[ARTICLE] Choice of Human–Computer Interaction Mode in Stroke Rehabilitation

Abstract

Background and Objective. Advances in technology are providing new forms of human–computer interaction. The current study examined one form of human–computer interaction, augmented reality (AR), whereby subjects train in the real-world workspace with virtual objects projected by the computer. Motor performances were compared with those obtained while subjects used a traditional human–computer interaction, that is, a personal computer (PC) with a mouse.

Methods. Patients used goal-directed arm movements to play AR and PC versions of the Fruit Ninja video game. The 2 versions required the same arm movements to control the game but had different cognitive demands. With AR, the game was projected onto the desktop, where subjects viewed the game plus their arm movements simultaneously, in the same visual coordinate space. In the PC version, subjects used the same arm movements but viewed the game by looking up at a computer monitor.

Results. Among 18 patients with chronic hemiparesis after stroke, the AR game was associated with 21% higher game scores (P = .0001), 19% faster reaching times (P = .0001), and 15% less movement variability (P = .0068), as compared to the PC game. Correlations between game score and arm motor status were stronger with the AR version.

Conclusions. Motor performances during the AR game were superior to those during the PC game. This result is due in part to the greater cognitive demands imposed by the PC game, a feature problematic for some patients but clinically useful for others. Mode of human–computer interface influences rehabilitation therapy demands and can be individualized for patients.

via Choice of Human–Computer Interaction Mode in Stroke Rehabilitation.

[ARTICLE] Utility of Augmented Reality in Relation to Virtual Reality in Stroke Rehabilitation

Abstract

Introduction: Virtual Reality (VR) has been found useful for numerous rehabilitation applications, but has some intrinsic constraints such as the need for a visuospatial transformation when guiding movements. Augmented Reality (AR) is a new approach to human-computer interaction that enables patients to interact directly with virtual objects. The current study compared AR and VR in a stroke rehabilitation setting.

METHODS: The Fruit Ninja game simulates a rehab setting by having subjects perform repeated goal-directed wrist/hand reaching tasks. Subjects held a cup-shaped color-marker in the paretic hand, then reached for a virtual fruit target that sliced in 2 when reached. This game was implemented in both AR and VR settings, with identical movement demands across the two. The target plus real-time visual feedback on hand movements were provided by a computer monitor in VR, and by a projection onto a tabletop in AR. After undergoing baseline assessments (arm motor Fugl-Meyer scale (FMA) and Box and Blocks (B&B)), 10 patients with hemiparetic stroke >6 mo prior and age >18 yr played three 1-min rounds each of the AR and VR games; 4 other subjects who were unable to hold the color-marker object were excluded from current analysis.

RESULTS: Of the 10 patients, age = 59±10 yr (mean±SD), FMA score = 57±11 (range 31-66), Hand/Wrist FMA subscore = 22±3 (range 15-24), and B&B score = 41±13 (range 16-58). When playing the exact same Fruit Ninja game, all 10 patients scored significantly (p<0.0001) higher in the AR setting (60±9 targets, range 48-78) as compared to the VR setting (48±8 targets, range 37-64 setting. Also, AR scores were stronger correlates of FM Hand/Wrist (rho=0.68, p<0.04) and B&B scores (rho=0.70, p<0.03) than were VR scores.

CONCLUSIONS: This study shows promising results with use of Augmented Reality in a patient-computer interface. Results also suggest advantages as compared to use of a Virtual Reality approach, possibly due to the fact that moving the hand requires a visuospatial transform in the VR setting but not in the AR setting. Compared to VR, AR scores were higher and correlated better with clinical scores, suggesting great potential for the use of Augmented Reality in a patient-computer interface during stroke rehabilitation.

via Abstract T MP43: Utility of Augmented Reality in Relation to Virtual Reality in Stroke Rehabilitation.