Virtual reality and its role in removing the barriers that turn cognitive impairments into intellectual disability

Early expectations of the contribution that virtual reality (VR) could make to education far exceeded actual applications. This was largely due to the initial immaturity of the technology and a lack of evidence base on which to base design and utilisation. While the early developments in computer based learning largely concentrated on mainstream education, leaving those with special needs behind, the potential of VR as an educational tool was exploited for those with intellectual disabilities right from the start. This paper describes the empirical evidence that has contributed to the development of educational virtual reality for those with intellectual disabilities: studies on transfer of learning from the virtual to the real world; how teachers might support those using VR; the design of virtual environments and what input/control devices best facilitate use of desktop VR. Future developments and ethical issues are also considered

Interactive Haptics for Remote and On-Site Assessment of Arm Function Following a Stroke

There is a great need to improve the rehabilitation and assessment of arm and hand function of stroke survivors in the home due to cost, time and availability of healthcare professionals. Robotics and haptic technologies can be used to improve and facilitate rehabilitation and assessment in the home. The primary goal of this thesis was to explore the feasibility of using lightweight, low-cost haptic devices for remote home-based rehabilitation. The strategy that this thesis followed was to develop tools, perform unit testing, and finally assess feasibility with target users in a series of case studies. The thesis started by developing an assessment tool, specifically the Nine Hole Peg Test (NHPT), and investigated how haptic devices can be used to enhance the data collection for this task to garner more information regarding the level of manual dexterity a stroke survivor has in their impaired limb. The next study investigated collaboration in haptic environments and how the findings from a collaborative haptic experiment could be used to influence task design for future experiments with haptic environments. The final study assessed the feasibility of a home-based assessment and rehabilitation system with elements of telerehabilitation and remote collaboration and interaction providing four complete case studies from stroke survivors. In summary, our findings showed that by combining physical apparatus with a virtual world, less variable results are observed than in purely virtual haptic tasks. We also showed that interaction techniques in collaborative haptic environments change depending on the shape of the objects in the virtual task – this information can be used to influence task design to target specific motor deficits when using the device for exercise. Finally, the home-based study showed the feasibility of using the experimental rig at home and provided improvement measures that matched the perceived benefits to arm function that the participants described on completing the trial

An Overview of Self-Adaptive Technologies Within Virtual Reality Training

This overview presents the current state-of-the-art of self-adaptive technologies within virtual reality (VR) training. Virtual reality training and assessment is increasingly used for five key areas: medical, industrial & commercial training, serious games, rehabilitation and remote training such as Massive Open Online Courses (MOOCs). Adaptation can be applied to five core technologies of VR including haptic devices, stereo graphics, adaptive content, assessment and autonomous agents. Automation of VR training can contribute to automation of actual procedures including remote and robotic assisted surgery which reduces injury and improves accuracy of the procedure. Automated haptic interaction can enable tele-presence and virtual artefact tactile interaction from either remote or simulated environments. Automation, machine learning and data driven features play an important role in providing trainee-specific individual adaptive training content. Data from trainee assessment can form an input to autonomous systems for customised training and automated difficulty levels to match individual requirements. Self-adaptive technology has been developed previously within individual technologies of VR training. One of the conclusions of this research is that while it does not exist, an enhanced portable framework is needed and it would be beneficial to combine automation of core technologies, producing a reusable automation framework for VR training

Learning force patterns with a multimodal system using contextual cues

Previous studies on learning force patterns (fine motor skills) have focused on providing “punctual information”, which means users only receive information about their performance at the current time step. This work proposes a new approach based on “contextual information”, in which users receive information not only about the current time step, but also about the past (how the target force has changed over time) and the future (how the target force will change). A test was run to compare the performance of the contextual approach in relation to the punctual information, in which each participant had to memorize and then reproduce a pattern of force after training with a multimodal system. The findings suggest that the contextual approach is a useful strategy for force pattern learning. The advantage of the contextual information approach over the punctual information approach is that users receive information about the evolution of their performance (helping to correct the errors), and they also receive information about the next forces to be exerted (providing them with a better understanding of the target force profile). Finally, the contextual approach could be implemented in medical training platforms or surgical robots to extend the capabilities of these systems

Diseño de entornos de realidad virtual aplicables a sistemas de robótica asistencial: un análisis literario

