Design and Evaluation of Virtual Reality Exergames for People Living with Dementia

Dementias such as Alzheimer’s disease are a progressive neurodegenerative disorder with consequences such as cognitive impairment and memory problems. While exercise is important to improve physical health and quality of life for people living with dementia (PWD), symptom-induced challenges, such as language processing and physical limitations, can make it more difficult for PWD to engage in exercise. In this study, exercise games (exergames) to promote exercise for PWD were designed in two virtual environments: a farm and a gym. To design the activities and interfaces of the games, a participatory design approach was followed with exercise therapists, kinesiologists, and PWD from Schlegel Villages long-term care facility. Five upper-body motions were selected and five corresponding activities developed for each game. The games were built for the Oculus Rift CV1 head mounted display virtual reality (HMD-VR) as this platform uses a fully immersive three-dimensional display with high frame rate display. The touch controllers of Oculus were used to provide hand-motion interactions in virtual reality (VR). A three-week evaluation experiment was conducted with six PWD to evaluate the designed exercise games. A mixed-methods approach was used to qualitatively and quantitatively investigate the impact of using designed HMD-VR exergames in engaging PWD in exercise. Questionnaires for participants recorded participants’ feelings of enjoyment, engagement, interest, easiness, comfort, and level of effort. Clinical measurements of fitness parameters and recorded motion parameters from sensors in Oculus Rift provided quantifiable metrics such as range of motion (ROM), distance traversed, speed, grip strength, and shoulder circumduction for evaluation. All the participants successfully completed the exercise using the exergames, demonstrating the promising potential of using HMD-VR for PWD. The analysis of the participants’ answers to the questionnaires shows subjective metrics for human-guided exercise is comparable to VR games conditions, which is a noteworthy result considering the novelty of using VR for PWD. Overall, the analysis of motion parameters showed no differences between environments, which indicates the participants’ level of movment in VR environments was as good as with human-lead exercise. This thesis research demonstrates the potential of HMD-VR as an engaging way to support exercise of PWD

VRShape: A Virtual Reality Tool for Shaping Movement Compensation

The majority of persons living with chronic stroke experience some form of upper extremity motor impairment that affects their functional movement, performance of meaningful activities, and participation in the flow of daily life. Stroke survivors often compensate for these impairments by adapting their movement patterns to incorporate additional degrees of freedom at new joints and body segments. One of the most common compensatory movements is the recruitment of excessive trunk flexion when reaching with the affected upper extremity. Long-term use of these compensations may lead to suboptimal motor recovery and chronic pain or injury due to overuse. Rehabilitation focuses on repetitive practice with the impaired limb to stimulate motor learning and neuroplasticity; however, few interventions achieve the required repetition dose or address the possible negative effects of compensatory movements. Virtual reality (VR) is an emerging tool in rehabilitation science that may be capable of (1) objectively measuring compensation during upper extremity movement, (2) motivating persons to perform large doses of repetitive practice through the integration of virtual environments and computer games, and (3) providing the basis for a motor intervention aimed at improving motor performance and incrementally reducing, or shaping, compensation. The purpose of this project was to develop and test a VR tool with these capabilities for shaping movement compensation for persons with chronic stroke, and to achieve this we performed three separate investigations (Chapters 2-4).First, we investigated the validity and reliability of two generations of an off-the-shelf motion sensor, namely the Microsoft Kinect, for measuring trunk compensations during reaching (Chapter 2). A small group of healthy participants performed various reaching movements on two separate days while simultaneously being recorded by the two sensors and a third considered to be the gold standard. We found that the second generation Kinect sensor was more accurate and showed greater validity for measuring trunk flexion relative to the gold standard, especially during extended movements, and therefore recommended that sensor for future VR development. Research with a more heterogeneous and representative population, such as persons with stroke, will further improve the evaluation of these sensors in future work.Second, we tested a newly-designed VR tool, VRShape, for use during a single session of upper extremity movement practice (Chapter 3). VRShape integrates the Microsoft Kinect and custom software to convert upper extremity movements into the control of various virtual environments and computer games while providing real-time feedback about compensation. A small group of participants with stroke used VRShape to repetitively perform reaching movements while simultaneously receiving feedback concerning their trunk flexion relative to a calibrated threshold. Our tool was able to elicit a large number of successful reaches and limit the amount of trunk flexion used during a single practice session while remaining usable, motivating, and safe. However, areas of improvement were identified relative to the efficiency of the software and the variety of virtual environments available. Third, we implemented VRShape over the course of a motor intervention for persons with stroke and evaluated its feasibility and effect on compensation during reaching tasks (Chapter 4). A small group of participants took part in 18 interventions session using VRShape for repetitive reaching practice with incrementally shaped trunk compensation. Trunk flexion decreased significantly and reaching kinematics improved significantly as a result of the intervention. Even with extended use, participants were able to complete intense practice and thousands of repetitions while continually rating the system as usable, motivating, engaging, and safe. Our VR tool demonstrated feasibility and preliminary efficacy within a small study, but future work is needed to identify its ideal applications and address its limitations. In summary, this project shows that use of a VR tool incorporating an accurate sensor (Chapter 2) and feedback from initial testing (Chapter 3) is capable of changing the amount of trunk flexion used during reaching movements for persons with stroke (Chapter 4). More research is needed to establish its efficacy and effectiveness, but improvements in motor recovery and associated decreases in compensation associated with the use of VRShape are important rehabilitation goals that may lead to improved participation and quality of life for persons living with long-term impairments due to chronic stroke

