A Taxonomy for Augmented and Mixed Reality Applications to Support Physical Exercises in Medical Rehabilitation—A Literature Review

Abstract

In the past 20 years, a vast amount of research has shown that Augmented and Mixed Reality applications can support physical exercises in medical rehabilitation. In this paper, we contribute a taxonomy, providing an overview of the current state of research in this area. It is based on a comprehensive literature review conducted on the five databases Web of Science, ScienceDirect, PubMed, IEEE Xplore, and ACM up to July 2021. Out of 776 identified references, a final selection was made of 91 papers discussing the usage of visual stimuli delivered by AR/MR or similar technology to enhance the performance of physical exercises in medical rehabilitation. The taxonomy bridges the gap between a medical perspective (Patient Type, Medical Purpose) and the Interaction Design, focusing on Output Technologies and Visual Guidance. Most approaches aim to improve autonomy in the absence of a therapist and increase motivation to improve adherence. Technology is still focused on screen-based approaches, while the deeper analysis of Visual Guidance revealed 13 distinct, reoccurring abstract types of elements. Based on the analysis, implications and research opportunities are presented to guide future work.

The evolution of augmented reality to augment physical therapy: A scoping review

“…AR technologies could also be motivating and foster adherence and increase effort at specific tasks. 24 , 55 Newer applications of digital technologies support applications of AR with mixed digital programing such as virtual reality, perhaps even in a gaming context to promote interest and engagement of therapeutic activities in the home setting. Adherence of evidence-based rehabilitation for people with chronic conditions is critical for clinical outcomes, yet the majority of people with chronic conditions do not engage in recommended programs.…”

“…Different approaches may result in different outcomes, and for physical therapy, it may be meaningful to develop an AR classification system that aligns with clinical and therapeutic needs that can then link to physical therapy outcomes. 55 …”

Design Space of Visual Feedforward And Corrective Feedback in XR-Based Motion Guidance Systems

“…The start set of our snowball comprises three logical subsets. Start set A contains two comprehensive survey papers: one on corrective feedback cues by Diller et al [13], and one on rehabilitation exercises in XR by Butz et al [5]. Start set B contains prominent publications (over 100 citations on Google Scholar) that fit our scope: Just Follow Me [58], ShadowGuides [18], LightGuide [51], YouMove [1] and Physio@Home [53].…”

“…Feedforward may also take the form of playful and funny cues to increase engagement, also known as "serious games", which are often employed in the field of physiotherapy and rehabilitation [4,10]. However, in this paper we focus primarily on task-based scenarios that provide clear movement instructions, focusing on the execution of simple, repetitive exercises rather than gamely motivational aspects [5].…”

Feasibility of digital technology-supported home exercise intervention for health promotion in community-dwelling older adults: A pilot randomized controlled trial

“…This type of intervention has been adapted according to different objectives, levels of maturity, and fundamental properties of the technology. The advantages and effectiveness of digital technology-supported interventions such as virtual reality, augmented reality (AR), and mixed reality have been demonstrated in diverse populations [ [14] , [15] , [16] , [17] , [18] , [19] ]. In these interventions, real-time user interaction and goal-directed movement induced better motivation and learn exercise performance effectively [ 20 ], resulting in improved health outcomes and regular exercise participation.…”