonly, wearable devices are used to deliver a haptic nudge to the wearer with the aim of promoting a particular behavior. However, little is known about the effectiveness of haptic nudging in promoting behaviors in patient populations. OBJECTIVE This study aimed to estimate the effect of haptic nudging delivered via a wrist-worn wearable device on UL movement in people with UL disability following stroke undertaking inpatient rehabilitation. METHODS A multiple-period randomized crossover design was used to measure the association of UL movement with the occurrence of haptic nudge reminders to move the affected UL in 20 people with stroke undertaking inpatient rehabilitation. UL movement was observed and classified using movement taxonomy across 72 one-minute observation periods from 7:00 AM to 7:00 PM on a single weekday. On 36 occasions, a haptic nudge to move the affected UL was provided just before the observation period. On the other 36 occasions, no haptic nudge was given. The timing of the haptic nudge was randomized across the observation period for each participant. Statistical analysis was performed using mixed logistic regression. The effect of a haptic nudge was evaluated from the intention-to-treat dataset as the ratio of the odds of affected UL movement during the observation period following a "Planned Nudge" to the odds of affected limb movement during the observation period following "No Nudge." RESULTS The primary intention-to-treat analysis showed the odds ratio (OR) of affected UL movement following a haptic nudge was 1.44 (95% CI 1.28-1.63, P<.001). The secondary analysis revealed an increased odds of affected UL movement following a Planned Nudge was predominantly due to increased odds of spontaneous affected UL movement (OR 2.03, 95% CI 1.65-2.51, P<.001) rather than affected UL movement in conjunction with unaffected UL movement (OR 1.13, 95% CI 0.99-1.29, P=.07). CONCLUSIONS Haptic nudging delivered via a wrist-worn wearable device increases affected UL movement in people with UL disability following stroke undertaking inpatient rehabilitation. The promoted movement appears to be specific to the instructions given. TRIAL REGISTRATION Australia New Zealand Clinical Trials Registry 12616000654459; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370687&isReview=true.
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Affiliation(s)
| | - Ruth McLaren
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Usman Rashid
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Alain Vandal
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Marcus King
- Callaghan Innovation, Christchurch, New Zealand
| | | | - Jeanette Henderson
- Assessment, Treatment and Rehabilitation Department, Waitakere Hospital, Waitemata District Health Board, Auckland, New Zealand
| | - Denise Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
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19
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Lehmann I, Baer G, Schuster-Amft C. Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study. Physiotherapy 2020; 107:317-326. [DOI: 10.1016/j.physio.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/10/2017] [Indexed: 10/20/2022]
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20
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Seo NJ, Crocher V, Spaho E, Ewert CR, Fathi MF, Hur P, Lum SA, Humanitzki EM, Kelly AL, Ramakrishnan V, Woodbury ML. Capturing Upper Limb Gross Motor Categories Using the Kinect® Sensor. Am J Occup Ther 2019; 73:7304205090p1-7304205090p10. [PMID: 31318673 DOI: 10.5014/ajot.2019.031682] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Along with growth in telerehabilitation, a concurrent need has arisen for standardized methods of tele-evaluation. OBJECTIVE To examine the feasibility of using the Kinect sensor in an objective, computerized clinical assessment of upper limb motor categories. DESIGN We developed a computerized Mallet classification using the Kinect sensor. Accuracy of computer scoring was assessed on the basis of reference scores determined collaboratively by multiple evaluators from reviewing video recording of movements. In addition, using the reference score, we assessed the accuracy of the typical clinical procedure in which scores were determined immediately on the basis of visual observation. The accuracy of the computer scores was compared with that of the typical clinical procedure. SETTING Research laboratory. PARTICIPANTS Seven patients with stroke and 10 healthy adult participants. Healthy participants intentionally achieved predetermined scores. OUTCOMES AND MEASURES Accuracy of the computer scores in comparison with accuracy of the typical clinical procedure (immediate visual assessment). RESULTS The computerized assessment placed participants' upper limb movements in motor categories as accurately as did typical clinical procedures. CONCLUSIONS AND RELEVANCE Computerized clinical assessment using the Kinect sensor promises to facilitate tele-evaluation and complement telehealth applications. WHAT THIS ARTICLE ADDS Computerized clinical assessment can enable patients to conduct evaluations remotely in their homes without therapists present.
