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. 2023 Feb 3;23(3):1680.
doi: 10.3390/s23031680.

A Proof of Concept Combined Using Mixed Reality for Personalized Neurorehabilitation of Cerebellar Ataxic Patients

Michela Franzò  1 , Andrada Pica  1 , Simona Pascucci  1   2 , Mariano Serrao  3 , Franco Marinozzi  1 , Fabiano Bini  1
Affiliations

A Proof of Concept Combined Using Mixed Reality for Personalized Neurorehabilitation of Cerebellar Ataxic Patients

Michela Franzò et al. Sensors (Basel). .

Abstract

Background: Guidelines for degenerative cerebellar ataxia neurorehabilitation suggest intensive coordinative training based on physiotherapeutic exercises. Scientific studies demonstrate virtual exergaming therapeutic value. However, patient-based personalization, post processing analyses and specific audio-visual feedbacks are not provided. This paper presents a wearable motion tracking system with recording and playback features. This system has been specifically designed for ataxic patients, for upper limbs coordination studies with the aim to retrain movement in a neurorehabilitation setting. Suggestions from neurologists and ataxia patients were considered to overcome the shortcomings of virtual systems and implement exergaming.

Methods: The system consists of the mixed-reality headset Hololens2 and a proprietary exergaming implemented in Unity. Hololens2 can track and save upper limb parameters, head position and gaze direction in runtime.

Results: Data collected from a healthy subject are reported to demonstrate features and outputs of the system.

Conclusions: Although further improvements and validations are needed, the system meets the needs of a dynamic patient-based exergaming for patients with cerebellar ataxia. Compared with existing solutions, the mixed-reality system is designed to provide an effective and safe therapeutic exergaming that supports both primary and secondary goals of an exergaming: what a patient should do and how patient actions should be performed.

Keywords: ataxia; exergaming; health monitoring; inertial measurement unit; mixed reality; motion capture; rehabilitation engineering.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Frames of the HL2 view during the exergaming: (a) space environment considered for the exergaming from a lateral vision, in blue the spaceship the patient has to reach; (b) space environment from a frontal vision, inside the wormhole-like object that limits the volume of work.
Figure 2
Figure 2
Scheme of input/output across the PoC: HL2, computer, medical expert interface interactive for clinician and the patient that wears HL2.
Figure 3
Figure 3
Pseudocodes of the exergaming implemented in C# style and reporting the conditions and feedbacks generated.
Figure 4
Figure 4
Graphs of the trajectories of the subject’s hand: (a) trajectory of the right hand during exergaming 1, (b) trajectory of the left hand during exergaming 1, (c) trajectory of the right hand during exergaming 2, (d) trajectory of the left hand during exergaming 2. The cross represents the position of the targets that are “grabbed” by the subject in the exergaming.
Figure 4
Figure 4
Graphs of the trajectories of the subject’s hand: (a) trajectory of the right hand during exergaming 1, (b) trajectory of the left hand during exergaming 1, (c) trajectory of the right hand during exergaming 2, (d) trajectory of the left hand during exergaming 2. The cross represents the position of the targets that are “grabbed” by the subject in the exergaming.
Figure 5
Figure 5
Graphs of the trajectories of the subject’s head: (a) trajectory during exergaming 1 performed with the right hand, (b) trajectory during exergaming 1 performed with the left hand, (c) trajectory during exergaming 2 performed with the right hand, (d) trajectory during exergaming 2 performed with the left hand.
Figure 5
Figure 5
Graphs of the trajectories of the subject’s head: (a) trajectory during exergaming 1 performed with the right hand, (b) trajectory during exergaming 1 performed with the left hand, (c) trajectory during exergaming 2 performed with the right hand, (d) trajectory during exergaming 2 performed with the left hand.
Figure 6
Figure 6
Graphs of the trajectories of the subject’s gaze: (a) trajectory during exergaming 1 performed with the right hand, (b) trajectory during exergaming 1 performed with the left hand, (c) trajectory during exergaming 2 performed with the right hand, (d) trajectory during exergaming 2 performed with the left hand.
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