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Evaluation of a Systems
Engineering Approach to
using a Virtual Reality
Game for Rehabilitation of
Motor Function

         Dr Alasdair G Thin
         Heriot-Watt University, Edinburgh, UK
 International Simulation and Gaming Association Conference, Singapore, 2009
Exercise can be Boring!




                    normanack
Human Motor Function
Impairment            Rehabilitation
 Variety of Disease    Promote neural
 processes             plasticity
 Physical Trauma       Early
 Aging                 Intensive
                       Repetitive
                       Prolonged
                       Poor Compliance?
Virtual Rehabilitation
“the combination of computers, special
interfaces, and simulation exercises used to
train patients in an engaging and motivating
way” (Burdea et al., 2007)

Call for holistic approach (Tinetti et al., 1994) to
improve both
  Motor Skill
  Confidence (self-efficacy)
Video Games
Video games are highly interactive and engaging
Potential application to rehabilitation only recently
recognized (Lange et al., 2009)
  Greater realism
  Correspond more closely to everyday activities
Current Game-based approaches to rehabilitation
generally very basic
Will aspiration of highly engaging game-based
approach have anticipated rehabilitation impact?
Systems Engineering Approach

Need to integrate physiological and psychological
aspects in an engaging game play scenario

Holistic approach is characteristic of systems
engineering

In order to assess potential of game-based rehabilitation
  Counter-intuitive approach adopted
  Developed Motor Deficit model to fit commercially
  available body-movement controlled video game
Training Protocol
Session           1          2          3          4            5            6

                            RWT        VRG        VRG          VRG          RWT
              Familiar-
Activity                    Pre-     Training   Training     Training      Post-
               ization
                          Training      1          2            3         Training




           Real World Task (RWT)                       Virtual Reality Game (VRG)
Real World Task Motor Skill Test




   10 Practice Shots for each Stroke
      Dominant Forehand (DF), Dominant Backhand (DB)
      Non-Dominant Forehand (NDF), Non-Dominant Backhand (NDB)
   10 Test Shots for Each Stroke
Virtual Reality Game Training




     30 minutes each session - Drills and Match Play
     Dominant and Non-Dominants Hands
Pre-Training Self-Efficacy




 Subjects’ (n=17) ratings of their ability to hit the target were
 significantly lower for both non-dominant hand strokes (NDF & NDB)
Pre-Training Motor Skill




 Mean number of shots on target were significantly lower for
 both non-dominant hand strokes (NDF & NDB)
Post-Training Self-Efficacy




   Subjects’ (n=17) ratings of their ability to hit the target were
   significantly increased after training for both non-dominant
   hand strokes (NDF & NDB)
Post-Training Skill




Mean number of shots on target increased significantly for non-
dominant backhand (NDB) and just failed to reach statistical
significance (p=0.06) for NDF
Summary
Motor Deficit Model valuable research tool
Systems Engineering Approach ensured that Virtual Reality
Game closely mimicked the Real World Task:
  Improvement in Motor Skill
  Increase in Confidence (self-efficacy)
  Engaging game play experience
Immersive nature of feedback was internalized and
operationalized
  Audio “Contact” with the virtual tennis ball
  Trajectory of the ball in the on screen game play
  Game score
  Response of Virtual Spectators
Conclusion

Results of study bode well for future development of
immersive and engaging interactive Virtual Reality
Games (VRGs) for Motor Rehabilitation Applications


Proviso that Systems Engineering Approach is
adopted so that VRGs are designed to closely
match the corresponding Real World Task (RWT)
Game Over
Dr Alasdair G Thin, BSc, PhD
      a.g.thin@hw.ac.uk
www.GamerSizeScience.org

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Evaluation of a Systems Engineering Approach to using a Virtual Reality Game for Rehabilitation of Motor Function

  • 1. Evaluation of a Systems Engineering Approach to using a Virtual Reality Game for Rehabilitation of Motor Function Dr Alasdair G Thin Heriot-Watt University, Edinburgh, UK International Simulation and Gaming Association Conference, Singapore, 2009
  • 2. Exercise can be Boring! normanack
  • 3. Human Motor Function Impairment Rehabilitation Variety of Disease Promote neural processes plasticity Physical Trauma Early Aging Intensive Repetitive Prolonged Poor Compliance?
  • 4. Virtual Rehabilitation “the combination of computers, special interfaces, and simulation exercises used to train patients in an engaging and motivating way” (Burdea et al., 2007) Call for holistic approach (Tinetti et al., 1994) to improve both Motor Skill Confidence (self-efficacy)
  • 5. Video Games Video games are highly interactive and engaging Potential application to rehabilitation only recently recognized (Lange et al., 2009) Greater realism Correspond more closely to everyday activities Current Game-based approaches to rehabilitation generally very basic Will aspiration of highly engaging game-based approach have anticipated rehabilitation impact?
  • 6. Systems Engineering Approach Need to integrate physiological and psychological aspects in an engaging game play scenario Holistic approach is characteristic of systems engineering In order to assess potential of game-based rehabilitation Counter-intuitive approach adopted Developed Motor Deficit model to fit commercially available body-movement controlled video game
  • 7. Training Protocol Session 1 2 3 4 5 6 RWT VRG VRG VRG RWT Familiar- Activity Pre- Training Training Training Post- ization Training 1 2 3 Training Real World Task (RWT) Virtual Reality Game (VRG)
  • 8. Real World Task Motor Skill Test 10 Practice Shots for each Stroke Dominant Forehand (DF), Dominant Backhand (DB) Non-Dominant Forehand (NDF), Non-Dominant Backhand (NDB) 10 Test Shots for Each Stroke
  • 9. Virtual Reality Game Training 30 minutes each session - Drills and Match Play Dominant and Non-Dominants Hands
  • 10. Pre-Training Self-Efficacy Subjects’ (n=17) ratings of their ability to hit the target were significantly lower for both non-dominant hand strokes (NDF & NDB)
  • 11. Pre-Training Motor Skill Mean number of shots on target were significantly lower for both non-dominant hand strokes (NDF & NDB)
  • 12. Post-Training Self-Efficacy Subjects’ (n=17) ratings of their ability to hit the target were significantly increased after training for both non-dominant hand strokes (NDF & NDB)
  • 13. Post-Training Skill Mean number of shots on target increased significantly for non- dominant backhand (NDB) and just failed to reach statistical significance (p=0.06) for NDF
  • 14. Summary Motor Deficit Model valuable research tool Systems Engineering Approach ensured that Virtual Reality Game closely mimicked the Real World Task: Improvement in Motor Skill Increase in Confidence (self-efficacy) Engaging game play experience Immersive nature of feedback was internalized and operationalized Audio “Contact” with the virtual tennis ball Trajectory of the ball in the on screen game play Game score Response of Virtual Spectators
  • 15. Conclusion Results of study bode well for future development of immersive and engaging interactive Virtual Reality Games (VRGs) for Motor Rehabilitation Applications Proviso that Systems Engineering Approach is adopted so that VRGs are designed to closely match the corresponding Real World Task (RWT)
  • 17. Dr Alasdair G Thin, BSc, PhD a.g.thin@hw.ac.uk www.GamerSizeScience.org