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Affiliation(s)
- Na Jin Seo
- Na Jin Seo, PhD, is Associate Professor, Division of Occupational Therapy, Department of Health Professions, and Associate Professor, Department of Health Science and Research, Medical University of South Carolina, Charleston;
| | - Vincent Crocher
- Vincent Crocher, PhD, is Research Associate, School of Engineering, University of Melbourne, Parkville, Victoria, Australia. At the time of the study, he was Postdoctoral Researcher, Department of Industrial and Manufacturing Engineering, University of Wisconsin-Milwaukee
| | - Egli Spaho
- Egli Spaho, DPT, is Physical Therapist, Ascension All Saints Hospital, Racine, Wisconsin. At the time of the study, he was Research Assistant, Department of Kinesiology, University of Wisconsin-Milwaukee
| | - Charles R Ewert
- Charles R. Ewert, BS, is Associate Software Engineer, Northwestern Mutual, Milwaukee, Wisconsin. At the time of the study, he was Research Assistant, Department of Computer Science, University of Wisconsin-Milwaukee
| | - Mojtaba F Fathi
- Mojtaba F. Fathi, PhD, is Research Associate, Department of Mechanical Engineering, University of Wisconsin-Milwaukee
| | - Pilwon Hur
- Pilwon Hur, PhD, is Assistant Professor, Department of Mechanical Engineering, Texas A&M University, College Station
| | - Sara A Lum
- Sara A. Lum, MS, OTR/L, is Occupational Therapist, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina. At the time of the study, she was Student, Division of Occupational Therapy, Department of Health Professions, Medical University of South Carolina, Charleston
| | - Elizabeth M Humanitzki
- Elizabeth M. Humanitzki, MS, OTR/L, is Occupational Therapist, Coastal Therapy Services Inc., Charleston, South Carolina. At the time of the study, she was Student, Division of Occupational Therapy, Department of Health Professions, Medical University of South Carolina, Charleston
| | - Abigail L Kelly
- Abigail L. Kelly, MS, is Instructor, Department of Stomatology, Medical University of South Carolina, Charleston. At the time of the study, she was Research Associate, Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Viswanathan Ramakrishnan
- Viswanathan Ramakrishnan, PhD, is Professor, Department of Public Health Sciences, Medical University of South Carolina, Charleston
| | - Michelle L Woodbury
- Michelle L. Woodbury, PhD, OTR/L, is Associate Professor, Division of Occupational Therapy, Department of Health Professions, and Associate Professor, Department of Health Science and Research, Medical University of South Carolina, Charleston
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21
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Malone LA, Thirumalai M, Padalabalanarayanan S, Neal WN, Bowman S, Mehta T. Energy Expenditure and Enjoyment During Active Video Gaming Using an Adapted Wii Fit Balance Board in Adults with Physical Disabilities: Observational Study. JMIR Serious Games 2019; 7:e11326. [PMID: 30707098 PMCID: PMC6376329 DOI: 10.2196/11326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 12/10/2018] [Accepted: 12/30/2018] [Indexed: 01/18/2023] Open
Abstract
Background Individuals with physical disabilities have fewer opportunities to participate in enjoyable physical activity. One option for increasing physical activity is playing active video games (AVGs); however, many AVGs are inaccessible or offer limited play options. Objective This study aimed to examine energy expenditure and enjoyment in adults with mobility impairment during AVG play using off-the-shelf (OTS) and adapted versions of the Wii Fit balance board (Nintendo). Methods During visit 1, participants completed a functional assessment and the familiarization period. During visit 2, metabolic data were collected during a 20-minute baseline and four 10-minute bouts of Wii Fit Plus game play, with two bouts on each of the boards. During the resting period, participants completed the Physical Activity Enjoyment Scale (PACES). Statistical analyses were computed using SPSS software. Data were analyzed separately for individuals who were able to play while standing on both boards (StdStd); those who could not play while standing on the OTS board, but were able to play while standing on the adapted board (aStd); and those who could only play while sitting on the adapted board (aSit). Results Data were collected for 58 participants (StdStd, n=17; aStd, n=10; aSit, n=31). The sample included 31 men and 27 women with a mean age of 41.21 (SD 12.70) years. Energy expenditure (metabolic equivalent [MET]) during game play was significantly greater than that during rest for all players. Only 17 participants (StdStd group) were able to play using the OTS board. During game play on the adapted board, the average MET values for the two game sets were 2.261 (SD 0.718) kcal/kg/hour and 2.233 (SD 0.751) kcal/kg/hour for the aSit group, 3.151 (SD 1.034) and 2.990 (SD 1.121) for the aStd group, and 2.732 (SD 0.655) and 2.777 (SD 0.803) for the StdStd group. For game play on the adapted board, self-reported ratings of perceived exertion on a 0-10 scale suggested greater exercise intensity levels, with median scores ranging from moderate (3) to very hard (7). The PACES scores indicated that all players enjoyed using the adapted board, with a median score of 4 on a 5-point scale. Conclusions The adapted Wii Fit balance board provided an opportunity for individuals with mobility impairments, including wheelchair users, to engage in AVG. All participants were able to utilize the adapted controller and enjoyed the AVG activity. Although the average MET values achieved during AVG represented light-intensity exercise (<3 METs), 16% of sitting participants and 41% of standing participants achieved moderate-intensity exercise (3-6 METs) in at least one of the games. Factors not accounted for, which may have influenced the intensity of exercise, include game selection, limited familiarization period, and discomfort wearing the COSMED portable metabolic system for measurement of oxygen consumption. Accessible AVG controllers offer an innovative approach to overcome various barriers to participation in physical activity. The next steps include assessment of an AVG intervention using an adapted board gaming controller on health and fitness outcomes. Trial Registration ClinicalTrials.gov NCT02994199; https://clinicaltrials.gov/ct2/show/NCT02994199 (Archived by Webcite at http://www.webcitation.org/75fc0mN39).
