1
|
Kim YM, Rhiu I. Development of a virtual reality system usability questionnaire (VRSUQ). APPLIED ERGONOMICS 2024; 119:104319. [PMID: 38797014 DOI: 10.1016/j.apergo.2024.104319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 05/01/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024]
Abstract
Virtual reality (VR) has gained significant attention as a technology that provides immersive experiences similar to the real world. In order for a VR system to be accepted, usability needs to be guaranteed. Accordingly, VR-related researchers are continuing their efforts to improve VR systems by conducting usability evaluations. However, existing studies have limitations in that they cannot comprehensively evaluate the detailed properties of VR systems by using questionnaires developed for general product usability evaluation or focusing only on some usability aspects of VR systems. This suggests it may be difficult to fully capture usability issues in a VR system, and that it is necessary to develop a usability evaluation tool that reflects the specific characteristics of the VR system. Therefore, this study develops and proposes the Virtual Reality System Usability Questionnaire (VRSUQ). In the development of the questionnaire, items were structured based on a literature review and discussions with experts. To account for the diverse characteristics of VR systems, the validity of the questionnaire was verified through both exploratory and confirmatory factor analysis, utilizing data obtained from three distinct experimental studies that employed different VR systems. In addition, by comparing the results of VRSUQ with the results from the System Usability Scale, which is widely used for perceived usability evaluation, alternative possibilities for using VRSUQ are presented. Further testing on various VR platforms is needed to ensure the reliability and validity of VRSUQ, and as results from using VRSUQ are accumulated, it is expected to be widely used as a more powerful and robust VR-specific perceived usability evaluation tool.
Collapse
Affiliation(s)
- Yong Min Kim
- Division of Interdisciplinary Studies in Cultural Intelligence (HCI Science Major), Dongduk Women's University, Seoul, South Korea.
| | - Ilsun Rhiu
- Division of Interdisciplinary Studies in Cultural Intelligence (HCI Science Major), Dongduk Women's University, Seoul, South Korea.
| |
Collapse
|
2
|
Birrenbach T, Stuber R, Müller CE, Sutter PM, Hautz WE, Exadaktylos AK, Müller M, Wespi R, Sauter TC. Virtual reality simulation to enhance advanced trauma life support trainings - a randomized controlled trial. BMC MEDICAL EDUCATION 2024; 24:666. [PMID: 38886688 PMCID: PMC11184689 DOI: 10.1186/s12909-024-05645-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND Advanced Trauma Life Support (ATLS) is the gold standard of initial assessment of trauma patients and therefore a widely used training program for medical professionals. Practical application of the knowledge taught can be challenging for medical students and inexperienced clinicians. Simulation-based training, including virtual reality (VR), has proven to be a valuable adjunct to real-world experiences in trauma education. Previous studies have demonstrated the effectiveness of VR simulations for surgical and technical skills training. However, there is limited evidence on VR simulation training specifically for trauma education, particularly within the ATLS curriculum. The purpose of this pilot study is to evaluate the feasibility, effectiveness, and acceptance of using a fully immersive VR trauma simulation to prepare medical students for the ATLS course. METHODS This was a prospective randomised controlled pilot study on a convenience sample of advanced medical students (n = 56; intervention group with adjunct training using a commercially available semi-automated trauma VR simulation, n = 28, vs control group, n = 28) taking part in the ATLS course of the Military Physician Officer School. Feasibility was assessed by evaluating factors related to technical factors of the VR training (e.g. rate of interruptions and premature termination). Objective and subjective effectiveness was assessed using confidence ratings at four pre-specified points in the curriculum, validated surveys, clinical scenario scores, multiple choice knowledge tests, and ATLS final clinical scenario and course pass rates. Acceptance was measured using validated instruments to assess variables of media use (Technology acceptance, usability, presence and immersion, workload, and user satisfaction). RESULTS The feasibility assessment demonstrated that only one premature termination occurred and that all remaining participants in the intervention group correctly stabilised the patient. No significant differences between the two groups in terms of objective effectiveness were observed (p = 0.832 and p = 0.237 for the pretest and final knowledge test, respectively; p = 0.485 for the pass rates for the final clinical scenario on the first attempt; all participants passed the ATLS course). In terms of subjective effectiveness, the authors found significantly improved confidence post-VR intervention (p < .001) in providing emergency care using the ATLS principles. Perceived usefulness in the TEI was stated with a mean of 4 (SD 0.8; range 0-5). Overall acceptance and usability of the VR simulation was rated as positive (System Usability Scale total score mean 79.4 (SD 11.3, range 0-100). CONCLUSIONS The findings of this prospective pilot study indicate the potential of using VR trauma simulations as a feasible and acceptable supplementary tool for the ATLS training course. Where objective effectiveness regarding test and scenario scores remained unchanged, subjective effectiveness demonstrated improvement. Future research should focus on identifying specific scenarios and domains where VR can outperform or enhance traditional learning methods in trauma simulation.
Collapse
Affiliation(s)
- Tanja Birrenbach
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010.
| | - Raphael Stuber
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010
| | | | | | - Wolf E Hautz
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010
| | - Aristomenis K Exadaktylos
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010
| | - Rafael Wespi
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Thomas Christian Sauter
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland, Freiburgstrasse 16C, CH-3010
| |
Collapse
|
3
|
Molins F, Gil-Gómez JA, Serrano MÁ, Mesa-Gresa P. An ecological assessment of decision-making under risk and ambiguity through the virtual serious game Kalliste Decision Task. Sci Rep 2024; 14:13144. [PMID: 38849446 PMCID: PMC11161587 DOI: 10.1038/s41598-024-63752-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/31/2024] [Indexed: 06/09/2024] Open
Abstract
Traditional methods for evaluating decision-making provide valuable insights yet may fall short in capturing the complexity of this cognitive capacity, often providing insufficient for the multifaceted nature of decisions. The Kalliste Decision Task (KDT) is introduced as a comprehensive, ecologically valid tool aimed at bridging this gap, offering a holistic perspective on decision-making. In our study, 81 participants completed KDT alongside established tasks and questionnaires, including the Mixed Gamble Task (MGT), Iowa Gambling Task (IGT), and Stimulating & Instrumental Risk Questionnaire (S&IRQ). They also completed the User Satisfaction Evaluation Questionnaire (USEQ). The results showed excellent usability, with high USEQ scores, highlighting the user-friendliness of KDT. Importantly, KDT outcomes showed significant correlations with classical decision-making variables, shedding light on participants' risk attitudes (S&IRQ), rule-based decision-making (MGT), and performance in ambiguous contexts (IGT). Moreover, hierarchical clustering analysis of KDT scores categorized participants into three distinct profiles, revealing significant differences between them on classical measures. The findings highlight KDT as a valuable tool for assessing decision-making, addressing limitations of traditional methods, and offering a comprehensive, ecologically valid approach that aligns with the complexity and heterogeneity of real-world decision-making, advancing research and providing insights for understanding and assessing decision-making across multiple domains.
Collapse
Affiliation(s)
- Francisco Molins
- Department of Psychobiology, Universitat de València, Av. Blasco Ibáñez, 13, 46010, Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
| | - Miguel Ángel Serrano
- Department of Psychobiology, Universitat de València, Av. Blasco Ibáñez, 13, 46010, Valencia, Spain.
| | - Patricia Mesa-Gresa
- Department of Psychobiology, Universitat de València, Av. Blasco Ibáñez, 13, 46010, Valencia, Spain
| |
Collapse
|
4
|
Salera C, Capua C, De Angelis D, Coiro P, Venturiero V, Savo A, Marinozzi F, Bini F, Paolucci S, Antonucci G, Iosa M. Michelangelo Effect in Cognitive Rehabilitation: Using Art in a Digital Visuospatial Memory Task. Brain Sci 2024; 14:479. [PMID: 38790457 PMCID: PMC11119589 DOI: 10.3390/brainsci14050479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The Michelangelo effect is a phenomenon that shows a reduction in perceived effort and an improvement in performance among both healthy subjects and patients when completing a motor task related to artistic stimuli, compared to performing the same task with non-artistic stimuli. It could contribute to the efficacy of art therapy in neurorehabilitation. In this study, the possible occurrence of this effect was tested in a cognitive task by asking 15 healthy subjects and 17 patients with a history of stroke to solve a digital version of the classical memory card game. Three different types of images were used in a randomized order: French cards, artistic portraits, and photos of famous people (to compensate for the possible effects of face recognition). Healthy subjects were involved to test the usability and the load demand of the developed system, reporting no statistically significant differences among the three sessions (p > 0.05). Conversely, patients had a better performance in terms of time (p = 0.014) and the number of attempts (p = 0.007) needed to complete the task in the presence of artistic stimuli, accompanied by a reduction in the perceived effort (p = 0.033). Furthermore, artistic stimuli, with respect to the other two types of images, seemed more associated with visuospatial control than linguistic functions.
