Cristina Ramírez-Fernández

On the Effect of Previous Technological Experience on the Usability of a Virtual Rehabilitation Tool for the Physical Activation and Cognitive Stimulation of Elders

We present and discuss our findings on the identified causes for the differences of the results of two usability studies on the borrowed use of Gesture Therapy, a virtual rehabilitation tool for the cognitive stimulation and physical activation of elders. The studies focused on usability aspects including perceived usefulness, ease of use, intention of use and user experience. In the first study, we used self-report techniques to gather data, and found that previous technological experience had a significant effect on the perceived anxiety of elders; while on the second study, we used indirect observation techniques to gather data, and found that previous technological experience had a significant effect on the perceived enjoyment of elders. After a further analysis of the video recordings of the playing sessions, we identified that elders developed two different approaches to their using the application (explore-and-learn and score-and-compete), which could be related to their previous technological experience, and explain the identified differences. We observed that in the presence of problems, the response of participants was different depending on the adopted behavior. Based on this evidence, we distilled a set of preliminary guidelines to foster or inhibit certain behaviors and outcomes related to the effect of previous experience that were observed during our evaluation studies of virtual tools for the cognitive stimulation and physical activation of the elderly.

Ontology-based Design Model of Virtual Environments for Upper Limb Motor Rehabilitation of Stroke Patients

Today, the development of virtual reality (VR) applications for upper limb motor rehabilitation is still a difficult and time-consuming task. It requires developers to be skilled in motor rehabilitation, interaction devices, and stroke survivor characteristics, among others, to be able to develop a virtual environment (VE). In the literature there are several recommendations to aid in the design of VEs. However, to integrate the recommendations it is necessary to understand key domain concepts in motor rehabilitation. In this paper, we introduce VEULMoR, an ontology-based approach for designing VEs for Upper Limb Motor Rehabilitation. This approach uses the domain expertise coded into the ontology to shorten and facilitate the design of a VE. The information contained in the ontology can be used to denote the design factors that integrate the VE.

Revisiting the User Experience of a Virtual Rehabilitation Tool for the Physical Activation and Cognitive Stimulation of Elders

We report the results of an indirect observation usability and user experience (UX) study on the use of the Gesture Therapy (GT) rehabilitation platform, as a physical activation and cognitive stimulation tool for the elderly. The results from this study complement those of a former self-report study [8]. Elders perceived the system with high usefulness, usability, and UX, as well as generating low anxiety in both studies. Also, the results allowed us to analyze and evaluate the impact of elders’ previous experience on computer use on specific aspects. Interestingly, the significance of the effect of previous computer use experience on perceived anxiety and perceived enjoyment aspects of UX was different in both studies, although there is an important overlap for ease of use factors. These results, although not conclusive yet on the causes for the difference, provides us with further evidence to establish that elders’ previous experience (or not) on computer use affects their user experience on the use of the GT platform.

Design Factors of Virtual Environments for Upper Limb Motor Rehabilitation of Stroke Patients

Stroke survivors are often left with motor disabilities. Virtual environments for motor therapy are an emerging strategy to motivate, entertain or engage the rehabilitation patient to the therapy after stroke. The design of these specialized virtual environments requires to meet the needs of patients and therapists, which is not a simple task. To support the design of these applications a number of recommendations for the developers have been proposed in literature. Here, a taxonomy is proposed to classify the identified principles, criteria, implications, usability factors or guidelines on which the recommendations are based. The taxonomy identifies key factors in the design of virtual environments for upper limb motor therapy. The taxonomy is organized into three categories corresponding to different stages of the therapy: configuration of the exercise, assistance during the execution of the exercise and management of therapy results. We believe that agglutinating and organizing design factors into a taxonomy may reduce development times, facilitate communication between developers and clinical counterparts and increase chances of therapeutic validity.

