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2016 Short Papers ∼ Abstracts and Papers
Abstracts are listed in alphabetical order, based on first author.
Click links below each abstract to view publication.
(Link to Full Paper Abstracts)
Kinect controlled game to improve space and depth perception, D Bekesi, C Sik-Lanyi, University of Pannonia, HUNGARY
Space perception is one of the most important skills of human life. Space perception is not a congenital faculty of human beings, but it evolves during the first few years of life. Experts are of the opinion that depth perception can be improved during the first 15-16 years of life. It is essential to perform in several occupation. We have developed virtual reality game with animations that were used by students to practice space perception tasks and to acquire better space perception. The game is controlled via Kinect sensor.
Influence of point of view and technology in presence and embodiment, B A Borrego, J Latorre, R Llorens, E Noé, M Alcañiz, Universitat Politècnica de València/Fundación Hospitales NISA, Valencia/Univesity of Jaume I, Castellón, SPAIN
Presence and embodiment have been reported to modulate the experience in virtual worlds. However, while these perceptions are presumably interconnected, little research has been done to unveil the nature of this relationship. In this study we show how presence and embodiment are modulated by the point of view of a virtual body and the enabling technology while being engaged in a virtual task.
Application of a rehabilitation game model to assistive technology design, J Boureaud, D E Holmes, D K Charles, S McClean, P J Morrow, S M McDonough, University of Limoges, FRANCE/Ulster University, UK
Games are increasingly used by physiotherapists in rehabilitation and the gamification of rehabilitation processes is an increasingly common practice. A key motivation for injecting playful or gameful activities into rehabilitation is to enhance engagement for home rehabilitation exercises by making them more fun. Multi-disciplinary cooperation is important to designing gameful activities. However, system design and development can be challenging between software engineers, health professionals, and academics due to terminology and knowledge differences. Sometimes skill and knowledge levels are also not optimal within the team. In both cases a comprehensive Rehabilitation Game Model (RGM) built on established principles, with an associated tool, can facilitate an effective design process. Factors that can be missed without use of a structured process include the potential impact of symptoms and variation in user demographic, personality or interaction preference. Our RGM helps game designers put a greater focus on variations between people in designing rehabilitation games. In this paper we provide an overview of the RGM and extending it to include rehabilitation aspects. We apply it to upper arm stroke rehabilitation. We present a representation of the output from the RGM that can form the basis for advice and guidance to serious game designers of upper arm stroke rehabilitation games.
Case study using virtual rehabilitation for a patient with fear of falling due to diabetic peripheral neuropathy, K E Carroll, D J Galles, St. Mary’s Medical Center, San Francisco/University of San Francisco, USA
The purpose of this case study is to report the effects of using virtual rehabilitation (VR) to facilitate improvement of gait stability and endurance in a patient recovering from diabetic neuropathy who also experienced fear of falling. Timed Up and Go (TUG) testing revealed objective improvements and the subject’s gait appeared more stable and fluid. She reported increased confidence in walking and endorsed increased confidence on the Activity-specific Balance Confidence Scale (ABC). This study also establishes how VR games can be inexpensively made and tailored to specific therapy needs since games were made by undergraduate Computer Science students for credit.
Application of invisible playground theory to assistive technology design for motivating exercise within activities of daily living, G Chaponneau, D E Holmes, D K Charles, S McClean, P J Morrow, S M McDonough, University of Limoges, FRANCE/Ulster University, UK
Regular exercise promotes safe mobility for people affected by stroke, multiple sclerosis, and other disability related health conditions. It is also important for the prevention of falls among older people. Recent research investigates the use of indoor technology such as virtual reality (VR) and games to support and motivate regular exercise. Other research considers the use of mobile and wearable technology to track and promote exercise within the home and outdoors. In this paper we propose an approach that uses ideas from both contexts to develop a more persistent connected health system for encouraging more enduring exercise associated behaviour change. We utilise gameful design principles and play research to blend home-based VR and Serious Games with wearable, mobile tracking and reminder system approaches that are integrated into activities of daily living. In particular, we utilise ideas about the Invisible Playground from play theory to frame our interactive multi-modal exercise system. Our hypothesis is that by establishing a gamified, information rich feedback loop between structured system based exercise indoors and tracked activities of daily living outdoors, that motivation to exercise regularly may be improved. In this paper we summarise key relevant literature, discuss the Invisible Playground, and present the system architecture, APPRAISER, which will be used for the system development.
