Clinical Decision Support Systems with Game-based Environments, Monitoring Symptoms of Parkinson’s Disease with Exergames

Parkinson’s Disease (PD) is a malady caused by progressive neuronal degeneration, deriving in several physical and cognitive symptoms that worsen with time. Like many other chronic diseases, it requires constant monitoring to perform medication and therapeutic adjustments. This is due to the significant variability in PD symptomatology and progress between patients. At the moment, this monitoring requires substantial participation from caregivers and numerous clinic visits. Personal diaries and questionnaires are used as data sources for medication and therapeutic adjustments. The subjectivity in these data sources leads to suboptimal clinical decisions. Therefore, more objective data sources are required to better monitor the progress of individual PD patients. A potential contribution towards more objective monitoring of PD is clinical decision support systems. These systems employ sensors and classification techniques to provide caregivers with objective information for their decision-making. This leads to more objective assessments of patient improvement or deterioration, resulting in better adjusted medication and therapeutic plans. Hereby, the need to encourage patients to actively and regularly provide data for remote monitoring remains a significant challenge. To address this challenge, the goal of this thesis is to combine clinical decision support systems with game-based environments. More specifically, serious games in the form of exergames, active video games that involve physical exercise, shall be used to deliver objective data for PD monitoring and therapy. Exergames increase engagement while combining physical and cognitive tasks. This combination, known as dual-tasking, has been proven to improve rehabilitation outcomes in PD: recent randomized clinical trials on exergame-based rehabilitation in PD show improvements in clinical outcomes that are equal or superior to those of traditional rehabilitation. In this thesis, we present an exergame-based clinical decision support system model to monitor symptoms of PD. This model provides both objective information on PD symptoms and an engaging environment for the patients. The model is elaborated, prototypically implemented and validated in the context of two of the most prominent symptoms of PD: (1) balance and gait, as well as (2) hand tremor and slowness of movement (bradykinesia). While balance and gait affections increase the risk of falling, hand tremors and bradykinesia affect hand dexterity. We employ Wii Balance Boards and Leap Motion sensors, and digitalize aspects of current clinical standards used to assess PD symptoms. In addition, we present two dual-tasking exergames: PDDanceCity for balance and gait, and PDPuzzleTable for tremor and bradykinesia. We evaluate the capability of our system for assessing the risk of falling and the severity of tremor in comparison with clinical standards. We also explore the statistical significance and effect size of the data we collect from PD patients and healthy controls. We demonstrate that the presented approach can predict an increased risk of falling and estimate tremor severity. Also, the target population shows a good acceptance of PDDanceCity and PDPuzzleTable. In summary, our results indicate a clear feasibility to implement this system for PD. Nevertheless, long-term randomized clinical trials are required to evaluate the potential of PDDanceCity and PDPuzzleTable for physical and cognitive rehabilitation effects

Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review

Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work

Leveraging eXtented Reality & Human-Computer Interaction for User Experi- ence in 360◦ Video

EXtended Reality systems have resurged as a medium for work and entertainment. While 360o video has been characterized as less immersive than computer-generated VR, its realism, ease of use and affordability mean it is in widespread commercial use. Based on the prevalence and potential of the 360o video format, this research is focused on improving and augmenting the user experience of watching 360o video. By leveraging knowledge from Extented Reality (XR) systems and Human-Computer Interaction (HCI), this research addresses two issues affecting user experience in 360o video: Attention Guidance and Visually Induced Motion Sickness (VIMS). This research work relies on the construction of multiple artifacts to answer the de- fined research questions: (1) IVRUX, a tool for analysis of immersive VR narrative expe- riences; (2) Cue Control, a tool for creation of spatial audio soundtracks for 360o video, as well as enabling the collection and analysis of captured metrics emerging from the user experience; and (3) VIMS mitigation pipeline, a linear sequence of modules (including optical flow and visual SLAM among others) that control parameters for visual modi- fications such as a restricted Field of View (FoV). These artifacts are accompanied by evaluation studies targeting the defined research questions. Through Cue Control, this research shows that non-diegetic music can be spatialized to act as orientation for users. A partial spatialization of music was deemed ineffective when used for orientation. Addi- tionally, our results also demonstrate that diegetic sounds are used for notification rather than orientation. Through VIMS mitigation pipeline, this research shows that dynamic restricted FoV is statistically significant in mitigating VIMS, while mantaining desired levels of Presence. Both Cue Control and the VIMS mitigation pipeline emerged from a Research through Design (RtD) approach, where the IVRUX artifact is the product of de- sign knowledge and gave direction to research. The research presented in this thesis is of interest to practitioners and researchers working on 360o video and helps delineate future directions in making 360o video a rich design space for interaction and narrative.Sistemas de Realidade EXtendida ressurgiram como um meio de comunicação para o tra- balho e entretenimento. Enquanto que o vídeo 360o tem sido caracterizado como sendo menos imersivo que a Realidade Virtual gerada por computador, o seu realismo, facili- dade de uso e acessibilidade significa que tem uso comercial generalizado. Baseado na prevalência e potencial do formato de vídeo 360o, esta pesquisa está focada em melhorar e aumentar a experiência de utilizador ao ver vídeos 360o. Impulsionado por conhecimento de sistemas de Realidade eXtendida (XR) e Interacção Humano-Computador (HCI), esta pesquisa aborda dois problemas que afetam a experiência de utilizador em vídeo 360o: Orientação de Atenção e Enjoo de Movimento Induzido Visualmente (VIMS). Este trabalho de pesquisa é apoiado na construção de múltiplos artefactos para res- ponder as perguntas de pesquisa definidas: (1) IVRUX, uma ferramenta para análise de experiências narrativas imersivas em VR; (2) Cue Control, uma ferramenta para a criação de bandas sonoras de áudio espacial, enquanto permite a recolha e análise de métricas capturadas emergentes da experiencia de utilizador; e (3) canal para a mitigação de VIMS, uma sequência linear de módulos (incluindo fluxo ótico e SLAM visual entre outros) que controla parâmetros para modificações visuais como o campo de visão restringido. Estes artefactos estão acompanhados por estudos de avaliação direcionados para às perguntas de pesquisa definidas. Através do Cue Control, esta pesquisa mostra que música não- diegética pode ser espacializada para servir como orientação para os utilizadores. Uma espacialização parcial da música foi considerada ineficaz quando usada para a orientação. Adicionalmente, os nossos resultados demonstram que sons diegéticos são usados para notificação em vez de orientação. Através do canal para a mitigação de VIMS, esta pesquisa mostra que o campo de visão restrito e dinâmico é estatisticamente significante ao mitigar VIMS, enquanto mantem níveis desejados de Presença. Ambos Cue Control e o canal para a mitigação de VIMS emergiram de uma abordagem de Pesquisa através do Design (RtD), onde o artefacto IVRUX é o produto de conhecimento de design e deu direcção à pesquisa. A pesquisa apresentada nesta tese é de interesse para profissionais e investigadores tra- balhando em vídeo 360o e ajuda a delinear futuras direções em tornar o vídeo 360o um espaço de design rico para a interação e narrativa

