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ICDVRAT 2010 - Full Papers Download

The 8th International Conference on Disability, Virtual Reality and Associated Technologies

31st August to 2nd September 2010 - Viña del Mar / Valparaíso, Chile

ICDVRAT Online Archive - Part VIII

Session I - Navigation & Motion

Session Chair: Jaime Sánchez

Exploring the intelligent agents for controlling user navigation in 3D games for cognitive stimulation, R M E M Costa, D S Souza, I Mendonça, Universidade do Estado do Rio de Janeiro, BRAZIL

Despite the many research efforts addressing the development of environments for Virtual Rehabilitation processes, only few of them consider a modeling step before system implementation. Our previous experience in developing virtual environments for stimulating cognitive functions stresses the necessity of adopting some Software Engineering practices. These open new possibilities to extend or integrate the system with others applications. The objective of this paper is to introduce some technical aspects related to modeling and implementing a multi-agent game for training memory and attention. We explore the integration of multi-agent model methodologies and present initial results of an experiment made with two specific languages for building three-dimensional virtual environments.

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Assessing navigation in real and virtual environments: a validation study, S T Koenig, G P Crucian, J C Dalrymple-Alford, A Dünser, University of Canterbury, NEW ZEALAND

For navigation ability, a transfer of knowledge from virtual training environments to real-world scenarios has been shown in several studies in the past. The purpose of this investigation is to demonstrate the equivalence of a series of navigation tasks in complex real-world and virtual buildings. Instead of testing knowledge transfer in very simple environments, identical tasks are performed in either version of a complex building. 29 participants are shown twelve landmarks, followed by a battery of tasks which are carried out in the real building by half of the participants, whereas the other half performs identical tasks in a virtual model of the same environment. No significant differences or effects were found, but due to the multifaceted nature of the gathered data and large variability within groups, overlap of both groups' distributions was minimal. To discover the underlying factors of this variability, further research is needed. Usability and future development of virtual environments are discussed.

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Wearable device to assist independent living, R J McCrindle, V M Williams, C R Victor, A P Harvey, S R Nyman, J Barrett, H Hogarth, P Levene, R Smith, P Panek, G Edelmayer, P Mayer, P Needham, N Floratos, University of Reading/Brunel University/ Bournemouth University/Docobo Limited, UK, Technical University of Vienna, AUSTRIA and e-ISOTIS, GREECE

Older people increasingly want to remain living independently in their own homes. The aim of the ENABLE project is to develop a wearable device that can be used both within and outside of the home to support older people in their daily lives and which can monitor their health status, detect potential problems, provide activity reminders and offer communication and alarm services. In order to determine the specifications and functionality required for development of the device user surveys and focus groups were undertaken and use case analysis and scenario modeling carried out. The project has resulted in the development of a wrist worn device and mobile phone combination that can support and assist older and vulnerable wearers with a range of activities and services both inside and outside of their homes. The device is currently undergoing pilot trials in five European countries. The aim of this paper is to describe the ENABLE device, its features and services, and the infrastructure within which it operates.

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Designing a workplace for workers with motion disability with a computer simulation and virtual reality techniques, P Budziszewski, A Grabowski, T Tokarski, M Dzwiarek, B Kurkus-Rozowska, J Jankowski, Central Institute for Labour Protection – National Research Institute, POLAND

This paper describes preliminary results of a project aimed at adapting workplaces for workers with motion disability with computer simulation and virtual reality techniques. For this task, special software called the Troll and a computer human model with a visualization of maximal arm reach and preferred working space were developed. The Troll can be used to create a virtual working space, to adjust the human model’s measurements and constraints to reflect a disabled person, and to analyze necessary modifications. The Troll also makes it possible to conduct research in an immersive virtual reality environment to assess a modified workplace and, if necessary, add further modifications.

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Session II - Visual Impairment

Session Chair: Mauricio Sáenz

Listening to complexity: blind people’s learning about gas particles through a sonified model, O Lahav, S T Levy, Tel-Aviv University/University of Haifa, ISRAEL

Students who are blind have been integrated at public schools with sighted students. Because most of Science Education curriculum resources are based on visual representations such as diagrams, charts, models (real and digital), and exploration in science laboratories, students who are blind are lack in participating and collecting the information from first hand. The current research project is based on the assumption that the supply of appropriate information through compensatory sensory channels may contribute to science education performance. In the research system - Listen to complexity system the user is interacting with dynamic objects in a real life scenario.

