Rehabilitative devices for a top-down approach

In recent years, neurorehabilitation has moved from a "bottom-up" to a "top down" approach. This change has also involved the technological devices developed for motor and cognitive rehabilitation. It implies that during a task or during therapeutic exercises, new "top-down" approaches are being used to stimulate the brain in a more direct way to elicit plasticity-mediated motor re-learning. This is opposed to "Bottom up" approaches, which act at the physical level and attempt to bring about changes at the level of the central neural system. Areas covered: In the present unsystematic review, we present the most promising innovative technological devices that can effectively support rehabilitation based on a top-down approach, according to the most recent neuroscientific and neurocognitive findings. In particular, we explore if and how the use of new technological devices comprising serious exergames, virtual reality, robots, brain computer interfaces, rhythmic music and biofeedback devices might provide a top-down based approach. Expert commentary: Motor and cognitive systems are strongly harnessed in humans and thus cannot be separated in neurorehabilitation. Recently developed technologies in motor-cognitive rehabilitation might have a greater positive effect than conventional therapies

Effects of Auditory Rhythm and Music on Gait Disturbances in Parkinson’s Disease

Gait abnormalities such as shuffling steps, start hesitation, and freezing are common and often incapacitating symptoms of Parkinson’s disease (PD) and other parkinsonian disorders. Pharmacological and surgical approaches have only limited efficacy in treating these gait disorders. Rhythmic auditory stimulation (RAS), such as playing marching music or dance therapy, has been shown to be a safe, inexpensive, and an effective method in improving gait in PD patients. However, RAS that adapts to patients’ movements may be more effective than rigid, fixed-tempo RAS used in most studies. In addition to auditory cueing, immersive virtual reality technologies that utilize interactive computer-generated systems through wearable devices are increasingly used for improving brain-body interaction and sensory-motor integration. Using multisensory cues, these therapies may be particularly suitable for the treatment of parkinsonian freezing and other gait disorders. In this review, we examine the affected neurological circuits underlying gait and temporal processing in PD patients and summarize the current studies demonstrating the effects of RAS on improving these gait deficits

Virtual reality-based assessment and rehabilitation of functional mobility

The advent of virtual reality (VR) as a tool for real-world training dates back to the mid-twentieth century and the early years of driving and flight simulators. These simulation environments, while far below the quality of today’s visual displays, proved to be advantageous to the learner due to the safe training environments the simulations provided. More recently, these training environments have proven beneficial in the transfer of user-learned skills from the simulated environment to the real world [5, 31, 48, 51, 57]. Of course the VR technology of today has come a long way. Contemporary displays boast high-resolution, wide-angle fields of view and increased portability. This has led to the evolution of new VR research and training applications in many different arenas, several of which are covered in other chapters of this book. This is true of clinical assessment and rehabilitation as well, as the field has recognized the potential advantages of incorporating VR technologies into patient training for almost 20 years [7, 10, 18, 45, 78]

Multimodality in VR: A survey

Virtual reality (VR) is rapidly growing, with the potential to change the way we create and consume content. In VR, users integrate multimodal sensory information they receive, to create a unified perception of the virtual world. In this survey, we review the body of work addressing multimodality in VR, and its role and benefits in user experience, together with different applications that leverage multimodality in many disciplines. These works thus encompass several fields of research, and demonstrate that multimodality plays a fundamental role in VR; enhancing the experience, improving overall performance, and yielding unprecedented abilities in skill and knowledge transfer

Design For Auditory Displays: Identifying Temporal And Spatial Information Conveyance Principles