Collapse
Affiliation(s)
- Claudia Salera
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Chiara Capua
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (F.M.); (F.B.)
| | - Domenico De Angelis
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Paola Coiro
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Vincenzo Venturiero
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Anna Savo
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Franco Marinozzi
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (F.M.); (F.B.)
| | - Fabiano Bini
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (F.M.); (F.B.)
| | - Stefano Paolucci
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Gabriella Antonucci
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Iosa
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Anastasiadou D, Herrero P, Garcia-Royo P, Vázquez-De Sebastián J, Slater M, Spanlang B, Álvarez de la Campa E, Ciudin A, Comas M, Ramos-Quiroga JA, Lusilla-Palacios P. Assessing the Clinical Efficacy of a Virtual Reality Tool for the Treatment of Obesity: Randomized Controlled Trial. J Med Internet Res 2024; 26:e51558. [PMID: 38578667 PMCID: PMC11031704 DOI: 10.2196/51558] [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: 08/03/2023] [Revised: 01/12/2024] [Accepted: 01/30/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Virtual reality (VR) interventions, based on cognitive behavioral therapy principles, have been proven effective as complementary tools in managing obesity and have been associated with promoting healthy behaviors and addressing body image concerns. However, they have not fully addressed certain underlying causes of obesity, such as a lack of motivation to change, low self-efficacy, and the impact of weight stigma interiorization, which often impede treatment adherence and long-term lifestyle habit changes. To tackle these concerns, this study introduces the VR self-counseling paradigm, which incorporates embodiment and body-swapping techniques, along with motivational strategies, to help people living with obesity effectively address some of the root causes of their condition. OBJECTIVE This study aims to assess the clinical efficacy of ConVRself (Virtual Reality self-talk), a VR platform that allows participants to engage in motivational self-conversations. METHODS A randomized controlled trial was conducted with 68 participants from the bariatric surgery waiting list from the obesity unit of the Vall d'Hebron University Hospital in Barcelona, Spain. Participants were assigned to 1 of 3 groups: a control group (CG), which only received treatment as usual from the obesity unit; experimental group 1 (EG1), which, after intensive motivational interviewing training, engaged in 4 sessions of VR-based self-conversations with ConVRself, and underwent embodiment and body-swapping techniques; and experimental group 2 (EG2), which engaged in 4 VR-based sessions led by a virtual counselor with a prerecorded discourse, and only underwent the embodiment technique. In the case of both EG1 and EG2, the VR interventions were assisted by a clinical researcher. Readiness to change habits, eating habits, and psychological variables, as well as adherence and satisfaction with ConVRself were measured at baseline, after the intervention, 1 week after the intervention, and 4 weeks after the intervention. RESULTS Regarding the primary outcomes, EG1 (24/68, 35%) and EG2 (22/68, 32%) showed significant improvements in confidence to lose weight compared to the CG (22/68, 32%) at all assessment points (β=-.16; P=.02). Similarly, EG1 demonstrated a significant increase after the intervention in readiness to exercise more compared to the CG (β=-.17; P=.03). Regarding the secondary outcomes, EG1 participants showed a significant reduction in uncontrolled eating (β=.71; P=.01) and emotional eating (β=.29; P=.03) compared to the CG participants, as well as in their anxiety levels compared to EG2 and CG participants (β=.65; P=.01). In addition, participants from the experimental groups reported high adherence and satisfaction with the VR platform (EG1: mean 59.82, SD 4.00; EG2: mean 58.43, SD 5.22; d=0.30, 95% CI -0.30 to 0.89). CONCLUSIONS This study revealed that using VR self-conversations, based on motivational interviewing principles, may have benefits in helping people with obesity to enhance their readiness to change habits and self-efficacy, as well as reduce dysfunctional eating behaviors and anxiety. TRIAL REGISTRATION ClinicalTrials.gov NCT05094557; https://www.clinicaltrials.gov/study/NCT05094557.
Collapse
Affiliation(s)
- Dimitra Anastasiadou
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
- Psychiatry, Mental Health and Addictions Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
| | - Pol Herrero
- Psychiatry, Mental Health and Addictions Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
| | - Paula Garcia-Royo
- Psychiatry, Mental Health and Addictions Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
| | - Julia Vázquez-De Sebastián
- Psychiatry, Mental Health and Addictions Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
- RE-FiT Barcelona Research Group, Vall d'Hebron Research Institute & Parc Sanitari Pere Virgili, Barcelona, Spain
| | - Mel Slater
- Virtual Bodyworks S.L., Barcelona, Spain
- The Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Andreea Ciudin
- Endocrinology and Nutrition Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Comas
- Endocrinology and Nutrition Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatry, Mental Health and Addictions Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
- Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Pilar Lusilla-Palacios
- Psychiatry, Mental Health and Addictions Research Group, Vall d´Hebron Research Institute, Barcelona, Spain
- Psychiatry Department, Vall d'Hebron University Hospital, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| |
Collapse
|
7
|
Belger J, Wagner S, Gaebler M, Karnath HO, Preim B, Saalfeld P, Schatz A, Villringer A, Thöne-Otto A. Application of immersive virtual reality for assessing chronic neglect in individuals with stroke: the immersive virtual road-crossing task. J Clin Exp Neuropsychol 2024:1-18. [PMID: 38516790 DOI: 10.1080/13803395.2024.2329380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 03/06/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Neglect can be a long-term consequence of chronic stroke that can impede an individual's ability to perform daily activities, but chronic and discrete forms can be difficult to detect. We developed and evaluated the "immersive virtual road-crossing task" (iVRoad) to identify and quantify discrete neglect symptoms in chronic stroke patients. METHOD The iVRoad task requires crossing virtual intersections and placing a letter in a mailbox placed either on the left or right. We tested three groups using the HTC Vive Pro Eye: (1) chronic right hemisphere stroke patients with (N = 20) and (2) without (N = 20) chronic left-sided neglect, and (3) age and gender-matched healthy controls (N = 20). We analyzed temporal parameters, errors, and head rotation to identify group-specific patterns, and applied questionnaires to measure self-assessed pedestrian behavior and usability. RESULTS Overall, the task was well-tolerated by all participants with fewer cybersickness-induced symptoms after the VR exposure than before. Reaction time, left-sided errors, and lateral head movements for traffic from left most clearly distinguished between groups. Neglect patients committed more dangerous crossings, but their self-rated pedestrian behavior did not differ from that of stroke patients without neglect. This demonstrates their reduced awareness of the risks in everyday life and highlights the clinical relevance of the task. CONCLUSIONS Our findings suggest that a virtual road crossing task, such as iVRoad, has the potential to identify subtle symptoms of neglect by providing virtual scenarios that more closely resemble the demands and challenges of everyday life. iVRoad is an immersive, naturalistic virtual reality task that can measure clinically relevant behavioral variance and identify discrete neglect symptoms.
Collapse
Affiliation(s)
- Julia Belger
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sebastian Wagner
- Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany
| | - Michael Gaebler
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Hans-Otto Karnath
- Center of Neurology, Division of Neuropsychology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Bernhard Preim
- Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany
| | - Patrick Saalfeld
- Department of Simulation and Graphics, University of Magdeburg, Magdeburg, Germany
| | - Anna Schatz
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
| | - Arno Villringer
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Berlin School of Mind and Brain, Humboldt University Berlin, Berlin, Germany
| | - Angelika Thöne-Otto
- Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|
8
|
Pascucci S, Forte G, Angelini E, Marinozzi F, Bini F, Antonucci G, Iosa M, Tieri G. Michelangelo Effect in Virtual Sculpturing: Prospective for Motor Neurorehabilitation in the Metaverse. J Cogn 2024; 7:17. [PMID: 38312943 PMCID: PMC10836160 DOI: 10.5334/joc.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024] Open
Abstract
We investigated the Michelangelo effect, i.e. the facilitatory effect of a virtual art therapy in motor rehabilitation (Iosa et al. 2021), with a novel virtual reality paradigm in which users are engaged in motor exercises with 3D sculptures. In particular, thirty young adults were immersed in a virtual environment where they could sculpt, by using the real hands, some famous sculptures in the history of art, such as the David of Michelangelo, the Venus of Milo and the statue of Laocoon and His Sons, and their control stimuli, i.e. statues in very low resolution or cubes. We recorded the kinematics (length, the time to complete each trial, mean normalized jerk) and questionnaire answers (objective and subjective beauty, User Satisfaction Evaluation Questionnaire and Nasa Task Load Index). In general, we found that the perception of subjective and objective beauty was higher when sculpting the statues than control stimuli, the judgment of usability of the system was high. The perceived fatigue was not higher when sculpting the statues despite the longer time spent in completing the task that with respect to the control stimuli. Moreover, we found that the interaction with the experimental statues affected the fluidity and symmetry of hands movements. Finally, we discuss this evidence regarding the art therapy and neuroaesthetics principles for motor rehabilitation in the Metaverse with VR, including the possible role of virtual embodiment (illusory feeling to have a virtual body) for boosting the efficacy of the clinical applications.
Collapse
Affiliation(s)
- Simona Pascucci
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | - Giorgia Forte
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
| | | | | | - Fabiano Bini
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
| | - Gabriella Antonucci
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Marco Iosa
- IRCCS Santa Lucia Foundation, Rome, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Gaetano Tieri
- IRCCS Santa Lucia Foundation, Rome, Italy
- Virtual Reality and Digital Neuroscience Lab, Department of Law and Digital Society, University of Rome UnitelmaSapienza, Rome, Italy
| |
Collapse
|
9
|
Uimonen J, Villarreal S, Laari S, Arola A, Ijäs P, Salmi J, Hietanen M. Virtual reality tasks with eye tracking for mild spatial neglect assessment: a pilot study with acute stroke patients. Front Psychol 2024; 15:1319944. [PMID: 38348259 PMCID: PMC10860750 DOI: 10.3389/fpsyg.2024.1319944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Objective Increasing evidence shows that traditional neuropsychological tests are insensitive for detecting mild unilateral spatial neglect (USN), lack ecological validity, and are unable to clarify USN in all different spatial domains. Here we present a new, fully immersive virtual reality (VR) task battery with integrated eye tracking for mild visual USN and extinction assessment in the acute state of stroke to overthrow these limitations. Methods We included 11 right-sided stroke patients and 10 healthy controls aged 18-75 years. Three VR tasks named the Extinction, the Storage and the Shoot the target tasks were developed to assess USN. Furthermore, neuropsychological assessment examining various parts of cognitive functioning was conducted to measure general abilities. We compared VR and neuropsychological task performance in stroke patients - those with (USN+, n = 5) and without USN (USN-, n = 6) - to healthy controls (n = 10) and tentatively reported the usability of VR system in the acute state of stroke. Results Patients had mostly mild neurological and USN symptoms. Nonetheless, we found several differences between the USN+ and healthy control groups in VR task performance. Compared to controls, USN+ patients showed visual extinction and asymmetry in gaze behavior and detection times in distinct spatial locations. Extinction was most evident in the extrapersonal space and delayed detection times on the extreme left and on the left upper parts. Also, USN+ patients needed more time to complete TMT A compared with USN- patients and TMT B compared with controls. VR system usability and acceptance were rated high; no relevant adverse effects occurred. Conclusion New VR technology with eye tracking enables ecologically valid and objective assessment methods with various exact measures for mild USN and thus could potentially improve future clinical assessments.
