Showing papers by "Albert Rizzo published in 2005"

A SWOT analysis of the field of virtual reality rehabilitation and therapy

Abstract: The use of virtual-reality technology in the areas of rehabilitation and therapy continues to grow, with encouraging results being reported for applications that address human physical, cognitive, and psychological functioning. This article presents a SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis for the field of VR rehabilitation and therapy. The SWOT analysis is a commonly employed framework in the business world for analyzing the factors that influence a company's competitive position in the marketplace with an eye to the future. However, the SWOT framework can also be usefully applied outside of the pure business domain. A quick check on the Internet will turn up SWOT analyses for urban-renewal projects, career planning, website design, youth sports programs, and evaluation of academic research centers, and it becomes obvious that it can be usefully applied to assess and guide any organized human endeavor designed to accomplish a mission. It is hoped that this structured examination of the factors relevant to the current and future status of VR rehabilitation will provide a good overview of the key issues and concerns that are relevant for understanding and advancing this vital application area.

Virtual Reality in Brain Damage Rehabilitation: Review

Abstract: Given the high incidence of brain injury in the population, brain damage rehabilitation is still a relatively undeveloped field. Virtual reality (VR) has the potential to assist current rehabilitation techniques in addressing the impairments, disabilities, and handicaps associated with brain damage. The main focus of much of the exploratory research performed to date has been to investigate the use of VR in the assessment of cognitive abilities, but there is now a trend for more studies to encompass rehabilitation training strategies. This review describes studies that have used VR in the assessment and rehabilitation of specific disabilities resulting from brain injury, including executive dysfunction, memory impairments, spatial ability impairments, attention deficits, and unilateral visual neglect. In addition, it describes studies that have used VR to try to offset some of the handicaps that people experience after brain injury. Finally, a table is included which, although not an exhaustive list of everything that has been published, includes many more studies that are relevant to the use of VR in the assessment and rehabilitation of brain damage. The review concludes that the use of VR in brain damage rehabilitation is expanding dramatically and will become an integral part of cognitive assessment and rehabilitation in the future.

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

Abstract: Virtual Reality (VR) has now emerged as a promising tool in many domains of therapy and rehabilitation (Rizzo, Schultheis, Kerns & Mateer, 2004; Weiss & Jessel, 1998; Zimand, Anderson, Gershon, Graap, Hodges, & Rothbaum, 2002; Glantz, Rizzo & Graap, 2003) Continuing advances in VR technology along with concomitant system cost reductions have supported the development of more usable, useful, and accessible VR systems that can uniquely target a wide range of physical, psychological, and cognitive rehabilitation concerns and research questions What makes VR application development in the therapy and rehabilitation sciences so distinctively important is that it represents more than a simple linear extension of existing computer technology for human use VR offers the potential to create systematic human testing, training and treatment environments that allow for the precise control of complex dynamic 3D stimulus presentations, within which sophisticated interaction, behavioral tracking and performance recording is possible Much like an aircraft simulator serves to test and train piloting ability, virtual environments (VEs) can be developed to present simulations that assess and rehabilitate human functional performance under a range of stimulus conditions that are not easily deliverable and controllable in the real world When combining these assets within the context of functionally relevant, ecologically enhanced VEs, a fundamental advancement could emerge in how human functioning can be addressed in many rehabilitation disciplines

Comparison of two VR platforms for rehabilitation: video capture versus HMD

Abstract: In recent years, clinical studies have begun to demonstrate the effectiveness of VR as an intervention tool for a variety of neurological conditions. There remain, however, a number of important issues that must be addressed in order to determine how widely VR-based intervention should be applied, and the user and platform characteristics that may be important when using VR in clinical settings. One of the unresolved issues that must be addressed is the suitability of particular VR platforms in relation to the therapeutic goals one wishes to achieve. Studying and identifying the characteristics of each platform may assist the therapist in choosing a suitable VR platform for the patient's needs. The purpose of this paper is to describe the results of a study of healthy participants (N -- 89) using 2 different VR platforms in combination with 1 of the 2 virtual environments that was designed to compare the sense of presence, incidence of side effects, perceived exertion, and performance. The data demonstrate significant differences in some of the key characteristics of both VR platforms and environments as they affect participants' sense of presence, performance, side effects, and exertion. We conclude that when seeking a suitable VR therapeutic application, the user's characteristics together with attributes of the VR platform must be taken into consideration since both appear to have an impact on key outcome measures.

