Multi-user Touch Surfaces to Promote Social Participation and Self-efficacy in Upper-limb Stroke Rehabilitation

This thesis addresses the growing incidence of stroke and its impact on long-term disability, emphasizing the importance of post-stroke rehabilitation. Predicting a 34% increase in stroke cases by 2025, this work focuses on factors affecting post-stroke motor rehabilitation, such as depressive symptoms, while recognizing the role of social participation and self-efficacy in modulating these outcomes. To tackle these challenges, we propose the use of a multi-user interactive table for upper limb rehabilitation. This innovative approach involves detecting objects of various sizes and shapes as interfaces for serious games, fostering collective therapeutic activities targeting motor rehabilitation, depressive symptoms, social participation, and self-efficacy. Four exploratory studies informed the development of the interactive table. The studies determined game mechanics, object types, and game features. Three game modes (competitive, co-active, and collaborative) were explored, with the collaborative mode showing higher social engagement and more positive outcomes. Subsequent studies involving stroke survivors confirmed the effectiveness of collaborative gameplay. Feasibility, engagement, and usability were tested using objects of different sizes and shapes, revealing insights into task performance, grasping, and task complexity adjustments. The developed interactive table accommodates up to four participants, using top down object shape tracking and a multi-touch panel. Four serious games were designed to target specific upper limb skills, played in collaborative mode with incorporated features to enhance the overall experience. A pilot study with 12 stroke survivors over four weeks demonstrated significant improvements in motor outcomes, including range of motion, dexterity, strength, and coordination. The participants reported high enjoyment and interest in the system, with good usability scores. The study suggests that a group-based holistic motor rehabilitation approach, as presented, holds potential for enhancing motor outcomes by promoting social interaction and self-efficacy. These results indicate the viability of the proposed system as a promising solution for stroke rehabilitation.Esta tese aborda a crescente incidência do AVC e o seu impacto na funcionalidade a longo prazo, realçando a importância da reabilitação pós-AVC. Prevendo-se um aumento de 34% nos casos de AVC até 2025, este trabalho foca-se em fatores que afetam a reabilitação motora pós-AVC, como os sintomas depressivos, reconhecendo o papel da participação social e do sentimento de auto-eficácia na nestes sintomas. Para enfrentar esses desafios, propomos o uso de uma mesa interativa multi utilizador para reabilitação dos membros superiores. Esta abordagem inovadora envolve a deteção de objetos de vários tamanhos e formas como interfaces para os jogos sérios, permitindo atividades terapêuticas em grupo direcionadas à reabilitação motora, sintomas depressivos, participação social e autoeficácia. Quatro estudos exploratórios suportaram o desenvolvimento da mesa interativa, determinando mecânicas de jogo, tipos de objetos e recursos do jogo. Três modos de jogo (competitivo, co-ativo e colaborativo) foram investigados, com o modo colaborativo mostrando maior envolvimento social e resultados mais positivos. Estudos subsequentes envolvendo sobreviventes de AVC confirmaram a eficácia do jogo colaborativo. Viabilidade, envolvimento e usabilidade foram testados usando objetos de diferentes tamanhos e formas, revelando insights importantes relativos ao desempenho nas tarefas, preensões e ajustes de complexidade da tarefa. A mesa interativa desenvolvida acomoda até quatro participantes, e permite a deteção de objectos para serem usados como interfaces e um painel multi-toque. Quatro jogos sérios foram projetados para reabilitar competências específicas dos membros superiores, desenhados para serem jogados em modo colaborativo e com recursos incorporados para potenciar o processo de reabilitação e a experiência do utilizador. Um estudo piloto com 12 sobreviventes de AVC ao longo de quatro semanas, demonstrou melhorias significativas nos resultados motores, nomeadamente amplitude de movimento, destreza, força e coordenação. Os participantes reportaram níveis altos de prazer e interesse no sistema, e pontuações de usabilidade promissoras. Este trabalho sugere que uma abordagem de reabilitação motora holística e em grupo, como apresentada, tem potencial para melhorar os resultados motores promovendo a interação social e o sentimento de auto-eficácia. Estes resultados sugerem a viabilidade do sistema proposto como uma solução promissora para a reabilitação motora no AVC

