Formative Evaluation and Preliminary Findings of a Virtual Reality Telerehabilitation System for the Lower Extremity

Abstract

Usability studies are an essential and iterative component of technology development and ease its transfer from the laboratory to the clinic. Although such studies are standard methodology in today's graphical user-interface applications, it is not clear that current methods apply to new technologies such as virtual reality. Thus experimentation is needed to examine what existing methods can be viably transferred to the new user-interaction situations. In this paper, 5 integrated interfaces with 3 simultaneous users are evaluated via a set of usability studies, which adapt traditional methods for assessing the ease of use of the interface design. A single expert domain user was run in an intensive study that examined the therapist manual and interfaces of the Rutgers Ankle Rehabilitation System (RARS). The interface and manual were extensively modified based on this evaluation. A second study involving 5 therapists was then conducted to evaluate the telerehabilitation component of the RARS system. In both studies, the tester and developer's observations, along with the session videotapes and therapist-user questionnaires, were triangulated to identify user problems and suggest design changes expected to increase the usability of the system. Changes that resulted from the analysis with the domain expert are described and recommendations for how to conduct usability studies in such multiuser remote virtual reality situations are proposed. Results from the pilot usability telemonitoring studies are also presented. The validity of usability studies in the development and refinement of rehabilitation technology is highlighted.

A SWOT Analysis of the Field of Virtual Reality Rehabilitation and Therapy

“…This functionality would allow client progress to be efficiently tracked, and this information could be used to evolve the performance demands on the client in a manner designed to foster effective and efficient rehabilitative outcomes. An example of some early efforts to apply VR in a telerehabilitation format for physical therapy are de-tailed in other articles in this issue (Holden, Dyar, Schwamm, & Bizzi, 2005;Deutsch et al, 2005), However, the possible benefits that could be accrued from VR telerehabilitation applications are equally matched by the enormous challenges that still need to be faced. It would be unfortunate for clinicians to become enamored with the obvious potential that exists with VR telerehabilitation, yet lose sight of the sheer technical, practical, clinical, and ethical complexities that still need to be addressed (Rizzo, Strickland, & Bouchard, 2004).…”

Reducing compensatory motions in video games for stroke rehabilitation

“…Researchers have proposed a number of solutions for homebased therapy using technology and games [1,2,3,4,5,6,10,11,14]. While the need to address compensation has been acknowledged in analyses [12], the majority of efforts only enabled therapeutic exercise without evaluating exercise correctness [1,4,5,6,10,11,14].…”

“…While the need to address compensation has been acknowledged in analyses [12], the majority of efforts only enabled therapeutic exercise without evaluating exercise correctness [1,4,5,6,10,11,14].…”

“…Also, the telerehabilitation studies in [15,20] relied on expensive hardware or a therapist to detect compensation, but detection could be more broadly accessible using our harness and Wii remotes. To be effective alternatives for stroke therapy, video games can address compensation by using our results [1,2,3,5,6,10,11,14].…”

“…During these meetings, clients typically perform only tens of motions [17]. Research suggests that motion-based video games can provide a motivating context in which players will perform the number of repetitions necessary for recovery [1,2,3,5,6,10,11,14].…”