Collapse
Affiliation(s)
- Jenni Uimonen
- Department of Neuropsychology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Sanna Villarreal
- Department of Neuropsychology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Siiri Laari
- Department of Neuropsychology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Anne Arola
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Petra Ijäs
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Juha Salmi
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Marja Hietanen
- Department of Neuropsychology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| |
Collapse
|
10
|
Moulaei K, Moulaei R, Bahaadinbeigy K. The most used questionnaires for evaluating the usability of robots and smart wearables: A scoping review. Digit Health 2024; 10:20552076241237384. [PMID: 38601185 PMCID: PMC11005511 DOI: 10.1177/20552076241237384] [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: 05/15/2023] [Accepted: 02/27/2024] [Indexed: 04/12/2024] Open
Abstract
Background As the field of robotics and smart wearables continues to advance rapidly, the evaluation of their usability becomes paramount. Researchers may encounter difficulty in finding a suitable questionnaire for evaluating the usability of robotics and smart wearables. Therefore, the aim of this study is to identify the most commonly utilized questionnaires for assessing the usability of robots and smart wearables. Methods A comprehensive search of databases, including PubMed, Web of Science, and Scopus, was conducted for this scoping review. Two authors performed the selection of articles and data extraction using a 10-field data extraction form. In cases of disagreements, a third author was consulted to reach a consensus. The inclusions were English-language original research articles that utilized validated questionnaires to assess the usability of healthcare robots and smart wearables. The exclusions comprised review articles, non-English publications, studies not focused on usability, those assessing clinical outcomes, articles lacking questionnaire details, and those using non-validated or researcher-made questionnaires. Descriptive statistics methods (frequency and percentage), were employed to analyze the data. Results A total of 314 articles were obtained, and after eliminating irrelevant and duplicate articles, a final selection of 50 articles was included in this review. A total of 17 questionnaires were identified to evaluate the usability of robots and smart wearables, with 10 questionnaires specifically for wearables and 7 questionnaires for robots. The System Usability Scale (50%) and Post-Study System Usability Questionnaire (19.44%) were the predominant questionnaires utilized to assess the usability of smart wearables. Moreover, the most commonly used questionnaires for evaluating the usability of robots were the System Usability Scale (56.66%), User Experience Questionnaire (16.66%), and Quebec User Evaluation of Satisfaction with Assistive Technology (10%). Conclusion Commonly employed questionnaires serve as valuable tools in assessing the usability of robots and smart wearables, aiding in the refinement and optimization of these technologies for enhanced user experiences. By incorporating user feedback and insights, designers can strive towards creating more intuitive and effective robotic and wearable solutions.
Collapse
Affiliation(s)
- Khadijeh Moulaei
- Department of Health Information Technology, Faculty of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Moulaei
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| |
Collapse
|
11
|
Isbel S, Holloway H, Greber C, Nguyen K, Frost J, Pearce C, D’Cunha NM. Virtual reality after stroke: Identifying important characteristics when designing experiences to improve engagement in upper limb rehabilitation. Digit Health 2024; 10:20552076241251634. [PMID: 38817838 PMCID: PMC11138195 DOI: 10.1177/20552076241251634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/12/2024] [Indexed: 06/01/2024] Open
Abstract
Objective Virtual reality (VR) has been used to improve upper limb function after stroke but there is little to guide product developers in building experiences that engage users in the sustained, repetitive training required. This research sought to understand the characteristics of VR scenarios best suited to engaging someone with a stroke during recovery to achieve therapeutic outcomes. Methods Five creative immersive VR scenarios were designed by an experienced VR content creator containing unique combinations of VR characteristics. The usefulness of the scenarios was reviewed by expert clinicians experienced in stroke rehabilitation. Following this review, seven stroke survivors participated in each experience and reported on their engagement and motivation. Outcome measures were the User Satisfaction Evaluation Questionnaire and the modified Intrinsic Motivation Inventory. Semi-structured interviews were conducted with five participants following their immersive VR experience and analysed thematically. Results Expert clinicians reported potential therapeutic value in the immersive VR scenarios by providing opportunities for repeated and graded practice of upper limb movements. Stroke survivors reported varied levels of enjoyment and engagement for each scenario. They recommended changes to the experiences, primarily relating to the tailoring of the scenarios to match varied upper limb capacities. Conclusion This study highlights the characteristics of immersive VR scenarios that are important in sustaining motivation and providing high-repetition task-specific movement experiences. Differences in the experience and preferences of stroke participants regarding the characteristics of immersive VR experiences indicate that a variety of experiences are necessary to engage and sustain participation in an immersive VR-related therapy programme.
Collapse
Affiliation(s)
- Stephen Isbel
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Helen Holloway
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Craig Greber
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Kelly Nguyen
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Jane Frost
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Claire Pearce
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Nathan M D’Cunha
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| |
Collapse
|
12
|
Birrenbach T, Wespi R, Hautz WE, Berger J, Schwab PR, Papagiannakis G, Exadaktylos AK, Sauter TC. Development and usability testing of a fully immersive VR simulation for REBOA training. Int J Emerg Med 2023; 16:67. [PMID: 37803269 PMCID: PMC10559413 DOI: 10.1186/s12245-023-00545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a potentially life-saving procedure for bleeding trauma patients. Being a rare and complex procedure performed in extreme situations, repetitive training of REBOA teams is critical. Evidence-based guidelines on how to train REBOA are missing, although simulation-based training has been shown to be effective but can be costly and complex. We aimed to determine the feasibility and acceptance of REBOA training using a fully immersive virtual reality (VR) REBOA simulation, as well as assess the confidence in conducting the REBOA procedure before and after the training. METHODS Prospective feasibility pilot study of prehospital emergency physicians and paramedics in Bern, Switzerland, from November 2020 until March 2021. Baseline characteristics of trainees, prior training and experience in REBOA and with VR, variables of media use (usability: system usability scale, immersion/presence: Slater-Usoh-Steed, workload: NASA-TLX, user satisfaction: USEQ) as well as confidence prior and after VR training were accessed. RESULTS REBOA training in VR was found to be feasible without relevant VR-specific side-effects. Usability (SUS median 77.5, IQR 71.3-85) and sense of presence and immersion (Slater-Usoh-Steed median 4.8, IQR 3.8-5.5) were good, the workload without under-nor overstraining (NASA-TLX median 39, IQR 32.8-50.2) and user satisfaction high (USEQ median 26, IQR 23-29). Confidence of trainees in conducting REBOA increased significantly after training (p < 0.001). CONCLUSIONS Procedural training of the REBOA procedure in immersive virtual reality is possible with a good acceptance and high usability. REBOA VR training can be an important part of a training curriculum, with the virtual reality-specific advantages of a time- and instructor-independent learning.
Collapse
Affiliation(s)
- T Birrenbach
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland.
| | - R Wespi
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - W E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - J Berger
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - P R Schwab
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
- Schutz und Rettung Bern, Sanitätspolizei Bern, Bern, Switzerland
| | - G Papagiannakis
- ORamaVR SA, Geneva, Switzerland
- Institute of Computer Science, Foundation for Research and Technology, Hellas, Heraklion, Greece
- Department of Computer Science, University of Crete, Heraklion, Greece
| | - A K Exadaktylos
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| | - T C Sauter
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse 16C, Bern, CH-3010, Switzerland
| |
Collapse
|
13
|
Vidal E, Castro-Gutierrez E, Arisaca R, Paz-Valderrama A, Albiol-Pérez S. Serious Game for Fine Motor Control Rehabilitation for Children With Epileptic Encephalopathy: Development and Usability Study. JMIR Form Res 2023; 7:e50492. [PMID: 37788071 PMCID: PMC10582812 DOI: 10.2196/50492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Epileptic encephalopathy (EE) is defined as the presence of frequent epileptiform activity that adversely impacts development, typically causing the slowing or regression of developmental skills, and is usually associated with frequent seizures. One of the main disturbances in EE is in the coordination of the upper extremities and hands. Traditional rehabilitation for this type of pathology focuses on the alleviation of gross or fine motor disability. In the last few years, the use of low-cost devices together with customized serious games has shown improvements in motor disorders and enrichments in activities of daily living. OBJECTIVE This study aims to explore the feasibility of a new serious game for improving fine motor control in children with EE. METHODS The participants were 4 children with EE (male: n=2, 50%; female: n=2, 50%) who were classified as belonging to level 1 in the Gross Motor Classification System. The children were tested over 10 sessions during the intervention period (before and after treatment). The clinical tests performed were the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition and Pittsburgh Rehabilitation Participation Scale. The subscales of the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition were fine motor precision, fine motor integration, manual dexterity, and upper-limb coordination. At the end of the first session, we used the User Satisfaction Evaluation Questionnaire to analyze user satisfaction. RESULTS The significance outcomes for a Student t test (1-tailed) were as follows: P=.009 for fine motor precision, P=.002 for fine motor integration, P=.56 for manual dexterity, and P=.99 for upper-limb coordination. The participation rate as measured using the Pittsburgh Rehabilitation Participation Scale was between good and very good, which means that, based on the therapist's evaluation, interest, independence, and motivation were achieved by each participant. The mean User Satisfaction Evaluation Questionnaire score was close to 30, which is the maximum value. CONCLUSIONS The results support the use of the proposed serious game as a complement in therapeutic sessions during the rehabilitation processes for children with EE. Significant improvements in fine motor control and activities of daily living revealed that the proposed serious game is beneficial for fine motor disorders of this pathology.
Collapse
Affiliation(s)
- Elizabeth Vidal
- Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru
| | | | - Robert Arisaca
- Universidad Nacional de San Agustín de Arequipa, Arequipa, Peru
| | | | - Sergio Albiol-Pérez
- Aragón Health Research Institute (IIS Aragón), Universidad de Zaragoza, Teruel, Spain
| |
Collapse
|
14
|
García-López FJ, Pastora-Bernal JM, Moreno-Morales N, Estebanez-Pérez MJ, Liñán-González A, Martín-Valero R. Virtual reality to improve low-back pain and pelvic pain during pregnancy: a pilot RCT for a multicenter randomized controlled trial. Front Med (Lausanne) 2023; 10:1206799. [PMID: 37731709 PMCID: PMC10507341 DOI: 10.3389/fmed.2023.1206799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
A significant proportion of women experience low back and pelvic pain during and after pregnancy, which can negatively impact their daily lives. Various factors are attributed to these complaints, and many affected women do not receive adequate healthcare. However, there is evidence to support the use of different physiotherapeutic interventions to alleviate these conditions. Virtual reality is a promising complementary treatment to physiotherapy, particularly in improving pain perception and avoidance. The primary objective of this study is to evaluate the efficacy of a four-week program combining VR and physiotherapy compared to standard physiotherapy in pregnant women with low back and pelvic pain, in terms of improving pain avoidance, intensity, disability, and functional level. The study also aims to investigate patient satisfaction with the VR intervention. This research will be conducted through a multi-center randomized controlled clinical trial involving pregnant patients residing in the provinces of Seville and Malaga with a diagnosis of low back and pelvic pain during pregnancy. The alternative hypothesis is that the implementation of a Virtual Reality program in combination with standard physiotherapy will result in better clinical outcomes compared to the current standard intervention, which could lead to the development of new policies and interventions for these pathologies and their consequences. Clinical trial registration: clinicaltrials.gov, identifier NCT05571358.
