A gamified VR-based patient interface and therapist application for robot-assisted gait therapy: implementation and perception study

The increase in life expectancy has led to a growing number of older individuals requiring specialized care, particularly in stroke recovery. Despite advancements in acute stroke therapy, many survivors still need continuous rehabilitation due to impairments. This has created a significant challenge in healthcare systems, as demand for rehabilitative care exceeds the available supply of healthcare professionals, negatively affecting patient well-being and quality of life. Robotic rehabilitation devices provide a solution by enabling patients to continue therapy at home autonomously. These devices offer effective rehabilitative support for healthcare workers, minimizing their workload. The TUM-MIRMI Geriatronics Lighthouse Initiative, in collaboration with Reactive Robotics, aims to create Project X: a low-cost therapeutic device for home-based gait rehabilitation among sub-acute and late-stage stroke patients. The focus of this thesis is on improving patient engagement and therapeutic effectiveness through the integration of a Graphical User Interface (GUI) and Virtual Reality (VR), aimed at enhancing the rehabilitation experience. The research examines how these technologies, along with adaptive systems like Assist-As-Needed (AAN), contribute to patient motivation and autonomy. It also emphasizes the role of a user-friendly interface, particularly for older individuals who may face difficulties with new technology. he ultimate goal of this study is to show that integrating VR and a gamified UI, by giving patients more control and involvement, can significantly increase motivation and improve therapy outcomes. Robotic rehabilitation equipment enables patients to continue therapy at home autonomously. These gadgets can provide accurate and effective rehabilitative support for healthcare workers, minimizing their workload. The TUM-MIRMI Geriatronics Lighthouse Initiative aims to develop breakthrough technologies for older individuals to live independently and autonomously. This program involves creating Project X with Munich-based startup Reactive Robotics, specializing in robotic-assisted in-bed therapy. A low-cost therapeutic device for home-care gait rehabilitation among sub-acute and late-stage patients has been prototyped. Current robotic rehabilitation systems use several methods to enhance patient involvement and therapeutic effectiveness. The key features include feedback mechanisms, gamification, and adaptive support systems like Assist-As-Needed (AAN). These devices dynamically adjust treatment parameters based on patient input, ensuring individualized and effective rehabilitation. The user interface (UI) design is crucial for the usability and effectiveness of devices, particularly for older individuals who may struggle with new technology. This thesis examines the impact of a graphical user interface (GUI) on improving the efficacy of robotic-assisted rehabilitation in a home-based setting. The work involves: Understanding and describing the context of use of the envisioned application, targeting three different users (Patients, Therapists, and Lay Users) and their interaction with the system. Generating and evaluating different concepts for motivating and engaging therapy. Setting up requirements for the application development. Designing and testing a graphical user interface (GUI) for the Project X device. An adaptive gamification system was designed, including points, rewards, levels in a task, and goals environment. Usability tests evidenced initial resistance from patients to engage with the system due to challenges in understanding. However, after initial guidance, the system was appreciated and confirmed the potential of using a tailored task-setting model to align with rehabilitation therapy.

L'aumento dell'aspettativa di vita ha portato a un numero crescente di persone anziane che necessitano di cure specialistiche, in particolare per il recupero dell'ictus. Nonostante i progressi nella terapia dell'ictus acuto, molti sopravvissuti hanno ancora bisogno di una riabilitazione continua a causa delle menomazioni. Ciò ha creato una sfida significativa nei sistemi sanitari, in quanto la domanda di assistenza riabilitativa supera l'offerta disponibile di professionisti sanitari, incidendo negativamente sul benessere e sulla qualità della vita dei pazienti. I dispositivi robotici per la riabilitazione offrono una soluzione, consentendo ai pazienti di continuare la terapia a casa in modo autonomo. Questi dispositivi offrono un efficace supporto riabilitativo agli operatori sanitari, riducendo al minimo il loro carico di lavoro. La TUM-MIRMI Geriatronics Lighthouse Initiative, in collaborazione con Reactive Robotics, mira a creare il Progetto X: un dispositivo terapeutico a basso costo per la riabilitazione domiciliare della deambulazione nei pazienti con ictus in fase subacuta e avanzata. L'obiettivo di questa tesi è migliorare il coinvolgimento del paziente e l'efficacia terapeutica attraverso l'integrazione di un'interfaccia grafica utente (GUI) e della realtà virtuale (VR), al fine di migliorare l'esperienza riabilitativa. La ricerca esamina come queste tecnologie, insieme a sistemi adattivi come l'Assist-As-Need (AAN), contribuiscano alla motivazione e all'autonomia del paziente. Inoltre, sottolinea il ruolo di un'interfaccia user-friendly, in particolare per le persone anziane che possono incontrare difficoltà con le nuove tecnologie. l fine ultimo di questo studio è dimostrare che l'integrazione della VR e di un'interfaccia utente gamificata, dando ai pazienti un maggiore controllo e coinvolgimento, può aumentare significativamente la motivazione e migliorare i risultati della terapia.