Visual elements influence on navigation in virtual environments, C Croucher, V Powell, A Molnar, W Powell, University of Portsmouth, UK
Virtual rehabilitation often incorporates an element of travel in a virtual environment. Whether patients are transported automatically through the environment, or whether they have navigational control, it is important to understand how the design of the environment itself can supply navigational cues, and how the processing of these cues may influence perception, behaviour and task performance. This paper explores the literature, which might inform application design, and presents a case study using a think-aloud protocol to explore the perception of users to visual cues within a running game. We conclude with some preliminary suggestions for positive and negative navigational cues.
Development of a low-cost upper limb rehabilitation system using BCI, eye-tracking and direct visual feedback, A Duenser, D Rozado, B Howell, G Rosolen, M Callisaya, M Lochner, M Cochrane, CSIRO, Hobart, AUSTRALIA/ Otago Polytechnic, Dunedin, NEW ZEALAND/University of Tasmania, Hobart/Swinburne University of Technology, Melbourne AUSTRALIA
We are developing a novel system to improve arm function in stroke patients who have no, or only residual upper limb movement. Such a system fills an important gap in treatment options for people with little-to-no upper limb movement after stroke, and for whom regular treatments often are unsuitable. The system provides real-time visual and proprioceptive feedback of the arm plus the ability for participants to steer the movement direction of the arm through an assistive movement platform. The patient controls the system by simply looking at stimuli and engaging in motor imagery. The patient gaze is monitored with an eye tracker and motor output intentions are monitored with an EEG-based brain computer interface. Stimuli are presented as games in order to create a motivating rehabilitation environment. In this paper we discuss our motivation and design of the system.
Human cognitive enhancement tested in virtual city environments, I Fajnerova, L Hejtmanek, H Rydlo, J Motyl, I Oravcova, T Zitka, J Hranicka, J Horacek, E Zackova, National Institute of Mental Health (NIMH), Klecany/University of West Bohemia, Plzeň, CZECH REPUBLIC
The presented study focuses on human cognitive enhancement (HCE). Our aim is to map the key moments in interfacing of biology and technology that have the capacity to strongly affect and transform cognitive processes, such as spatial memory and navigation. We hypothesize that long-term use of HCE technology, in or case Augmented Reality (AR) glasses, while navigating through real environment can elicit changes both in spatial memory performance and in brain activity, connectivity and morphology. Proposed experiment focuses on the effect of long-term use (10-12 weeks) of Smart glasses (Vuzix M100). We tested 25 healthy volunteers, who were required to use the Vuzix navigation software when navigating in daily life. Prior to the experiment and during the final 12th week all participants (25 experimental and 25 control subjects) underwent complex prospective evaluation. The following test battery was used in order to study the effect of AR glasses wearing on 1) vision (Ophthalmology examination); 2) cognitive abilities (RBANS, CPT, TMT); 3) specific spatial abilities (e.g. Money Road Map test, Perspective Taking Test); 4) eye-movements (eye-tracking) in the route-following and way-finding navigation performance in complex virtual city environment, and 5) brain activity (fMRI navigation task in virtual city, resting state fMRI) and morphology (VBM, DTI). The poster will present pilot data of the currently running experiment.
Remediation of cognitive deficit in neuropsychiatric disorders using virtual carousel task and episodic memory task, I Fajnerova, K Sedlakova, V Vorackova, A Dorazilova, L Hejtmanek, A Plechata, M Rodriguez, K Vlcek, National Institute of Mental Health (NIMH), Klecany, CZECH REPUBLIC
The impairment of cognitive functioning represents a characteristic manifestation in various neuropsychiatric disorders, such as schizophrenia (SZ). Previous studies demonstrated mild to severe deficit almost in all cognitive domains. Our results obtained in the virtual analogue of the Carousel maze also demonstrate impairment of spatial memory and cognitive flexibility in schizophrenia patients. In addition, results of the Episodic-like memory task (EMT) also support the hypothesis of episodic memory deficit in schizophrenia. The aim of the presented study is to improve these impaired cognitive functions using remediation methods based on similar methods in a complex virtual environment. The remediation plan will be presented together with preliminary data obtained in a small group of schizophrenia patients.
