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9th International Conference on Disability , Virtual Reality and Associated Technologies Laval , France September 10–12, 2012. Upper-Body Interactive Rehabilitation System for Children with Cerebral Palsy: The Effect of Control/Display Ratios.
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9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Upper-Body Interactive Rehabilitation System for Children with Cerebral Palsy: The Effect of Control/Display Ratios Takehiko Yamaguchi1, Paul Richard2, Fabienne Veaux3, Mickaël Dinomais4, Sylvie Nguyen5 1,2,3,4,5Laboratoire d'Ingénierie des Systèmes Automatisés, Université d’Angers, Angers, France 3,4Centre les Capucins, Département de Médecine Physique et de Rééducation Pédiatrique, Angers, France 4Faculté de Médecine; Département de Médecine Physique et de Réadaptation Pédiatrique, Université d’Angers, Angers, France
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 • Related Studies • Proposed System • System Evaluation • Results and Discussion • Conclusion Introduction
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Introduction Cerebral palsy (CP):various motor impairments caused by damage to the central nervous system during foetal development Physical therapy is need; - Improve their movement patterns. - Maintain the range of the affected arm/leg joints. It affects about 0.3%of births (Krageloh-Mann, and Cans, 2009) It often manifests itself during childhood Constraint-induced movement therapy (CIMT) It encourages the use of the affected hand by restricting the unaffected hand and asking for intensive movement with the impaired upper limb Having the "good" arm blocked for long periods of time can generate frustration in the child More "child-friendly" approaches are needed
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Introduction Traditional CP Therapy: is often of little interest to a child, affecting his motivation to continue such therapeutic activities (Schmidt, and Lee, 2005) Traditional CP Therapy is not motivating and entertaining for child Virtual Reality (VR): systems offer the capability to achieve rehabilitative goals through the use of real-time feedback and adaptive strategy/difficulty (Le Gal et al., 2008) VR remains motivating and entertaining Goal of project: is to develop a “child-friendly, motivating, and entertaining” rehabilitation system for children with CP
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Introduction Traditional CP Therapy: is often of little interest to a child, affecting his motivation to continue such therapeutic activities (Schmidt, and Lee, 2005) Traditional CP Therapy is not motivating and entertaining for child Virtual Reality (VR): systems offer the capability to achieve rehabilitative goals through the use of real-time feedback and adaptive strategy/difficulty (Le Gal et al., 2008) VR remains motivating and entertaining Motion capture based VR rehabilitation system using Kinect sensor
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 • Proposed System • System Evaluation • Results and Discussion • Conclusion • Introduction Related Studies
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, FranceSeptember10–12, 2012 Related Studies VR Rehabilitation : Using full-body interaction via a tracking device EyeToy Cybex Trazer IREX Working Space of Previous Systems: Visually limited since the user’s movement is directly projected on a screen via a tracking system • Limited working space could generate frustration on children’s motivation • Limit system capability: task variation, and interaction techniques for the rehabilitation task. Concept of our system: Assist children with CP in a full-range of avatar movements to adapt the Control/Display (C/D) ratio of limb positions
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Related Studies VR Rehabilitation : Using full-body interaction via a tracking device EyeToy Cybex Trazer IREX Working Space of Previous Systems: Visually limited since the user’s movement is directly projected on a screen via a tracking system • Limited working space could generate frustration on children’s motivation • Limit system capability: task variation, and interaction techniques for the rehabilitation task. Aim of this study: Explore the effectiveness of C/D ratios to analyze user performance, work load, and user enjoyment
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 • System Evaluation • Results and Discussion • Conclusion • Introduction • Related Studies Proposed System
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Proposed System System Configuration • A 60” TV monitor, • A laptop • A Microsoft Kinect sensor • A rehabilitation application running on the laptop • The application renders a visually-realistic 3D environment.
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Proposed System VR Rehabilitation Application
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 • Introduction • Related Studies • Proposed system • Results and Discussion • Conclusion System Evaluation
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 System Evaluation Participants • 12 university students: • 9 male and 3 female, • between 19 and 30 years (M = 24.3, SD = 3.3 years) • Dominant hand: All participants were right-handed • Health: in good health, • Kinect experience: had not used a game using Kinect Apparatus • Kinect: one Kinect was used for training exercises and experimental tasks • FPS: Kinect was updated to about 20Hz • Platform: The Unity3D platform was used for graphic rendering • Monitor: 60 inch LG • PC: TOSHIBA laptop • OS: Windows 7 • CPU: Intel Core i7 720QM processor • RAM: 4GB of memory All subjects were at a distance of about 3 meters from the Kinect sensor.