Collapse
Affiliation(s)
| | | | - Noelia Moreno-Morales
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
| | - María-José Estebanez-Pérez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
- Department of Physiotherapy, Faculty of Health Science, Campus of Melilla, University of Granada, Melilla, Spain
| | - Antonio Liñán-González
- Department of Nursing, Faculty of Health Science, Campus of Melilla, University of Granada, Melilla, Spain
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
| |
Collapse
|
15
|
Rickenbacher-Frey S, Adam S, Exadaktylos AK, Müller M, Sauter TC, Birrenbach T. Development and evaluation of a virtual reality training for emergency treatment of shortness of breath based on frameworks for serious games. GMS JOURNAL FOR MEDICAL EDUCATION 2023; 40:Doc16. [PMID: 37361243 PMCID: PMC10285370 DOI: 10.3205/zma001598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 06/28/2023]
Abstract
Background Virtual reality (VR) can offer an innovative approach to providing training in emergency situations, especially in times of COVID-19. There is no risk of infection, and the procedure is scalable and resource-efficient. Nevertheless, the challenges and problems that can arise in the development of VR training are often unclear or underestimated. As an example, we present the evaluation of the feasibility of development of a VR training session for the treatment of dyspnoea. This is based on frameworks for serious games, and provides lessons learned. We evaluate the VR training session with respect to usability, satisfaction, as well as perceived effectiveness and workload of participants. Methods The VR training was developed using the established framework (Steps 1-4) for serious games of Verschueren et al. and Nicholson's RECIPE elements for meaningful gamification. Primary validation (Step 4) was performed at the University of Bern, Switzerland, in a pilot study without control group, with a convenience sample of medical students (n=16) and established measurement tools. Results The theoretical frameworks permitted guided development of the VR training session. Validation gave a median System Usability Scale of 80 (IQR 77.5-85); for the User Satisfaction Evaluation Questionnaire, the median score was 27 (IQR 26-28). After the VR training, there was a significant gain in the participants' confidence in treating a dyspnoeic patient (median pre-training 2 (IQR 2-3) vs. post-training 3 (IQR 3-3), p=0.016).Lessons learned include the need for involving medical experts, medical educators and technical experts at an equivalent level during the entire development process. Peer-teaching guidance for VR training was feasible. Conclusion The proposed frameworks can be valuable tools to guide the development and validation of scientifically founded VR training. The new VR training session is easy and satisfying to use and is effective - and is almost without motion sickness.
Collapse
Affiliation(s)
| | - Selina Adam
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | | | - Martin Müller
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Thomas C. Sauter
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| | - Tanja Birrenbach
- University Hospital Bern, Inselspital, Department of Emergency Medicine, Bern, Switzerland
| |
Collapse
|
16
|
Varela-Aldás J, Buele J, López I, Palacios-Navarro G. Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4609. [PMID: 36901618 PMCID: PMC10002257 DOI: 10.3390/ijerph20054609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Few works analyze the parameters inherent to immersive virtual reality (IVR) in applications for memory evaluation. Specifically, hand tracking adds to the immersion of the system, placing the user in the first person with full awareness of the position of their hands. Thus, this work addresses the influence of hand tracking in memory assessment with IVR systems. For this, an application based on activities of daily living was developed, where the user must remember the location of the elements. The data collected by the application are the accuracy of the answers and the response time; the participants are 20 healthy subjects who pass the MoCA test with an age range between 18 to 60 years of age; the application was evaluated with classic controllers and with the hand tracking of the Oculus Quest 2. After the experimentation, the participants carried out presence (PQ), usability (UMUX), and satisfaction (USEQ) tests. The results indicate no difference with statistical significance between both experiments; controller experiments have 7.08% higher accuracy and 0.27 ys. faster response time. Contrary to expectations, presence was 1.3% lower for hand tracking, and usability (0.18%) and satisfaction (1.43%) had similar results. The findings indicate no evidence to determine better conditions in the evaluation of memory in this case of IVR with hand tracking.
Collapse
Affiliation(s)
- José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
| | - Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, 44003 Teruel, Spain
| | - Irene López
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
| | | |
Collapse
|
17
|
Leal Vega L, Piñero DP, Hernández Rodríguez CJ, Molina Martín A, Morales-Quezada L, Vallelado Álvarez AI, Arenillas Lara JF, Coco Martín MB. Study protocol for a randomized controlled trial of the NEIVATECH virtual reality system to improve visual function in children with anisometropic amblyopia. BMC Ophthalmol 2022; 22:253. [PMID: 35672688 PMCID: PMC9172013 DOI: 10.1186/s12886-022-02466-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interest in developing alternative methods for the treatment of amblyopia has long been a topic of interest among clinicians and researchers, as prescribed occlusion and penalization therapies do not always provide an effective response and are associated with a high risk of recurrence and non-compliance. Here, we present the protocol of a small-scale RCT to evaluate the safety and clinical efficacy of a novel VR-based system designed to provide binocular vision training to children with anisometropic amblyopia. METHODS We aim to recruit a total of 60 children with anisometropic amblyopia aged 5-17 years with no previous treatment for amblyopia other than refractive correction from the pediatric ophthalmology units of the University Clinical Hospital of Valladolid and the Vithas Medimar International Hospital of Alicante. Children who meet the eligibility criteria and consent to participate will be randomly assigned to a three-month intervention group of 18 half-hour in-office therapy sessions with the NEIVATECH system (group A) or to a parallel group receiving 2 hours of conventional patching per day at home for the same period of time (group B). Assessments of visual function will be carried out before the intervention and at 1, 2 and 3 months, with changes in distance BCVA being the primary outcome measure to be considered. Patient safety, compliance, satisfaction and acceptance to treatment will also be assessed after therapy as other valuable outcome measures. In addition, a rsfMRI scan will be performed on a subgroup of 5 patients from each group at the pre-intervention visit and at the post-intervention visit to test the effects of both therapies on neural plasticity in the visual cortex. DISCUSSION The NEIVATECH system has been conceived as a serious game designed to provide binocular vision training to anisometropic amblyopic children by complementing the concepts of perceptual learning, dichoptic training and gamification in an immersive VR environment. We hope that this novel approach may lead to greater improvements in vision performance than those provided so far by conventional patching in anisometropic amblyopic children. TRIAL REGISTRATION This protocol was registered with ClinicalTrials.gov ( NCT04819386 ) on 29 March 2021.
Collapse
Affiliation(s)
- L Leal Vega
- Group of Applied Clinical Neurosciences and Advanced Data Analysis, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Av. Ramón y Cajal, 7, 47005, Valladolid, Spain
| | - D P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Clinical Optometry Unit, Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - C J Hernández Rodríguez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Clinical Optometry Unit, Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - A Molina Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - L Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, USA
| | - A I Vallelado Álvarez
- Pediatric Ophthalmology Unit, Department of Ophthalmology, University Clinical Hospital of Valladolid, Valladolid, Spain
| | - J F Arenillas Lara
- Group of Applied Clinical Neurosciences and Advanced Data Analysis, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Av. Ramón y Cajal, 7, 47005, Valladolid, Spain.
- Stroke Unit and Stroke Program, Department of Neurology, University Clinical Hospital of Valladolid, Valladolid, Spain.
| | - M B Coco Martín
- Group of Applied Clinical Neurosciences and Advanced Data Analysis, Department of Medicine, Dermatology and Toxicology, University of Valladolid, Av. Ramón y Cajal, 7, 47005, Valladolid, Spain
| |
Collapse
|
18
|
Domingos C, Costa P, Santos NC, Pêgo JM. Usability, Acceptability, and Satisfaction of a Wearable Activity Tracker in Older Adults: Observational Study in a Real-Life Context in Northern Portugal. J Med Internet Res 2022; 24:e26652. [PMID: 35080503 PMCID: PMC8829694 DOI: 10.2196/26652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/24/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of activity trackers has significantly increased over the last few years. This technology has the potential to improve the levels of physical activity and health-related behaviors in older adults. However, despite the potential benefits, the rate of adoption remains low among older adults. Therefore, understanding how technology is perceived may potentially offer insight to promote its use. OBJECTIVE This study aimed to (1) assess acceptability, usability, and user satisfaction with the Xiaomi Mi Band 2 in Portuguese community-dwelling older adults in a real-world context; (2) explore the mediating effect of the usability on the relationship between user characteristics and satisfaction; and (3) examine the moderating effect of user characteristics on the relationship between usability and user satisfaction. METHODS Older adults used the Xiaomi Mi Band 2 over 15 days. The user experience was evaluated through the Technology Acceptance Model 3, System Usability Scale, and User Satisfaction Evaluation Questionnaire. An integrated framework for usability and user satisfaction was used to explore user experience. Statistical data analysis included descriptive data analysis, reliability analysis, confirmatory factor analysis, and mediation and moderation analyses. RESULTS A sample of 110 older adults with an average age of 68.41 years (SD 3.11) completed the user experience questionnaires. Mean user acceptance was very high-perceived ease of use: 6.45 (SD 0.78); perceptions of external control: 6.74 (SD 0.55); computer anxiety: 6.85 (SD 0.47); and behavioral intention: 6.60 (SD 0.97). The usability was excellent with an average score of 92.70 (SD 10.73), and user satisfaction was classified as a good experience 23.30 (SD 2.40). The mediation analysis confirmed the direct positive effect of usability on satisfaction (β=.530; P<.01) and the direct negative effect of depression on usability (β=-.369; P<.01). Lastly, the indirect effect of usability on user satisfaction was higher in individuals with lower Geriatric Depression Scale levels. CONCLUSIONS Findings demonstrate that the Xiaomi Mi Band 2 is suitable for older adults. Furthermore, the results confirmed usability as a determinant of satisfaction with the technology and extended the existing knowledge about wearable activity trackers in older adults.
