Chien-Yen Chang

Development of an interactive game-based rehabilitation tool for dynamic balance training.

Abstract Conventional physical therapy techniques have been shown to improve balance, mobility, and gait following neurological injury. Treatment involves training patients to transfer weight onto the impaired limb to improve weight shift while standing and walking. Visual biofeedback and force plate systems are often used for treatment of balance and mobility disorders. Researchers have also been exploring the use of video game consoles such as the Nintendo Wii Fit as rehabilitation tools. Case studies have demonstrated that the use of video games may have promise for balance rehabilitation. However, initial usability studies and anecdotal evidence suggest that the current commercial games are not compatible with controlled, specific exercise required to meet therapy goals. Based on focus group data and observations with patients, a game has been developed to specifically target weight shift training using an open source game engine and the Nintendo Wii Fit Balance Board. The prototype underwent initial usability testing with a sample of clinicians and with persons with neurological injury. Overall, feedback was positive, and areas for improvement were identified. This preliminary research provides support for the development of a game that caters specifically to the key requirements of balance rehabilitation.

Designing informed game-based rehabilitation tasks leveraging advances in virtual reality

Purpose: This paper details a brief history and rationale for the use of virtual reality (VR) technology for clinical research and intervention, and then focuses on game-based VR applications in the area of rehabilitation. An analysis of the match between rehabilitation task requirements and the assets available with VR technology is presented. Key messages and implications: Low-cost camera-based systems capable of tracking user behavior at sufficient levels for game-based virtual rehabilitation activities are currently available for in-home use. Authoring software is now being developed that aims to provide clinicians with a usable toolkit for leveraging this technology. This will facilitate informed professional input on software design, development and application to ensure safe and effective use in the rehabilitation context. Conclusion: The field of rehabilitation generally stands to benefit from the continual advances in VR technology, concomitant system cost reductions and an expanding clinical research literature and knowledge base. Home-based activity within VR systems that are low-cost, easy to deploy and maintain, and meet the requirements for “good” interactive rehabilitation tasks could radically improve users’ access to care, adherence to prescribed training and subsequently enhance functional activity in everyday life in clinical populations. Implications for Rehabilitation Virtual reality (VR) technology has an established track record of success in addressing the therapeutic needs of persons across a range of clinical health conditions. In-home systems for VR rehabilitation are now technologically and pragmatically feasible, but it will require informed professional input on software design, development and application to ensure safe and effective use. New tools are being created that will allow clinicians without programming expertise to build game-based VR tasks and this will serve to drive advances in rehabilitation interventions.

Interactive game-based rehabilitation using the Microsoft Kinect

Using video games in rehabilitation settings has the potential to provide patients with fun and motivating exercise tools. Within the Medical VR and MxR groups at the USC Institute for Creative Technologies, we have been leveraging the technology of the Microsoft Kinect 3D depth-sensing camera. Our Kinect-based rehabilitation game “JewelMine” consists of a set of static balance training exercises which encourage the players to reach out of their base of support. We plan to demonstrate a sophisticated post-session analysis tool and several content themes which can be changed dynamically during a therapy session.

Leveraging unencumbered full body control of animated virtual characters for game-based rehabilitation

The use of commercial video games as rehabilitation tools, such as the Nintendo® Wii Fit™, has recently gained much interest in the physical therapy arena. However, physical rehabilitation requires accurate and appropriate tracking and feedback of performance, often not provided by existing commercial console devices or games. This paper describes the development of an application that leverages recent advances in commercial video game technology to provide fullbody control of animated virtual characters with low cost markerless tracking. The aim of this research is to develop and evaluate an interactive game-based rehabilitation tool for balance training of adults with neurological injury. This paper outlines the development and evaluation of a game-based rehabilitation tool using the PrimeSense depth sensing technology, designed to elicit specific therapeutic motions when controlling a virtual avatar in pursuit of in-game goals. A sample of nine adults participated in the initial user testing, providing feedback on the hardware and software prototype.

SmartGlove for upper extremities rehabilitative gaming assessment

This paper presents a quantitative assessment solution for an upper extremities rehabilitative gaming application [1]. This assessment solution consists of a set of stand-alone hardware, including SmartGlove and Kinect, a depth capturing sensor made by Microsoft. SmartGlove is a specially designed motion and finger angle extraction device which is packaged in an easy-to-wear and adjustable manner for a patient with an upper extremity impairment. Sensor data extraction, alignment, and visualization algorithms were designed for integrating hand-mounted sensors data streams into skeleton coordinates captured by the Kinect. This enhanced skeleton information can be summarized and replayed as upper extremity joint coordinate animations which can be used for physical therapists to quantify rehabilitation progress. In addition, to serve as an assessment tool, enhanced skeleton information can be used to extend the capability of the Kinect vision system, such as providing motion capture of the upper extremities, even when the testing subject is out of camera scope or ones upper extremities are occluded by the body.

Development of an interactive stepping game to reduce falls in older adults

Abstract More than one-third of people over the age of 65 years experience falls each year, and those who fall once are two to three times more likely to fall again. A fall can significantly limit a person’s ability to remain self-sufficient. Fall injuries are responsible for significant disability, reduced physical function, and loss of independence. However, falls are not an inevitable result of aging. Systematic reviews of fall intervention studies have established that prevention programs can reduce falls. Physical activities, including strengthening exercises, Tai Chi, dancing and walking have been demonstrated to improve balance and decrease risk of falls in older adults. Modified dance-based exercises that include step-based movements have been demonstrated to improve endurance and balance in older adults. Dance video games, using a dance mat with areas that the player must step on in time with cues on the screen, have been demonstrated to improve activity and mood and reduce weight in children and youth. However, these dance games often include fast paced music, frequent jumping and an overload of visual information, movement and colors on the screen. This paper outlines the development of a prototype rhythm game that leverages the benefits of step-based exercise and dance video games to improve balance and reduce falls in older adults.

