Author ' s personal copy Augmented Reality Visual manipulations for motor rehabilitation

Mixed reality rehabilitation systems and games are demonstrating potential as innovative adjunctive therapies for health professionals in their treatment of various hand and upper limb motor impairments. Unilateral motor deficits of the arm, for example, are commonly experienced poststroke. Our Augmented Reflection Technology (ART) system provides an augmented reality environment that contributes to this increasingly rich area of research. We present the current set of technological capabilities of the ART system exemplified in two experimental laboratory studies as well as a prototype system built on top of ART which ‘‘fools the brain’’ by visually amplifying user’s hand movements—small actual hand movements lead to perceived larger movements. We validate the usability of our system in an empirical study with forty-five non-clinical participants. In addition, we present the first qualitative evidence for the utility of our approach and system for stroke recovery and motor rehabilitation. Future uses of the system are considered by way of conclusion. & 2012 Elsevier Ltd. All rights reserved.

[1]  J. Geertzen,et al.  Mirror box therapy added to cognitive behavioural therapy in three chronic complex regional pain syndrome type I patients: a pilot study , 2007, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[2]  Paul F. M. J. Verschure,et al.  Interactive visuo-motor therapy system for stroke rehabilitation , 2007, Medical & Biological Engineering & Computing.

[3]  M. Patton Qualitative research and evaluation methods , 1980 .

[4]  E. Altschuler,et al.  Mirror therapy in a patient with a fractured wrist and no active wrist extension , 2008, Scandinavian journal of plastic and reconstructive surgery and hand surgery.

[5]  David R. Rowland The brain that changes itself: Stories of personal triumph from the frontiers of brain science , 2010 .

[6]  Henk J. Stam,et al.  Mirror therapy in patients with causalgia (complex regional pain syndrome type II) following peripheral nerve injury: two cases. , 2008, Journal of rehabilitation medicine.

[7]  Ergonomic requirements for office work with visual display terminals ( VDTs ) — Part 11 : Guidance on usability , 1998 .

[8]  Holger Regenbrecht,et al.  Out of reach? — A novel AR interface approach for motor rehabilitation , 2011, 2011 10th IEEE International Symposium on Mixed and Augmented Reality.

[9]  Elizabeth A. Franz,et al.  Fooling the brain into thinking it sees both hands moving enhances bimanual spatial coupling , 2004, Experimental Brain Research.

[10]  Michael Recce,et al.  A Virtual RealityBased Exercise System for Hand Rehabilitation Post-Stroke , 2005, Presence: Teleoperators & Virtual Environments.

[11]  Jilyan Decker,et al.  Wiihabilitation : Rehabilitation of Wrist Flexion and Extension Using a Wiimote-Based Game System , 2009 .

[12]  Uri Feintuch,et al.  VirHab - A virtual reality system for treatment of chronic pain and disability , 2009, 2009 Virtual Rehabilitation International Conference.

[13]  Maria V. Sanchez-Vives,et al.  First Person Experience of Body Transfer in Virtual Reality , 2010, PloS one.

[14]  Jeffrey A. Lewis,et al.  The Rutgers Arm, a Rehabilitation System in Virtual Reality: A Pilot Study , 2006, Cyberpsychology Behav. Soc. Netw..

[15]  D. Rand,et al.  The Sony PlayStation II EyeToy: Low-Cost Virtual Reality for Use in Rehabilitation , 2008, Journal of neurologic physical therapy : JNPT.

[16]  Holger Regenbrecht,et al.  The Experience of Presence: Factor Analytic Insights , 2001, Presence: Teleoperators & Virtual Environments.

[17]  E. Tunik,et al.  Innovative approaches to the rehabilitation of upper extremity hemiparesis using virtual environments. , 2009, European journal of physical and rehabilitation medicine.

[18]  M. Levin,et al.  Virtual Reality in Stroke Rehabilitation: A Meta-Analysis and Implications for Clinicians , 2011, Stroke.

[19]  Holger Regenbrecht,et al.  Beyond the Looking Glass: Fooling the Brain with the Augmented Mirror Box , 2011, PRESENCE: Teleoperators and Virtual Environments.

[20]  V. Ramachandran,et al.  Size reduction using Mirror Visual Feedback (MVF) reduces phantom pain , 2009, Neurocase.

[21]  S Bermudez i Badia,et al.  A virtual reality system for motor and cognitive neurorehabilitation , 2007 .

[22]  Mark Hallett,et al.  Cortical reorganization and associated functional motor recovery after virtual reality in patients with chronic stroke: an experimenter-blind preliminary study. , 2005, Archives of physical medicine and rehabilitation.