Collapse
Affiliation(s)
- Célia Domingos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal.,Associação Centro de Medicina P5, School of Medicine, University of Minho, Braga, Portugal
| | - José Miguel Pêgo
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal
| |
Collapse
|
19
|
Valipoor S, Ahrentzen S, Srinivasan R, Akiely F, Gopinadhan J, Okun MS, Ramirez-Zamora A, Wagle Shukla AA. The use of virtual reality to modify and personalize interior home features in Parkinson's disease. Exp Gerontol 2022; 159:111702. [PMID: 35038568 DOI: 10.1016/j.exger.2022.111702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/08/2022] [Accepted: 01/10/2022] [Indexed: 11/04/2022]
Abstract
As the second most common progressive neurodegenerative disorder with increased prevalence in the aging population, Parkinson's disease (PD) affects more than 10 million individuals worldwide with approximately 60,000 new cases occurring each year only in the US. While daily living abilities deteriorate in people with PD, they spend a significant amount of time in their homes. Unfortunately, most existing guidelines for home modification design reflect a standardized, singular plan. This study aimed to demonstrate the feasibility of using a virtual reality (VR) system for persons with PD to virtually walk through different home modifications and to adapt and personalize interior features. A sample of 15 participants with idiopathic PD and 24 healthy adults ambulated on a pressure mat, while using a VR headset and hand controller. Both groups envisioned walking through a virtual doorway from a simulated bedroom into its attached bathroom. Design features for the intervention included doorway width and door-frame color. Each participant was randomly assigned to one of three intervention conditions: (1) standard design, (2) enhanced design, and (3) co-design. The codesign module allowed participants to manipulate design features using a hand controller. We recorded 4 movement variables. Participants completed three questionnaires assessing anxiety, system usability, and satisfaction. Healthy control adults revealed no differences in movement or subjective assessment between the three intervention conditions. However, there were significant differences in the PD group between co-design and the other conditions. The changes were appreciated in the baseline measures of gait distance and strikes as well as in the composite gait component score. This study showed that using VR as a participatory design tool for persons with PD is safe and feasible. Additionally, the self-determination of interior design conditions may possibly affect movement performance measures and merits additional controlled trials.
Collapse
Affiliation(s)
- Shabboo Valipoor
- Department of Interior Design, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA.
| | - Sherry Ahrentzen
- Shimberg Center for Housing Studies, University of Florida, Gainesville, FL, USA
| | - Ravi Srinivasan
- Rinker School of Construction Management, University of Florida, Gainesville, FL, USA
| | - Farah Akiely
- Department of Urban and Regional Planning, College of Design, Construction and Planning, University of Florida, Gainesville, FL, USA
| | - Jithin Gopinadhan
- Rinker School of Construction Management, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, University of Florida, Gainesville, FL, USA; Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | | | | |
Collapse
|
20
|
Bansal S, Wiegelmann J, Matava C, Bereznicki C, Alam F. Cutting corners: donning under duress-a VR teaching tool. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:129-131. [PMID: 35003448 PMCID: PMC8740249 DOI: 10.36834/cmej.72143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
- Shikha Bansal
- Department of Anesthesia, Northern Ontario School of Medicine and Thunder Bay Regional Health Sciences Centre, Ontario, Canada
| | - Julian Wiegelmann
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Ontario, Canada
| | - Clyde Matava
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Ontario, Canada
| | | | - Fahad Alam
- Department of Anesthesia, Sunnybrook Health Sciences Centre, Ontario, Canada
| |
Collapse
|
21
|
Li C, Song X, Chen S, Wang C, He J, Zhang Y, Xu S, Yan Z, Jia J, Shull P. Long-term Effectiveness and Adoption of a Cellphone Augmented Reality System on Patients with Stroke: Randomized Controlled Trial. JMIR Serious Games 2021; 9:e30184. [PMID: 34817390 PMCID: PMC8663710 DOI: 10.2196/30184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/15/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background A serious game–based cellphone augmented reality system (CARS) was developed for rehabilitation of stroke survivors, which is portable, convenient, and suitable for self-training. Objective This study aims to examine the effectiveness of CARS in improving upper limb motor function and cognitive function of stroke survivors via conducting a long-term randomized controlled trial and analyze the patient’s acceptance of the proposed system. Methods A double-blind randomized controlled trial was performed with 30 poststroke, subacute phase patients. All patients in both the experimental group (n=15) and the control group (n=15) performed a 1-hour session of therapy each day, 5 days per week for 2 weeks. Patients in the experimental group received 30 minutes of rehabilitation training with CARS and 30 minutes of conventional occupational therapy (OT) each session, while patients in the control group received conventional OT for the full 1 hour each session. The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) subscale, Action Research Arm Test (ARAT), manual muscle test and Brunnstrom stage were used to assess motor function; the Mini-Mental State Examination, Add VS Sub, and Stroop Game were used to assess cognitive function; and the Barthel index was used to assess activities of daily living before and after the 2-week treatment period. In addition, the User Satisfaction Evaluation Questionnaire was used to reflect the patients’ adoption of the system in the experimental group after the final intervention. Results All the assessment scores of the experimental group and control group were significantly improved after intervention. After the intervention. The experimental group’s FMA-UE and ARAT scores increased by 11.47 and 5.86, respectively, and were both significantly higher than the increase of the control group. Similarly, the score of the Add VS Sub and Stroop Game in the experimental group increased by 7.53 and 6.83, respectively, after the intervention, which also represented a higher increase than that in the control group. The evaluation of the adoption of this system had 3 sub-dimensions. In terms of accessibility, the patients reported a mean score of 4.27 (SD 0.704) for the enjoyment of their experience with the system, a mean 4.33 (SD 0.816) for success in using the system, and a mean 4.67 (SD 0.617) for the ability to control the system. In terms of comfort, the patients reported a mean 4.40 (SD 0.737) for the clarity of information provided by the system and a mean 4.40 (SD 0.632) for comfort. In terms of acceptability, the patients reported a mean 4.27 (SD 0.884) for usefulness in their rehabilitation and a mean 4.67 (0.617) in agreeing that CARS is a suitable tool for home-based rehabilitation. Conclusions The rehabilitation based on combined CARS and conventional OT was more effective in improving both upper limb motor function and cognitive function than was conventional OT. Due to the low cost and ease of use, CARS is also potentially suitable for home-based rehabilitation. Trial Registration Chinese Clinical Trial Registry ChiCTR1800017568; https://tinyurl.com/xbkkyfyz
Collapse
Affiliation(s)
- Chong Li
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Xinyu Song
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| | - Shugeng Chen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuankai Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jieying He
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yongli Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuo Xu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhijie Yan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.,National Center for Neurological Disorders, Shanghai, China
| | - Peter Shull
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
22
|
Birrenbach T, Zbinden J, Papagiannakis G, Exadaktylos AK, Müller M, Hautz WE, Sauter TC. Effectiveness and Utility of Virtual Reality Simulation as an Educational Tool for Safe Performance of COVID-19 Diagnostics: Prospective, Randomized Pilot Trial. JMIR Serious Games 2021; 9:e29586. [PMID: 34623315 PMCID: PMC8510143 DOI: 10.2196/29586] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/12/2021] [Accepted: 09/09/2021] [Indexed: 01/16/2023] Open
Abstract
Background Although the proper use of hygiene and personal protective equipment (PPE) is paramount for preventing the spread of diseases such as COVID-19, health care personnel have been shown to use incorrect techniques for donning/doffing of PPE and hand hygiene, leading to a large number of infections among health professionals. Education and training are difficult owing to the social distancing restrictions in place, shortages of PPE and testing material, and lack of evidence on optimal training. Virtual reality (VR) simulation can offer a multisensory, 3-D, fully immersive, and safe training opportunity that addresses these obstacles. Objective The aim of this study is to explore the short- and long-term effectiveness of a fully immersive VR simulation versus a traditional learning method regarding a COVID-19–related skill set and media-specific variables influencing training outcomes. Methods This was a prospective, randomized controlled pilot study on medical students (N=29; intervention VR training, n=15, vs control video-based instruction, n=14) to compare the performance of hand disinfection, nasopharyngeal swab taking, and donning/doffing of PPE before and after training and 1 month later as well as variables of media use. Results Both groups performed significantly better after training, with the effect sustained over one month. After training, the VR group performed significantly better in taking a nasopharyngeal swab, scoring a median of 14 out of 17 points (IQR 13-15) versus 12 out of 17 points (IQR 11-14) in the control group, P=.03. With good immersion and tolerability of the VR simulation, satisfaction was significantly higher in the VR group compared to the control group (median score of User Satisfaction Evaluation Questionnaire 27/30, IQR 23-28, vs 22/30, IQR 20-24, in the control group; P=.01). Conclusions VR simulation was at least as effective as traditional learning methods in training medical students while providing benefits regarding user satisfaction. These results add to the growing body of evidence that VR is a useful tool for acquiring simple and complex clinical skills.
Collapse
Affiliation(s)
- Tanja Birrenbach
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.,Centre for Health Sciences Education, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Josua Zbinden
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - George Papagiannakis
- ORamaVR SA, Geneva, Switzerland.,Institute of Computer Science, Foundation for Research and Technology, Hellas, Heraklion, Greece.,Department of Computer Science, University of Crete, Heraklion, Greece
| | | | - Martin Müller
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Wolf E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | | |
Collapse
|
23
|
Assessing the Outcome of Rehabilitation after Hip Fracture with a Wearable Device-A Study Protocol for a Randomized Control Trial in Community Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910165. [PMID: 34639466 PMCID: PMC8508243 DOI: 10.3390/ijerph181910165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND The increase of the aging population is a challenge to society, as age is related to dependence. Injuries such as hip fractures cause morbidity, loss of independent life, and mortality. The purpose of this protocol is to describe a randomized control trial, with three intervention arms, aiming at investigating if there are any differences in outcomes after hip fracture between different rehabilitation interventions including (1) High-Intensity Functional Exercise (HIFE), (2) HIFE with the addition of continuous measures of movement and body positions with a wearable device, or (3) standard rehabilitation. A secondary aim is to evaluate physiotherapists' satisfaction with using the wearable device in rehabilitation. METHOD Patients with hip fracture that require rehabilitation at home will be invited to participate and randomly assigned to one intervention arm. The primary outcome is balance, measured by postural sway using an Inertial Measurement Unit and by Functional Balance test for Geriatric patients. Secondary outcomes are functional independence in everyday activities, measured with the Barthel Index, and health-related quality of life measured with EuroQol 5 Dimension questionnaire and EuroQol Visual Analogue Scale for health and user satisfaction measured by the User Satisfaction Evaluation Questionnaire. DISCUSSION This study protocol is the first step in securing the research process before performing a full randomized controlled trial. The next step will be a pilot- and feasibility study.