Ankle-Actuated Human-Machine Interface for Walking in Virtual Reality

This thesis work presents design, implementation and experimental study of an impedance type ankle haptic interface for providing users with the immersive navigation experience in virtual reality (VR). The ankle platform enables the use of foot-tapping gestures to reproduce realistic walking experience in VR and to haptically render different types of walking terrains. The system is designed to be used by seated users allowing more comfort, causing less fatigue and motion sickness. The custom-designed ankle interface is composed of a single actuator-sensors system making it a cost-efficient solution for VR applications. The designed interface consists of a single degree of freedom actuated platform which can rotate around the ankle joint of the user. The platform is impedance controlled around the horizontal position by an electric motor and capstan transmission system. to perform walking in a virtual scene, a seated user is expected to perform walking gestures in form of ankle plantar-flexion and dorsiflexion movements causing the platform to tilt forward and backward. We present three algorithms for simulating the immersive locomotion of a VR avatar using the platform movement information. We also designed multiple impedance controllers to render haptic feedback for different virtual terrains during walking. We carried out experiments to understand how quickly users adapt to the interface, how well they can control their locomotion speed in VR, and how well they can distinguish different types of terrains presented through haptic feedback. We implemented qualitative questionnaires on the usability of the device and the task load of the experimental procedures. The experimental studies demonstrated that the interface can be easily used to navigate in VR and it is capable of rendering dynamic multi-layer complex terrains containing structures with different stiffness and brittleness properties