Motion sickness related aspects of inclusion of color deficient observers in virtual reality, D A Gusev, R Eschbach, T Westin, J Yong, Purdue University, USA/Norwegian National University for Science and Technology, Gjøvik, NORWAY/Monroe Community College, Rochester, New York, USA/ Stockholm University, SWEDEN
Color blindness is one of the most common forms of disability. Virtual reality (VR) development has increased recently, and it is important not to exclude people with impairments or other limitations. Visually induced motion sickness (VIMS) can be worse due to color versus black, white and gray environments. Can non-color factors in dynamic environments be excluded by performing color deficiency impacted tasks and comparing them to the equivalent static and dynamic tasks performed by a color-sighted person? Would a color-based experiment causing VIMS produce different results for a color deficient observer (CDO)? This paper advocates a novel approach to color blindness and motion sickness in VR based on psychophysical experiments. The aim is to find solutions and develop recommendations that will improve accessibility of VR for the colorblind.
Labyrinth game with Kinect control, R Haas, V Szucs, C Sik-Lanyi, University of Pannonia, HUNGARY
Stroke changes not only the patients’, but also their families’ lives. The improvement of the active movement of the upper limbs is of great importance after stroke, which helps regain self-sufficiency and the the recovery of fine movements. One of the key elements is the development of the active movements of the arm and fingers. The aim of the Flash-based labyrinth game of the article is to develop these motoric skills, and that the patients may become self-sufficient in their home environment, or capable of working by the end of the rehabilitation. The Labyrinth Game is focusing on the movement of arms and elbows, out of the 17 exercises of Wolf Motor Function Test’s (WMFT) upper limb rehabilitation tasks. The game uses simple forms and colours, and contains understandable and useable menu for more efficient usability.
Gaming for health: an updated systematic review and meta-analysis of the physical, cognitive and psychosocial effects of active computer gaming in older adults, S C Howes, D Charles, K Pedlow, J Marley, A Matcovic, P Diehl, S M McDonough, Ulster University, Newtownabbey/Coleraine, NORTHERN IRELAND
Active computer gaming (ACG) is method of enabling physical activity in older adults. This review aimed to determine the effect of ACG on health outcomes in older adults. Four electronic databases were searched to identify 24 eligible randomised controlled studies: 1049 participants; 72.2% female; mean age 78±5 years. Data were pooled for six outcomes, with small to moderate effects observed in favour of ACG for functional mobility and balance outcomes. A large effect was observed in favour of ACG for cognitive function. This review presents evidence that ACG is effective in improving physical and cognitive function in older adults.
Pirate adventure autism assessment app: a new tool to aid clinical assessment of children with possible autistic spectrum disorder, E Jordan, W Farr, S Fager, I Male, University of Sussex/Sussex Community NHS Foundation Trust, Haywards Heath/Cell Software Services, Brighton, UK
Diagnostic assessment of possible Autistic Spectrum Disorder requires multidisciplinary assessment incorporating information from various settings, including psychometric assessment of the child. The Pirate Adventure Autism Assessment App includes a number of these psychometric tests adapted into a pirate adventure storyline. Early experience, presented here, suggests the tool is a useful adjunct to parental history and school questionnaire obtained at initial clinic, in determining the need for the child to proceed to a full, time consuming, expensive, diagnostic assessment.
Effects of reintroducing haptic feedback to virtual-reality systems on movement profiles when reaching to virtual targets, M A Just, P J Stapley, M Ros, F Naghdy, D Stirling, University of Wollongong, AUSTRALIA
Virtual Reality (VR) has been shown to have significant impacts on the efficacy of rehabilitation, improving a patient’s motivation and participation, as well as improving scores in functional assessments when used to enhance traditional therapy. However, movements in VR have been demonstrated to have significant differences in movement profiles whilst performing simple reaching tasks compared to their real counterparts. The lack of tactile perception in VR systems is often attributed to be one of the causes of these differences. Therefore, to investigate the degree to which the lack of haptic feedback impacts movement profiles in VR, we have reintroduced the sense of touch through vibration motors on the fingertips. Participants were required to reach to virtual targets, both with and without haptic feedback. Their movements were quantified using motion capture, and the virtual targets were rendered using the Oculus Rift. The motions to both targets were compared using a number of measures to characterize the velocity profiles. Preliminary results suggest that the reintroduction of haptic feedback improves performance based indicators in virtual reaching tasks, such as the time to complete a reach, and the stability of the reaching hand whilst touching the virtual target.