Sonic Interactions in Virtual Environments

This open access book tackles the design of 3D spatial interactions in an audio-centered and audio-first perspective, providing the fundamental notions related to the creation and evaluation of immersive sonic experiences. The key elements that enhance the sensation of place in a virtual environment (VE) are: Immersive audio: the computational aspects of the acoustical-space properties of Virutal Reality (VR) technologies Sonic interaction: the human-computer interplay through auditory feedback in VE VR systems: naturally support multimodal integration, impacting different application domains Sonic Interactions in Virtual Environments will feature state-of-the-art research on real-time auralization, sonic interaction design in VR, quality of the experience in multimodal scenarios, and applications. Contributors and editors include interdisciplinary experts from the fields of computer science, engineering, acoustics, psychology, design, humanities, and beyond. Their mission is to shape an emerging new field of study at the intersection of sonic interaction design and immersive media, embracing an archipelago of existing research spread in different audio communities and to increase among the VR communities, researchers, and practitioners, the awareness of the importance of sonic elements when designing immersive environments

Sonic Interactions in Virtual Environments

This open access book tackles the design of 3D spatial interactions in an audio-centered and audio-first perspective, providing the fundamental notions related to the creation and evaluation of immersive sonic experiences. The key elements that enhance the sensation of place in a virtual environment (VE) are: Immersive audio: the computational aspects of the acoustical-space properties of Virutal Reality (VR) technologies Sonic interaction: the human-computer interplay through auditory feedback in VE VR systems: naturally support multimodal integration, impacting different application domains Sonic Interactions in Virtual Environments will feature state-of-the-art research on real-time auralization, sonic interaction design in VR, quality of the experience in multimodal scenarios, and applications. Contributors and editors include interdisciplinary experts from the fields of computer science, engineering, acoustics, psychology, design, humanities, and beyond. Their mission is to shape an emerging new field of study at the intersection of sonic interaction design and immersive media, embracing an archipelago of existing research spread in different audio communities and to increase among the VR communities, researchers, and practitioners, the awareness of the importance of sonic elements when designing immersive environments

Sonic interactions in virtual environments

This book tackles the design of 3D spatial interactions in an audio-centered and audio-first perspective, providing the fundamental notions related to the creation and evaluation of immersive sonic experiences. The key elements that enhance the sensation of place in a virtual environment (VE) are: Immersive audio: the computational aspects of the acoustical-space properties of Virutal Reality (VR) technologies Sonic interaction: the human-computer interplay through auditory feedback in VE VR systems: naturally support multimodal integration, impacting different application domains Sonic Interactions in Virtual Environments will feature state-of-the-art research on real-time auralization, sonic interaction design in VR, quality of the experience in multimodal scenarios, and applications. Contributors and editors include interdisciplinary experts from the fields of computer science, engineering, acoustics, psychology, design, humanities, and beyond. Their mission is to shape an emerging new field of study at the intersection of sonic interaction design and immersive media, embracing an archipelago of existing research spread in different audio communities and to increase among the VR communities, researchers, and practitioners, the awareness of the importance of sonic elements when designing immersive environments

A virtual musical instrument exhibit for a science centre.