User-Centered Design of a Controller-Free Game for Hand Rehabilitation

OBJECTIVE The purpose of this study was to develop and test a hand therapy game using the Microsoft (Redmond, WA) Kinect(®) sensor with a customized videogame. MATERIALS AND METHODS Using the Microsoft Kinect sensor as an input device, a customized game for hand rehabilitation was developed that required players to perform various gestures to accomplish a virtual cooking task. Over the course of two iterative sessions, 11 participants with different levels of wrist, hand, and finger injuries interacted with the game in a single session, and user perspectives and feedback were obtained via a questionnaire and semistructured interviews. RESULTS Participants reported high levels of enjoyment, specifically related to the challenging nature of the game and the visuals. Participant feedback from the first iterative round of testing was incorporated to produce a second prototype for the second round of testing. Additionally, participants expressed the desire to have the game adapt and be customized to their unique hand therapy needs. CONCLUSIONS The game tested in this study has the potential to be a unique and cutting edge method for the delivery of hand rehabilitation for a diverse population.

Effects of stereoscopic displays and interaction devices on human motor behavior

The goal of this research is to compare the performance of different stereoscopic displays and tracking/interaction devices in the context of motor behavior and interaction quality within various Virtual Reality (VR) environments. Participants were given a series of VR tasks requiring motor behaviors with different degrees of freedom. The VR tasks were performed using a monoscopic display and two stereoscopic displays (shutter glasses and autostereoscopic display) and two tracking devices (optical and magnetic). The two 3D tracking/ interaction devices were used to capture continuous 3D spatial hand position with time stamps. Participants completed questionnaires evaluating display comfort and simulation fidelity among the three displays and the efficiency of the two interaction devices. The trajectory of motion was reconstructed from the tracking data to investigate the users motor behavior. Results provide information on how stereoscopic displays can affect human motor behavior and interaction modes during VR tasks. These preliminary results suggest that the use of shutter glasses provides a more immersive and user-friendly display than autostereoscopic displays. Results also suggest that the optical tracking device, available at a fraction of the cost of the magnetic tracker, provides similar results for users in terms of functionality and usability features.

Breathe: A Game to Motivate the Adherence of Breathing Exercises

Background and Purpose. Breathing often becomes impaired or difficult after surgeries or in the presence of disease or injury. Breathing exercises are imperative to ensure the health of lungs. Despite this, patient adherence with breathing exercise regimes is not commonly assessed. There is a need for breathing exercise programs that will stimulate motivation, the lack of which is often associated with exercise. Typically, breathing exercises must be performed at regular intervals throughout the day while recovering from surgery or undertaking cycles of prophylactic breathing exercises. Furthermore, there is a need for a device that will provide quantitative measures of patient progress and adherence. An incentive spirometer apparatus measures the volume of air inspired and expired, and provides visual feedback while performing breathing exercises. The development of a game-based incentive spirometry system aims to overcome the typical exercise inertia to motivate patients to perform breathing exercises and to provide individualized challenge levels and quantitative measurement of progress and adherence. Method/Model Description and Evaluation. This research involves an interdisciplinary team of physical therapists, game designers, engineers, and computer scientists. The iterative game-design process was used to develop 6 prototype games. The games underwent a series of user tests. Two game prototypes underwent further refinement and user testing with a sample of physical therapists and people with disabilities. Game usability was assessed and feedback was provided on the incentive spirometry device, game play, system goals, and potential improvements. Outcomes. Initial assessment of the prototype system indicated that both physical therapists and potential users enjoyed the incentive spirometry game and encouraged further development. The potential end users indicated their excitement about the concept of using games for breathing exercises and look forward to the completed game. Discussion and Conclusions. Following further refinement and development, the game-based breathing system will be assessed for effectiveness in improving patient adherence and reducing pulmonary complications, compared to standard treatment techniques. The integration of medical devices with video game technologies offers great potential to improve assessment and treatment tools and patient adherence with physical therapy.

Object-based disparity adjusting tool for stereo panoramas

We want to create realistic immersive personal virtual environments using stereo panoramas. We explore methods to adjust the disparity of stereoscopic images to lie within an acceptable range for human viewers and provide a comfortable stereo viewing experience. Peleg et al described a disparity adjusting method which modifies the disparity of selected objects but also the columns including the object. In this paper, we develop a human interactive object-based tool to adjust selectively the horizontal disparity in stereo panoramas. It enhances or reduces the stereo visual effect for selected 2D object regions without changing the disparities of other regions in the image. Our interactive object-selecting tool is based on the mean-shift segmentation method. The object presented in either a left or right image is selected by users inputting seed points near the desired object boundary, and object contours both in left and right image are automatically found by our object-selecting algorithm. The complete interactive disparity-adjusting tool allows the user to select the object either from manual input using a cursor, or by defining an area with a certain distance range, with the ability to observe the results immediately on an autostereoscopic display or other stereo display.