Sensorimotor experience in virtual environments

The goal of rehabilitation is to reduce impairment and provide functional improvements resulting in quality participation in activities of life, Plasticity and motor learning principles provide inspiration for therapeutic interventions including movement repetition in a virtual reality environment, The objective of this research work was to investigate functional specific measurements (kinematic, behavioral) and neural correlates of motor experience of hand gesture activities in virtual environments stimulating sensory experience (VE) using a hand agent model. The fMRI compatible Virtual Environment Sign Language Instruction (VESLI) System was designed and developed to provide a number of rehabilitation and measurement features, to identify optimal learning conditions for individuals and to track changes in performance over time. Therapies and measurements incorporated into VESLI target and track specific impairments underlying dysfunction. The goal of improved measurement is to develop targeted interventions embedded in higher level tasks and to accurately track specific gains to understand the responses to treatment, and the impact the response may have upon higher level function such as participation in life. To further clarify the biological model of motor experiences and to understand the added value and role of virtual sensory stimulation and feedback which includes seeing one\u27s own hand movement, functional brain mapping was conducted with simultaneous kinematic analysis in healthy controls and in stroke subjects. It is believed that through the understanding of these neural activations, rehabilitation strategies advantaging the principles of plasticity and motor learning will become possible. The present research assessed successful practice conditions promoting gesture learning behavior in the individual. For the first time, functional imaging experiments mapped neural correlates of human interactions with complex virtual reality hands avatars moving synchronously with the subject\u27s own hands, Findings indicate that healthy control subjects learned intransitive gestures in virtual environments using the first and third person avatars, picture and text definitions, and while viewing visual feedback of their own hands, virtual hands avatars, and in the control condition, hidden hands. Moreover, exercise in a virtual environment with a first person avatar of hands recruited insular cortex activation over time, which might indicate that this activation has been associated with a sense of agency. Sensory augmentation in virtual environments modulated activations of important brain regions associated with action observation and action execution. Quality of the visual feedback was modulated and brain areas were identified where the amount of brain activation was positively or negatively correlated with the visual feedback, When subjects moved the right hand and saw unexpected response, the left virtual avatar hand moved, neural activation increased in the motor cortex ipsilateral to the moving hand This visual modulation might provide a helpful rehabilitation therapy for people with paralysis of the limb through visual augmentation of skills. A model was developed to study the effects of sensorimotor experience in virtual environments, and findings of the effect of sensorimotor experience in virtual environments upon brain activity and related behavioral measures. The research model represents a significant contribution to neuroscience research, and translational engineering practice, A model of neural activations correlated with kinematics and behavior can profoundly influence the delivery of rehabilitative services in the coming years by giving clinicians a framework for engaging patients in a sensorimotor environment that can optimally facilitate neural reorganization

The development and applications of serious games in the public services: defence and health

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London.The latest advances of Virtual Reality technologies and three-dimensional graphics, as well as the developments in Gaming Technologies in the recent years, have stemmed the proliferation of Serious Games in a broader spectrum of research applications. Among the most popular areas of application are public services such as Defence and Health, where digital technologies realise new challenges and opportunities for research and development of Serious Games and for a variety of contexts. As with all games, the user engagement is elevated and apart from the entertaining aspect, Serious Games serve as a novel and promising alternative experience to knowledge transfer. Furthermore, Serious Games bring to the end user and the overall society a series of attractive benefits. These benefits include safety, cost-effectiveness, increased motivation and personalisation. Hence, this Thesis aims to investigate novel approaches of developing Serious Games that utilise the recent advances of Virtual Reality and Gaming Technology and facilitate the aforementioned benefits. The process of design and development of the novel tools and applications follow an iterative manner and are driven by the review of the available literature as well as end-user feedbackEPSRC (Engineering and Physical Sciences Research Council ) , MOD (UK), NHS (UK

Proceedings of the 8th international conference on disability, virtual reality and associated technologies (ICDVRAT 2010)

The proceedings of the conferenc

Virtual environments for stroke rehabilitation: examining a novel technology against end-user, clinical and management demands with reference to UK care provision