Step in time: exploration of synchrony and timing correction in response to virtual reality avatars for gait re-training, O Khan, I Ahmed, M Rahhal, T N Arvanitis, M T Elliott, University of Warwick/University Hospitals Coventry and Warwickshire NHS Trust, UK
This study investigates the use of virtual reality avatars as exercise cues for retraining gait. A feasibility test was conducted by asking participants to step in time with the avatar viewed through a virtual reality headset. We observed that a temporal perturbation (a speeding up or slowing down of one step cycle) applied to the avatar resulted in a significant corrective response in participants’ own step timing. If this response can extend to spatial perturbations, we suggest that virtual reality avatars have the potential to assist in the targeted rehabilitation of neuromuscular or other disorders and retraining of gait post-surgery.
Do user motivation and attention influence performance of a postural reaching task in a virtual environment?, D Levac, A Kelly, M Polizzano, S Saffee, Northeastern University, USA
Practice in a virtual environment (VE) can enhance motivation and attention, but the relationship between these constructs and motor skill acquisition requires exploration. This study evaluated the impact of motivation (as measured by the Intrinsic Motivation Inventory) and attention to a task-irrelevant visual distraction (as measured by proxy via recall) on performance of a postural reaching task in a 2D VE in 27 young adults. Higher motivation was associated with higher scores, while poorer attention to task was associated with lower scores. Findings suggest that motivation and attention can impact VE practice; subsequent research will include retention and transfer tests.
How do the perspectives of clinicians with and without virtual reality/active video game experience differ about its use in practice?, D Levac, P Miller, S M N Glegg, H Colquhoun, Northeastern University, USA/McMaster University/ Sunny Hill Health Centre for Children, Vancouver/University of Toronto, CANADA
Little is known about clinicians’ perspectives on the use of virtual reality (VR) and active video games (AVGs) in rehabilitation. We undertook an online survey of VR/AVG experience and learning needs in a sample of 1068 physical therapists and occupational therapists practicing in Canada. Nearly half (47%) had clinical experience with at least one system. While both therapist groups identified challenges and barriers, experienced therapists highlighted VR/AVGs’ potential to increase patient motivation and engagement. Respondents without experience identified new potential avenues for VR/AVG use. Findings from this study will inform the content of open-access knowledge translation resources hosted at www.vr4rehab.com.
Development of smart mobile phone application to monitor progress and wellness for Chronic Obstructive Pulmonary Disease patients, S M McDonough, A Boyd, T Patterson, P McCullagh, I Cleland, C Nugent, M Donnelly, H Zheng, N Black, Affiliations
A bespoke application (app), ‘KeepWell’, tuned to COPD self-management has been developed. The app facilitates goal setting, progress monitoring and personal reporting; features were informed by n=4 clinicians. Eight other clinicians tested usability by undertaking a list of interaction tasks and completing a usability questionnaire. Qualitative comments or problems experienced during the completion of each task were noted. Overall the participants reported high levels of usability. Features that scored consistently well were setting goals, self-reporting and viewing progress. Suggested changes were: setting and editing reminders and ensuring the manual information was consistent with the operation of the KeepWell app.
Towards a novel biometric facial input for emotion recognition and assistive technology for virtual reality, J T McGhee, M Hamedi, M Fatoorechi, D Roggen, A Cleal, R Prance, C Nduka, Imperial College, London/Emteq Ltd, Brighton/Sussex University, Brighton, UNITED KINGDOM
Preliminary work using facial EMG to identify facial expressions is reported in this paper. Ten subjects performed 14 different facial expressions following an agreed protocol. Facial EMG signals, measured from surface electrodes were processed and analysed using a machine learning algorithm. Our system is able to differentiate facial expressions for assistive input to a high degree of accuracy (99.25%) and posed emotional responses with 100% accuracy. We conclude facial EMG technology has the potential for both assistive input and emotion detection and could replace conventional assistive input devices or video based techniques for use with VR technologies.