Development of a VR therapy application for Iraq war military personnel with PTSD.

Abstract: Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experiences including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that 1 out of 6 returning Iraq War military personnel are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) exposure therapy has been used in previous treatments of PTSD patients with reports of positive outcomes. The aim of the current paper is to specify the rationale, design and development of an Iraq War PTSD VR application that is being created from the virtual assets that were initially developed for theX-Box game entitled Full Spectrum Warrior which was inspired by a combat tactical training simulation, Full Spectrum Command.

Virtual reality and applied psychophysiology.

Abstract: Virtual reality (VR) technology has undergone a transition in the past few years that has taken it from the realm of “expensive toy” into that of “functional technology.” After a period of inflated expectations and limited delivery in the early 90s, this form of computerbased simulation technology is now beginning to emerge as a viable tool for a wide range of clinical and research applications. Continuing advances in VR technology along with concomitant system cost reductions have supported the development of more usable, useful, and accessible VR systems that can uniquely target a variety of psychological, cognitive, and physical disorders and research questions. VR integrates real-time computer graphics, body tracking sensors, audio/visual/touch displays, and sensory input devices to immerse a participant in an interactive computer-generated virtual environment (VE) that changes in a natural way with head and body motion. The rationale for VR applications designed for these purposes is fairly straightforward. By analogy, much like an aircraft simulator serves to test and train piloting ability, VEs can be developed to present simulations that assess and treat human processes and performance under a range of stimulus conditions that are not easily (or safely) deliverable using traditional methods. What makes VR applications in these areas so distinctively important is that they represent more than a simple linear extension of existing computer technology for human use. VR offers the potential to create systematic human testing, training, and treatment environments that allow for the precise control of complex, immersive, and dynamic three-dimensional (3D) stimulus presentations, within which sophisticated interaction, behavioral tracking and performance recording is possible. When combining these assets within the context of functionally relevant, ecologically enhanced VEs, a fundamental advancement could emerge in how human functioning can be addressed in many healthcare and scientific disciplines. In this regard, there is a rather compelling rationale for the integration of VR with human physiological monitoring and brain imaging for advanced research and clinical application. There exists a rich history of research in the discipline of psychophysiology, where, the technology for recording bodily events in the least invasive fashion possible has evolved in order to capture and understand correlates of human mental and/or physical activity. Examples of such efforts would include measuring skin conductance, heart rate, and electroencephalography, etc. while a person attends to emotionally laden or cognitively

Virtual anesthesia: The use of virtual reality for pain distraction during acute medical interventions

Abstract: Pediatric pain management for routine medical interventions continues to receive considerable attention. To date, investigators have demonstrated the efficacy of simple pain distraction strategies for acute procedures (ie, venipuncture) as well as more invasive interventions (ie, wound care, chemotherapy). Recent technological advances in the field of virtual reality (VR) have produced more engaging forms of pain distraction. Although clinical case studies and randomized control trials have begun to explore the utilization of VR anesthesia, this research is still in its infancy. In spite of some limitations, VR researchers have successfully demonstrated its feasibility, satisfaction, and innovation for decreasing pain associated with medical interventions. VR anesthesia also has the potential to minimize pharmacological therapy, thereby reducing risks associated with sedation. Future directions in VR anesthesia are contingent on further technological advances, sound methodology, and appropriate participant-to-intervention match. This manuscript reviews current literature on state-of-the-art pain distraction and future directions in VR.

Virtual Therapeutic Environments with Haptics: An Interdisciplinary Approach for Developing Post-Stroke Rehabilitation Systems.