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Using augmented reality to support the understanding of three-dimensional concepts by blind people, C Kirner, T G Kirner, R S Wataya, J A Valente, Federal University of Itajuba/Adventist University of Sao Paulo/State University of Campinas, BRAZIL

Seeing and describing real and imaginary three-dimensional scenes from the observer’s viewpoint is an intuitive activity for non-impaired people, but it is difficult for congenitally blind people, once it involves abstract concepts for them, such as: perspective, depth planes, occlusion, etc. This paper discusses the problem related to understanding three-dimensional concepts by blind people and presents physical environments and procedures supported by an augmented reality tool in order to help blind people to understand, describe and convert three-dimensional scenes into two-dimensional embossed representations, like painting. To verify how the blind people can acquire those concepts, we developed an augmented reality application, working as an audio spatial tutor to make the perspective learning process easy. That application was tested with ten congenitally blind people, who understood the perspective concepts and made comments about the experience. Finally, we discuss the learning method and technical aspects, pointing out directions to improve the augmented reality application and ways to release it.

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Visual tracking and audio-based interfaces for the navigation of people who are blind, J Sánchez, A Tadres, University of Chile, CHILE

A person who is blind can be capable of locating objects and also other people, such as a sighted person, by just using audio cues. In this research we present the design, development and evaluation of ARTAB, a technological assistant for people who are blind that uses Augmented Reality to identify a set of objects in an indoor environment. As a result, we generated audio-based representations that allow a user to determine the position of an object relative to the angle of vision of the video capture device for navigation purposes. The usability testing performed allowed us to detect that it is not trivial to assign sound effects so that the variation of such effects would imply changes in the position of an object. The continual variation of the sound pitch does not generate the contrast necessary for the blind user to be able to obtain a certain kind of information. However, users generally perceive ARTAB as a useful tool for assisting orientation and mobility tasks.

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Session III - Brain Injury & Memory Training

Session Chair: Imre Cikajlo

PiTaSu: a wearable interface for assisting senior citizens with memory problems, T Kuroda, G Yamamoto, D Yoshitake, S Hickey, J Hyry, K Chihara, P Pulli, Kyoto University Hospital/Okayama University/Nara Institute of Science and Technology, JAPAN and University of Oulu, FINLAND

Little research has been carried out on specialized wearable user interfaced designs to assist memory impaired senior citizens. This paper proposes and implements PiTaSu (Picture based Tapping on wall Surfaces) to realize direct user interface system to offer visual feedback and tactile feedback. PiTaSu is based on a pictorial based Augmented and Alternative Communication (AAC) system. PiTaSu consists of a body-worn or shoulder-attached mobile projector, a camera and an accelerometer wrist band. The projector shows information that will help assist the memory impaired senior citizen in their daily task. The camera and the accelerometer detect a tapping position and tapping trigger. Experimental results have demonstrated that a senior citizen can use PiTaSu without learning special skills, and the projection based user interface has potential. Therefore, PiTaSu can assist memory-impaired senior citizens as a daily task reminder.

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Designing an ecological virtual task in the context of executive functions: preliminary study, X Cao, A-S Douguet, P Fuchs, E Klinger, Arts et Métiers Paristech/Kerpape Rehabilitation Center/MINES ParisTech, FRANCE

Brain damage is a major cause of disability that often leads to deficits in executive functions with dramatic consequences on activities of daily living. While rehabilitation approaches of the dysexecutive syndrome are still limited, virtual reality has shown its potential to propose innovative intervention strategies based on ecologically valid functional tasks. The Therapeutic Virtual Kitchen (TVK) was designed as an assessment tool to help therapists and their patients with brain injury. In the TVK, some ecological virtual tasks may be configured by the therapists for patients’ assessment and rehabilitation. The purpose of this paper is to validate the feasibility of the TVK with healthy subjects and patients with brain injury in Kerpape Rehabilitation Center.

