Adaptable videogame platform for interactive upper extremity rehabilitation

The primary objective of this work is to design a recreational rehabilitation videogame platform for customizing motivating games that interactively encourage purposeful upper extremity gross motor movements. Virtual reality (VR) technology is a popular application for rehabilitation therapies but there is a constant need for more accessible and affordable systems. We have developed a recreational VR game platform can be used as an independent therapy supplement without laboratory equipment and is inexpensive, motivating, and adaptable. The behaviors and interactive features can be easily modified and customized based on players\u27 limitations or progress. A real-time method of capturing hand movements using programmed color detection mechanisms to create the simulated virtual environments (VEs) is implemented. Color markers are tracked and simultaneously given coordinates in the VE where the player sees representations of their hands and other interacting objects whose behaviors can be customized and adapted to fit therapeutic objectives and players\u27 interests. After gross motor task repetition and involvement in the adaptable games, mobility of the upper extremities may improve. The videogame platform is expanded and optimized to allow modifications to base inputs and algorithms for object interactions through graphical user interfaces, thus providing the adaptable need in VR rehabilitation

CIRCLING INTERFACE: AN ALTERNATIVE INTERACTION METHOD FOR ON-SCREEN OBJECT MANIPULATION

An alternative interaction method, called the circling interface, was developed and evaluated for individuals with disabilities who find it difficult or impossible to consistently and efficiently perform pointing operations involving the left and right mouse buttons. The circling interface is a gesture-based interaction technique. To specify a target of interest, the user makes a circling motion around the target. To specify a desired pointing command with the circling interface, each edge of the screen is used. The user selects a command before circling the target. Empirical evaluations were conducted with human subjects from three different groups (individuals without disability, individuals with spinal cord injury, and individuals with cerebral palsy), comparing each group's performance on pointing tasks with the circling interface to performance on the same tasks when using a mouse button or dwell-clicking software. Across all three groups, the circling interface was faster than the dwelling interface (although the difference was not statistically significant). For the single-click operation, the circling interface was slower than dwell selection, but for both double-click and drag-and-drop operations, the circling interface was faster. In terms of performance accuracy, the results were mixed: for able-bodied subjects circling was more accurate than dwelling, for subjects with SCI dwelling was more accurate than circling, and for subjects with CP there was no difference. However, if errors caused by circling on an area with no target or by ignoring circles that are too small or too fast were automatically corrected by the circling interface, the performance accuracy of the circling interface would significantly outperform dwell selection. This suggests that the circling interface can be used in conjunction with existing pointing techniques and this combined approach may provide more effective mouse use for people with pointing problems. Consequently, the circling interface can improve clinical practice by providing an alternative pointing method that does not require physically activating mouse buttons and is more efficient than dwell-clicking. It is also expected to be useful for both computer access and augmentative communication software

Improvement of Pointing Operation Ability of the Cerebral Palsies -Estimation of the Optimal D/C Ratio for Pointer Movement Distance-

早大学位記番号:新7820早稲田大

International Conference on NeuroRehabilitation 2012

This volume 3, number 2 gathers a set of articles based on the most outstanding research on accessibility and disability issues that was presented in the International Conference on NeuroRehabilitation 2012 (ICNR).The articles’ research present in this number is centred on the analysis and/or rehabilitation of body impairment most due to brain injury and neurological disorders.JACCES thanks the collaboration of the ICNR members and the research authors and reviewers that have collaborated for making possible that issue

The role of HCI in the construction of disability

As a discipline concerned with the design, evaluation and implementation of interactive computing systems for human use, and with the study of major phenomena surrounding them, human computer interaction (HCI) is involved in the phenomenon of disability. For an interaction between humans and computers to take place, there should be an interface mediating between both parties. The design of such an interface may inadvertently impose access barriers to some people. HCI literature addresses the relationship between the theory and practice of HCI and disability from different angles, some of which are diametrically opposed. This thesis explores three modern conceptions, or models, of disability — the individualistic medical, the biopsychosocial and the social models —, investigates which model predominates in the HCI literature, and analyzes why choosing a particular model may determine and constrain the classes of problems that can be identified during a solution discovery process. Departing from HCI’s traditional discourse, which interprets the phenomenon of disability as a problem in the human body, the author, leading a team of engineers and psychologists, carried out a project in a school for children with cerebral palsy. The project was aimed to improve different areas of child development, using non conventional user interfaces — i.e. user interfaces that use other input/output devices than the keyboard, mouse or screen. After two years working directly within the field of operations”, the author had the opportunity to contrast the theory underpinning HCI’s methods with real practice and to expand his understandings about the relationships between HCI and disability. The research process involved an action research approach, which allowed the author and the team of experimenters to formulate new hypotheses as they learned more about the context, to review the process and, ultimately and most importantly,to readapt their actions to better serve the end beneficiaries. The experiences and learnings gathered throughout the process have been included in this thesis as a case study, for the purpose of helping HCI researchers embarking on projects relatable to the one described. Finally, the author urges the HCI community to update its discourse and to connect it with the vast literature related to modern conceptions of the phenomenon of disability

Access to Eye-Gaze Control Technology for Children with Cerebral Palsy

Children with cerebral palsy (CP), whose disability may limit speech production and motor skills, are often considered good candidates for the use of eye-gaze technology to access communication, learning and play. At present, little is known about the skills needed to control this technology, which can make it difficult for clinicians to make decisions, or to manage expectations around progress. This is further complicated by the emergence of “teaching” software packages, claiming to improve basic skills such as cause and effect. Children with CP are known to be at a higher risk of vision disorders, including those related to functional vision – how a child functions in vision related activities. These skills (in particular fixation and gaze switching) are similar to those required to make use of eye-gaze technology, so are likely to impact on children’s performance. This thesis uses typically developing children to provide baseline information and to observe how they respond to tasks which were incrementally lowered in terms of cognitive demand. Over three rounds of experiments a pattern emerged that children aged 32 months were able to use it with only minimal instruction. The impact of teaching on performance was also investigated in this section of the study. A group of children with CP were recruited to investigate the most effective way of assessing functional vision skills in this group, with results indicating behavioural measures were most effective. A final study with children with CP used the activities above to look at the performance of this group on eye-gaze tasks. Results suggested good functional gaze control skills were related to better performance on a novel eye-gaze task. The findings suggest that some children may be at a “developmental advantage” if their functional vision and cognitive skills are more developed

The development of assistive technology to reveal knowledge of physical world concepts in young people who have profound motor impairments.