Collapse
|
24
|
A Comparative Study of Interaction Time and Usability of Using Controllers and Hand Tracking in Virtual Reality Training. INFORMATICS 2021. [DOI: 10.3390/informatics8030060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Virtual Reality (VR) technology is frequently applied in simulation, particularly in medical training. VR medical training often requires user input either from controllers or free-hand gestures. Nowadays, hand gestures are commonly tracked via built-in cameras from a VR headset. Like controllers, hand tracking can be used in VR applications to control virtual objects. This research developed VR intubation training as a case study and applied controllers and hand tracking for four interactions—namely collision, grabbing, pressing, and release. The quasi-experimental design assigned 30 medical students in clinical training to investigate the differences between using VR controller and hand tracking in medical interactions. The subjects were divided into two groups, one with VR controllers and the other with VR hand tracking, to study the interaction time and user satisfaction in seven procedures. System Usability Scale (SUS) and User Satisfaction Evaluation Questionnaire (USEQ) were used to measure user usability and satisfaction, respectively. The results showed that the interaction time of each procedure was not different. Similarly, according to SUS and USEQ scores, satisfaction and usability were also not different. Therefore, in VR intubation training, using hand tracking has no difference in results to using controllers. As medical training with free-hand gestures is more natural for real-world situations, hand tracking will play an important role as user input for VR medical training. This allows trainees to recognize and correct their postures intuitively, which is more beneficial for self-learning and practicing.
Collapse
|
25
|
Khundam C, Sukkriang N, Noël F. No difference in learning outcomes and usability between using controllers and hand tracking during a virtual reality endotracheal intubation training for medical students in Thailand. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2021; 18:22. [PMID: 34403577 PMCID: PMC8616725 DOI: 10.3352/jeehp.2021.18.22] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/26/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE We developed a virtual reality (VR) endotracheal intubation training that applied 2 interaction modalities (hand-tracking or controllers). It aimed to investigate the differences in usability between using hand tracking and controllers during the VR intervention for intubation training for medical students from February 2021 to March 2021 in Thailand. METHODS Forty-five participants were divided into 3 groups: video only, video with VR controller training, and video with VR hand tracking training. Pre-test, post-test, and practice scores were used to assess learning outcomes. The System Usability Scale (SUS) and User Satisfaction Evaluation Questionnaire (USEQ) questionnaires were used to evaluate the differences between the VR groups. The sample comprised 45 medical students (undergraduate) who were taking part in clinical training at Walailak University in Thailand. RESULTS The overall learning outcomes of both VR groups were better than those of the video group. The post-test scores (P=0.581) and practice scores (P=0.168) of both VR groups were not significantly different. Similarly, no significant between-group differences were found in the SUS scores (P=0.588) or in any aspects of the USEQ scores. CONCLUSION VR enhanced medical training. Interactions using hand tracking or controllers were not significantly different in terms of the outcomes measured in this study. The results and interviews provided a better understanding of support learning and training, which will be further improved and developed to create a self-learning VR medical training system in the future.
Collapse
Affiliation(s)
- Chaowanan Khundam
- Informatics Innovative Center of Excellence (IICE), School of Informatics, Walailak University, Nakhon Si Thammarat, Thailand
| | - Naparat Sukkriang
- School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Frédéric Noël
- Institute of Engineering, Université Grenoble Alpes, Grenoble, France
| |
Collapse
|
26
|
Feingold-Polak R, Barzel O, Levy-Tzedek S. A robot goes to rehab: a novel gamified system for long-term stroke rehabilitation using a socially assistive robot-methodology and usability testing. J Neuroeng Rehabil 2021; 18:122. [PMID: 34321035 PMCID: PMC8316882 DOI: 10.1186/s12984-021-00915-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 07/19/2021] [Indexed: 01/18/2023] Open
Abstract
Background Socially assistive robots (SARs) have been proposed as a tool to help individuals who have had a stroke to perform their exercise during their rehabilitation process. Yet, to date, there are no data on the motivating benefit of SARs in a long-term interaction with post-stroke patients. Methods Here, we describe a robot-based gamified exercise platform, which we developed for long-term post-stroke rehabilitation. The platform uses the humanoid robot Pepper, and also has a computer-based configuration (with no robot). It includes seven gamified sets of exercises, which are based on functional tasks from the everyday life of the patients. The platform gives the patients instructions, as well as feedback on their performance, and can track their performance over time. We performed a long-term patient-usability study, where 24 post-stroke patients were randomly allocated to exercise with this platform—either with the robot or the computer configuration—over a 5–7 week period, 3 times per week, for a total of 306 sessions. Results The participants in both groups reported that this rehabilitation platform addressed their arm rehabilitation needs, and they expressed their desire to continue training with it even after the study ended. We found a trend for higher acceptance of the system by the participants in the robot group on all parameters; however, this difference was not significant. We found that system failures did not affect the long-term trust that users felt towards the system. Conclusions We demonstrated the usability of using this platform for a long-term rehabilitation with post-stroke patients in a clinical setting. We found high levels of acceptance of both platform configurations by patients following this interaction, with higher ratings given to the SAR configuration. We show that it is not the mere use of technology that increases the motivation of the person to practice, but rather it is the appreciation of the technology’s effectiveness and its perceived contribution to the rehabilitation process. In addition, we provide a list of guidelines that can be used when designing and implementing other technological tools for rehabilitation. Trial registration: This trial is registered in the NIH ClinicalTrials.gov database. Registration number NCT03651063, registration date 21.08.2018. https://clinicaltrials.gov/ct2/show/NCT03651063.
Collapse
Affiliation(s)
- Ronit Feingold-Polak
- Department of Physical Therapy, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Oren Barzel
- Sheba Medical Center, Ramat Gan, Israel.,Adi-Negev Rehabilitation Center, Nahalat Eran, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Ono Academic College, Kiryat Ono, Israel
| | - Shelly Levy-Tzedek
- Department of Physical Therapy, Recanati School for Community Health Professions, Ben-Gurion University of the Negev, Beer-Sheva, Israel. .,Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel. .,Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany.
| |
Collapse
|
27
|
Domingos C, Costa PS, Santos NC, Pêgo JM. European Portuguese Version of the User Satisfaction Evaluation Questionnaire (USEQ): Transcultural Adaptation and Validation Study. JMIR Mhealth Uhealth 2021; 9:e19245. [PMID: 34185018 PMCID: PMC8278297 DOI: 10.2196/19245] [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: 04/10/2020] [Revised: 09/24/2020] [Accepted: 10/10/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Wearable activity trackers have the potential to encourage users to adopt healthier lifestyles by tracking daily health information. However, usability is a critical factor in technology adoption. Older adults may be more resistant to accepting novel technologies. Understanding the difficulties that older adults face when using activity trackers may be useful for implementing strategies to promote their use. OBJECTIVE The purpose of this study was to conduct a transcultural adaptation of the User Satisfaction Evaluation Questionnaire (USEQ) into European Portuguese and validate the adapted questionnaire. Additionally, we aimed to provide information about older adults' satisfaction regarding the use of an activity tracker (Xiaomi Mi Band 2). METHODS The USEQ was translated following internationally accepted guidelines. The psychometric evaluation of the final version of the translated USEQ was assessed based on structural validity using exploratory and confirmatory factor analyses. Construct validity was examined using divergent and discriminant validity analysis, and internal consistency was evaluated using Cronbach α and McDonald ω coefficients. RESULTS A total of 110 older adults completed the questionnaire. Confirmatory factor analysis supported the conceptual unidimensionality of the USEQ (χ24=7.313, P=.12, comparative fit index=0.973, Tucker-Lewis index=0.931, goodness of fit index=0.977, root mean square error of approximation=0.087, standardized root mean square residual=0.038). The internal consistency showed acceptable reliability (Cronbach α=.677, McDonald ω=0.722). Overall, 90% of the participants reported excellent satisfaction with the Xiaomi Mi Band 2. CONCLUSIONS The findings support the use of this translated USEQ as a valid and reliable tool for measuring user satisfaction with wearable activity trackers in older adults, with psychometric properties consistent with the original version.
Collapse
Affiliation(s)
- Célia Domingos
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
| | - Patrício Soares Costa
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Faculty of Psychology and Education Sciences, University of Porto, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,Associação Centro de Medicina Digital P5, Braga, Portugal
| | - José Miguel Pêgo
- Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - Braga, Braga, Portugal
| |
Collapse
|
28
|
Guinet AL, Bouyer G, Otmane S, Desailly E. Validity of Hololens Augmented Reality Head Mounted Display for Measuring Gait Parameters in Healthy Adults and Children with Cerebral Palsy. SENSORS 2021; 21:s21082697. [PMID: 33920452 PMCID: PMC8069043 DOI: 10.3390/s21082697] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/31/2021] [Accepted: 04/08/2021] [Indexed: 12/02/2022]
Abstract
Serious games are a promising approach to improve gait rehabilitation for people with gait disorders. Combined with wearable augmented reality headset, serious games for gait rehabilitation in a clinical setting can be envisaged, allowing to evolve in a real environment and provide fun and feedback to enhance patient’s motivation. This requires a method to obtain accurate information on the spatiotemporal gait parameters of the playing patient. To this end, we propose a new algorithm called HoloStep that computes spatiotemporal gait parameters using only the head pose provided by an augmented reality headset (Hololens). It is based on the detection of peaks associated to initial contact event, and uses a combination of locking distance, locking time, peak amplitude detection with custom thresholds for children with CP. The performance of HoloStep was compared during a walking session at comfortable speed to Zeni’s reference algorithm, which is based on kinematics and a full 3D motion capture system. Our study included 62 children with cerebral palsy (CP), classified according to Gross Motor Function Classification System (GMFCS) between levels I and III, and 13 healthy participants (HP). Metrics such as sensitivity, specificity, accuracy and precision for step detection with HoloStep were above 96%. The Intra-Class Coefficient between steps length calculated with HoloStep and the reference was 0.92 (GMFCS I), 0.86 (GMFCS II/III) and 0.78 (HP). HoloStep demonstrated good performance when applied to a wide range of gait patterns, including children with CP using walking aids. Findings provide important insights for future gait intervention using augmented reality games for children with CP.