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Traumatic brain injury memory training: a virtual reality online solution, P Gamito, J Oliveira, J Pacheco, D Morais, T Saraiva, R Lacerda, A Baptista, N Santos, F Soares, L Gamito, P Rosa, Universidade Lusófona de Humanidades e Tecnologias/Centro de Medicina de Reabilitação de Alcoitão/Clínica São João de Deus/Centro de Investigação Social/Instituto Universitário de Lisboa, PORTUGAL

This study aims at assessing an online portal where patients with traumatic brain injury (TBI) can carry on memory and attention exercises outside clinic premises. The training took place in a VR setup where one TBI patient had to complete a set of 10 online VR sessions. The neuropsychological evaluation was carried out with the PASAT (Paced Auditory Serial Addition Task) at pre, during and after treatment assessments. The results showed an increase in working memory and attention levels from the first to the final assessment, which can suggest that VR applications may promote the autonomy and increase in overall quality of life of these patients. The average time for task conclusion was of 5 minutes.

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Impact of the physical field of view on the performance in a purchasing task in the VAP-S for patients with brain injury, H Cherni, A Kadri, A Tarruella, P-A Joseph, E Klinger, Arts Métiers Paristech/Université Victor Segalen de Bordeaux, FRANCE

In VR-based cognitive rehabilitation, there is a particular interest in subject’s performance in the virtual tasks in which the patients are engaged. This performance is function of many factors among which the characteristics of visual information delivered by the virtual system. This study was designed to examine the impact of the physical field of view (PFOV) on the performance in a virtual task in the Virtual Action Planning Supermarket (VAP-S) among patients with brain injury and control subjects. Results show that, for all the participants, there is no significant difference between the main VAP-S variables in two experimental configurations (large FOV and small FOV), except for the number of incorrect actions that increases in the small FOV situation. We conclude in suggesting some explanations about the impact of the PFOV on patient use of the visual VAP-S information.

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Session IV - Virtual Environments: Design & Analysis

Session Chair: Sebastian Koenig

Post traumatic stress disorder treatment with virtual reality exposure for criminal violence: a case study in assault with violence, A De la Rosa-Gómez, G Cárdenas-López, Universidad Nacional Autónoma de México, MÉXICO

The criminal violence is attached with mental health problems as depression and substance use and abuse. However one of most important psychological problems linked with the victims of violence is post traumatic stress disorder (PSTD). In Mexico, according to the ENSI-5 in 2009, 11% (6,800/for each 100 thousands of habitants) of the population over 18 years, experienced a crime. One in four of the people victim of violence develops PSTD symptoms. Due to this socially relevant problem and based on the efficacy treatments, it is important to design treatments involving the use of Virtual Reality (VR), because it can help overcome some of the limitations of traditional therapy using exposure. The present paper expounds a case study of treatment program to PTSD in assault with violence.

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Participatory design with children with autism: the development of collaborative virtual environments, L Millen, S V Cobb, H Patel, University of Nottingham, UK

The COSPATIAL (Communication and social participation: collaborative technologies for interaction and learning) project explores how we can develop effective and useful educational technologies in the form of shared active surfaces (SAS) and collaborative virtual environments (CVEs) to support the enhancement of social skills for children on the autism spectrum. The UK design team comprises technology developers, design engineers, educational psychologists as well as teachers from both mainstream and autism specialist schools. A user centred design approach is used to make decisions and review prototype development using CVE technology. The team is then involved in detailed specification of CVE scenarios and iterative review of prototypes. The involvement of teachers throughout the entire process is crucial, but in order to understand the primary user further and implement concepts optimally it is also desirable to involve the target end users directly in the design process. This paper describes the participatory design approach for elicitation of user requirements and CVE scenario design that is being used with typically developing children and how these methods have been adapted to facilitate involvement of children on the autism spectrum.

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Session V - Upper Limb & Hand Rehabilitation

Session Chair: Sarah Kruger

Stroke rehabilitation using m-Health Care and 3D virtual environments – work in progress, J Broeren, L Pareto, B Johansson, C Ljungberg, M Rydmark, Trollhättan/Uddevalla NU-Hospital Organization, SWEDEN

We have now started testing a telehealth system for stroke rehabilitation in a rural area in Sweden (NU- Hospital Group Area). For collection of assessments and audiovisual communication, the telehealth system has bidirectional contact with the home-based units. To date, three stroke subjects’ participated; they were instructed to play 3D computer games with the hemiplegic upper extremity. The intervention led to clinical changes for all subjects. The analysis of the audiovisual communication revealed that the both stroke subjects and therapists were not yet effective in regulating their turn taking process. The data suggests the feasibility of a distance based approach using 3D virtual environments for upper extremity rehabilitation after stroke.