Cognitively able children and young people who have profound motor impairments and complex communication needs (the target group or TG) face many barriers to learning, communication, personal development, physical interaction and play experiences, compared to their typically developing peers. Physical interaction (and play) are known to be important components of child development, but this group currently has few suitable ways in which to participate in these activities. Furthermore, the TG may have knowledge about real world physical concepts despite having limited physical interaction experiences but it can be difficult to reveal this knowledge and conventional assessment techniques are not suitable for this group, largely due to accessibility issues. This work presents a pilot study involving a robotics-based system intervention which enabled members of the TG to experience simulated physical interaction and was designed to identify and develop the knowledge and abilities of the TG relating to physical concepts involving temporal, spatial or movement elements. The intervention involved the participants using an eye gaze controlled robotic arm with a custom made haptic feedback device to complete a set of tasks. To address issues with assessing the TG, two new digital Assistive Technology (AT) accessible assessments were created for this research, one using static images, the other video clips. Two participants belonging to the TG took part in the study. The outcomes indicated a high level of capability in performing the tasks, with the participants exhibiting a level of knowledge and ability which was much higher than anticipated. One explanation for this finding could be that they have acquired this knowledge through past experiences and ‘observational learning’. The custom haptic device was found to be useful for assessing the participants’ sense of ‘touch’ in a way which is less invasive than conventional ‘pin-prick’ techniques. The new digital AT accessible assessments seemed especially suitable for one participant, while results were mixed for the other. This suggests that a combination of ‘traditional’ assessment and a ‘practical’ intervention assessment approach may help to provide a clearer, more rounded understanding of individuals within the TG. The work makes contributions to knowledge in the field of disability and Assistive Technology, specifically regarding: AT accessible assessments; haptic device design for the TG; the combination of robotics, haptics and eye gaze for use by the TG to interact with the physical world; a deeper understanding of the TG in general; insights into designing for and working with the TG. The work and information gathered can help therapists and education staff to identify strengths and gaps in knowledge and skills, to focus learning and therapy activities appropriately, and to change the perceptions of those who work with this group, encouraging them to broaden their expectations of the TG

Upper extremity rehabilitation using interactive virtual environments

Stroke affects more than 700,000 people annually in the U.S. It is the leading cause of major disability. Recovery of upper extremity function remains particularly resistant to intervention, with 80% to 95% of persons demonstrating residual upper extremity impairments lasting beyond six months after the stroke. The NJIT Robot Assistive Virtual Rehabilitation (NJIT-RAVR) system has been developed to study optimal strategies for rehabilitation of arm and hand function. Several commercial available devices, such as HapticMaster™, Cyberglove™, trakSTAR™ and Cybergrasp™, have been integrated and 11 simulations were developed to allow users to interact with virtual environments. Visual interfaces used in these simulations were programmed either in Virtools or in C++ using the Open GL library. Stereoscopic glasses were used to enhance depth perception and to present movement targets to the subjects in a 3-dimensional stereo working space. Adaptive online and offline algorithms were developed that provided appropriate task difficulty to optimize the outcomes. A pilot study was done on four stroke patients and two children with cerebral palsy to demonstrate the usability of this robot-assisted VR system. The RAVR system performed well without unexpected glitches during two weeks of training. No subjects experienced side effects such as dizziness, nausea or disorientation while interacting with the virtual environment. Each subject was able to finish the training, either with or without robotic adaptive assistance. To investigate optimal therapeutic approaches, forty stroke subjects were randomly assigned to two groups: Hand and Arm training Together (HAT) and Hand and Arm training Separately (HAS). Each group was trained in similar virtual reality training environments for three hours a day, four days a week for two weeks. In addition, twelve stroke subjects participated as a control group. They received conventional rehabilitation training of similar intensity and duration as the HAS and HAT groups. Clinical outcome measurements included the Jebsen Test of Hand Function, the Wolf Motor Function Test, and the ReachGrasp test. Secondary outcome measurements were calculated from kinematic and kinetic data collected during training in real time at 100 Hz. Both HAS and HAT groups showed significant improvement in clinical and kinematic outcome measurements. Clinical improvement compared favorably to the randomized clinical trials reported in the literature. However, there was no significant improvement difference between the two groups. Subjects from the control group improved in clinical measurements and in the ReachGrasp test. Compared to the control group, the ReachGrasp test showed a larger increase in movement speed during reaching and in the efficiency of lifting an object from the table in the combined HAS and HAT group. The NJIT-RAVR system was further modified to address the needs of children with hemiplegia due to Cerebral Palsy. Thirteen children with cerebral palsy participated in the total of nine sessions of one hour training that lasted for three weeks. Nine of the children were trained using the RAVR system alone, and another four had training with the combined Constraint-Induced Movement therapy and RAVR therapy. As a group, the children demonstrated improved performance across measurements of the Arm Range of Motion (AROM), motor function, kinematics and motor control. While subjects\u27 responses to the games varied, they performed each simulation while maintaining attention sufficient to improve in both robotic task performance and in measures of motor function