Abstract: – Stroke is the leading cause of serious, long-term disability among American adults. Each year, nearly 400,000 people survive but suffer from neurological disability. Patients’ motivation and engagement during rehabilitation therapy is important because the amount, type and intensity of practice available to the patients during the recovery process is critical for the functional recovery after stroke. In the current paper we will introduce a National Institutes of Health-supported interdisciplinary project, involving researchers from the fields of Communication, Cell Neurobiology, Computer Science, Psychology, and Physical Therapy, to develop virtual therapeutic environments for post-stroke recovery. The purpose of the project is to develop virtual environments (VEs) that include different levels of haptic sensory feedback and to evaluate the effectiveness of these applications for neurorehabilitation training. The current system development, including applications using the PHANToM and CyberGrasp (haptic devices) as well as future research plans are discussed.

An integrated system: virtual reality, haptics and modern sensing technique (VHS) for post-stroke rehabilitation

Abstract: In this paper, we introduce an interdisciplinary project, involving researchers from the fields of Physical Therapy, Computer Science, Psychology, Communication and Cell Neurobiology, to develop an integrated virtual reality, haptics and modern sensing technique system for post-stroke rehabilitation. The methodology to develop the system includes identification of movement pattern, development of simulated task and diagnostics. Each part of the methodology can be achieved through several sub-steps that are described in detail in this paper. The system is designed from Physical Therapy perspective that can address the motor rehabilitation needs of stroke patients. The system is implemented through stereoscopic displays, force feedback devices and modern sensing techniques that have game-like features and can capture accurate data for further analysis. Diagnostics and evaluation can be made through an Artificial Intelligence based model using collected data and clinical tests have been conducted.

Human Emotional State and its Relevance for Military VR Training

Abstract: : Combat environments by their nature can produce a dramatic range of emotional responses in military personnel. When immersed in the emotional "fog of war", the potential exists for optimal human decision-making and performance of goal-directed activities to be seriously compromised. Real world military training often naturally includes stress induction that aims to promote a similarity of internal emotional stimulus cues with what is expected to be present on the battlefield. Current Virtual Reality military training approaches are noteworthy in their emphasis on creating hi-fidelity graphic and audio realism with the aim to foster better transfer of training. However, less emphasis is typically placed on the creation of emotionally evocative virtual training scenarios that can induce emotional stress in a manner similar to what is typically experienced under real world training conditions. As well, emotional issues in the post-combat aftermath need to be addressed. In view of these issues, the USC Institute for Creative Technologies (ICT) has initiated a research program to study emotional issues that are relevant to VR military applications. This paper will present the rationale and status of two ongoing VR research programs at the ICT that address sharply contrasting ends of the emotional spectrum relevant to the military: 1. The Sensory Environments Evaluation (SEE) Project is examining basic factors that underlie emotion as it occurs within VR training environments and how this could impact transfer of training, and 2. The Full Spectrum Warrior (FSW) Post Traumatic Stress Disorder Project which is currently in the process of converting the existing FSW combat tactical simulation training scenario (and X-Box game) into a VR treatment system for the conduct of graduated exposure therapy in Iraq war military personnel with Post Traumatic Stress Disorder.

Development of a data management tool for investigating multivariate space and free will experiences in virtual reality.