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A simple camera tracking virtual reality system for evaluation of wrist range of motion, D Shefer Eini, N Ratzon, A A Rizzo, S-C Yeh, B S Lange, B Yafa, A Dietz, P L Weiss, R Kizony, Tel-Aviv University/Chaim Sheba Medical Center at Tel Hashomer/University of Haifa/Ono Academic College, ISRAEL and University of Southern California, USA

Clinicians assess wrist and hand function to identify pathology, monitor effectiveness of treatment, and determine the readiness to return to work and other activities. The goniometer, the conventional evaluation tool used to assess range of motion (ROM), is most suited to the measurement of passive and active joint ROM under conditions that entail static, non-functional movements. Instruments that measure ROM during complex, dynamic tasks may encumber the movement. We have adapted a simple optical tracking device that uses a low-cost webcam to track two diodes, referred to as the Virtual Wrist Tracker (VWT), to assess wrist ROM in 30 subjects, aged 18-65 years; fifteen patients had sustained orthopaedic injuries and 15 were control subjects. ROM was assessed by a standard goniometer and by the VWT under two conditions: visual auditory feedback and auditory pacing feedback. The results of test-retest analysis of control subjects demonstrated good reliability for the VWT during wrist extension and moderate reliability during wrist flexion. High, significant correlations were found between the ROM for wrist extension and flexion as measured by a goniometer and via the VWT in the research group and for wrist extension but not for wrist flexion in the control group. A repeated measures ANOVA mixed design showed no significant differences in wrist extension ROM or in wrist flexion ROM during the performance of the task with visual and auditory feedback versus a task with auditory pacing, nor was there interaction effects between task type and group during extension and flexion. Wrist ROM in either direction increased as the participant progressed from one target rectangle to the next; statistically significant interaction effect was found between ROM in target position and group indicating that the difference between the targets in the control group was significantly different than in the research group. Finally, both groups enjoyed performing the VWT tasks but the control subjects felt greater presence, success and control. The VWT appears to be a reliable and valid tool for assessing wrist ROM during dynamic activities.

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Integrated arm and hand training using adaptive robotics and virtual reality simulations, A S Merians, G G Fluet, Q Qiu, S Saleh, I Lafond, S V Adamovich, University of Medicine and Dentistry of New Jersey, USA

Virtual Reality simulations interfaced with robotic arm devices are being used for training the upper extremity of people post-stroke. The benefit has been hypothesized to be the ability to provide repetitive task practice, directed visual and auditory feedback, learning algorithms and graded resistive and assistive forces. All of these elements can be manipulated to provide individualized motor learning paradigms. We have developed a unique exercise system, interfaced with complex virtual reality gaming simulations that can train both the upper arm and the hand of people in the chronic phase post-stroke. After two weeks of intensive training, eleven subjects, were able to more effectively control the limb during hand interaction with the target as demonstrated by improved proximal stability, smoothness and efficiency of the movement path. This was in concert with improvement in the distal kinematic measures of fractionation and improved timing. These changes in kinematic measures were accompanied by robust changes in functional tests of upper extremity motor control, the Wolf Motor Function Test, the Jebsen Test of Hand Function and the 9-hole Peg Test.

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Study to evaluate a low cost virtual reality system for home based rehabilitation of the upper limb following stroke, P J Standen, D J Brown, S Battersby, M Walker, L Connell, A Richardson, University of Nottingham/ Nottingham Trent University/Erewash Community Occupational Therapy Service, UK

Stroke survivors with continuing impairment in their upper limb find it difficult to access the early intensive, task specific practice that research has shown is necessary for motor recovery. A systematic review of studies that investigate the effects of robot-assisted therapy on motor and functional recovery in patients with stroke found significant improvement in upper limb motor function but the systems reviewed are expensive, require technical support and are hospital or laboratory based. This paper describes the development of a low cost home based system together with a suite of games which would allow patients to practice the movements required for activities of daily living at the frequency required. The ongoing feasibility study is described.