In the field of post-stroke rehabilitation, there appears to be growing interest in the use of virtual reality (VR)-based systems as adjunct technologies to standard therapeutic practices. The limitations and the potentials of this technology are not, however, generally well understood. The present study thus seeks to determine the value of the technology with reference to end-user requirements by surveying and evaluating its application against a variety of parameters: user focus, clinical effectiveness, marketability and contextual meaningfulness, etc. A key theme in the research considers how a technology developed internationally might interface with care provision demands and cultures specific to the United Kingdom. The barriers to innovation entry in this context are thus examined. Further practical study has been conducted in the field with a small sample of post-stroke rehabilitation patients. The data garnered from these enquiries have informed a detailed system analysis, a strategy for innovation and a broad theoretical discussion as to the effectiveness of the technology in delivering VR environments by which the patient can undertake ‘meaningful’ therapeutic activities. The data reveal that there does appear to be clinical value in using this technology, yet establishing its maximal value necessitates greater integrity among clinicians and engineers, and the furthering of progressive channels for innovation by public health administrators

Embodiment, altered perception and comfort after stroke

After stroke, changes to body perception are common. However, little is known about what these disturbed perceptions feel like to the stroke survivor. This programme of work used embodiment theory to explore stroke survivors’ experiences of altered body perception and whether these perceptions were uncomfortable from a biopsychosocial perspective. It explored whether participants indicated a need for clinical interventions and the feasibility of using assessment tools to collate information about the body. A range of methodologies were used. A scoping review of the literature identified 28 studies exploring first-person accounts of altered body perception. Stroke survivors described the body across conditions as strange and unfamiliar; reflecting a changed awareness and means of relating to the body. Concurrently, a phenomenological study was conducted. A purposive sample of 16 stroke survivors able to communicate verbally, at least six-months post-stroke and experiencing motor and sensory impairments, were selected. Semi-structured interviews were conducted and analysed using interpretative phenomenological analysis. Participants described uncomfortable altered perceptions. The body did not exist, was hindered by strange perceptions and uncontrollable. The body was isolated, but participants were hopeful for improvement. Altered perceptions were difficult to comprehend and describe. From this, a feasibility and acceptability study explored the use of three assessment tools to communicate the altered body. Ten participants experiencing including a proportion with communication problems, were purposively selected. Participants wanted to communicate the experience of altered body perception and discomfort to health professionals and their preferred visual tools to achieve this. Stroke causes a complex sense of physical and psychosocial disembodiment, which is uncomfortable and of concern to survivors. Embodiment research suggests these domains may interact with one another. Clinical recognition and support to communicate altered body perception and discomfort from a holistic perspective may elucidate the multimodal experience of altered perceptions and foster new approaches for rehabilitation

Learning Therapy Strategies from Demonstration Using Latent Dirichlet Allocation

The use of robots in stroke rehabilitation has become a pop-ular trend in rehabilitation robotics. However, despite the ac-knowledged value of customized service for individual pa-tients, research on programming adaptive therapy for indi-vidual patients has received little attention. The goal of the current study is to model teletherapy sessions in the form of a generative process for autonomous therapy that approxi-mate the demonstrations of the therapist. The resulting au-tonomous programs for therapy may imitate the strategy that the therapist might have employed and reinforce therapeutic exercises between teletherapy sessions. We propose to en-code the therapist’s decision criteria in terms of the patient’s motor performance features. Specifically, in this work, we apply Latent Dirichlet Allocation on the batch data collected during teletherapy sessions between a single stroke patient and a single therapist. Using the resulting models, the thera-peutic exercise targets are generated and are verified with the same therapist who generated the data

Embodied Imagination: An Exploration of Participatory Performance and Interactive Technology to Support Stroke Recovery

Life after a stroke leads to the challenge of adjusting to new possibilities and fosters an increased risk of social isolation and depression. Re-building personal narratives and creating new community networks are key to conceiving an identity beyond the stroke. In this context, participatory performance provides methods for exploring physical and social identities, imagining new ways of being. Meanwhile, digital technology offers tools to help envision these possibilities. A participatory performance workshop supported by real-time motion capture technology has been redesigned in collaboration with the performance company Split Britches. The Green Screening workshop’s objective is to help stroke survivors imagine new physical and social possibilities by enacting fantasies of things they have always wanted to do. Participants construct storylines supported by a custom-built interactive scenography. Movement data is collected and transformed into real-time visualisations to progressively build fantasy narratives enacted with and for other participants. Three research studies conducted with stroke support groups around England analysed progressive iterations of the Green Screening workshop. The first study focused on the project's feasibility in aiding social support. The second study explored embodied imagination and social collaboration in enacted storylines. Finally, the third study analysed communication as a means of recovery and further potential to foster social collaboration. Findings are based on qualitative analysis of the participants' experience. Results reveal that the narrative process and visualisations encouraged a rich repertoire of improvised movements, and the communal aspect of the process was found especially important in achieving these results. This work argues that this framework can simultaneously bring a rich, prospective and political understanding of people’s lived experience to the design space in HCI and provide community stroke support