Reinforced feedback in virtual environment for rehabilitation of upper extremity dysfunction after stroke: preliminary data from a randomized controlled trial.

OBJECTIVES: To study whether the reinforced feedback in virtual environment (RFVE) is more effective than traditional rehabilitation (TR) for the treatment of upper limb motor function after stroke, regardless of stroke etiology (i.e., ischemic, hemorrhagic). DESIGN: Randomized controlled trial. Participants. Forty-four patients affected by stroke. Intervention. The patients were randomized into two groups: RFVE (N = 23) and TR (N = 21), and stratified according to stroke etiology. The RFVE treatment consisted of multidirectional exercises providing augmented feedback provided by virtual reality, while in the TR treatment the same exercises were provided without augmented feedbacks. Outcome Measures. Fugl-Meyer upper extremity scale (F-M UE), Functional Independence Measure scale (FIM), and kinematics parameters (speed, time, and peak). RESULTS: The F-M UE (P = 0.030), FIM (P = 0.021), time (P = 0.008), and peak (P = 0.018), were significantly higher in the RFVE group after treatment, but not speed (P = 0.140). The patients affected by hemorrhagic stroke significantly improved FIM (P = 0.031), time (P = 0.011), and peak (P = 0.020) after treatment, whereas the patients affected by ischemic stroke improved significantly only speed (P = 0.005) when treated by RFVE. CONCLUSION: These results indicated that some poststroke patients may benefit from RFVE program for the recovery of upper limb motor function. This trial is registered with NCT01955291

A Person-Centric Design Framework for At-Home Motor Learning in Serious Games

abstract: In motor learning, real-time multi-modal feedback is a critical element in guided training. Serious games have been introduced as a platform for at-home motor training due to their highly interactive and multi-modal nature. This dissertation explores the design of a multimodal environment for at-home training in which an autonomous system observes and guides the user in the place of a live trainer, providing real-time assessment, feedback and difficulty adaptation as the subject masters a motor skill. After an in-depth review of the latest solutions in this field, this dissertation proposes a person-centric approach to the design of this environment, in contrast to the standard techniques implemented in related work, to address many of the limitations of these approaches. The unique advantages and restrictions of this approach are presented in the form of a case study in which a system entitled the "Autonomous Training Assistant" consisting of both hardware and software for guided at-home motor learning is designed and adapted for a specific individual and trainer. In this work, the design of an autonomous motor learning environment is approached from three areas: motor assessment, multimodal feedback, and serious game design. For motor assessment, a 3-dimensional assessment framework is proposed which comprises of 2 spatial (posture, progression) and 1 temporal (pacing) domains of real-time motor assessment. For multimodal feedback, a rod-shaped device called the "Intelligent Stick" is combined with an audio-visual interface to provide feedback to the subject in three domains (audio, visual, haptic). Feedback domains are mapped to modalities and feedback is provided whenever the user's performance deviates from the ideal performance level by an adaptive threshold. Approaches for multi-modal integration and feedback fading are discussed. Finally, a novel approach for stealth adaptation in serious game design is presented. This approach allows serious games to incorporate motor tasks in a more natural way, facilitating self-assessment by the subject. An evaluation of three different stealth adaptation approaches are presented and evaluated using the flow-state ratio metric. The dissertation concludes with directions for future work in the integration of stealth adaptation techniques across the field of exergames.Dissertation/ThesisDoctoral Dissertation Computer Science 201

Haptic Media Scenes

The aim of this thesis is to apply new media phenomenological and enactive embodied cognition approaches to explain the role of haptic sensitivity and communication in personal computer environments for productivity. Prior theory has given little attention to the role of haptic senses in influencing cognitive processes, and do not frame the richness of haptic communication in interaction design—as haptic interactivity in HCI has historically tended to be designed and analyzed from a perspective on communication as transmissions, sending and receiving haptic signals. The haptic sense may not only mediate contact confirmation and affirmation, but also rich semiotic and affective messages—yet this is a strong contrast between this inherent ability of haptic perception, and current day support for such haptic communication interfaces. I therefore ask: How do the haptic senses (touch and proprioception) impact our cognitive faculty when mediated through digital and sensor technologies? How may these insights be employed in interface design to facilitate rich haptic communication? To answer these questions, I use theoretical close readings that embrace two research fields, new media phenomenology and enactive embodied cognition. The theoretical discussion is supported by neuroscientific evidence, and tested empirically through case studies centered on digital art. I use these insights to develop the concept of the haptic figura, an analytical tool to frame the communicative qualities of haptic media. The concept gauges rich machine- mediated haptic interactivity and communication in systems with a material solution supporting active haptic perception, and the mediation of semiotic and affective messages that are understood and felt. As such the concept may function as a design tool for developers, but also for media critics evaluating haptic media. The tool is used to frame a discussion on opportunities and shortcomings of haptic interfaces for productivity, differentiating between media systems for the hand and the full body. The significance of this investigation is demonstrating that haptic communication is an underutilized element in personal computer environments for productivity and providing an analytical framework for a more nuanced understanding of haptic communication as enabling the mediation of a range of semiotic and affective messages, beyond notification and confirmation interactivity