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Remote monitoring and quantification of upper limb and hand function in chronic disability conditions, S H Brown, J Langan, K L Kern, E A Hurvitz, University of Michigan, USA

This paper describes a convenient, home-based telerehabilitation system designed to improve upper limb and hand function in adults with cerebral palsy. The training program incorporates a variety of computer-guided sensorimotor activities such as unilateral and bilateral reaching, reaching and grasping, object manipulation, and tactile discrimination tasks. Quantitative measures of performance are uploaded to the laboratory after each training session for further analysis. Webcam monitoring of performance occurs periodically throughout the training period. Twelve adults with cerebral palsy completed a 40 min/day, five days/week training program over eight weeks. Temporal measures of performance indicated significant improvement in reaching and hand manipulation ability as well as improved tactile discrimination. Preliminary analysis of the time course of change revealed variable patterns within and across participants. The capacity to measure change throughout a training program provides an opportunity to investigate how learning occurs over time in chronic disability. Compliance was excellent with subjective reports indicating improvement in activities of daily living. Future development includes a fully automated system with stand alone modules which allow for customization of training protocols depending upon specific needs of the user.

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Session VI - ArtAbilitation

Session Chair: Paul Sharkey

Light Arrays: a system for extended engagement, D Wilde, A Cassinelli, A Zerroug, R J N Helmer, M Ishikawa, Tokyo University, JAPAN and Monash University/ Commonwealth Scientific and Industrial Research Organisation, AUSTRALIA

We present the development vision of a range of interactive body-worn lighting systems for performance, play, rehabilitation and dis- or altered- ability support. The systems combine experimental and off-the-shelf technologies to arrive at outcomes that require and inspire extended physical and expressive engagement, and afford a range of different learning opportunities. We discuss the context and background, our aims and approach – mixing art, design and engineering methodologies. We then outline a number of scenarios of use and their relevance to ArtAbilitation. Our aim is to open up a dialogue with the ArtAbilitation community in the early stages, to generate collaborative interest and inform development.

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Warrior’s Journey – a path to healing through narrative exploration, J F Morie, K Haynes, E Chance, University of Southern California, USA

The Warriors’ Journey is an interactive narrative experience that is part of the online, virtual world healing space of the Coming Home Project (www.cominghomecenter.org) at the University of Southern California’s Institute for Creative Technologies. This project is exploring new ways to reach veterans who are returning from recent conflicts and who often have mental health issues or difficulty fitting back into their home communities. We are looking at the affordances of online 3D virtual worlds to address some of the issues that may prevent or deter veterans from getting the help they need. We are exploring the use of specific therapies within the virtual world space, as well as social and enrichment activities designed around the needs of this group. The Warriors’ Journey is one such activity that engages participants in stories to emphasize and reinforce common ideals of honorable warriors throughout history. After experiencing these stories, participants are then encouraged to construct their own warrior’s story within the Coming Home space. It is hoped that such activities may help contribute to a more positive sense of self-esteem, a restructured life narrative, and a feeling of control over the stresses incurred during their service to their country.

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Extending body & imagination: moving to move, D Wilde, R J N Helmer, M Miles, Tokyo University, JAPAN and Monash University/ Commonwealth Scientific and Industrial Research Organisation, AUSTRALIA

We present a range of body-worn devices that have evolved from a common design intent: ‘to move the body through real and virtual extension’. These devices encourage people to move in extra-normal ways, and thereby view and experience their bodies from perhaps hitherto unknown perspectives. They provide a rich playground for self-expression, as well as learning opportunities that we believe might be relevant for people with physical challenges and unconventional or altered abilities. Our desire in presenting this work to the ArtAbilitation community is to open up a dialogue and examine opportunities for engagement.

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Session VII - Games for Rehabilitation

Session Chair: Susan Brown

Games for rehabilitation: the voice of the players, S M Flynn, B S Lange, Blue Marble Game Co./University of Southern California, USA

The purpose of this study is to explore the use of video games from the perspective of the disabled player. Over 150 participants responded to an online survey exploring the use of video games for rehabilitation. The respondents represented 9 countries throughout the world. The survey consisted of questions regarding subject demographics, living situation, activities of daily living assistance requirements, use of assistive devices, and computer use. Other questions addressed the responders’ disability. Video game play experience, activity, game play, controller use and accessibility are addressed. Questions regarding the use of currently available off the shelf video games in rehabilitation are explored. Lastly, we surveyed the future of video games and how they can be improved for rehabilitation and leisure enjoyment. The results of this survey are presented. In general, individuals with disabilities enjoy playing video games and play video games often. However, players with disabilities would appreciate educating the game industry about disabilities and how to makes games with a more “universal game design”.

