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Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study

BACKGROUND: Robotic therapy and serious gaming support motor learning in neurorehabilitation. Traditional monitor-based gaming outputs cannot adequately represent the third dimension, whereas virtual reality headsets lack the connection to the real world. The use of Augmented Reality (AR) techniques...

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Autores principales: de Crignis, Alexandra Charlotte, Ruhnau, Salome-Thamar, Hösl, Matthias, Lefint, Jérémy, Amberger, Tamara, Dressnandt, Jürgen, Brunner, Hans, Müller, Friedemann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10422755/
https://www.ncbi.nlm.nih.gov/pubmed/37568195
http://dx.doi.org/10.1186/s12984-023-01225-5
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author de Crignis, Alexandra Charlotte
Ruhnau, Salome-Thamar
Hösl, Matthias
Lefint, Jérémy
Amberger, Tamara
Dressnandt, Jürgen
Brunner, Hans
Müller, Friedemann
author_facet de Crignis, Alexandra Charlotte
Ruhnau, Salome-Thamar
Hösl, Matthias
Lefint, Jérémy
Amberger, Tamara
Dressnandt, Jürgen
Brunner, Hans
Müller, Friedemann
author_sort de Crignis, Alexandra Charlotte
collection PubMed
description BACKGROUND: Robotic therapy and serious gaming support motor learning in neurorehabilitation. Traditional monitor-based gaming outputs cannot adequately represent the third dimension, whereas virtual reality headsets lack the connection to the real world. The use of Augmented Reality (AR) techniques could potentially overcome these issues. The objective of this study was thus to evaluate the usability, feasibility and functionality of a novel arm rehabilitation device for neurorehabilitation (RobExReha system) based on a robotic arm (LBR iiwa, KUKA AG) and serious gaming using the AR headset HoloLens (Microsoft Inc.). METHODS: The RobExReha system was tested with eleven adult inpatients (mean age: 64.4 ± 11.2 years; diagnoses: 8 stroke, 2 spinal cord injury, 1 Guillain-Barré-Syndrome) who had paretic impairments in their upper limb. Five therapists administered and evaluated the system. Data was compared with a Reference Group (eleven inpatients; mean age: 64.3 ± 9.1 years; diagnoses: 10 stroke, 1 spinal cord injury) who trained with commercially available robotic therapy devices (ArmeoPower or ArmeoSpring, Hocoma AG). Patients used standardized questionnaires for evaluating usability and comfort (Quebec User Evaluation of Satisfaction with assistive technology [QUEST]), workload (Raw Task Load Index [RTLX]) and a questionnaire for rating visual perception of the gaming scenario. Therapists used the QUEST, the System Usability Scale and the short version of the User Experience Questionnaire. RESULTS: Therapy with the RobExReha system was safe and feasible for patients and therapists, with no serious adverse events being reported. Patients and therapists were generally satisfied with usability. The patients’ usability ratings were significantly higher in the Reference Group for two items of the QUEST: reliability and ease of use. Workload (RTLX) ratings did not differ significantly between the groups. Nearly all patients using the RobExReha system perceived the gaming scenario in AR as functioning adequately despite eight patients having impairments in stereoscopic vision. The therapists valued the system’s approach as interesting and inventive. CONCLUSIONS: We demonstrated the clinical feasibility of combining a novel robotic upper limb robot with an AR-serious game in a neurorehabilitation setting. To ensure high usability in future applications, a reliable and easy-to-use system that can be used for task-oriented training should be implemented. TRIAL REGISTRATION: Ethical approval was obtained and the trial was registered at the German Clinical Trials Register (DRKS00022136).
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spelling pubmed-104227552023-08-13 Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study de Crignis, Alexandra Charlotte Ruhnau, Salome-Thamar Hösl, Matthias Lefint, Jérémy Amberger, Tamara Dressnandt, Jürgen Brunner, Hans Müller, Friedemann J Neuroeng Rehabil Research BACKGROUND: Robotic therapy and serious gaming support motor learning in neurorehabilitation. Traditional monitor-based gaming outputs cannot adequately represent the third dimension, whereas virtual reality headsets lack the connection to the real world. The use of Augmented Reality (AR) techniques could potentially overcome these issues. The objective of this study was thus to evaluate the usability, feasibility and functionality of a novel arm rehabilitation device for neurorehabilitation (RobExReha system) based on a robotic arm (LBR iiwa, KUKA AG) and serious gaming using the AR headset HoloLens (Microsoft Inc.). METHODS: The RobExReha system was tested with eleven adult inpatients (mean age: 64.4 ± 11.2 years; diagnoses: 8 stroke, 2 spinal cord injury, 1 Guillain-Barré-Syndrome) who had paretic impairments in their upper limb. Five therapists administered and evaluated the system. Data was compared with a Reference Group (eleven inpatients; mean age: 64.3 ± 9.1 years; diagnoses: 10 stroke, 1 spinal cord injury) who trained with commercially available robotic therapy devices (ArmeoPower or ArmeoSpring, Hocoma AG). Patients used standardized questionnaires for evaluating usability and comfort (Quebec User Evaluation of Satisfaction with assistive technology [QUEST]), workload (Raw Task Load Index [RTLX]) and a questionnaire for rating visual perception of the gaming scenario. Therapists used the QUEST, the System Usability Scale and the short version of the User Experience Questionnaire. RESULTS: Therapy with the RobExReha system was safe and feasible for patients and therapists, with no serious adverse events being reported. Patients and therapists were generally satisfied with usability. The patients’ usability ratings were significantly higher in the Reference Group for two items of the QUEST: reliability and ease of use. Workload (RTLX) ratings did not differ significantly between the groups. Nearly all patients using the RobExReha system perceived the gaming scenario in AR as functioning adequately despite eight patients having impairments in stereoscopic vision. The therapists valued the system’s approach as interesting and inventive. CONCLUSIONS: We demonstrated the clinical feasibility of combining a novel robotic upper limb robot with an AR-serious game in a neurorehabilitation setting. To ensure high usability in future applications, a reliable and easy-to-use system that can be used for task-oriented training should be implemented. TRIAL REGISTRATION: Ethical approval was obtained and the trial was registered at the German Clinical Trials Register (DRKS00022136). BioMed Central 2023-08-12 /pmc/articles/PMC10422755/ /pubmed/37568195 http://dx.doi.org/10.1186/s12984-023-01225-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
de Crignis, Alexandra Charlotte
Ruhnau, Salome-Thamar
Hösl, Matthias
Lefint, Jérémy
Amberger, Tamara
Dressnandt, Jürgen
Brunner, Hans
Müller, Friedemann
Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
title Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
title_full Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
title_fullStr Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
title_full_unstemmed Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
title_short Robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
title_sort robotic arm training in neurorehabilitation enhanced by augmented reality – a usability and feasibility study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10422755/
https://www.ncbi.nlm.nih.gov/pubmed/37568195
http://dx.doi.org/10.1186/s12984-023-01225-5
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