The aim of this work is to facilitate the application of Augmented Reality (AR) in rehabilitative clinics to support the therapist by providing real-time AR visualizations. The feasibility of AR as a support tool in rehabilitation is explored by developing a prototype that would meet the demand of the therapists during their evaluations. In this work, a prototype which consist of two parts has been developed; one for chair training and another for walking training. Different combinations of AR technologies and concepts that would best serve the therapist's needs in the rehabilitation and training setting are discussed. After the development phase, a qualitative user research was done through demonstrations and interviews to validate the effectiveness and feasibility. The overall feedback from the participating therapists was positive, confirming the potential of this work to be extended to everyday clinical use.
In rehabilitation settings that exploit Mixed Reality, a clinician risks losing empathy with the patient by being immersed in different worlds, either real and/or virtual. While the patient perceives the rehabilitation stimuli in a mixed real–virtual world, the physician is only immersed in the real part. While in rehabilitation, this may cause the impossibility for the clinician to intervene, in skill assessment, this may cause difficulty in evaluation. To overcome the above limitation, we propose an innovative Augmented Reality (AR) framework for rehabilitation and skill assessment in clinical settings. Data acquired by a distributed sensor network are used to feed a “shared AR” environment so that both therapists and end-users can effectively operate/perceive it, taking into account the specific interface requirements for each user category: (1) for patients, simplicity, immersiveness, engagement and focus on the task; (2) for clinicians/therapists, contextualization and natural interaction with the whole set of data that is linked with the users’ performances in real-time. This framework has a strong potential in Occupational Therapy (OT) but also in physical, psychological, and neurological rehabilitation. Hybrid real and virtual environments may be quickly developed and personalized to match end users’ abilities and emotional and physiological states and evaluate nearly all relevant performances, thus augmenting the clinical eye of the therapist and the clinician-patient empathy. In this paper, we describe a practical exploitation of the proposed framework in OT: setting-up the table for eating. Both a therapist and a user wear Microsoft HoloLens 2. First, the therapist sets up the table with virtual furniture. Next, the user places the corresponding real objects (also in shape) to match them as closely as possible to the corresponding virtual ones. The therapist’s view is augmented during the test with motion, balance, and physiological estimated cues. Once the training is completed, he automatically perceives deviations in the position and attitude of each object and the elapsed time. We used a camera-based localization algorithm achieving a level of accuracy of 5 mm with a confidence level of 95% for position and 1° for rotation. The framework was designed and tested in collaboration with clinical experts of Villa Rosa rehabilitation hospital in Pergine (Italy), involving both a set of patients and healthy users to demonstrate the effectiveness of the designed architecture and the significance of the analyzed parameters between healthy users and patients.
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