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Designing engaging, playable games for rehabilitation, J W Burke, M D J McNeill, D K Charles, P J Morrow, J H Crosbie, S M McDonough, University of Ulster, UK

Stroke is a leading cause of severe physical disability and can result in of a range of impairments, including loss of balance, attention and concentration deficiencies, pain, weakness and paralysis. This paper reports on the design of serious games for upper limb rehabilitation following stroke. In particular, we focus on identifying principles of video game design which are important in the context of rehabilitation and show how these principles can be implemented. We also report on an evaluation of the games for playability, usability and engagement.

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Designing studies for requirements and modelling of users for an accessible set-top box, P Langdon, M F Gonzalez, P Biswas, University of Cambridge, UK

This paper describes work carried out to address the human centred design process behind the generation of requirements and user data for the prototyping of a user-model intended as part of a TV set-top box intended for use by mild to moderately impaired users. The aim is to develop both the technology and user modelling required within one STB system that will enable individuals with sensory, cognitive and physical impairments to interact with a number of reference applications. In order to do this it will be necessary for the system to categorise users on the basis of their input and interaction performance with a variety of input devices and assign them to a pre-assigned profile in the systems internal user-model. We address the issue of whether a human centred design process can be developed that is in principle capable of adequately generating the required data and specifications. We report the development of an inclusive design approach which subsumes both accessibility and usability. The ultimate aim will be to create a foundation for actual research and development work by identification of requirements from users as well as application and framework developers. We report the requirements analysis of this development and some preliminary results from user focus groups, chosen using an inclusive survey of capability, and interacting with early prototypes of interaction interfaces.

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Birth of intelligent virtual humans in clinical training, A A Rizzo, B S Lange, J Williams, J G Buckwalter, J Difede, B Rothbaum, T Parsons, P Kenny, University of Southern California/Cornell University/Emory University, USA

Over the last 15 years, a virtual revolution has taken place in the use of Virtual Reality simulation technology for clinical purposes. Recent shifts in the social and scientific landscape have now set the stage for the next major movement in Clinical Virtual Reality with the “birth” of intelligent virtual humans. This paper will present an overview of the SimCoach project that aims to develop virtual human support agents to serve as online guides for promoting access to psychological healthcare information and for assisting military personnel and family members in breaking down barriers to initiating care. While we believe that the use of virtual humans to serve the role of virtual therapists is still fraught with both technical and ethical concerns, the SimCoach project does not aim to become a “doc in box”. Rather, the SimCoach experience is being designed to attract and engage military Service Members, Veterans and their significant others who might not otherwise seek help with a live healthcare provider. It is expected that this experience will motivate users to take the first step – to empower themselves to seek advice and information regarding their healthcare (e.g., psychological health, traumatic brain injury, addiction, etc.) and general personal welfare (i.e., other non-medical stressors such as economic or relationship issues) – and encourage them to take the next step towards seeking other, more formal resources if needed.

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Session VIII - Balance & Gait

Session Chair: Laura Millen

Development of an interactive stepping game to reduce falls in the elderly, B S Lange, S M Flynn, C Y Chang, Y Si, C Nanavati, C L Chieng, A A Rizzo, University of Southern California, USA

More than one-third of people over the age of 65 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.

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Virtual reality approach to gait training in service members with lower extremity amputations, S E Kruger, Walter Reed Army Medical Center, USA

Gait training is an essential part of the rehabilitation process for those with lower extremity (LE) amputations.  For service members at Walter Reed Army Medical Center, the Computer Assisted Rehabilitation Environment (CAREN) allows virtual reality to be incorporated into gait training as an adjunct to conventional therapies.  This retrospective case series examines the self-selected velocities achieved in two different virtual environments (VE) by 11 service members with LE amputations.  These VEs allowed participants to progress from level walking to more challenging terrain.  Over periods of four to eight weeks, all participants were found to increase their self-selected velocities; progression appears to be individual.  The preliminary results obtained indicate that further investigation is warranted.