A Multi-Modal, Modified-Feedback and Self-Paced Brain-Computer Interface (BCI) to Control an Embodied Avatar's Gait

Brain-computer interfaces (BCI) have been used to control the gait of a virtual self-avatar with the aim of being used in gait rehabilitation. A BCI decodes the brain signals representing a desire to do something and transforms them into a control command for controlling external devices. The feelings described by the participants when they control a self-avatar in an immersive virtual environment (VE) demonstrate that humans can be embodied in the surrogate body of an avatar (ownership illusion). It has recently been shown that inducing the ownership illusion and then manipulating the movements of one’s self-avatar can lead to compensatory motor control strategies. In order to maximize this effect, there is a need for a method that measures and monitors embodiment levels of participants immersed in virtual reality (VR) to induce and maintain a strong ownership illusion. This is particularly true given that reaching a high level of both BCI performance and embodiment are inter-connected. To reach one of them, the second must be reached as well. Some limitations of many existing systems hinder their adoption for neurorehabilitation: 1- some use motor imagery (MI) of movements other than gait; 2- most systems allow the user to take single steps or to walk but do not allow both, which prevents users from progressing from steps to gait; 3- most of them function in a single BCI mode (cue-paced or self-paced), which prevents users from progressing from machine-dependent to machine-independent walking. Overcoming the aforementioned limitations can be done by combining different control modes and options in one single system. However, this would have a negative impact on BCI performance, therefore diminishing its usefulness as a potential rehabilitation tool. In this case, there will be a need to enhance BCI performance. For such purpose, many techniques have been used in the literature, such as providing modified feedback (whereby the presented feedback is not consistent with the user’s MI), sequential training (recalibrating the classifier as more data becomes available). This thesis was developed over 3 studies. The objective in study 1 was to investigate the possibility of measuring the level of embodiment of an immersive self-avatar, during the performing, observing and imagining of gait, using electroencephalogram (EEG) techniques, by presenting visual feedback that conflicts with the desired movement of embodied participants. The objective of study 2 was to develop and validate a BCI to control single steps and forward walking of an immersive virtual reality (VR) self-avatar, using mental imagery of these actions, in cue-paced and self-paced modes. Different performance enhancement strategies were implemented to increase BCI performance. The data of these two studies were then used in study 3 to construct a generic classifier that could eliminate offline calibration for future users and shorten training time. Twenty different healthy participants took part in studies 1 and 2. In study 1, participants wore an EEG cap and motion capture markers, with an avatar displayed in a head-mounted display (HMD) from a first-person perspective (1PP). They were cued to either perform, watch or imagine a single step forward or to initiate walking on a treadmill. For some of the trials, the avatar took a step with the contralateral limb or stopped walking before the participant stopped (modified feedback). In study 2, participants completed a 4-day sequential training to control the gait of an avatar in both BCI modes. In cue-paced mode, they were cued to imagine a single step forward, using their right or left foot, or to walk forward. In the self-paced mode, they were instructed to reach a target using the MI of multiple steps (switch control mode) or maintaining the MI of forward walking (continuous control mode). The avatar moved as a response to two calibrated regularized linear discriminant analysis (RLDA) classifiers that used the μ power spectral density (PSD) over the foot area of the motor cortex as features. The classifiers were retrained after every session. During the training, and for some of the trials, positive modified feedback was presented to half of the participants, where the avatar moved correctly regardless of the participant’s real performance. In both studies, the participants’ subjective experience was analyzed using a questionnaire. Results of study 1 show that subjective levels of embodiment correlate strongly with the power differences of the event-related synchronization (ERS) within the μ frequency band, and over the motor and pre-motor cortices between the modified and regular feedback trials. Results of study 2 show that all participants were able to operate the cued-paced BCI and the selfpaced BCI in both modes. For the cue-paced BCI, the average offline performance (classification rate) on day 1 was 67±6.1% and 86±6.1% on day 3, showing that the recalibration of the classifiers enhanced the offline performance of the BCI (p < 0.01). The average online performance was 85.9±8.4% for the modified feedback group (77-97%) versus 75% for the non-modified feedback group. For self-paced BCI, the average performance was 83% at switch control and 92% at continuous control mode, with a maximum of 12 seconds of control. Modified feedback enhanced BCI performances (p =0.001). Finally, results of study 3 show that the constructed generic models performed as well as models obtained from participant-specific offline data. The results show that there it is possible to design a participant-independent zero-training BCI.Les interfaces cerveau-ordinateur (ICO) ont été utilisées pour contrôler la marche d'un égo-avatar virtuel dans le but d'être utilisées dans la réadaptation de la marche. Une ICO décode les signaux du cerveau représentant un désir de faire produire un mouvement et les transforme en une commande de contrôle pour