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Affiliation(s)
- Laurie A Malone
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
| | - Mohanraj Thirumalai
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
| | | | - Whitney N Neal
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
| | - Sean Bowman
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
| | - Tapan Mehta
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, Birmingham, AL, United States
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22
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Wiederhold MD, Crisci M, Patel V, Nonaka M, Wiederhold BK. Physiological Monitoring During Augmented Reality Exercise Confirms Advantages to Health and Well-Being. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 22:122-126. [DOI: 10.1089/cyber.2018.0027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Megan Crisci
- Interactive Media Institute, San Diego, California
| | | | - Makoto Nonaka
- La Jolla Institute for Allergy and Immunology, La Jolla, California
| | - Brenda K. Wiederhold
- Virtual Reality Medical Center, San Diego, California
- Interactive Media Institute, San Diego, California
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23
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Cannell J, Jovic E, Rathjen A, Lane K, Tyson AM, Callisaya ML, Smith ST, Ahuja KDK, Bird ML. The efficacy of interactive, motion capture-based rehabilitation on functional outcomes in an inpatient stroke population: a randomized controlled trial. Clin Rehabil 2018; 32:191-200. [PMID: 28719977 PMCID: PMC5777543 DOI: 10.1177/0269215517720790] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 06/24/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To compare the efficacy of novel interactive, motion capture-rehabilitation software to usual care stroke rehabilitation on physical function. DESIGN Randomized controlled clinical trial. SETTING Two subacute hospital rehabilitation units in Australia. PARTICIPANTS In all, 73 people less than six months after stroke with reduced mobility and clinician determined capacity to improve. INTERVENTIONS Both groups received functional retraining and individualized programs for up to an hour, on weekdays for 8-40 sessions (dose matched). For the intervention group, this individualized program used motivating virtual reality rehabilitation and novel gesture controlled interactive motion capture software. For usual care, the individualized program was delivered in a group class on one unit and by rehabilitation assistant 1:1 on the other. MAIN MEASURES Primary outcome was standing balance (functional reach). Secondary outcomes were lateral reach, step test, sitting balance, arm function, and walking. RESULTS Participants (mean 22 days post-stroke) attended mean 14 sessions. Both groups improved (mean (95% confidence interval)) on primary outcome functional reach (usual care 3.3 (0.6 to 5.9), intervention 4.1 (-3.0 to 5.0) cm) with no difference between groups ( P = 0.69) on this or any secondary measures. No differences between the rehabilitation units were seen except in lateral reach (less affected side) ( P = 0.04). No adverse events were recorded during therapy. CONCLUSION Interactive, motion capture rehabilitation for inpatients post stroke produced functional improvements that were similar to those achieved by usual care stroke rehabilitation, safely delivered by either a physical therapist or a rehabilitation assistant.