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Continuation of balance training for stroke subjects in home environment using virtual reality, I Cikajlo, M Rudolf, N Goljar, Z Matjacic, University Rehabilitation Institute, SLOVENIA

The objective of the telerehabilitation is a continuation of the rehabilitation process on subjects’ home and making the therapists and physicians possible to follow the progress remotely. Hereby the pilot project with virtual reality based tasks for dynamic standing frame supported balance training is presented. Six stroke subjects participated in the preliminary study. The subjects performed the therapy five times a week, each time for up to 20 minutes for three weeks. The results were evaluated by objective game parameters as track time, number of collisions and clinical instruments Berg Balance Scale, Timed Up&Go and 10m walk test. The outcomes demonstrated a significant improvement of all parameters. However, the follow up after two weeks demonstrated that functional improvement could be possible on a long term, if the subjects continue with targeted tasks for extended period of time. Besides, the balance training could be continued on subject’s home instead of the hospital, which would decrease the number of outpatients’ visits and reduce related costs.

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Audio-visual biofeedback system for postural control, M Milosevic, K M V McConville, Ryerson University, CANADA

This study presents an application of biofeedback in balance training, in particular an audio-visual balance rehabilitation system designed for training of the elderly. Motivated by the need to provide portable, cost-effective and accessible training devices, the system implements a MEMS accelerometer to quantify the balance board movements during a balancing task and use them to provide a real-time, synchronous audio-visual biofeedback. The visual feedback displays the offset and the overall performance of the balance board. The audio feedback is based on the sound localization cues that indicate the direction of the balance board movements using stereo sound. Initial results indicate a significant improvement in the postural stability when the audio-visual biofeedback is provided. The pilot study found significant improvements in maintenance and recovery of dynamic balance manifested through decreased variability of complex, lateral and front-to-back movements during a balancing task.

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Development of an interactive rehabilitation game using the Nintendo® WiiFit™ Balance Board for people with neurological injury, B S Lange, S M Flynn, C Y Chang, A Ahmed, Y Geng, K Utsav, M Xu, D Seok, S Cheng, A A Rizzo, University of Southern California, USA

Visual biofeedback and force plate systems are often used for treatment of balance and mobility disorders following neurological injury. Conventional Physical Therapy techniques have been shown to improve balance, mobility and gait. The training program encourages patients to transfer weight onto the impaired limb in order to improve weight shift in standing and during gait. Researchers and therapists have been exploring the use of video game consoles such as the Nintendo® WiiFit™ as rehabilitation tools. Initial case studies have demonstrated that the use of video games has some promise for balance rehabilitation. However, initial usability studies and anecdotal evidence has indicated that the commercial games that are currently available are not necessarily suitable for the controlled, specific exercise required for therapy. 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 WiiFit balance board. The prototype underwent initial usability testing with a sample of four Physical Therapists and four patients with neurological injury or disease. 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.

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Session IX - Speech & Audio

Session Chair: Orly Lahav

Development of a voice-based rhythm game for training speech motor skills of children with speech motor disorders, D Umanski, D Kogovšek, M Ozbič, N O Schiller, Leiden University, THE NETHERLANDS and University of Ljubljana, SLOVENIA

In this project, we deal with the development and evaluation of a new tool for conducting speech rhythm exercises. A training methodology is proposed, based on a schedule of exercises, each presenting a sequence of syllables arranged in a specific rhythmic pattern. In order to assist the therapists with conducting speech rhythm exercises with children, we have developed a computer game prototype which implements the training, by providing the exercises, visual feedback and evaluation of performance. The game prototype was further evaluated in a usability study involving children with various speech disorders. We discuss the limitations of the current system and propose improvements for further development.

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Robotic vocalization training system for the auditory-impaired, M Kitani, T Hara, H Hanada, H Sawada, Kagawa University, JAPAN

The authors are developing a vocalization training system for the auditory-impaired using a talking robot. The training system mainly consists of a talking robot which has mechanical organs like a human. With an adaptive learning strategy using an auditory feedback control, the robot autonomously learns the vocalization, and then reproduces the speech articulation from inputted sounds. By employing the talking robot, the training is realized by two different approaches. One is a training based on the hardware demonstration, which shows the speech articulation by the robotic motions, and the other is a software-based training, which shows the phonetic characteristics of generated voices. Training experiments are being conducted in Kagawa Prefectural School for the Deaf, and significant results have been obtained. In the previous system, the speech learning algorithm of the robot was constructed by using a Self-organizing Neural Network (SONN), which consists of the combination of a Self-organizing Map (SOM) and a Neural Network (NN). However, improper maps were found in the results of the speech articulation learning. In this study, a new algorithm using two SOMs, called a dual-SOM, is introduced for the autonomous learning of the robotic articulations. Firstly, the construction of the training system is described together with the autonomous learning of robotic vocalization using the dual-SOM algorithm, and then the analysis of the speech training progress is presented based on the phoneme characteristics and the mechanical vocal articulations.