contrôler des appareils externes. Les sentiments décrits par les participants lorsqu'ils contrôlent un égo-avatar dans un environnement virtuel immersif démontrent que les humains peuvent être incarnés dans un corps d'un avatar (illusion de propriété). Il a été récemment démontré que provoquer l’illusion de propriété puis manipuler les mouvements de l’égo-avatar peut conduire à des stratégies de contrôle moteur compensatoire. Afin de maximiser cet effet, il existe un besoin d'une méthode qui mesure et surveille les niveaux d’incarnation des participants immergés dans la réalité virtuelle (RV) pour induire et maintenir une forte illusion de propriété. D'autre part, atteindre un niveau élevé de performances (taux de classification) ICO et d’incarnation est interconnecté. Pour atteindre l'un d'eux, le second doit également être atteint. Certaines limitations de plusieurs de ces systèmes entravent leur adoption pour la neuroréhabilitation: 1- certains utilisent l'imagerie motrice (IM) des mouvements autres que la marche; 2- la plupart des systèmes permettent à l'utilisateur de faire des pas simples ou de marcher mais pas les deux, ce qui ne permet pas à un utilisateur de passer des pas à la marche; 3- la plupart fonctionnent en un seul mode d’ICO, rythmé (cue-paced) ou auto-rythmé (self-paced). Surmonter les limitations susmentionnées peut être fait en combinant différents modes et options de commande dans un seul système. Cependant, cela aurait un impact négatif sur les performances de l’ICO, diminuant ainsi son utilité en tant qu'outil potentiel de réhabilitation. Dans ce cas, il sera nécessaire d'améliorer les performances des ICO. À cette fin, de nombreuses techniques ont été utilisées dans la littérature, telles que la rétroaction modifiée, le recalibrage du classificateur et l'utilisation d'un classificateur générique. Le projet de cette thèse a été réalisé en 3 études, avec objectif d'étudier dans l'étude 1, la possibilité de mesurer le niveau d'incarnation d'un égo-avatar immersif, lors de l'exécution, de l'observation et de l'imagination de la marche, à l'aide des techniques encéphalogramme (EEG), en présentant une rétroaction visuelle qui entre en conflit avec la commande du contrôle moteur des sujets incarnés. L'objectif de l'étude 2 était de développer un BCI pour contrôler les pas et la marche vers l’avant d'un égo-avatar dans la réalité virtuelle immersive, en utilisant l'imagerie motrice de ces actions, dans des modes rythmés et auto-rythmés. Différentes stratégies d'amélioration des performances ont été mises en œuvre pour augmenter la performance (taux de classification) de l’ICO. Les données de ces deux études ont ensuite été utilisées dans l'étude 3 pour construire des classificateurs génériques qui pourraient éliminer la calibration hors ligne pour les futurs utilisateurs et raccourcir le temps de formation. Vingt participants sains différents ont participé aux études 1 et 2. Dans l'étude 1, les participants portaient un casque EEG et des marqueurs de capture de mouvement, avec un avatar affiché dans un casque de RV du point de vue de la première personne (1PP). Ils ont été invités à performer, à regarder ou à imaginer un seul pas en avant ou la marche vers l’avant (pour quelques secondes) sur le tapis roulant. Pour certains essais, l'avatar a fait un pas avec le membre controlatéral ou a arrêté de marcher avant que le participant ne s'arrête (rétroaction modifiée). Dans l'étude 2, les participants ont participé à un entrainement séquentiel de 4 jours pour contrôler la marche d'un avatar dans les deux modes de l’ICO. En mode rythmé, ils ont imaginé un seul pas en avant, en utilisant leur pied droit ou gauche, ou la marche vers l’avant . En mode auto-rythmé, il leur a été demandé d'atteindre une cible en utilisant l'imagerie motrice (IM) de plusieurs pas (mode de contrôle intermittent) ou en maintenir l'IM de marche vers l’avant (mode de contrôle continu). L'avatar s'est déplacé en réponse à deux classificateurs ‘Regularized Linear Discriminant Analysis’ (RLDA) calibrés qui utilisaient comme caractéristiques la densité spectrale de puissance (Power Spectral Density; PSD) des bandes de fréquences µ (8-12 Hz) sur la zone du pied du cortex moteur. Les classificateurs ont été recalibrés après chaque session. Au cours de l’entrainement et pour certains des essais, une rétroaction modifiée positive a été présentée à la moitié des participants, où l'avatar s'est déplacé correctement quelle que soit la performance réelle du participant. Dans les deux études, l'expérience subjective des participants a été analysée à l'aide d'un questionnaire. Les résultats de l'étude 1 montrent que les niveaux subjectifs d’incarnation sont fortement corrélés à la différence de la puissance de la synchronisation liée à l’événement (Event-Related Synchronization; ERS) sur la bande de fréquence μ et sur le cortex moteur et prémoteur entre les essais de rétroaction modifiés et réguliers. L'étude 2 a montré que tous les participants étaient capables d’utiliser le BCI rythmé et auto-rythmé dans les deux modes. Pour le BCI rythmé, la performance hors ligne moyenne au jour 1 était de 67±6,1% et 86±6,1% au jour 3, ce qui montre que le recalibrage des classificateurs a amélioré la performance hors ligne du BCI (p <0,01). La performance en ligne moyenne était de 85,9±8,4% pour le groupe de rétroaction modifié (77-97%) contre 75% pour le groupe de rétroaction non modifié. Pour le BCI auto-rythmé, la performance moyenne était de 83% en commande de commutateur et de 92% en mode de commande continue, avec un maximum de 12 secondes de commande. Les performances de l’ICO ont été améliorées par la rétroaction modifiée (p = 0,001). Enfin, les résultats de l'étude 3 montrent que pour la classification des initialisations des pas et de la marche, il a été possible de construire des modèles génériques à partir de données hors ligne spécifiques aux participants. Les résultats montrent la possibilité de concevoir une ICO ne nécessitant aucun entraînement spécifique au participant