Designing for Shareable Interfaces in the Wild

Despite excitement about the potential of interactive tabletops to support collaborative work, there have been few empirical demonstrations of their effectiveness (Marshall et al., 2011). In particular, while lab-based studies have explored the effects of individual design features, there has been a dearth of studies evaluating the success of systems in the wild. For this technology to be of value, designers and systems builders require a better understanding of how to develop and evaluate tabletop applications to be deployed in real world settings. This dissertation reports on two systems designed through a process that incorporated ethnography-style observations, iterative design and in the wild evaluation. The first study focused on collaborative learning in a medical setting. To address the fact that visitors to a hospital emergency ward were leaving with an incomplete understanding of their diagnosis and treatment, a system was prototyped in a working Emergency Room (ER) with doctors and patients. The system was found to be helpful but adoption issues hampered its impact. The second study focused on a planning application for visitors to a tourist information centre. Issues and opportunities for a successful, contextually-fitted system were addressed and it was found to be effective in supporting group planning activities by novice users, in particular, facilitating users’ first experiences, providing effective signage and offering assistance to guide the user through the application. This dissertation contributes to understanding of multi-user systems through literature review of tabletop systems, collaborative tasks, design frameworks and evaluation of prototypes. Some support was found for the claim that tabletops are a useful technology for collaboration, and several issues were discussed. Contributions to understanding in this field are delivered through design guidelines, heuristics, frameworks, and recommendations, in addition to the two case studies to help guide future tabletop system creators

tCAD: a 3D modeling application on a depth enhanced tabletop computer

Tabletop computers featuring multi-touch input and object tracking are a common platform for research on Tangible User Interfaces (also known as Tangible Interaction). However, such systems are confined to sensing activity on the tabletop surface, disregarding the rich and relatively unexplored interaction canvas above the tabletop. This dissertation contributes with tCAD, a 3D modeling tool combining fiducial marker tracking, finger tracking and depth sensing in a single system. This dissertation presents the technical details of how these features were integrated, attesting to its viability through the design, development and early evaluation of the tCAD application. A key aspect of this work is a description of the interaction techniques enabled by merging tracked objects with direct user input on and above a table surface.Universidade da Madeir

Considering Reach in Tangible and Table Top Design

Reach heavily impacts all aspects of designing for tangible and tabletop user interfaces. It dictates the input space available to each user and heavily shapes how that space is used. Despite its impact to date tangible, table top, and user interface design have all largely overlooked reach as a design constraint. As a result advancing the state of the art for tangible and table top designs requires rethinking existing designs to consider the repercussions of reach, and starting to formally consider reach as part of our designs process. Designing in consideration of reach will allow for more usable tables, applications supporting diverse environments, and user interfaces which are optimally scaled to their current set of users. 1

