Collaborative tele-rehabilitation: A strategy for increasing engagement

This paper examines the influence of a collaborative rehabilitation environment that encourages a long-distance collaborative "play" using two robot-mediated environments. This study presents a strategy for increasing motivation on able-bodied persons, applicable to impaired persons, to engage, sustain play and relate during a shared task. The study consisted of a series of eighteen single case studies, each involved in two distinct phases and assessed using a multidimensional measurement intended to assess participant' subjective experience. The results showed a clear positive trend in favour of the robot-mediated game environment. Subjects found the collaborative environment more valuable and more interesting and enjoyable. As a consequence, it appears subjects were willing to spend more time at a task.

Communicating eye gaze across a distance without rooting participants to the spot

Eye gaze is an important conversational resource that until now could only be supported across a distance if people were rooted to the spot. We introduce EyeCVE, the worldpsilas first tele-presence system that allows people in different physical locations to not only see what each other are doing but follow each otherpsilas eyes, even when walking about. Projected into each space are avatar representations of remote participants, that reproduce not only body, head and hand movements, but also those of the eyes. Spatial and temporal alignment of remote spaces allows the focus of gaze as well as activity and gesture to be used as a resource for non-verbal communication. The temporal challenge met was to reproduce eye movements quick enough and often enough to interpret their focus during a multi-way interaction, along with communicating other verbal and non-verbal language. The spatial challenge met was to maintain communicational eye gaze while allowing free movement of participants within a virtually shared common frame of reference. This paper reports on the technical and especially temporal characteristics of the system.

A Gentle/S approach to robot assisted neuro-rehabilitation

Movement disorders (MD) include a group of neurological disorders that involve neuromotor systems. MD can result in several abnormalities ranging from an inability to move, to severe constant and excessive movements. Strokes are a leading cause of disability affecting largely the older people worldwide. Traditional treatments rely on the use of physiotherapy that is partially based on theories and also heavily reliant on the therapists training and past experience. The lack of evidence to prove that one treatment is more effective than any other makes the rehabilitation of stroke patients a difficult task. UL motor re-learning and recovery levels tend to improve with intensive physiotherapy delivery. The need for conclusive evidence supporting one method over the other and the need to stimulate the stroke patient clearly suggest that traditional methods lack high motivational content, as well as objective standardised analytical methods for evaluating a patient's performance and assessment of therapy effectiveness. Despite all the advances in machine mediated therapies, there is still a need to improve therapy tools. This chapter describes a new approach to robot assisted neuro-rehabilitation for upper limb rehabilitation. Gentle/S introduces a new approach on the integration of appropriate haptic technologies to high quality virtual environments, so as to deliver challenging and meaningful therapies to people with upper limb impairment in consequence of a stroke. The described approach can enhance traditional therapy tools, provide therapy "on demand" and can present accurate objective measurements of a patient's progression. Our recent studies suggest the use of tele-presence and VR-based systems can potentially motivate patients to exercise for longer periods of time. Two identical prototypes have undergone extended clinical trials in the UK and Ireland with a cohort of 30 stroke subjects. From the lessons learnt with the Gentle/S approach, it is clear also that high quality therapy devices of this nature have a role in future delivery of stroke rehabilitation, and machine mediated therapies should be available to patient and his/her clinical team from initial hospital admission, through to long term placement in the patient's home following hospital discharge.

Upper limb robot mediated stroke therapy - GENTLE/s approach

Stroke is a leading cause of disability in particular affecting older people. Although the causes of stroke are well known and it is possible to reduce these risks, there is still a need to improve rehabilitation techniques. Early studies in the literature suggest that early intensive therapies can enhance a patient's recovery. According to physiotherapy literature, attention and motivation are key factors for motor relearning following stroke. Machine mediated therapy offers the potential to improve the outcome of stroke patients engaged on rehabilitation for upper limb motor impairment. Haptic interfaces are a particular group of robots that are attractive due to their ability to safely interact with humans. They can enhance traditional therapy tools, provide therapy "on demand" and can present accurate objective measurements of a patient's progression. Our recent studies suggest the use of tele-presence and VR-based systems can potentially motivate patients to exercise for longer periods of time. The creation of human-like trajectories is essential for retraining upper limb movements of people that have lost manipulation functions following stroke. By coupling models for human arm movement with haptic interfaces and VR technology it is possible to create a new class of robot mediated neuro rehabilitation tools. This paper provides an overview on different approaches to robot mediated therapy and describes a system based on haptics and virtual reality visualisation techniques, where particular emphasis is given to different control strategies for interaction derived from minimum jerk theory and the aid of virtual and mixed reality based exercises.