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Affiliation(s)
- John Cannell
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Health Service, Hobart, TAS, Australia
| | - Emelyn Jovic
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Health Service, Hobart, TAS, Australia
| | - Amy Rathjen
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Health Service, Hobart, TAS, Australia
| | - Kylie Lane
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Health Service, Hobart, TAS, Australia
| | - Anna M Tyson
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
- Tasmanian Health Service, Hobart, TAS, Australia
| | - Michele L Callisaya
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | - Kiran DK Ahuja
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
| | - Marie-Louise Bird
- Faculty of Health, University of Tasmania, Hobart, TAS, Australia
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
- GF Strong Research Rehabilitation Laboratory, Vancouver, BC, Canada
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Tobler-Ammann BC, Surer E, Knols RH, Borghese NA, de Bruin ED. User Perspectives on Exergames Designed to Explore the Hemineglected Space for Stroke Patients With Visuospatial Neglect: Usability Study. JMIR Serious Games 2017; 5:e18. [PMID: 28842390 PMCID: PMC5591406 DOI: 10.2196/games.8013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/12/2017] [Accepted: 07/27/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Visuospatial neglect due to stroke is characterized by the inability to perceive stimuli emerging in the area opposite to the side of brain damage. Besides adopting conventional rehabilitation methods to treat neglect symptoms, the use of virtual reality (VR) is becoming increasingly popular. We designed a series of 9 exergames aimed to improve exploration of the neglected side of space. When new VR interventions are designed, it is important to assess the usability aspects of such management strategies within the target population. To date, most studies used questionnaires to assess user satisfaction with the intervention or product being tested. However, only a combination of both quantitative and qualitative data allows a full picture of user perspective. OBJECTIVE The purpose of this study was to quantitatively and qualitatively assess patient and therapist perspectives of a VR intervention based on the series of 9 exergames designed to explore hemineglected space. Specifically, we wanted to evaluate (1) perceived-user friendliness of the exergames, (2) attitude towards using the exergames, and (3) intention to use the exergames in the future. METHODS A total of 19 participants (7 patients, 12 therapists) evaluated the exergames they had used 5 times a week during 3 weeks. The Technology Acceptance Model (TAM) questionnaire was filled out after the intervention. Based on those responses, we conducted focus group interviews (with therapists) and individual interviews (with patients). To analyze the TAM questionnaires, we used descriptive statistics. We adopted content and comparative analysis to analyze the interviews and drew illustration maps to analyze the focus group interviews. RESULTS The therapists took a more critical stance with a mean TAM questionnaire total score of 48.6 (SD 4.5) compared to the patients who had a mean total score of 56.1 (SD 12.3). The perceived user-friendliness score was 5.6 (SD 1.4) for patients and 4.9 (SD 1.4) for therapists. The attitude towards using the exergames was rated 4.8 (SD 1.9) by patients and 3.6 (SD 1.4) by therapists, respectively. The intention to use the exergames in the future was rated 3.9 (SD 2.1) by patients and 3.7 (SD 1.8) by therapists. We gained information on how to improve the exergames in the interviews. CONCLUSIONS Patients and therapists perceived the exergames as user-friendly; however, using the games further with the actual test version was not perceived as conceivable. The therapists were generally more critical towards future use than the patients. Therefore, involving both users to achieve acceptable and user-friendly versions of game-based rehabilitation for the future is deemed crucial and warranted. TRIAL REGISTRATION Clinicaltrials.gov NCT02353962; https://clinicaltrials.gov/ct2/show/NCT02353962 (Archived by WebCite at http://www.webcitation.org/6soxIJlAZ).
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Affiliation(s)
- Bernadette C Tobler-Ammann
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland.,Care and Public Health Research Institute [CAPHRI], Maastricht University, Maastricht, Netherlands
| | - Elif Surer
- Graduate School of Informatics, Department of Modeling and Simulation, Middle East Technical University, Ankara, Turkey.,Applied Intelligent Systems Laboratory, Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Ruud H Knols
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
| | - N Alberto Borghese
- Applied Intelligent Systems Laboratory, Department of Computer Science, Università degli Studi di Milano, Milan, Italy
| | - Eling D de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
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New Approaches to Exciting Exergame-Experiences for People with Motor Function Impairments. SENSORS 2017; 17:s17020354. [PMID: 28208682 PMCID: PMC5336067 DOI: 10.3390/s17020354] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/18/2017] [Accepted: 02/09/2017] [Indexed: 12/02/2022]
Abstract
The work presented here suggests new ways to tackle exergames for physical rehabilitation and to improve the players’ immersion and involvement. The primary (but not exclusive) purpose is to increase the motivation of children and adolescents with severe physical impairments, for doing their required exercises while playing. The proposed gaming environment is based on the Kinect sensor and the Blender Game Engine. A middleware has been implemented that efficiently transmits the data from the sensor to the game. Inside the game, different newly proposed mechanisms have been developed to distinguish pure exercise-gestures from other movements used to control the game (e.g., opening a menu). The main contribution is the amplification of weak movements, which allows the physically impaired to have similar gaming experiences as the average population. To test the feasibility of the proposed methods, four mini-games were implemented and tested by a group of 11 volunteers with different disabilities, most of them bound to a wheelchair. Their performance has also been compared to that of a healthy control group. Results are generally positive and motivating, although there is much to do to improve the functionalities. There is a major demand for applications that help to include disabled people in society and to improve their life conditions. This work will contribute towards providing them with more fun during exercise.