Physical Interaction Concepts for Knowledge Work Practices

The majority of workplaces in developed countries concern knowledge work. Accordingly, the IT industry and research made great efforts for many years to support knowledge workers -- and indeed, computer-based information workplaces have come of age. Nevertheless, knowledge work in the physical world has still quite a number of unique advantages, and the integration of physical and digital knowledge work leaves a lot to be desired. The present thesis aims at reducing these deficiencies; thereby, it leverages late technology trends, in particular interactive tabletops and resizable hand-held displays. We start from the observation that knowledge workers develop highly efficient practices, skills, and dexterity of working with physical objects in the real world, whether content-unrelated (coffee mugs, stationery etc.) or content-related (books, notepads etc.). Among the latter, paper-based objects -- the notorious analog information bearers -- represent by far the most relevant (super-) category. We discern two kinds of practices: collective practices concern the arrangement of objects with respect to other objects and the desk, while specific practices operate on individual objects and usually alter them. The former are mainly employed for an effective management of the physical desktop workspace -- e.g., everyday objects are frequently moved on tables to optimize the desk as a workplace -- or an effective organization of paper-based documents on the desktop -- e.g., stacking, fanning out, sorting etc. The latter concern the specific manipulation of physical objects related to the task at hand, i.e. knowledge work. Widespread assimilated practices concern not only writing on, annotating, or spatially arranging paper documents but also sophisticated manipulations -- such as flipping, folding, bending, etc. Compared to the wealth of such well-established practices in the real world, those for digital knowledge work are bound by the indirection imposed by mouse and keyboard input, where the mouse provided such a great advancement that researchers were seduced to calling its use "direct manipulation". In this light, the goal of this thesis can be rephrased as exploring novel interaction concepts for knowledge workers that i) exploit the flexible and direct manipulation potential of physical objects (as present in the real world) for more intuitive and expressive interaction with digital content, and ii) improve the integration of the physical and digital knowledge workplace. Thereby, two directions of research are pursued. Firstly, the thesis investigates the collective practices executed on the desks of knowledge workers, thereby discerning content-related (more precisely, paper-based documents) and content-unrelated object -- this part is coined as table-centric approaches and leverages the technology of interactive tabletops. Secondly, the thesis looks at specific practices executed on paper, obviously concentrating on knowledge related tasks due to the specific role of paper -- this part is coined as paper-centric approaches and leverages the affordances of paper-like displays, more precisely of resizable i.e. rollable and foldable displays. The table-centric approach leads to the challenge of blending interactive tabletop technology with the established use of physical desktop workspaces. We first conduct an exploratory user study to investigate behavioral and usage patterns of interaction with both physical and digital documents on tabletop surfaces while performing tasks such as grouping and browsing. Based on results of the study, we contribute two sets of interaction and visualization concepts -- coined as PaperTop and ObjecTop -- that concern specific paper based practices and collective practices, respectively. Their efficiency and effectiveness are evaluated in a series of user studies. As mentioned, the paper-centric perspective leverages late ultra-thin resizable display technology. We contribute two sets of novel interaction concepts again -- coined as FoldMe and Xpaaand -- that respond to the design space of dual-sided foldable and of rollout displays, respectively. In their design, we leverage the physical act of resizing not "just" for adjusting the screen real estate but also for interactively performing operations. Initial user studies show a great potential for interaction with digital contents, i.e. for knowledge work

Digital tabletops and collaborative learning

People collaborate around tables at home, school and work. Digital tabletop technology presents an opportunity to bring computer support to these traditional face-to-face collaborative settings. This thesis principally addresses the challenge of designing digital tabletop applications for small group learning in the classroom and makes contributions in two distinct, but closely related areas: (i) interaction techniques for digital tabletops; and (ii) the design and evaluation of a digital tabletop-based system for supporting collaborative learning. A review of previous literature combined with a preliminary observational study on collaboration around traditional tables indentifies a number of requirements for tabletop interaction. These include the need for fluid interaction techniques that allow control of interface object attributes when these objects are moved between tabletop territories. Attribute gates are proposed as a solution to this problem through utilizing a novel, crossing-based, interaction technique. A recognition of the territorial focus in existing interaction techniques, and their limiting assumption that users work at relatively fixed locations around the table, led to the identification of another challenge, supporting the mobility of users around the shared workspace of the table. TANGISOFT is presented as a hybrid tangible-soft keyboard designed specifically for applications that require mobile users with moderate text entry requirements. The investigation of the potential of tabletop technology to support collaborative learning was carried out through the design, development, and evaluation of Digital Mysteries. From an interaction design perspective, the design aimed to utilize the unique affordances of tabletops in terms of combining the benefits of traditional tables and digital technology. From a learning perspective, the design aimed to support higher-level thinking skills, feedback, reflection, and metacognition by focusing on activities that promote these skills and supporting effective collaboration. The evaluation of Digital Mysteries demonstrated that the design was successful in encouraging the targeted learning activities. The design process and validation of Digital Mysteries embody a significant contribution to the development of our understanding of digital tabletop technology at the application level, and collaborative learning applications in particular. This understanding is summarized in the form of general guidelines for designing collaborative learning applications for digital tabletop technology.EThOS - Electronic Theses Online ServiceDiwan Software LtdGBUnited Kingdo