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 324)

This bibliography lists 200 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during May, 1989. Subject coverage includes: aerospace medicine and psychology, life support systems and controlled environments, safety equipment, exobiology and extraterrestrial life, and flight crew behavior and performance

Biomove: Biometric user identification from human kinesiological movements for virtual reality systems

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Virtual reality (VR) has advanced rapidly and is used for many entertainment and business purposes. The need for secure, transparent and non-intrusive identification mechanisms is important to facilitate users’ safe participation and secure experience. People are kinesiologically unique, having individual behavioral and movement characteristics, which can be leveraged and used in security sensitive VR applications to compensate for users’ inability to detect potential observational attackers in the physical world. Additionally, such method of identification using a user’s kinesiological data is valuable in common scenarios where multiple users simultaneously participate in a VR environment. In this paper, we present a user study (n = 15) where our participants performed a series of controlled tasks that require physical movements (such as grabbing, rotating and dropping) that could be decomposed into unique kinesiological patterns while we monitored and captured their hand, head and eye gaze data within the VR environment. We present an analysis of the data and show that these data can be used as a biometric discriminant of high confidence using machine learning classification methods such as kNN or SVM, thereby adding a layer of security in terms of identification or dynamically adapting the VR environment to the users’ preferences. We also performed a whitebox penetration testing with 12 attackers, some of whom were physically similar to the participants. We could obtain an average identification confidence value of 0.98 from the actual participants’ test data after the initial study and also a trained model classification accuracy of 98.6%. Penetration testing indicated all attackers resulted in confidence values of less than 50% (\u3c50%), although physically similar attackers had higher confidence values. These findings can help the design and development of secure VR systems

How technology applied to music-therapy and sound-based activities addresses motor and social skills in autistic children

Autism affects how people perceive and make sense of the world around them. Autism is a spectrum condition which impacts people in different ways. Also referred to as Autism Spectrum Disorder (ASD), it is characterized by challenges in the domains of social, cognitive and motor functioning, which differ in severity. Previous research suggests that music can have cognitive, psychosocial, behavioural, and motor benefits in this population. We systematically review the use of technology in Music-therapy and related sound-based activities to improve the motor and social skills of children. In May 2020 we conducted a systematic search on Music-therapy and musical activities for autistic children in research databases including Science Direct, APA PsycNet, Cochrane, IEE and Web of Science, to collect relevant studies. We initially collected 5179 papers of which only 27 studies were identified as suitable for the scope of this review. In the paper, we analyse and describe key characteristics of each project. We then highlight the commonalities, strengths and limitations of existing work, and identify implications for future interaction design

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

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