Virtual Reality (VR) environments can be applied to assistive robotics to improve the effectiveness and the user experience perception in the rehabilitation process due to its innovative nature, getting to entertain patients while they recover their motor functions. This literature review pretends to analyze some design principles of VR environments developed for upper limb rehabilitation processes. The idea is to identify features related to peripheral and central nervous systems, types of information included as feedback to increase the user's levels of immersion having a positive impact on the user's performance and experience during the treatment. A total of 32 articles published in Scopus, IEEE, PubMed, and Web of Science in the last four years were reviewed. We present the article selection process, the division by concepts presented previously, and the guidelines that can be considered for the design of VR environments applicable to assistive robots for upper limbs rehabilitation processes.Los entornos de Realidad Virtual (RV) aplicables a sistemas de robótica asistencial pueden ser diseñados de manera que mejoren la efectividad y la experiencia de usuario de los procesos de rehabilitación debido a su naturaleza novedosa, logrando entretener a los pacientes mientras recuperan sus funciones motoras. Esta revisión literaria pretende analizar los criterios de diseño de entornos de RV utilizados en procesos de rehabilitación de miembro superior, identificando las características de entornos para rehabilitación de problemas asociados el sistema nervioso central y periféricos, los tipos de información que se realimenta al usuario para beneficiar los niveles de inmersión y su impacto en términos del desempeño y la experiencia del usuario en tratamiento. Un total de 32 artículos publicados en revistas indexadas de Scopus, IEEE, PubMed y Web of Science en los últimos cuatro años fueron revisados. Se presenta el proceso de selección de artículos, la división por las temáticas presentadas anteriormente y los lineamientos generales que pueden ser considerados para el diseño de entornos de RV aplicables a robots asistenciales en procesos de rehabilitación de miembro superior

An evaluation of the Wii Nunchuk as an alternative assistive device for people with intellectual and physical disabilities using switch controlled software

Many people with intellectual disabilities also have physical difficulties which prevent them from using standard computer control devices. Custom made alternative devices for those with special needs can be expensive and the low unit turnover makes the prospect unattractive to potential manufacturers. One solution is to explore the potential of devices used in contemporary gaming technology, such as the Nintendo Wii. The Wii Nunchuk has the potential to replace joystick functions with the advantages of not being surface bound and easier for some individuals to grasp. This study evaluated the feasibility of using the Nunchuk by comparing its performance as a switch with the participant's usual switch. Twenty three volunteers aged between 17 and 21 with intellectual and physical disabilities completed a Single Switch Performance Test using the new device and their familiar device. For most functions of the switch, there was no significant difference between the participants' performance using the Nunchuck and their familiar device. Additional analysis found that some participants' performance did improve whilst using the Nunchuck, but this was not significantly related to physical or cognitive ability. Those whose performance was better with the Nunchuk were more likely to hold it in the conventional way than were those who had better performance with their familiar device. This merits it being offered as a possible alternative to currently available switches for those with physical difficulties affecting their grip

Self-rehabilitation based on user interactive environment

It has been reported that 53,000 stroke events annually with ongoing costs are nearly $500 million per year for physical therapy care. This paper aims to provide effective and active rehabilitation for patients suffering from upper limb that a slight or partial paralysis, using gaming based a therapy technique. By disguising the tasks into more entertaining, patients are motivated to train for longer and more frequently. The advantage of this system can be a self-managed, at-home therapy system; reducing fatigue for physical therapists, and the time required for therapist-patient sessions. The system incorporates a virtual reality (VR) environment displaying both the games and a human model as feedback of the patients' actions whilst playing the games. Two games were developed; Whack-a-Mouse, and Rolly games, each targeting improvement of muscle strength, control, accuracy and speed. The difficulty of the games can be varied to suit a number of impairments and patient progress is monitored. The games are played using a Nintendo Wii controller. The successful improvements with lower costs associated with this system, are marked improvements for patients suffering from such a debilitating condition

Virtual Reality Games for Motor Rehabilitation

This paper presents a fuzzy logic based method to track user satisfaction without the need for devices to monitor users physiological conditions. User satisfaction is the key to any product’s acceptance; computer applications and video games provide a unique opportunity to provide a tailored environment for each user to better suit their needs. We have implemented a non-adaptive fuzzy logic model of emotion, based on the emotional component of the Fuzzy Logic Adaptive Model of Emotion (FLAME) proposed by El-Nasr, to estimate player emotion in UnrealTournament 2004. In this paper we describe the implementation of this system and present the results of one of several play tests. Our research contradicts the current literature that suggests physiological measurements are needed. We show that it is possible to use a software only method to estimate user emotion