Collapse
Affiliation(s)
- Anne-Laure Guinet
- Pôle Recherche & Innovation, Fondation Ellen Poidatz, 77310 Saint-Fargeau-Ponthierry, France;
- IBISC Lab, University Paris-Saclay, University Evry, 91020 Evry, France; (G.B.); (S.O.)
- Correspondence:
| | - Guillaume Bouyer
- IBISC Lab, University Paris-Saclay, University Evry, 91020 Evry, France; (G.B.); (S.O.)
| | - Samir Otmane
- IBISC Lab, University Paris-Saclay, University Evry, 91020 Evry, France; (G.B.); (S.O.)
| | - Eric Desailly
- Pôle Recherche & Innovation, Fondation Ellen Poidatz, 77310 Saint-Fargeau-Ponthierry, France;
| |
Collapse
|
29
|
Head-Mounted Display-Based Application for Cognitive Training. SENSORS 2020; 20:s20226552. [PMID: 33212748 PMCID: PMC7696435 DOI: 10.3390/s20226552] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/08/2020] [Accepted: 11/12/2020] [Indexed: 12/20/2022]
Abstract
Virtual Reality (VR) has had significant advances in rehabilitation, due to the gamification of cognitive activities that facilitate treatment. On the other hand, Immersive Virtual Reality (IVR) produces outstanding results due to the interactive features with the user. This work introduces a VR application for memory rehabilitation by walking through a maze and using the Oculus Go head-mounted display (HMD) technology. The mechanics of the game require memorizing geometric shapes while the player progresses in two modes, autonomous or manual, with two levels of difficulty depending on the number of elements to remember. The application is developed in the Unity 3D video game engine considering the optimization of computational resources to improve the performance in the processing and maintaining adequate benefits for the user, while the generated data is stored and sent to a remote server. The maze task was assessed with 29 subjects in a controlled environment. The obtained results show a significant correlation between participants’ response accuracy in both the maze task and a face–pair test. Thus, the proposed task is able to perform memory assessments.
Collapse
|
30
|
Meca-Lallana V, Prefasi D, Alabarcez W, Hernández T, García-Vaz F, Portaña A, Gomis D, Téllez N, García-Bernáldez C, Mauriño J, Medrano N, Vázquez-Doce A. A Pilot Study to Explore Patient Satisfaction With a Virtual Rehabilitation Program in Multiple Sclerosis: The RehabVR Study Protocol. Front Neurol 2020; 11:900. [PMID: 33162924 PMCID: PMC7580492 DOI: 10.3389/fneur.2020.00900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/13/2020] [Indexed: 01/14/2023] Open
Abstract
Background: Virtual reality (VR) has emerged as a promising treatment approach in rehabilitation for patients with multiple sclerosis (MS) due to its potential to increase patient motivation and rehabilitation adherence. One of the key features for rehabilitation adherence is patient satisfaction with the VR rehabilitation (VRR) program, and information on user satisfaction and not only effectiveness is required to systematically include VRR in routine clinical practice. Given that information on patient satisfaction with VRR is scarce, the primary objective of this study is to assess long-term patient satisfaction with a novel VRR program. This program has been specifically designed for MS patients by a multidisciplinary team of specialists, based on an effective conventional rehabilitation (CR) program. Secondarily, discomfort with VRR will be evaluated, and therapy adherence and changes in a variety of domains typically affected by MS will be compared between patients receiving VRR and patients receiving CR. Methods: In this prospective single-center 6-months follow-up study, 32 and 16 MS patients will receive VRR or CR, respectively. Patients will attend twice weekly rehabilitation sessions on site during 4 weeks, and they will continue with rehabilitation at home for five additional months. Satisfaction, assessed by the User Satisfaction Evaluation Questionnaire (USEQ), at 6 months of the VRR program initiation will be the primary outcome. Secondary outcomes include adherence, disability, spasms and spasticity, balance, fatigue, activities of daily living (ADLs), depression, anxiety, work status, cognition, demographic, and clinical characteristics (in the VRR and CR groups), and discomfort (in the VRR group). Outcome measures will be assessed at baseline, and at 1 and 6 months of rehabilitation initiation. Discussion: The study is intended to provide a better understanding of long-term patient satisfaction with a VRR program specifically designed for MS patients. Additionally, the study will provide information on long-term adherence, changes in motor symptoms, cognitive functions and patient-reported outcomes after the rehabilitation program. The results from this study will help to gather valuable knowledge on the use of rehabilitation with a new VR tool in MS patients.
Collapse
Affiliation(s)
| | | | | | - Teresa Hernández
- Rehabilitation Department and Physiotherapy Unit, Hospital Universitario de La Princesa, Madrid, Spain
| | - Fabiola García-Vaz
- Biomedical Research Foundation, Hospital Universitario de La Princesa, Madrid, Spain
| | | | | | | | | | | | | | - Aránzazu Vázquez-Doce
- Physical Medicine and Rehabilitation Department, Hospital Universitario de La Princesa, Madrid, Spain
| |
Collapse
|
31
|
Kalron A, Achiron A, Pau M, Cocco E. The effect of a telerehabilitation virtual reality intervention on functional upper limb activities in people with multiple sclerosis: a study protocol for the TEAMS pilot randomized controlled trial. Trials 2020; 21:713. [PMID: 32787896 PMCID: PMC7425044 DOI: 10.1186/s13063-020-04650-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/04/2020] [Indexed: 01/13/2023] Open
Abstract
Background Approximately 60% of people with multiple sclerosis (PwMS) suffer from upper limb dysfunction. Our primary goal is to implement a single-blind, randomized control trial (RCT) designed to compare the effectiveness of an 8-week home-based telerehab virtual reality (VR) program with conventional therapy in PwMS with manual dexterity difficulties. Secondary aims include (a) evaluating the impact of the programs on quality of life after the intervention and a follow-up 1 month later and (b) evaluating the impact of the programs on adherence and satisfaction. Methods Twenty-four PwMS will be recruited to the study which will be conducted at two established MS centers: (1) The Regional Center for Diagnosis and Treatment of Multiple Sclerosis, Binaghi Hospital, Cagliari, Italy, and (2) The Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel. Participants will complete a total of three assessments focusing on upper limb functions. Both groups will receive 16 training sessions focusing on functional upper limb activities. The home-based telerehab VR intervention will comprise a custom-made software program running on a private computer or laptop. PwMS will perform several activities of daily living (ADL) functions associated with self-care, dressing, and meal preparation. Conventional therapy will focus on task-related upper-limb treatments while in a sitting position, indicative of the standard care in MS. Following 8 weeks of training, participants will complete a further outcome assessment. The same tests will be conducted 1 month (as a follow-up) after completion of the intervention. Discussion The outcomes of this study have tremendous potential to improve the quality of evidence and informed decisions of functional upper limb activities in PwMS. If comparable results are found between the treatments in improving upper limb outcomes, this would suggest that PwMS can choose the program that best meets their personal needs, e.g., financial concerns, transportation, or accessibility issues. Secondly, this information can be used by healthcare providers and medical professionals in developing upper limb exercise programs that will most likely succeed in PwMS. Trial registration ClinicalTrials.gov NCT04032431. Registered on 19 July 2019.
Collapse
Affiliation(s)
- Alon Kalron
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. .,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.
| | - Anat Achiron
- Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Center, Binaghi Hospital, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| |
Collapse
|
32
|
A naturalistic viewing paradigm using 360° panoramic video clips and real-time field-of-view changes with eye-gaze tracking. Neuroimage 2020; 216:116617. [DOI: 10.1016/j.neuroimage.2020.116617] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 02/05/2020] [Indexed: 11/18/2022] Open
|
33
|
Tao G, Charm G, Kabacińska K, Miller WC, Robillard JM. Evaluation Tools for Assistive Technologies: A Scoping Review. Arch Phys Med Rehabil 2020; 101:1025-1040. [PMID: 32059944 DOI: 10.1016/j.apmr.2020.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/02/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. DATA SOURCES We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. STUDY SELECTION Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. DATA EXTRACTION We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. DATA SYNTHESIS From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. CONCLUSIONS We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement.
Collapse
Affiliation(s)
- Gordon Tao
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Geoffrey Charm
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Integrated Sciences, The University of British Columbia, Vancouver, British Columbia
| | - Katarzyna Kabacińska
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia
| | - William C Miller
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, British Columbia; Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, British Columbia
| | - Julie M Robillard
- Division of Neurology, Department of Medicine, The University of British Columbia, Vancouver, British Columbia; British Columbia Women's and Children's Hospital, Vancouver, British Columbia, Canada.
| |
Collapse
|
34
|
Ahmed N, Mauad VAQ, Gomez-Rojas O, Sushea A, Castro-Tejada G, Michel J, Liñares JM, Pedrosa Salles L, Candido Santos L, Shan M, Nassir R, Montañez-Valverde R, Fabiano R, Danyi S, Hassan Hosseyni S, Anand S, Ahmad U, Casteleins WA, Sanchez AT, Fouad A, Jacome A, Moura de Oliveira Paiva MS, Saavedra Ruiz AG, Grochowski RA, Toyama M, Nagi H, Sarvodelli MZ, Halalau A. The Impact of Rehabilitation-oriented Virtual Reality Device in Patients With Ischemic Stroke in the Early Subacute Recovery Phase: Study Protocol for a Phase III, Single-Blinded, Randomized, Controlled Clinical Trial. J Cent Nerv Syst Dis 2020; 12:1179573519899471. [PMID: 32009828 PMCID: PMC6974741 DOI: 10.1177/1179573519899471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 12/08/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND RATIONALE Stroke is considered the most common cause of adult disability. Intensive rehabilitation protocols outperform nonintensive counterparts. The subacute stroke phase represents a potential window to recovery. Virtual reality (VR) has been shown to provide a more stimulating environment, allowing for increased patient compliance. However, the quality of current literature comparing VR with standard therapies is limited. Our aim is to measure the impact of VR versus standard therapy on the recovery of the upper limb motor function in patients with stroke in the early subacute recovery phase. METHOD This is a randomized, controlled trial that will assign 262 patients to tailor-made standard rehabilitation (TMSR) or TMSR plus immersive VR device. The trial will be conducted in an urban rehabilitation clinic in the United States with expertise in the management of poststroke patients. Patients will be 18 to 70 years of age and in the early subacute period (30-90 days post ischemic stroke). The primary outcome will be the change of Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, measured at baseline and 13 weeks after randomization. The secondary outcome will be the change in the UK Functional Independence Measure and Functional Assessment Measure (UK FIM-FAM) score at the same time points. DISCUSSION If the use of VR in the rehabilitation of patients with stroke proves to have a significant impact on their motor recovery, it will constitute an extremely important step into decreasing the functional impairment associated with stroke and the related health care expense burden.
