Increasing patient engagement in rehabilitation exercises using computer-based citizen science

Abstract

Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

Fig 1. The experimental setup, consisting of a laptop computer and a Novint Falcon haptic device.

Fig 2. Path displayed to users in map mode, with overlaid dots displaying waypoints (red) and cursor start position (green).

The image presented to the participants was superimposed on an aerial photo of the Gowanus Canal.

Fig 3. Example of image displayed during tagging mode with on-screen keyboard.

Fig 4. Bar plot of survey results for questions Q3–Q9 (see Table 1).

Gray bars indicate the proportion of positive responses from patients, while black bars refer to healthy subjects (for Q6–Q9, neutral responses are omitted). An asterisk above the bar indicates a significant difference from chance. For Q6–Q9, the fraction of neutral responses is: 0.17, 0.57, 0.43, and 0.50 for healthy subjects, respectively, and 0.33, 0.63, 0.37, and 0.27 for patients.

Fig 5. Speed metric (SM), normalized path length (NPL), mean of jerk (MJ), mean arrest period ratio (MAPR), path duration (PD), and task duration (TD) for both groups and both tasks, where P_T, P_NT, H_T, and H_NT denote respectively patients task T, patients task NT, healthy subjects task T, and healthy subjects task NT.

Results are given as box plots, where the red line is the median, edges are the 25th and 75th percentiles, and whiskers extend to the extremes of the data. Whiskers not sharing a common letter are statistically different.