Conference paper Open Access
Recovery of upper-body fine-motor skills after brain trauma, e.g. after a stroke, involves a long process of movement rehabilitation. When the arms and hands are affected patients often spend many hours exercising in order to regain control of their movements, often using children’s toys. This paper describes the process of development of a Virtual Reality (VR) system designed to supplement rehabilitation by encouraging hand movements while playing a fun game. The system is based on the well-known Buzzwire children’s toy that requires steady hand-eye coordination to pass a ring along a wire without touching the wire. The toy has in the past been used in a variety of research studies, but we considered it ideal for motor rehabilitation because it requires steady hand and finger movements. In our virtualised version of the toy the wire consists of a parametric spline curve with cylindrical cross-section positioned in front of the player. Cylinders at the ends of the ’wire’ change colour to indicate which hand to use. The parametric nature of the wire allows us to record performance variables which are not readily available in the physical version. We report on two initial experiments which tested and evaluated various aspects of performance on able-bodied participants and stroke patients, followed by a description of how we developed the toy into a multi-level game that encourages increasingly intricate hand movements. In the first evaluation we tested if performance variables (such as average speed, and distance from the wire) could distinguish between dominant and non-dominant hands of able-bodied participants. We also compared performance with and without binocular viewing. Results showed that our metrics could distinguish between the players dominant versus non-dominant hand. We also noted a dramatic disruption of performance when binocular stereopsis was not available. The second experiment was a usability study involving a sample of stroke-affected participants with post-stroke hemiparesis. Results showed positive acceptance of the technology with no fatigue or nausea. Our gamified version of the task utilizes learnings from the previous studies to create an enjoyable multi-level game involving auditory guidance as feedback. Results are discussed in terms of potential benefits of using such technology in addition to conventional therapy.
BALASUBRAMANIAN S., MELENDEZ-CALDERON A., ROBY-BRAMI A., BURDET E.: On the analysis of movement smoothness. Journal of neuroengineering and rehabilitation 12, 1 (2015), 112.
BUDINI F., LOWERY M. M., HUTCHINSON M., BRADLEY D., CONROY L., DE VITO G.: Dexterity training improves manual precision in patients affected by essential tremor. Archives of physical medicine and rehabilitation 95, 4 (2014), 705–710.
CAMEIRÃO M. S., BERMÚDEZ S., VERSCHURE P.: Virtual reality based upper extremity rehabilitation following stroke: a review. Journal of CyberTherapy & Rehabilitation 1, 1 (2008), 63–74.
CHEUNG K. L., TUNIK E., ADAMOVICH S. V., BOYD L. A.: Neuroplasticity and virtual reality. In Virtual Reality for Physical and Motor Rehabilitation. Springer, 2014, pp. 5–24.
CUSTANCE D. M., MAYER J. L., KUMAR E., HILL E., HEATON P. F.: Do children with autism re-enact object movements rather than imitate demonstrator actions? Autism Research 7, 1 (2014), 28–39.
DITTRICH W. H., JOHANSEN T., METCALFE L., LANDRØ N. I.: Cognitive performance and specific deficits in ocd symptom dimensions: Iv. impairments in manual movement control. German Journal of Psychiatry 15, 1 (2012), 32–40.
HENDERSON A., KORNER-BITENSKY N., LEVIN M.: Virtual reality in stroke rehabilitation: a systematic review of its effectiveness for upper limb motor recovery. Topics in stroke rehabilitation 14, 2 (2007), 52–61.
HOLDER M.: Why are more people right-handed. Scientific American (2001).
JOY S., DAVIS H., BUCKLEY D.: Is stereopsis linked to handeye coordination? British Orthoptic Journal, 58 (2001), 38–41.
JURKIEWICZ M. T., MARZOLINI S., OH P.: Adherence to a home-based exercise program for individuals after stroke. Topics in stroke rehabilitation 18, 3 (2011), 277–284.
KWAKKEL G., VAN PEPPEN R., WAGENAAR R. C., WOOD DAUPHINEE S., RICHARDS C., ASHBURN A., MILLER K., LINCOLN N., PARTRIDGE C., WELLWOOD I., ET AL.: Effects of augmented exercise therapy time after stroke: a meta-analysis. stroke 35, 11 (2004), 2529–2539.
LAVER K. E., LANGE B., GEORGE S., DEUTSCH J. E., SAPOSNIK G., CROTTY M.: Virtual reality for stroke rehabilitation. The Cochrane Library (2017).
LURIA A. R.: Higher cortical functions in man. Springer Science & Business Media, 2012.
MURDOCH J., MCGHEE C., GLOVER V.: The relationship between stereopsis and fine manual dexterity: pilot study of a new instrument. Eye 5, 5 (1991), 642.
OLDFIELD R. C.: The assessment and analysis of handedness: the edinburgh inventory. Neuropsychologia 9, 1 (1971), 97–113.
READ J. C., BEGUM S. F., MCDONALD A., TROWBRIDGE J.: The binocular advantage in visuomotor tasks involving tools. i- Perception 4, 2 (2013), 101–110.
ROHRER B., FASOLI S., KREBS H. I., HUGHES R., VOLPE B., FRONTERA W. R., STEIN J., HOGAN N.: Movement smoothness changes during stroke recovery. Journal of Neuroscience 22, 18 (2002), 8297–8304.
SHAFTI A., LAZPITA B. U., ELHAGE O., WURDEMANN H. A., ALTHOEFER K.: Analysis of comfort and ergonomics for clinical work environments. In Engineering in Medicine and Biology Society (EMBC), 2016 IEEE 38th Annual International Conference of the (2016), IEEE, pp. 1894–1897.