Design Principles for Hapto-Virtual Rehabilitation Environments: Effects on Effectiveness of Fine Motor Hand Therapy

We propose a set of principles to facilitate the design of haptic feedback virtual environments, which is expected to contribute to the effectiveness of the fine motor hand therapy. Firstly, we conducted a contextual study in a rehabilitation center to identify preliminary design elements using grounded theory. Based on these results, we defined a set of principles aiming to aid in the design of haptic feedback virtual environments to favour therapy effectiveness and patient’s safety. Secondly, in order to evaluate the proposed design principles, we developed a haptic feedback virtual environment based on them and conducted a formative evaluation with five patients and three therapists. Preliminary results provided promising evidence, indicating a high perception of usefulness, ease of use and intention of use of the proposed environment and principles. Finally, to validate the impact of the design principles in therapy effectiveness, we carried out a second study with thirty participants, from which fifteen elderly had hand motor impairments. We found no significant differences in task execution time between healthy adults and elders with hand motor impairments. We found significant differences in precision or accuracy of the exercise. We confirmed the importance of key principles to facility the design of hapto-virtual environments that contribute to the effectiveness of the fine motor hand therapy. Further evaluations are needed to validate our results from a clinical viewpoint. We confirmed the importance of key principles to contribute to the effectiveness of the fine motor hand therapy. Further evaluations are needed to validate our results from a clinical viewpoint.

Haptic Mobile Augmented Reality System for the Treatment of Phobia of Small Animals in Teenagers

Some of the fears of small animals present in childhood are maintained and cause significant discomfort until the adolescent stage, even causing phobias. A treatment used in the traditional therapy of phobias is the live exposure to the object of fear, however one of the problems with this treatment is patient resistance and eventual therapy abandonment. The use of intelligent environments is an alternative that allows to support the therapy through the virtual, gradual and controlled exposure of the patient to the animal to which s/he is afraid. In this research, we present the design, development and evaluation of a haptic mobile augmented reality system for the treatment of small animals phobia using the TPAD haptic device. The proposed haptic system includes features that allow (i) diagnosing the level of phobia of small animals, (ii) self-adjusting the phobia treatment using support vector machines, and (iii) user progress statistics based on the estimated stress level and time touching the screen. A usability and performance evaluation of the system with 14 teenagers, suggests that the haptic system is perceived as useful and usable, while providing an effective and accessible way to treat the patient and to adjust the therapy challenge level.

Towards a Taxonomy of Feedback Factors Affecting the User Experience of Augmented Reality Exposure Therapy Systems for Small-Animal Phobias

Small-animal phobias has been treated using in vivo exposure therapies (IVET) and virtual reality exposure therapies (VRET). Recently, augmented reality for exposure therapies (ARET) has also been presented and validated as a suitable tool. In this work we identified an ensemble of feedback factors that affect the user experience of patients using ARET systems for the treatment of small-animal phobias, and propose a taxonomy to characterize this kind of applications according to the feedback factors used in the application. Further, we present a customized version of the taxonomy by considering factors/attributes specific to the visual stimuli. To the best of our knowledge, no other work has identified nor provided an explicit classification or taxonomy of factors that affect the user experience of patients using this kind of systems for the treatment of small-animal phobias. Our final aim is to two-fold: (i) provide a tool for the design, classification and evaluation of this kind of systems, and (ii) inspire others to conduct further work on this topic.

Massage Therapy of the Back Using a Real-Time Haptic-Enhanced Telerehabilitation System

We present the usability evaluation of a haptic-enhanced telerehabilitation system for massage therapy of the back using the Vybe haptic gaming pad and the gesture sensor LEAP motion controller. The evaluated system includes features that allow for (i) administering online therapy programs, (ii) providing self-adjustable and safety treatment of back massages using a virtual environment, and (iii) saving and replaying massage sessions according to a patient’s therapy program. The usability evaluation with 25 older adults and 10 specialists suggests that the haptic telerehabilitation system is perceived with high usability and pleasurable user experience, while providing personalized intensity of haptic therapy in a supervised, real-time, and secure way to treat the patient. Moreover, the specialists totally agree that the system design features, such as save and play, and delimiting therapy zones are the most important for back massage therapy, while the features of regulating feedback intensity and providing/receiving a massage remotely are also important. Finally, based on their comments, five design insights aiming at improving the current version of the system were generated.

GoodVybesConnect: A Real-Time Haptic Enhanced Tele-Rehabilitation System for Massage Therapy

We present the design, development and evaluation of a haptic enhanced tele-rehabilitation system for massage therapy of the back using the Vybe haptic gaming pad. The proposed haptic system includes features that allow (i) administering online therapy programs, (ii) self-adjustable and safety treatment of back massages using a virtual environment, the gesture sensor LEAP Motion controller and the Vybe haptic device, and (iii) save and replay messages according to the therapy program. A usability evaluation with 25 elders suggests that the haptic tele-rehabilitation system is perceived as relaxing, useful and usable, while providing a supervised, real-time and secure way to treat the patient and adjusting the therapy haptic feedback intensity.