User-Centered Design and Evaluation of an Upper Limb Rehabilitation System with a Virtual Environment

Abstract

Virtual environments (VEs) and haptic devices increase patients’ motivation. Furthermore, they observe their performance during rehabilitation. However, some of these technologies present disadvantages because they do not consider therapists’ needs and experience. This research presents the development and usability evaluation of an upper limb rehabilitation system based on a user-centered design approach for patients with moderate or mild stroke that can perform active rehabilitation. The system consists of a virtual environment with four virtual scenarios and a developed haptic device with vibrotactile feedback, and it can be visualized using a monitor or a Head-Mounted Display (HMD). Two evaluations were carried out; in the first one, five therapists evaluated the system’s usability using a monitor through the System Usability Scale, the user experience with the AttrakDiff questionnaire, and the functionality with customized items. As a result of these tests, improvements were made to the system. The second evaluation was carried out by ten volunteers who evaluated the usability, user experience, and performance with a monitor and HMD. A comparison of the therapist and volunteer scores has shown an increase in the usability evaluation (from 78 to >85), the hedonic score rose from 0.6 to 2.23, the pragmatic qualities from 1.25 to 2.20, and the attractiveness from 1.3 to 2.95. Additionally, the haptic device and the VE showed no relevant difference between their performance when using a monitor or HMD. The results show that the proposed system has the characteristics to be a helpful tool for therapists and upper limb rehabilitation.

Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation

“…The development of the LPVirSim was based on the UCD approach, which means that some physicians provided feedback during the process. This approach has been used in the development of medical applications, for instance, rehabilitation, 26,27 wheelchair simulator, 28 systems of clinical decision support, 29,30 and simulators. 31,32 For the development of this simulator, the basic requirements were identified, then the integration and programming of the different components were carried out, and finally, the LPVirSim was evaluated.…”

“…The design of the LPVirSim was based on the characteristics mentioned in Ref. (25) and on 13 requirements obtained through the UCD approach 26 with a questionnaire, an interview, and an explanation of the LP performed with a mannequin. i) The questionnaire was applied to nine physicians experienced in the LP procedure; in this questionnaire, they were asked about the activities performed during the LP, the most common mistakes of the novices, and their experience with their first LP on a patient, this questionnaire is available in https://bit.ly/3AYil9v.…”

“…Additionally, usability was measured through the System Usability Scale (SUS) like in Ref. (26), obtaining a score of 61.66 (see Figure 11 in Section 3). In addition, the instructions were not clear, and some visual cues (current layer and angle) were added for a better understanding.…”

Design and Validation of Virtual Reality Task for Neuro-Rehabilitation of Distal Upper Extremities

“…Basically, establishing and modulating the complexity of task levels should be based on individual requirements and the ability of the patients. VR tasks have been implemented in various ways, e.g., different joysticks, Microsoft Kinect gaming console [15][16][17]40], Nintendo Wii [18,19] and Sony PlayStation [20], external wearable hand gloves, such as Cyber-Glove [13] and RAPAEL smart glove [5,14]; however, such commercial gaming consoles are not specifically customized for rehabilitation purposes and may require patients to make undesirable and difficult movements while performing the tasks. We observed a critical requirement of joystick tool for rehabilitation of patients with stroke, which should be customizable according to individual patient's need with a higher range of motion, speed, higher range of wrist extension for focusing on flexor hypertonia, and also customizable in terms of spasticity of individual patients, given the observation that patient having MAS = 2 had difficulty operating the joystick than the patient with MAS = 1.…”