Physical therapist´s opinion regarding the creation of a new virtual game to treat pelvic floor muscles dysfunction amongst children in school age, M C Moreira, A Lemos, Federal University of Pernambuco, Recife, PE, BRAZIL
The study aimed to investigate physical therapists´ feedback regarding important points that should be added to a new virtual game application which will treat lower urinary tract dysfunction among children. This study used a questionnaire answered by ten physiotherapists, where the majority (80%) considered positive the idea of creating an application, hence, only 40% use technological device in rehabilitation. With regards of observing patients progress, the majority (70%) reported a lack of tools that motivate the patient was the biggest problem. Based on that, we concluded that motivating tools are necessary to assist on pelvic floor treatment.
Mobile application to increase consciousness and strengthening of the pelvic floor muscles, E C Moretti, M C Moreira, A E S P Souza, A Lemos, Federal University of Pernambuco – UFPE, Recife, PE, BRAZIL
This research included the development of a computer interface for capturing electromyography signals via Bluetooth enabling the transmission of data to mobile devices combined with a specific virtual gaming application to the biomechanical characteristics of the pelvic floor muscles. The capture of data is performed via electrodes placed at specific anatomic pelvic floor sites. The game was designed based on the evidence available on consciousness and strengthening of the pelvic floor muscles, in addition to coordinating training of the muscles at different levels of demand, according to each user.
Kinect sensor controlled game for early diagnosis of visual problems, R Nemeth, V Szucs, C Sik-Lanyi, University of Pannonia, HUNGARY
The serious game was designed for early (preschool aged) vision-test at home or kindergartens. It was created with Windows Presentation Foundation framework. This framework is a good choice to develop vision-test game modules, so they can be easily accessed from one main application. Our game module is a “Drag and Drop” game, which can be controlled with Kinect v2 sensor. The game is designed to take various objects along the tracks to the suitable finish. This type of game will help the user discover the visual acuity problems. The game monitors that how long it takes to complete the track with different difficulty settings. The results are stored.
Development and validation of haptic interface for deaf-blind horseback riding, M Ogrinc, I Farkhatdinov, R Walker, E Burdet, Imperial College, London/Shadow Robot Company Ltd, London, UNITED KINGDOM
We present a haptic interface to help blind and deaf-blind people to practice horse riding as a recreational and therapeutic activity. Horseback riding is a form of animal assisted therapy which can improve self-esteem and sensation of independence. It has been shown to benefit people with various medical conditions including autism. However, in the case of deaf-blind individuals a therapist or an interpreter must stand by at all times to communicate with the rider by touch. We developed a novel and low cost interface which enables blind and deaf-blind people to enjoy horseback riding while the instructor is observing and remotely providing cues to the rider, which improves their independence. Initial tests of the concept with an autistic deaf-blind individual received very positive feedback from the rider, his family and therapist.
Eyeblink rate during a virtual shopping game performance for cognitive rehabilitation, S Okahashi, R Watanabe, Z Luo, T Futaki, Kyoto University/Kobe University, JAPAN
We developed a virtual shopping game having four levels using virtual reality technology for realistic cognitive rehabilitation. The objective of this study was to investigate characteristic in eyeblink rate in relation to task difficulty level. Six healthy adults were asked to buy two specific items in level 1, four items in level 2, six items in level 3, and eight items in level 4 at a virtual mall. Shopping items were daily necessaries which were independent of each other. Task performance, subjective assessments, and eye blinks during the game performance were recorded. As a result, the mean numbers of movements buttons use and the mean time required were larger/longer in level 4 than in level 1. The average subjective assessment scores were larger in level 4 than in level 1. Although the transitions of eyeblink rates were individually different; there was no statistical difference between phases, there were some relationships between subjective assessments and eyeblink rates. It suggests that eyeblink rate could be an index that reflects psychological aspects.