Virtual reality is a technology rapidly gaining interest from research and commercial groups around the world, but it's introduction into New Zealand has been slow. The majority of the general public have no concept of virtual reality, and only a few research institutes have begun virtual reality programmes of any sort. Partially this is due to the high cost of 'off the shelf' virtual reality systems, which is usually beyond the range of many organisations. Also the complexity of the software and the knowledge required to create and manipulate this software makes it a daunting prospect for many. This work describes the development of an economical system for the demonstration of virtual reality and some of its concepts and applications to the general public, in the form of an educational science centre exhibit. The system creates virtual musical instruments, overlayed onto the real world, and the user experiences these instruments as if they were in physical existence

Maritime Augmented Reality mit a prioriWissen aus Seekarten

The main objective of this thesis is to provide a concept to augment mar- itime sea chart information into the camera view of the user. The benefit is the simpler navigation due to the offered 3D information and the overlay onto the real 3D environment. In the maritime context special conditions hold. The sensor technologies have to be reliable in the environment of a ship’s ferrous construction. The aug- mentation of the objects has to be very precise due to the far distances of observable objects on the sea surface. Furthermore, the approach has to be reliable due to the wide range of light conditions. For a practical solution, the system has to be mobile, light-weight and with a real-time performance. To achieve this goal, the requirements are set, the possible measurement units and the data base structure are presented. First, the requirements are analyzed and a suitable system is designed. By the combination of proper sensor techniques, the local position and orienta- tion of the user can be estimated. To verify the concept, several prototypes with exchangeable units have been evaluated. This first concept is based on a marker-based approach which leads to some drawbacks. To overcome the drawbacks, the second aspect is the improvement of the sys- tem and the analysis of markerless approaches. One possible strategy will be presented. The approach uses the statistical technique of Bayesian networks to vote for single objects in the environment. By this procedure it will be shown, that due to the a priori information the underlying sea chart system has the most benefit. The analysis of the markerless approach shows, that the sea charts structure has to be adapted to the new requirements of interactive 3D augmentation scenes. After the analysis of the chart data concept, an approach for the optimization of the charts by building up an object-to-object topology within the charts data and the Bayesian object detection approach is presented. Finally, several evaluations show the performance of the imple- mented evaluation application.Diese Arbeit stellt ein Konzept zur Verfügung, um Seekarteninformationen in eine Kamera so einzublenden, dass die Informationen lagerichtig im Sichtfeld des Benutzers erscheinen. Der Mehrwert ist eine einfachere Navigation durch die Nutzung von 3D-Symbolen in der realen Umgebung. Im maritimen Umfeld gelten besondere Anforderungen an die Aufgabenstellung. Die genutzten Sensoren müssen in der Lage sein, robuste Daten in Anwesenheit der eisenhaltigen Materialien auf dem Schiff zu liefern. Die Augmentierung muss hoch genau berechnet werden, da die beobachtbaren Objekte zum Teil sehr weit entfernt auf der Meeresoberfläche verteilt sind. Weiterhin gelten die Bedingungen einer Außenumgebung, wie variierende Wetter- und Lichtbedingungen. Um eine praktikable Anwendung gewährleisten zu können, ist ein mobiles, leicht-gewichtiges und echtzeitfähiges System zu entwickeln. In dieser Arbeit werden die Anforderungen gesetzt und Konzepte für die Hardware- und Softwarelösungen beschrieben. Im ersten Teil werden die Anforderungen analysiert und ein geeignetes Hardwaresystem entwickelt. Durch die passende Kombination von Sensortechnologien kann damit die lokale Position und Orientierung des Benutzers berechnet werden. Um das Konzept zu evaluieren sind verschiedene modulare Hardware- und Softwarekonzepte als Prototypen umgesetzt worden. Das erste Softwarekonzept befasst sich mit einem markerbasierten Erkennungsalgorithmus, der in der Evaluation einige Nachteile zeigt. Dementsprechende Verbesserungen wurden in einem zweiten Softwarekonzept durch einen markerlosen Ansatz umgesetzt. Dieser Lösungsansatz nutzt Bayes'sche Netzwerke zur Erkennung einzelner Objekte in der Umgebung. Damit kann gezeigt werden, dass mit der Hilfe von a priori Informationen die dem System zugrunde liegenden Seekarten sehr gut zu diesem Zweck genutzt werden können. Die Analyse des Systemkonzeptes zeigt des weiteren, dass die Datenstruktur der Seekarten für die Anforderungen einer interaktiven, benutzergeführten 3D- Augmentierungsszene angepasst werden müssen. Nach der ausführlichen Analyse des Seekarten-Datenkonzeptes wird ein Lösungsansatz zur Optimierung der internen Seekartenstruktur aufgezeigt. Dies wird mit der Erstellung einer Objekt-zu-Objekt-Topologie in der Datenstruktur und der Verbindung zum Bayes'schen Objekterkennungsalgorithmus umgesetzt. Anschließend zeigen Evaluationen die Fähigkeiten des endgültigen Systems