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Seo NJ, Fathi MF, Hur P, Crocher V. Modifying Kinect placement to improve upper limb joint angle measurement accuracy. J Hand Ther 2016; 29:465-473. [PMID: 27769844 PMCID: PMC6701865 DOI: 10.1016/j.jht.2016.06.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 06/02/2016] [Accepted: 06/19/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Repeated measures. INTRODUCTION The Kinect (Microsoft, Redmond, WA) is widely used for telerehabilitation applications including rehabilitation games and assessment. PURPOSE OF THE STUDY To determine effects of the Kinect location relative to a person on measurement accuracy of upper limb joint angles. METHODS Kinect error was computed as difference in the upper limb joint range of motion (ROM) during target reaching motion, from the Kinect vs 3D Investigator Motion Capture System (NDI, Waterloo, Ontario, Canada), and compared across 9 Kinect locations. RESULTS The ROM error was the least when the Kinect was elevated 45° in front of the subject, tilted toward the subject. This error was 54% less than the conventional location in front of a person without elevation and tilting. The ROM error was the largest when the Kinect was located 60° contralateral to the moving arm, at the shoulder height, facing the subject. The ROM error was the least for the shoulder elevation and largest for the wrist angle. DISCUSSION Accuracy of the Kinect sensor for detecting upper limb joint ROM depends on its location relative to a person. CONCLUSION This information facilitates implementation of Kinect-based upper limb rehabilitation applications with adequate accuracy. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
- Na Jin Seo
- Division of Occupational Therapy, Department of Health Professions, Medical University of South Carolina, Charleston, SC, USA; Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, USA.
| | - Mojtaba F Fathi
- Department of Mechanical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Pilwon Hur
- Department of Mechanical Engineering, Texas A&M University, College Station, TX, USA
| | - Vincent Crocher
- The Melbourne School of Engineering, The University of Melbourne, Melbourne, Victoria, Australia
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27
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Lakshminarayanan K, Wang F, Webster JG, Seo NJ. Feasibility and usability of a wearable orthotic for stroke survivors with hand impairment. Disabil Rehabil Assist Technol 2016; 12:175-183. [PMID: 26735630 DOI: 10.3109/17483107.2015.1111945] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The concept of a vibrating wristband, to improve dextrous hand function of stroke survivors, was recently proposed with clinical results and is referred to as 'TheraBracelet' in this paper. The purpose of this study was to demonstrate feasibility of a portable, wearable TheraBracelet, and to apply usability evaluation techniques to assess potential demands of TheraBracelet and to identify critical improvement needs of the prototype. METHOD A prototype was developed with a vibrating element housed in an elastic wristband and connected to a wearable electronics box via a cable. Expectation for TheraBracelet and evaluation of the prototype were obtained from 10 chronic stroke survivors using surveys before and after using the prototype and House of Quality analysis. RESULTS The survey for expectation showed stroke survivors' willingness to try out TheraBracelet at a low cost. The survey evaluating the prototype showed that the current prototype was overall satisfactory with a mean rating of 3.7 out of 5. The House of Quality analysis revealed that the priority improvement needs for the prototype are to improve clinical knowledge on long-term effectiveness, reduce cost, ease donning/doffing and waterproof. CONCLUSIONS This study presents a potential for a low-cost wearable hand orthotic likable by stroke survivors. Implications for Rehabilitation Feasibility for a portable wearable wristband-type hand orthotic was demonstrated. The survey showed stroke survivors are willing to try such an orthotic at low cost. The current prototype was rated overall satisfactory by stroke survivors. This study provides a potential for a low-cost wearable hand orthotic likable by stroke survivors.
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Affiliation(s)
- Kishor Lakshminarayanan
- a Department of Industrial and Manufacturing Engineering , University of Wisconsin-Milwaukee , Milwaukee , WI , USA
| | - Fa Wang
- b Department of Biomedical Engineering , University of Wisconsin-Madison , Madison , WI , USA
| | - John G Webster
- b Department of Biomedical Engineering , University of Wisconsin-Madison , Madison , WI , USA
| | - Na Jin Seo
- c Division of Occupational Therapy, Department of Health Professions, Department of Health Sciences and Research , Medical University of South Carolina , Charleston , SC , USA
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