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

Autor: de Crignis AC; Schön Klinik Bad Aibling, Bad Aibling, Germany., Ruhnau ST; BEC GmbH, Pfullingen, Germany., Hösl M; Schön Klinik Bad Aibling, Bad Aibling, Germany.; Schön Klinik Vogtareuth, Vogtareuth, Germany., Lefint J; Fraunhofer Institute for Manufacturing, Engineering and Automation IPA, Stuttgart, Germany., Amberger T; Schön Klinik Bad Aibling, Bad Aibling, Germany., Dressnandt J; Schön Klinik Bad Aibling, Bad Aibling, Germany., Brunner H; Schön Klinik Bad Aibling, Bad Aibling, Germany., Müller F; Schön Klinik Bad Aibling, Bad Aibling, Germany. FMueller@schoen-klinik.de.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2023 Aug 12; Vol. 20 (1), pp. 105. Date of Electronic Publication: 2023 Aug 12.
DOI: 10.1186/s12984-023-01225-5
Abstrakt: 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).
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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