Designing auditory interfaces is a challenge for current human-systems developers. This is largely due to a lack of theoretical guidance for directing how best to use sounds in today\u27s visually-rich graphical user interfaces. This dissertation provided a framework for guiding the design of audio interfaces to enhance human-systems performance. This doctoral research involved reviewing the literature on conveying temporal and spatial information using audio, using this knowledge to build three theoretical models to aid the design of auditory interfaces, and empirically validating select components of the models. The three models included an audio integration model that outlines an end-to-end process for adding sounds to interactive interfaces, a temporal audio model that provides a framework for guiding the timing for integration of these sounds to meet human performance objectives, and a spatial audio model that provides a framework for adding spatialization cues to interface sounds. Each model is coupled with a set of design guidelines theorized from the literature, thus combined, the developed models put forward a structured process for integrating sounds in interactive interfaces. The developed models were subjected to a three phase validation process that included review by Subject Matter Experts (SMEs) to assess the face validity of the developed models and two empirical studies. For the SME review, which assessed the utility of the developed models and identified opportunities for improvement, a panel of three audio experts was selected to respond to a Strengths, Weaknesses, Opportunities, and Threats (SWOT) validation questionnaire. Based on the SWOT analysis, the main strengths of the models included that they provide a systematic approach to auditory display design and that they integrate a wide variety of knowledge sources in a concise manner. The main weaknesses of the models included the lack of a structured process for amending the models with new principles, some branches were not considered parallel or completely distinct, and lack of guidance on selecting interface sounds. The main opportunity identified by the experts was the ability of the models to provide a seminal body of knowledge that can be used for building and validating auditory display designs. The main threats identified by the experts were that users may not know where to start and end with each model, the models may not provide comprehensive coverage of all uses of auditory displays, and the models may act as a restrictive influence on designers or they may be used inappropriately. Based on the SWOT analysis results, several changes were made to the models prior to the empirical studies. Two empirical evaluation studies were conducted to test the theorized design principles derived from the revised models. The first study focused on assessing the utility of audio cues to train a temporal pacing task and the second study combined both temporal (i.e., pace) and spatial audio information, with a focus on examining integration issues. In the pace study, there were four different auditory conditions used for training pace: 1) a metronome, 2) non-spatial auditory earcons, 3) a spatialized auditory earcon, and 4) no audio cues for pace training. Sixty-eight people participated in the study. A pre- post between subjects experimental design was used, with eight training trials. The measure used for assessing pace performance was the average deviation from a predetermined desired pace. The results demonstrated that a metronome was not effective in training participants to maintain a desired pace, while, spatial and non-spatial earcons were effective strategies for pace training. Moreover, an examination of post-training performance as compared to pre-training suggested some transfer of learning. Design guidelines were extracted for integrating auditory cues for pace training tasks in virtual environments. In the second empirical study, combined temporal (pacing) and spatial (location of entities within the environment) information were presented. There were three different spatialization conditions used: 1) high fidelity using subjective selection of a best-fit head related transfer function, 2) low fidelity using a generalized head-related transfer function, and 3) no spatialization. A pre- post between subjects experimental design was used, with eight training trials. The performance measures were average deviation from desired pace and time and accuracy to complete the task. The results of the second study demonstrated that temporal, non-spatial auditory cues were effective in influencing pace while other cues were present. On the other hand, spatialized auditory cues did not result in significantly faster task completion. Based on these results, a set of design guidelines was proposed that can be used to direct the integration of spatial and temporal auditory cues for supporting training tasks in virtual environments. Taken together, the developed models and the associated guidelines provided a theoretical foundation from which to direct user-centered design of auditory interfaces

Recent developments in biofeedback for neuromotor rehabilitation

The original use of biofeedback to train single muscle activity in static positions or movement unrelated to function did not correlate well to motor function improvements in patients with central nervous system injuries. The concept of task-oriented repetitive training suggests that biofeedback therapy should be delivered during functionally related dynamic movement to optimize motor function improvement. Current, advanced technologies facilitate the design of novel biofeedback systems that possess diverse parameters, advanced cue display, and sophisticated control systems for use in task-oriented biofeedback. In light of these advancements, this article: (1) reviews early biofeedback studies and their conclusions; (2) presents recent developments in biofeedback technologies and their applications to task-oriented biofeedback interventions; and (3) discusses considerations regarding the therapeutic system design and the clinical application of task-oriented biofeedback therapy. This review should provide a framework to further broaden the application of task-oriented biofeedback therapy in neuromotor rehabilitation

Multimodality in {VR}: {A} Survey

Virtual reality has the potential to change the way we create and consume content in our everyday life. Entertainment, training, design and manufacturing, communication, or advertising are all applications that already benefit from this new medium reaching consumer level. VR is inherently different from traditional media: it offers a more immersive experience, and has the ability to elicit a sense of presence through the place and plausibility illusions. It also gives the user unprecedented capabilities to explore their environment, in contrast with traditional media. In VR, like in the real world, users integrate the multimodal sensory information they receive to create a unified perception of the virtual world. Therefore, the sensory cues that are available in a virtual environment can be leveraged to enhance the final experience. This may include increasing realism, or the sense of presence; predicting or guiding the attention of the user through the experience; or increasing their performance if the experience involves the completion of certain tasks. In this state-of-the-art report, we survey the body of work addressing multimodality in virtual reality, its role and benefits in the final user experience. The works here reviewed thus encompass several fields of research, including computer graphics, human computer interaction, or psychology and perception. Additionally, we give an overview of different applications that leverage multimodal input in areas such as medicine, training and education, or entertainment; we include works in which the integration of multiple sensory information yields significant improvements, demonstrating how multimodality can play a fundamental role in the way VR systems are designed, and VR experiences created and consumed

16th Sound and Music Computing Conference SMC 2019 (28–31 May 2019, Malaga, Spain)

The 16th Sound and Music Computing Conference (SMC 2019) took place in Malaga, Spain, 28-31 May 2019 and it was organized by the Application of Information and Communication Technologies Research group (ATIC) of the University of Malaga (UMA). The SMC 2019 associated Summer School took place 25-28 May 2019. The First International Day of Women in Inclusive Engineering, Sound and Music Computing Research (WiSMC 2019) took place on 28 May 2019. The SMC 2019 TOPICS OF INTEREST included a wide selection of topics related to acoustics, psychoacoustics, music, technology for music, audio analysis, musicology, sonification, music games, machine learning, serious games, immersive audio, sound synthesis, etc