Nicotine-enhanced responding for chocolate rewards in humans, A N Palmisano, E Hudd, C McQuade, H De Wit, R S Astur, University of Connecticut, Storrs, CT/University of Chicago, IL, USA
Despite an abundance of evidence illustrating the harmful effects of nicotine use, only a small percentage of users successfully quit (Messer et al., 2008). Moreover, current treatments for nicotine cessation produce only a slight increase in the likelihood of successfully quitting, which emphasizes the need for more effective strategies that facilitate smoking cessation (Hopkins et al., 2001). Several studies suggest that difficulty in controlling nicotine use behaviors results from nicotine’s ability to enhance the motivating function of cues associated with obtaining rewards. In order to better understand the reward mechanisms that underlie the risk for becoming dependent, the aim of the current study was to examine nicotine’s effects on conditioning, extinction, and reinstatement in humans. Using a novel virtual reality translation of the hallmark conditioned place preference paradigm to investigate the aforementioned objectives, our main findings suggest that nicotine (1) increases the sensitivity of reward properties by enhancing the strength of food-reward conditioning, (2) delays the rate of extinction of conditioned preferences, and (3) increases the reinstatement of previous conditioning.
Face tracking training in children with severe motor impairment: case report, A Pasquale, L Morgia, F Cappelli, C Vignati, E Pasquale, S Grazzellini, M Sabbadini, S Staccioli, E Castelli, Bambino Gesù Ospedale Pediatrico, Roma/S.Raffaele, Roma/Universita di Roma, ITALY
The article reports an interactive training experience in children with tetraplegia using a face tracking system. Classic assessment scale and specific interactive tasks was used to evaluate and carry on the treatment based on a multimodal approach. The aim of the training was to improve lateral head rotation and oral motor ability with a specific interactive patch connected to the head and face movement. Finally further trajectory movements and Pc control by means of face movement were evaluated. From a descriptive point of view the system proved to be a functional tool to help subjects with severe motor impairment and it empowered the use of their residual functional movements.
Process and feedback oriented platform for home-based rehabilitation based on depth sensor technology, A Ridderstolpe, J Broeren, G Clemons, J Jalminger, L-Å Johansson, M Johanson, M Rydmark, Alkit Communications, Mölndal/The Sahlgrenska Academy, University of Gothenburg, SWEDEN
In this paper a game-based rehabilitation platform for home usage, supporting stroke and COPD rehabilitation is presented. The main goal is to make rehabilitation more enjoyable and easily accessible for the patients. The platform provides facilities for creation of individualized plans for each patient with a program of game-exercises planned by the patient’s caregiver through a web-based planning service. The games are based on specific motion patterns designed in collaboration with rehabilitation specialists. Motion regulations and guidance functions are implemented specifically for each exercise to provide feedback to the user and to ensure proper execution of the desired motion pattern. The caregiver can follow the progression of the rehabilitation and interact with the patient by video conferencing through the web-based service.
Comparison of Wii Balance Board and force platform (baropodometry) on evaluation of plantar pressures among healthy subjects, A E S P Souza, A A L Carneiro, L H A N Dutra, M C Moreira, R M A Cunha, Federal University of Pernambuco – UFPE, Recife, PE, BRAZIL
This study aimed to compare the use of Wii Balance Board® (Nintendo) with a baropodometer (force platform) to evaluate plantar pressure on healthy individuals. We also analysed the reliability of both platforms and we found that in addition to not be valid the data between the two platforms, there not was also a good reliability index none of the two devices.
Reducing impact of stress in patients with psychiatric disorders – a pilot study on the effects of swimming with wild, free dolphins in virtual reality, W Veling, M J Sjollema, B C Brada, University Medical Center Groningen/The Dolphin Swim Club, Leeuwarden, THE NETHERLANDS
In this pilot study, a 360o video VR relaxation program (VRelax) will be developed in order to reduce the impact of stress in patients with depressive, anxiety and psychotic disorders. The relaxing effect of an underwater VR experience with wild, free dolphins will be compared to the effect of an VR experience with natural surroundings such as beach, open fields and dunes and to a 2D experience with video clips of natural surroundings.
Can visual stimulus induce proprioceptive drift in the upper arm using virtual reality?, D Willis, V Powell, B Stevens, W Powell, University of Portsmouth, UK
Sustained isometric contractions (SIC), such as holding an arm stationary in a space, are often used in upper limb rehabilitation exercises, particularly where it is important to protect the joints and tendons or to reduce patient fatigue. However, visual cues within a virtual environment may have an unanticipated effect on the ability to maintain SIC. This study investigated the influence of background motion within a virtual environment on the ability to maintain a fixed position during an upper limb task. It was found that introducing directional movement had a significant differential effect on the ability to maintain SIC.
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