Abstract: Virtual reality (VR) has become mature enough to be successfully used in clinical applications such as exposure therapy, pain distraction, and neuropsychological assessment However, we now need to go beyond the outcome data from this research and conduct the detailed scientific investigations required to better understand what factors influence why VR works (or doesn’t) in these types of clinical applications This knowledge is required to guide the development of VR applications in the key areas of education, training, and rehabilitation and to further evolve existing VR approaches One of the primary assets obtained with the use of VR is the ability to simulate the complexity of real world environments, within which human performance can be tested and trained But this asset comes with a price in terms of the capture, quantification and analysis of large, multivariate and concurrent data sources that reflect the naturalistic behavioral interaction that is afforded in a virtual world As well, while achieving realism has been a main goal in making convincing VR environments, just what constitutes realism and how much is needed is still an open question situated firmly in the research domain Just as in real “reality,” such factors in virtual reality are complex and multivariate, and the understanding of this complexity presents exceptional challenges to the VR researcher For certain research questions, good behavioral science often requires consistent delivery of stimuli within tightly controlled lab-based experimental conditions However, for other important research questions we do not want to constrain naturalistic behavior and limit VR’s ability to replicate real world conditions, simply because it is easier to study human performance with traditional lab-based methodologies By doing so we may compromise the very qualities that comprise VR’s unique capacity to mimic the experiences and challenges that exist in everyday life What is really needed to address scientific questions that require natural exploration of a simulated environment are more usable and robust tools to instrument, organize, and visualize the complex data generated by measurements of participant behaviors within a virtual world This paper briefly describes the rationale and methodology of an initial study in an ongoing research program that aims to investigate human performance within a virtual environment where unconstrained “free will” exploratory behavior is essential to research questions that involve the relationships between physiology, emotion, and memory After a discussion of the research protocol and the types of data that were collected, we describe a novel tool that was borne from our need to more efficiently capture, manage, and explore the complex data that was generated in this research An example of a research participant’s annotated display from this data management and visualization tool is then presented It is our view that this tool provides the capacity to better visualize and understand the complex data relationships that may arise in VR research that investigates naturalistic free will behavior and its impact on other human performance variables

Development of a Data Management Tool for Investigating Multivariate Space and Free Will Experiences

Abstract: Virtual reality (VR) has become mature enough to be successfully used in clinical applications such as exposure therapy, pain distraction, and neuropsychological assessment. However, we now need to go beyond the outcome data from this research and conduct the detailed scientific investigations required to better understand what factors influence why VR works (or doesn’t) in these types of clinical applications. This knowledge is required to guide the development of VR applications in the key areas of education, training, and rehabilitation and to further evolve existing VR approaches. One of the primary assets obtained with the use of VR is the ability to simulate the complexity of real world environments, within which human performance can be tested and trained. But this asset comes with a price in terms of the capture, quantification and analysis of large, multivariate and concurrent data sources that reflect the naturalistic behavioral interaction that is afforded in a virtual world. As well, while achieving realism has been a main goal in making convincing VR environments, just what constitutes realism and how much is needed is still an open question situated firmly in the research domain. Just as in real “reality,” such factors in virtual reality are complex and multivariate, and the understanding of this complexity presents exceptional challenges to the VR researcher. For certain research questions, good behavioral science often requires consistent delivery of stimuli within tightly controlled lab-based experimental conditions. However, for other important research questions we do not want to constrain naturalistic behavior and limit VR’s ability to replicate real world conditions, simply because it is easier to study human performance with traditional lab-based methodologies. By doing so we may compromise the very qualities that comprise VR’s unique capacity to mimic the experiences and challenges that exist in everyday life. What is really needed to address scientific questions that require natural exploration of a simulated environment are more usable and robust tools to instrument, organize, and visualize the complex data generated by measurements of participant behaviors within a virtual world. This paper briefly describes the rationale and methodology of an initial study in an ongoing research program that aims to investigate human performance within a virtual environment where unconstrained “free will” exploratory behavior is essential to research questions that involve the relationships between physiology, emotion, and memory. After a discussion of the research protocol and the types of data that were collected, we describe a novel tool that was borne from our need to more efficiently capture, manage, and explore the complex data that was generated in this research. An example of a research participant’s annotated display from this data management and visualization tool is then presented. It is our view that this tool provides the capacity to better visualize and understand the complex data relationships that may arise in VR research that investigates naturalistic free will behavior and its impact on other human performance variables.

Development of a Benchmarking Scenario for Testing 3D User Interface Devices and Interaction Methods

Abstract: To address a part of the challenge of testing and comparing various 3D user interface devices and methods, we are currently developing and testing a VR 3D User Interface benchmarking scenario. The approach outlined in this paper focuses on the capture of human interaction performance on object selection and manipulation tasks using standardized and scalable block configurations that allow for measurement of speed and efficiency with any interaction device or method. The block configurations that we are using as benchmarking stimuli are accompanied by a pure mental rotation visuospatial assessment test. This feature will allow researchers to test users’’ existing spatial abilities and statistically parcel out the variability due to innate ability, from the actual hands-on performance metrics. This statistical approach could lead to a more pure analysis of the ergonomic features of interaction devices and methods separate from existing user abilities. An initial test was conducted at two sites using this benchmarking system to make comparisons between 3D/gesture-based and 2D/mouse-based interactions for 3D selection and manipulation. Our preliminary results demonstrated, as expected, that the 3D/gesture based method in general outperformed the 2D/mouse interface. As well there were statistically significant performance differences between different user groups when categorized by their sex, visuospatial ability and educational background.