[23]  H. Bülthoff,et al.  Merging the senses into a robust percept , 2004, Trends in Cognitive Sciences.

[24]  C. Maihöfner,et al.  Complex regional pain syndromes: new pathophysiological concepts and therapies , 2010, European journal of neurology.

[25]  Zhengyou Zhang,et al.  A Flexible New Technique for Camera Calibration , 2000, IEEE Trans. Pattern Anal. Mach. Intell..

[26]  John L. Bradshaw,et al.  Central mechanisms in phantom limb perception: The past, present and future , 2007, Brain Research Reviews.

[27]  C. Spence,et al.  Visual distortion of a limb modulates the pain and swelling evoked by movement , 2008, Current Biology.

[28]  P. Verschure,et al.  Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation , 2010, Journal of NeuroEngineering and Rehabilitation.

[29]  V. Ramachandran,et al.  Synaesthesia in phantom limbs induced with mirrors , 1996, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[30]  G. Moseley,et al.  The context of a noxious stimulus affects the pain it evokes , 2007, Pain.

[31]  M. Levin,et al.  Virtual Reality in Stroke Rehabilitation: A Systematic Review of its Effectiveness for Upper Limb Motor Recovery , 2007, Topics in stroke rehabilitation.

[32]  R.S. Leder,et al.  Nintendo Wii remote for computer simulated arm and wrist therapy in stroke survivors with upper extremity hemipariesis , 2008, 2008 Virtual Rehabilitation.

[33]  H. Stam,et al.  ''Playstation eyetoy games'' improve upper extremity-related motor functioning in subacute stroke: a randomized controlled clinical trial. , 2008, European journal of physical and rehabilitation medicine.

[34]  Hongliu Yu,et al.  Motor rehabilitation training after stroke using haptic handwriting and games , 2010 .

[35]  Jiping He,et al.  An Adaptive Mixed Reality Training System for Stroke Rehabilitation , 2010, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[36]  James R. Lewis,et al.  IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use , 1995, Int. J. Hum. Comput. Interact..

[37]  Hannes Kaufmann,et al.  Full body interaction for serious games in motor rehabilitation , 2011, AH '11.

[38]  H. Karbe,et al.  Mirror Therapy Promotes Recovery From Severe Hemiparesis: A Randomized Controlled Trial , 2009, Neurorehabilitation and neural repair.

[39]  T. Mexia,et al.  Author ' s personal copy , 2009 .

[40]  G.C. Burdea,et al.  The Rutgers Arm II rehabilitation system , 2008, 2008 Virtual Rehabilitation.

[41]  H. Hoffman,et al.  Virtual Reality Pain Control During Burn Wound Debridement in the Hydrotank , 2008, The Clinical journal of pain.

[42]  Michael McNeill,et al.  Virtual reality in the rehabilitation of the upper limb after stroke: the user's perspective , 2004 .

[43]  Mariano Alcañiz Raya,et al.  VR-Mirror: A Virtual Reality System for Mental Practice in Post-Stroke Rehabilitation , 2005, Smart Graphics.

[44]  A. Sirigu,et al.  Illusory movements of the paralyzed limb restore motor cortex activity , 2003, NeuroImage.

[45]  Andrea Gaggioli,et al.  The virtual reality mirror: Mental practice with augmented reality for post-stroke rehabilitation: (705572011-034) , 2005 .

[46]  H. Sveistrup,et al.  Application of virtual reality in upper limb rehabilitation , 2008, 2008 Virtual Rehabilitation.

[47]  George A. Mensah,et al.  The atlas of heart disease and stroke , 2005 .

[48]  Howard Poizner,et al.  Development and application of virtual reality technology to improve hand use and gait of individuals post-stroke. , 2004, Restorative neurology and neuroscience.

[49]  Soha Saleh,et al.  Robotically facilitated virtual rehabilitation of arm transport integrated with finger movement in persons with hemiparesis , 2011, Journal of NeuroEngineering and Rehabilitation.

[50]  Darryl Charles,et al.  Optimising engagement for stroke rehabilitation using serious games , 2009, The Visual Computer.

[51]  Paul F. M. J. Verschure,et al.  Stroke rehabilitation using the Rehabilitation Gaming System (RGS): initial re-sults of a clinical study. , 2008 .

[52]  Hunter G. Hoffman,et al.  Virtual Reality Pain Control during Physical Therapy Range of Motion Exercises for a Patient with Multiple Blunt Force Trauma Injuries , 2009, Cyberpsychology Behav. Soc. Netw..