Personalized Interaction with High-Resolution Wall Displays

Fallende Hardwarepreise sowie eine zunehmende Offenheit gegenüber neuartigen Interaktionsmodalitäten haben in den vergangen Jahren den Einsatz von wandgroßen interaktiven Displays möglich gemacht, und in der Folge ist ihre Anwendung, unter anderem in den Bereichen Visualisierung, Bildung, und der Unterstützung von Meetings, erfolgreich demonstriert worden. Aufgrund ihrer Größe sind Wanddisplays für die Interaktion mit mehreren Benutzern prädestiniert. Gleichzeitig kann angenommen werden, dass Zugang zu persönlichen Daten und Einstellungen — mithin personalisierte Interaktion — weiterhin essentieller Bestandteil der meisten Anwendungsfälle sein wird. Aktuelle Benutzerschnittstellen im Desktop- und Mobilbereich steuern Zugriffe über ein initiales Login. Die Annahme, dass es nur einen Benutzer pro Bildschirm gibt, zieht sich durch das gesamte System, und ermöglicht unter anderem den Zugriff auf persönliche Daten und Kommunikation sowie persönliche Einstellungen. Gibt es hingegen mehrere Benutzer an einem großen Bildschirm, müssen hierfür Alternativen gefunden werden. Die daraus folgende Forschungsfrage dieser Dissertation lautet: Wie können wir im Kontext von Mehrbenutzerinteraktion mit wandgroßen Displays personalisierte Schnittstellen zur Verfügung stellen? Die Dissertation befasst sich sowohl mit personalisierter Interaktion in der Nähe (mit Touch als Eingabemodalität) als auch in etwas weiterer Entfernung (unter Nutzung zusätzlicher mobiler Geräte). Grundlage für personalisierte Mehrbenutzerinteraktion sind technische Lösungen für die Zuordnung von Benutzern zu einzelnen Interaktionen. Hierzu werden zwei Alternativen untersucht: In der ersten werden Nutzer via Kamera verfolgt, und in der zweiten werden Mobilgeräte anhand von Ultraschallsignalen geortet. Darauf aufbauend werden Interaktionstechniken vorgestellt, die personalisierte Interaktion unterstützen. Diese nutzen zusätzliche Mobilgeräte, die den Zugriff auf persönliche Daten sowie Interaktion in einigem Abstand von der Displaywand ermöglichen. Einen weiteren Teil der Arbeit bildet die Untersuchung der praktischen Auswirkungen der Ausgabe- und Interaktionsmodalitäten für personalisierte Interaktion. Hierzu wird eine qualitative Studie vorgestellt, die Nutzerverhalten anhand des kooperativen Mehrbenutzerspiels Miners analysiert. Der abschließende Beitrag beschäftigt sich mit dem Analyseprozess selber: Es wird das Analysetoolkit für Wandinteraktionen GIAnT vorgestellt, das Nutzerbewegungen, Interaktionen, und Blickrichtungen visualisiert und dadurch die Untersuchung der Interaktionen stark vereinfacht.An increasing openness for more diverse interaction modalities as well as falling hardware prices have made very large interactive vertical displays more feasible, and consequently, applications in settings such as visualization, education, and meeting support have been demonstrated successfully. Their size makes wall displays inherently usable for multi-user interaction. At the same time, we can assume that access to personal data and settings, and thus personalized interaction, will still be essential in most use-cases. In most current desktop and mobile user interfaces, access is regulated via an initial login and the complete user interface is then personalized to this user: Access to personal data, configurations and communications all assume a single user per screen. In the case of multiple people using one screen, this is not a feasible solution and we must find alternatives. Therefore, this thesis addresses the research question: How can we provide personalized interfaces in the context of multi-user interaction with wall displays? The scope spans personalized interaction both close to the wall (using touch as input modality) and further away (using mobile devices). Technical solutions that identify users at each interaction can replace logins and enable personalized interaction for multiple users at once. This thesis explores two alternative means of user identification: Tracking using RGB+depth-based cameras and leveraging ultrasound positioning of the users' mobile devices. Building on this, techniques that support personalized interaction using personal mobile devices are proposed. In the first contribution on interaction, HyDAP, we examine pointing from the perspective of moving users, and in the second, SleeD, we propose using an arm-worn device to facilitate access to private data and personalized interface elements. Additionally, the work contributes insights on practical implications of personalized interaction at wall displays: We present a qualitative study that analyses interaction using a multi-user cooperative game as application case, finding awareness and occlusion issues. The final contribution is a corresponding analysis toolkit that visualizes users' movements, touch interactions and gaze points when interacting with wall displays and thus allows fine-grained investigation of the interactions

La Revista de Taos and the Taps Cresset, 05-13-1905

https://digitalrepository.unm.edu/revista_taos_news/1610/thumbnail.jp

A comparative study of high school commercial curricula with suggestions for reorganization

Thesis (M.A.)--Boston Universit

Knox County

The Works Progress Administration\u27s Historical Records Survey of Knox County, Kentucky circa 1936 to 1939

Portland Daily Press: November 19,1872

https://digitalmaine.com/pdp_1872/1182/thumbnail.jp

History of Acadie, Penobscot Bay and River, With a More Particular Geographical and Statistical View of the District of Maine Than Has Ever Been Published

The Compiler of the following work made these selections for a History of Penobscot, about two years since; the object of which was, to bring a direct and concise view of this part of the country into a more compact, and cheaper volume than can now be obtained. As reference must be made to many publications, to obtain the information which this contains, all of which are very expensive works; and as it is the general wish of the inhabitants to possess a history of the country in which they live—it was presumed that nearly every family in this part of the country would avail themselves of as cheap and interesting a collection as could have been made; nor was the Compiler disappointed, as above 300 copies were immediately subscribed for in this town only.—In consequence of this liberal encouragement, and by the request of several subscribers, the work is augmented, and calculated for the use of schools, giving a more succinct and accurate description of the boundaries of the District of Maine than now exists, with a more particular description of the Penobscot, and its tributary streams, which combines superior advantages to any other river in the North-eastern States, and perhaps not exceeded by any in the Union of the same extent. There are also added valuable Statistical Tables, shewing the comparative progress of the population of Maine with each individual State in the Union, since the year 1790, with a correct list of the different towns in this District, with their date of incorporation, census in 1810, polls, valuation, and distances from Boston, on the plan of a Gazetteer—Also, some remarks on the climate, sod, and productions.—Most of the materials for this work were selected from Robertson\u27s History of America, Hutchinson\u27s History of Massachusetts, Mi nut\u27s Continuation do. Sullivan\u27s History of Maine, Marshall\u27s Life of Washington, Naval H story of the United States, official documents from State Papers, with some information from reputable persons now living on the Penobscot river