Quantitative comparison of interaction with shutter glasses and autostereoscopic displays

Abstract: In this paper we describe experimental measurements and comparison of human interaction with three different types of stereo computer displays. We compare traditional shutter glasses-based viewing with three-dimensional (3D) autostereoscopic viewing on displays such as the Sharp LL-151-3D display and StereoGraphics SG 202 display. The method of interaction is a sphere-shaped “cyberprop” containing an Ascension Flock-of-Birds tracker that allows a user to manipulate objects by imparting the motion of the sphere to the virtual object. The tracking data is processed with OpenGL to manipulate objects in virtual 3D space, from which we synthesize two or more images as seen by virtual cameras observing them. We concentrate on the quantitative measurement and analysis of human performance for interactive object selection and manipulation tasks using standardized and scalable configurations of 3D block objects. The experiments use a series of progressively more complex block configurations that are rendered in stereo on various 3D displays. In general, performing the tasks using shutter glasses required less time as compared to using the autostereoscopic displays. While both male and female subjects performed almost equally fast with shutter glasses, male subjects performed better with the LL-151-3D display, while female subjects performed better with the SG202 display. Interestingly, users generally had a slightly higher efficiency in completing a task set using the two autostereoscopic displays as compared to the shutter glasses, although the differences for all users among the displays was relatively small. There was a preference for shutter glasses compared to autostereoscopic displays in the ease of performing tasks, and glasses were slightly preferred for overall image quality and stereo image quality. However, there was little difference in display preference in physical comfort and overall preference. We present some possible explanations of these results and point out the importance of the autostereoscopic "sweet spot" in relation to the user's head and body position.

Virtual reality technology for behavioral/cognitive/neuropsychologicai assessment and intervention: applications and issues

Abstract: Brenda K. WiederhoId Thevirtual Reality Medical Center After an early period of inflated expectations and limited delivery, virtual reality (VR) technology has emerged as a viable to01 for cognitive/behavioral mental health and rehabilitation applications. VR allows for the systematic presentation of stimuli within simulations of functional environments that target human behavioral and cognitive processes relevant fur assessment and intervention purposes. The capacity of virtual environment (VE) technology to create dynamic, interactive, three-dimensional (3D) stimulus environments, within which all behavioral responding can be recorded and measured, offers clinical assessment and intervention options that are not available using traditional methods. These applications have shown promise for: reducing fear and anxiety with phobic and post-traumatic stress disorder (PTSD) clients, distracting patients during painful and anxiety-provoking medical and dental procedures, treating eating disorders and obesity, navigation and spatial training in children with motor impairments, functional skills training in persons with developmental disabilities and autism, and in the assessment (and in some cases, rehabiljtation) of memory, attention, visuospatial skills, and executive cognitive functions in populations with central nervous system (CNS) dysfunction. Functional VE training scenarios have also been designed to test and teach instrumental activities of daily living such as street-crossing, automobile driving, meal preparation, supermarket shopping, use of public transportation, and wheelchair navigation. The cherapeutic targets chosen thus far for these clinical applications reflect an informed appreciation for the unique assets that are available using VR technology, and these initiatives have formed a foundation of work that provides support for the value of further development of VR mental health/rehabilitation applications. The current tutorial will present an overview of VR applications and address the issues related to the use of virtual reality technology for cognitivelbehaviozal assessment and intervention. The tutorial will give participancs the latest information on how the technology is being applied with clinical (and some non-clinical) populations, professional issues involved in its use, and what is in store for the future!