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Automatic speech recognition for assistive technology devices, A P Harvey, R J McCrindle, K Lundqvist, P Parslow, University of Reading, UK

Speech offers great potential as a mode of interaction with devices to control our environment, support our work or assist us with tasks of daily living, however, to date the level to which this has been universally achieved and exploited has not matched its potential. Automatic Speech Recognition (ASR) is the process of interpretation of human speech by a machine. This may take two forms; continuous speech, as with human to human interaction or dictation, and discrete speech, such as commands issued to a device. ASR in the ‘ENABLE’ project uses discrete utterances to allow navigation of the user interface on a wrist worn device, control of the associated ECS (Environmental Control System) components as well as the ability to provide feedback for long term conditions using speech alone; features widely requested by users with a range of disabilities as well as by others for general ease of use. The aim of this paper is to explain the rationale and process behind the development of the ASR for the ENABLE device.

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Basic study toward automatic generation of glove-type command input device with optimal number of sensors, Y Tabata, T Kuroda, K Okamoto, Kyoto College of Medical Science/Kyoto University Hospital, JAPAN

Data-gloves are one of the most essential devices for VR systems. Although most of conventional data-gloves are designed to capture “analogue” hand postures, most of information systems require just “digital” hand postures corresponding to commands. This paper proposed a method to calculate a data-glove with optimal number of sensors to obtain given set of “digital” hand postures. The authors applied the proposed method to JSL. The result tells that a data-glove with just eight sensors can obtain all hand postures given in JSL.

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Poster Papers

Virtual environments for exposure in obsessive-compulsive disorder, G Cárdenas López, S Muñoz, Universidad Nacional Autónoma de México, MÉXICO

Obsessive Compulsive Disorder (OCD) affects 2.6% of the population in Mexico, severely affecting the quality of life of the people who suffer it. The World Health Organization (WHO) ranks OCD as the tenth leading cause of disability in the world, representing a health issue that requires attention, especially from health professionals. Several studies on the different treatments developed for this disorder have been carried, including: exposure, response prevention and cognitive therapy. We developed a treatment based on virtual reality (VR) technologies to expose patients with OCD to controlled virtual environments. The treatment includes sessions of psychoeducation, breathing training, cognitive restructuring and exposure, using a Head Mounted Display (HMD). VR increases the sense of immersion and presence in the environment, and evokes the same reactions and emotions that are experienced in real situations.

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Integrative approach for designing collaborative technologies for social competence training in children with autism spectrum conditions, S V Cobb, L Millen, T Glover, S Parsons, S Garib-Penna, P L Weiss, E Gal, N Bauminger, S Eden, University of Nottingham/University of Birmingham, UK and University of Haifa, Bar Ilan University, ISRAEL

The COSPATIAL project is exploring the use of two collaborative interaction technologies, Collaborative Virtual Environments (CVEs) and Shared Active Surfaces (SASs), as suitable media to support learning of social competence skills for typically developing children and those with Autism Spectrum Conditions (ASC)s. This paper describes the integrated approach used to design and develop learning scenarios in each technology.

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Videogame for improving orientation and mobility in blind children, J Sánchez, J P Rodríguez, Universidad de Chile, CHILE

This work presents an evaluative study on the usability of a haptic device together with a sound-based videogame for the development and use of orientation and mobility (O&M) skills in closed, unfamiliar spaces by blind, school-aged children. A usability evaluation was implemented for a haptic device especially designed for this study (Digital Clock Carpet) and a 3D videogame (MOVA3D) in order to determine the degree to which the user accepted the device, and the level of the user’s satisfaction regarding her interaction with these products for O&M purposes. In addition, a preliminary cognitive evaluation was administered. Usability results show that both the haptic device and the videogame are usable, accepted and considered to be pleasant for use by blind children. The results also show that they are ready to be used for cognitive learning purposes. Results from the preliminary cognitive study demonstrated significant gains in the development of tempo-spatial orientation skills of blind children when navigating in unfamiliar spaces.

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