Traditional methods of movement assessment in clinical rehab are often labor intensive and provide a limited number of outcome variables for tracking recovery. Entry level virtual reality (VR) systems afford new possibilities for systematic assessment and treatment. This paper describes the development of a virtual tabletop environment for the assessment of upper limb function in Traumatic Brain Injury (TBI). The system is designed to present realistic virtual workspaces and to measure performance at both a functional and kinematic level. In addition, we incorporate the use of Tangible User Interfaces (TUIs) as a means of integrating performance with the workspace. Unlike top-end movement analysis systems, the experimental system utilizes readily available computing technologies: mid-range PC, LCD panels, stereo camera, Virtools software, and TUI enabled by Wii Remote, Wii Sensor Bar (Nintendo™) and passive markers. The combination of visionbased marker tracking with a low cost game controller (viz Wii system) provides a stable and accurate means of tracking the TUI on the virtual workspace, and for interactivity within this space. The system provides a compelling sense of realism for the performer and an innovative means of assessing movement capabilities over time.

In this paper we describe the design and development of Resonance, an interactive tabletop artwork that targets upper-limb movement rehabilitation for patients with an acquired brain injury. The artwork consists of several interactive game environments, which enable artistic expression, exploration and play. Each environment aims to encourage collaborative, cooperative, and competitive modes of interaction for small groups (2-4) of co-located participants. We discuss how participants can perform movement tasks face-to-face with others using tangible user interfaces in creative and engaging activities. We pay particular attention to design elements that support multiple users and discuss preliminary user evaluation of the system. Our research indicates that group based rehabilitation using Resonance has the potential to stimulate a high level of interest and enjoyment in patients; facilitates social interaction, complements conventional therapy; and is intrinsically motivating.

No abstract

Upper-limb virtual rehabilitation (VR) in adult acquired brain injury (ABI) is based largely on systems administered on a one-to-one basis. Multi-user interaction between co-located participants may offer advantages over single-user methods. The present study examined the feasibility of deploying a co-located VR system (Resonance) in a clinical setting. Following a baselining period, 5 patients with ABI completed 12 Resonance sessions over 4-6 weeks. Feasibility criteria included recruitment, intervention delivery, attrition, user experience, and suitability of outcome measures. Individual participant motor proficiency (box and blocks task) was examined using a time-series analysis with reliable change indices and curve fitting. All feasibility criteria were satisfied, with positive reports of user experience. Repeated collection of outcome measures was successfully integrated into the training schedule. Time-series analysis was successfully conducted, providing a detailed account of individual training-related change. Within a clinical setting, it was feasible to deliver Resonance and regularly monitor motor function. User feedback regarding the co-located VR intervention was generally positive, but expectations regarding the level of immersion may need to be managed. Individual time-series analysis is recommended as an adjunct to group-based analysis in future VR research. These findings can inform the design of a clinical trial.

The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI). A mixed-approach design was used. Performance was evaluated at three time points using a within-group design: Preintervention 1 and 2, conducted 4 weeks apart, and Postintervention. Subjective ratings were provided after patients completed exploratory tasks. The intervention consisted of 12 1hour training sessions over 4 weeks in addition to conventional physical therapy. Nine patients aged 18-48 years with severe TBI were recruited. The Elements system is comprised of a 40-inch tabletop LCD, camera tracking system, tangible user interfaces (i.e., graspable objects), and software. The system provided two modes of interaction with augmented feedback: goal-directed and exploratory. Upper-limb performance was assessed using systemrated measures (movement speed, accuracy, & efficiency), and standardised tests. Planned comparisons revealed little change in performance over the pretest period apart from an increase in movement speed. Significant training effects, with large effect sizes were shown on most measures. Subjective data revealed high levels of presence (inc. user involvement/control) and user satisfaction for the exploratory tasks. These findings support an earlier case study evaluation of the Elements system, further demonstrating that VR training is a viable adjunct in movement rehabilitation of TBI.