Wearable Haptics and Immersive Virtual Reality Rehabilitation Training in Children With Neuromotor Impairments

Abstract

The past decade has seen the emergence of rehabilitation treatments using virtual reality (VR) environments although translation into clinical practice has been limited so far. In this paper, an immersive VR rehabilitation training system endowed with wearable haptics is proposed for children with neuromotor impairments: it aims to enhance involvement and engagement of patients, to provide congruent multi-sensory afferent feedback during motor exercises and to benefit from the flexibility of VR in adapting exercises to the patient's need. An experimental rehabilitation session conducted with children with cerebral palsy (CP) and developmental dyspraxia (DD) has been performed to evaluate the usability of the system and proof of concept trial of the proposed approach. We compared CP/DD performance with both typically developing children and adult control group. Results show the system was compliant with different levels of motor skills and allowed patients to complete the experimental rehabilitation session, with performance varying according to the expected motor abilities of different groups. Moreover, a kinematic assessmentbased on the presented system has been designed. Obtained results reflected different motor abilities of patients and participants, suggesting suitability of the proposed kinematic assessment as a motor function outcome.

Immersive Virtual Environments and Wearable Haptic Devices in rehabilitation of children with neuromotor impairments: a single-blind randomized controlled crossover pilot study

“…b , c Show detail of the fingertip haptic device rendering tangential and normal contact forces through cutaneous feedback [ 23 , 46 ]. Screenshots of the virtual gaming scenarios [ 1 , 2 , 39 ] involving grasping and reaching task in the frontal plane ( d ), and path tracking tasks in the horizontal plane ( e ) …”

“…In addition, kinesiological assessment, as described in detail in Bortone et al [ 39 ], was performed in order to detect any impairment-dependent difference. The kinesiological assessment was carried out in a real setting scenario during two different motor tasks involving the following target actions: Linear path tracking on different directions with respect to the sagittal plane Reach-to-grasp with subsequent pronation/supination of the forearm.…”

“…Each task was performed 6 to 10 consecutive times, during which the hand position and orientation was recorded through an optical tracking system. We analyzed kinematic variables of movements related to reach-to-grasp, with precision pinch and forearm pronation-supination, and linear path tracking in terms of: Smoothness of movements: computed as the number of peaks in the speed profile, whose increase correspond to a worse performance; Velocity weighted error (V-W Error): in order to balance the effect of the speed on estimated errors [ 39 ], we computed the ratio between the movement error (root mean square error from the optimal trajectory) and the mean velocity, lower values correspond to better performance. …”

“…Velocity weighted error (V-W Error): in order to balance the effect of the speed on estimated errors [ 39 ], we computed the ratio between the movement error (root mean square error from the optimal trajectory) and the mean velocity, lower values correspond to better performance.…”

The effect of tactile augmentation on manipulation and grip force control during force-field adaptation

“…However, kinesthetic haptic devices are often large, heavy, and expensive, whereas tactile devices are small, lightweight, low cost, and can be wearable [82]. These qualities make tactile devices, combined with virtual reality [83], attractive for ambulatory [84] and inhome rehabilitation [85].…”