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 System Evaluation Task Procedure • Independent variable: C/D ratio • Level: ratio 1.0, ratio 1.5, ratio 2.0 1 session x 3 times
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 System Evaluation Task Procedure • Independent variable: C/D ratio • Level: ratio 1.0, ratio 1.5, ratio 2.0 1 session x 3 times Training • 20 – 40 objects were applied every 2 seconds Randomly between 0 -180 °
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 System Evaluation Task Procedure • Independent variable: C/D ratio • Level: ratio 1.0, ratio 1.5, ratio 2.0 1 session x 3 times Trial • 60 objects • The applied direction : randomly selected out of 3 angles 60° -5° -40° C/D 1.0
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 System Evaluation Task Procedure • Independent variable: C/D ratio • Level: ratio 1.0, ratio 1.5, ratio 2.0 1 session x 3 times Trial • 60 objects • The applied direction : randomly selected out of 3 angles 60° 125° 60° 27.5° -10° 190° -5° -25° -40° C/D 2.0 C/D 1.0 C/D 1.5
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 System Evaluation Task Procedure • Independent variable: C/D ratio • Level: ratio 1.0, ratio 1.5, ratio 2.0 1 session x 3 times Questionnaire • Nasa TLX for workload • Physical Activity Enjoyment Scale (PACES) for Enjoyment of the training
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 • Introduction • Related Studies • Proposed system • System evaluation • Conclusion Results and Discussion
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Results and Discussion Dependent variables • Performance data: • Take success rate • Subjective data: • Nasa TLX • Physical Activity Enjoyment Scale
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Results and Discussion Task success rate • C/D 1.0 (M = 99.72% , SD = 0.96%)> C/D 2.0 (M = 90.28% , SD = 10.77%) • C/D 1.5 (M = 97.50% , SD = 3.51% ) > C/D 2.0 (M = 90.28% , SD = 10.77%) C/D ratio was related to task difficulty 60° 60° 125° User comments 27.5° -5° -10° -25° -40° 190°
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Results and Discussion Task success rate • C/D 1.0 (M = 99.72% , SD = 0.96%)> C/D 2.0 (M = 90.28% , SD = 10.77%) • C/D 1.5 (M = 97.50% , SD = 3.51% ) > C/D 2.0 (M = 90.28% , SD = 10.77%) C/D ratio was related to task difficulty User comments 60° 60° 125° 27.5° 190° -5° -10° -25° -40° The user’s movement strategy for the task could be changed
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Results and Discussion Nasa TLX • Temporal Demand (Significant trend): • C/D 2.0 (M = 3.67 , SD = 1.15) > C/D 1.0 (M = 2.67 , SD = 0.98) • Effort (Significant effect): • C/D 2.0 (M = 3.41 , SD = 1.24)> C/D 1.0 (M = 2.08, SD = 0.67) User comments • Required to make an effort to complete a task with a C/D 2.0 ratio • There was time pressure with C/D 2.0 ratio • Concerning frustration: • Expected Result : Felt stress for avatar operations in C/D 1.5 and 2.0 ratio conditions • Result : No significant effect • comfortable operation for the C/D 2.0 ratio because of the speed of the avatar's movement. • uncomfortable operation for C/D 1.0 because the avatar’s movement was slow.
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Results and Discussion Enjoyment • No significant effect User comments • C/D 1.5 and 2.0 : • Could be challenged, excited, and motivated to perform the task • C/D 1.0 condition : • no excited, and no challenged , but the movement was realistic, natural, simulated • User motivation can be changed with different C/D ratios.
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 • Introduction • Related Studies • Proposed system • System evaluation • Results and Discussion Conclusion
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Conclusion Aim of this study • Explored the effectiveness of C/D ratios in our prototype application Method - Applied the object catching task with 3 kinds of C/D ratio to analyze user performance, work load, and user enjoyment with university students without motor impairments Findings • Performance data - Success rate: • C/D ratio was related to task difficulty • The user’s movement strategy for the task could be changed • Subjective data - Workload: • High C/D ratio could make an effort, and time pressure • High C/D ratio could make it comfortable on avatar movement • Low C/D ratio could make it uncomfortable on avatar movement • Subjective data - Enjoyment: • User motivation could be changed with different C/D ratios. Future works • Different kinds of C/D ratios will be designed to better understand their effectiveness. • Other kinds of interaction techniques we have developed will be investigated using patients with impaired motor function.
9th International Conference on Disability, Virtual Reality and Associated Technologies Laval, France September 10–12, 2012 Any questions?