Collapse
Affiliation(s)
- Nima Ahmed
- Neurology Department, Hamad Medical
Corporation, Doha, Qatar
| | | | - Olga Gomez-Rojas
- Occupational Health Department,
Alexander von Humboldt School, Lima, Peru
| | - Ammu Sushea
- Department of Anesthesia and Critical
Care, Harvard Medical School Teaching Hospital, Beth Israel Deaconess Medical
Center, Boston, MA, USA
| | - Gelanys Castro-Tejada
- Regional University Hospital Jose Maria
Cabral y Baez (HRUJMCB), Biomedical and Clinical Research Center (CINBIOCLI),
Santiago, Dominican Republic
| | - Janet Michel
- Health Systems and Policy Department,
University of Basel, Swiss TPH, Basel, Switzerland
| | - Juan Manuel Liñares
- Department of Pediatric Neurosurgery,
SAMIC Pediatric Hospital “Prof. Dr. Juan Pedro Garrahan,” Buenos Aires,
Argentina
| | - Loise Pedrosa Salles
- Dentistry Department, Faculty of Health
Sciences, University of Brasilia, Brasilia, Brazil
| | | | - Ming Shan
- Translational Research &
Development, TESARO, Inc., Waltham, MA, USA
| | - Rami Nassir
- Department of Pathology, School of
Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | | | - Sofia Danyi
- Lusíada University Centre’s Medical
School, Santos, Brazil
| | | | - Seerat Anand
- Jawaharlal Nehru Medical College,
Belgaum, India
| | - Usman Ahmad
- Department of Pharmacology &
Therapeutics, Hamdard University, Karachi, Pakistan
| | | | | | - Ahmed Fouad
- Clinical Pharmacy Department, Hamad
Medical Corporation, Doha, Qatar
| | | | | | | | | | - Mayumi Toyama
- School of Public Health, Department of
Health Informatics, Kyoto University, Kyoto, Japan
| | - Hibatalla Nagi
- Neurology Department, Hamad Medical
Corporation, Doha, Qatar
| | | | - Alexandra Halalau
- Internal Medicine Department, Beaumont
Hospital, Royal Oak, MI, USA
- Oakland University William Beaumont
School of Medicine, Rochester, MI, USA
| |
Collapse
|
35
|
Dash A, Lahiri U. Design of Virtual Reality-Enabled Surface Electromyogram-Triggered Grip Exercise Platform. IEEE Trans Neural Syst Rehabil Eng 2019; 28:444-452. [PMID: 31841415 DOI: 10.1109/tnsre.2019.2959449] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Adequate grip ability is important for effective execution of daily living activities. Neurological disorders like stroke that result in muscle weakness, limited strength and poor control often lead to reduced grip ability in the affected limb. Conventional rehabilitation for grip training is often monotonous and subjective. Technology-assisted Virtual Reality (VR)-based rehabilitation offers a motivating environment to the participants for rehabilitation. However, the existing systems need specialized set-up architecture, thereby limiting their accessibility. Furthermore, these systems quantify the functional grip ability based on task performance, and do not explore physiological basis of grip ability. In this work, we develop a VR-based rehabilitation platform integrated with physiology-sensitive biofeedback. The developed platform, Gripx makes use of features extracted from sEMG data collected from upper limb muscles to adaptively provide audio-visual biofeedback through a VR environment. We compare task based performance, physiological indices and clinical measures to evaluate the potential of Gripx. The results of our study with 8 healthy and 12 post-stroke participants show the potential of Gripx to contribute to grip rehabilitation over multiple exposures. This approach of integrating VR-based task design with physiology-sensitive biofeedback helps patients to better assess their physiological responses and enhance the efficacy of rehabilitation.
Collapse
|
36
|
Booth ATC, van der Krogt MM, Buizer AI, Steenbrink F, Harlaar J. The validity and usability of an eight marker model for avatar-based biofeedback gait training. Clin Biomech (Bristol, Avon) 2019; 70:146-152. [PMID: 31499394 DOI: 10.1016/j.clinbiomech.2019.08.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/18/2019] [Accepted: 08/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Virtual reality presents a platform for therapeutic gaming, and incorporation of immersive biofeedback on gait may enhance outcomes in rehabilitation. Time is limited in therapeutic practice, therefore any potential gait training tool requires a short set up time, while maintaining clinical relevance and accuracy. The aim of this study was to develop, validate, and establish the usability of an avatar-based application for biofeedback-enhanced gait training with minimal set up time. METHODS A simplified, eight marker model was developed using eight passive markers placed on anatomical landmarks. This allowed for visualisation of avatar-based biofeedback on pelvis kinematics, hip and knee sagittal angles in real-time. Retrospective gait analysis data from typically developing children (n = 41) and children with cerebral palsy (n = 25), were used to validate eight marker model. Gait outcomes were compared to the Human Body Model using statistical parametric mapping. Usability for use in clinical practice was tested in five clinical rehabilitation centers with the system usability score. FINDINGS Gait outcomes of Human Body Model and eight marker model were comparable, with small differences in gait parameters. The discrepancies between models were <5°, except for knee extension where eight marker model showed significantly less knee extension, especially towards full extension. The application was considered of 'high marginal acceptability' (system usability score, mean 68 (SD 13)). INTERPRETATION Gait biofeedback can be achieved, to acceptable accuracy for within-session gait training, using an eight marker model. The application may be considered usable and implemented for use in patient populations undergoing gait training.
Collapse
Affiliation(s)
- A T C Booth
- Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, Netherlands; Department of Clinical Applications and Research, Motek Medical B.V., Amsterdam, Netherlands.
| | - M M van der Krogt
- Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, Netherlands
| | - A I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, Netherlands
| | - F Steenbrink
- Department of Clinical Applications and Research, Motek Medical B.V., Amsterdam, Netherlands
| | - J Harlaar
- Department of Rehabilitation Medicine, Amsterdam UMC, VU University Medical Center, Amsterdam Movement Sciences, Netherlands; Department Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| |
Collapse
|
37
|
Dash A, Yadav A, Chauhan A, Lahiri U. Kinect-Assisted Performance-Sensitive Upper Limb Exercise Platform for Post-stroke Survivors. Front Neurosci 2019; 13:228. [PMID: 30967755 PMCID: PMC6438898 DOI: 10.3389/fnins.2019.00228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 02/26/2019] [Indexed: 11/23/2022] Open
Abstract
One's ability to use upper limbs is critical for performing activities of daily living necessary for enjoying quality community life. However, after stroke, such abilities becomes adversely affected and it often deprives one of their capability to perform tasks that need coordinated movement in the upper limbs. To address issues with upper limb dysfunction, patients typically undergo rehabilitative exercises. Given the high patient to doctor ratio particularly in developing countries like India, conventional rehabilitation with patients undergoing exercises under one-on-one therapist's supervision often becomes a challenge. Thus, investigators are exploring technology such as computer-based platforms coupled with cameras that can alleviate the need for the continuous presence of a therapist and can offer a powerful complementary tool in the hands of the clinicians. Such marker-based imaging systems used for rehabilitation can offer real-time processing and high accuracy of data. However, these systems often require dedicated lab space and high set-up time. Often this is very expensive and suffers from portability issues. Investigators have been exploring marker-less imaging techniques e.g., Kinect integrated computer-based graphical user interfaces in stroke-rehabilitation such as tracking one's limb movement during rehabilitation. In our present study, we have developed a Kinect-assisted computer-based system that offered Human Computer Interaction (HCI) tasks of varying challenge levels. Execution of the tasks required one to use reaching and coordination skills of the upper limbs. Also, the system was Performance-sensitive i.e., adaptive to the individualized residual movement ability of one's upper limb quantified in terms of task performance score. We tested for the usability of our system by exposing 15 healthy participants to our system. Subsequently, seven post-stroke patients interacted with our system over a few sessions spread over 2 weeks. Also, we studied patient's mean tonic activity corresponding to the HCI tasks as a possible indicator of one's post-stroke functional recovery suggesting its potential of our system to serve as a rehabilitation platform. Our results indicate the potential of such systems toward the improvement of task performance capability of post-stroke patients with possibilities of upper limb movement rehabilitation.
Collapse
Affiliation(s)
- Adyasha Dash
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Anand Yadav
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Anand Chauhan
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| | - Uttama Lahiri
- Department of Electrical Engineering, Indian Institute of Technology Gandhinagar, Gandhinagar, India
| |
Collapse
|
38
|
Development of an interactive game-based mirror image hand rehabilitation system. INTEL SERV ROBOT 2019. [DOI: 10.1007/s11370-018-00272-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
39
|
Implementation and Assessment of an Intelligent Motor Tele-Rehabilitation Platform. ELECTRONICS 2019. [DOI: 10.3390/electronics8010058] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Over the past few years, software applications for medical assistance, including tele-rehabilitation, have known an increasing presence in the health arena. Despite the several therapeutic and economic advantages of this new paradigm, it is important to follow certain guidelines, in order to build a safe, useful, scalable, and ergonomic tool. This work proposes to address all these points, through the case study of a physical tele-rehabilitation platform for patients after hip replacement surgery. The scalability and versatility of the system is handled by the implementation of a modular architecture. The safeness and effectiveness of the tool is ensured by an artificial intelligence module that assesses the quality of the movements performed by the user. The usability of the application is evaluated by a cognitive walkthrough method. Results show that the system (i) is able to properly assess the correctness of the human’s motion through two possible methods (Dynamic Time Warping and Hidden Markov Model), and (ii) provides a good user experience. The discussion addresses (i) the advantages and disadvantages of the main approaches for a gesture recognition of therapeutic movements, and (ii) critical aspects to provide the patient with the best usability of a tele-rehabilitation platform.
Collapse
|