Augmented reality system for rehabilitation : new approach based on human interaction and biofeedback

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Rehabilitation is the process of training for someone in order to recover or improve their lost functions caused by neurological deficits. The upper limb rehabilitation system provides relearning of motor skills that are lost due to any neurological injuries via motor rehabilitation training. The process of motor rehabilitation is a form of motor learning via practice or experience. It requires thorough understanding and examination of neural processes involved in producing movement and learning as well as the medical aspects that may affect the central nervous system (CNS) or peripheral nervous system (PNS) in order to develop an effective treatment system. Although there are numerous rehabilitation systems which have been proposed in literatures, a low cost upper limb rehabilitation system that maximizes the functional recovery by stimulating the neural plasticity is not widely available. This is due to lack of motivation during rehabilitation training, lack of real time biofeedback information with complete database, the requirement of one to one attention between physiotherapist and patient, the technique to stimulate human neural plasticity. Therefore, the main objective of this thesis is to develop a novel low cost rehabilitation system that helps recovery not only from loss of physical functions, but also from loss of cognitive functions to fulfill the aforementioned gaps via multimodal technologies such as augmented reality (AR), computer vision and signal processing. In order to fulfill such ambitious objectives, the following contributions have been implemented. Firstly, since improvements in physical functions are targeted, the Rehabilitation system with Biofeedback simulation (RehaBio) is developed. The system enhances user’s motivation via game based therapeutic exercises and biofeedback. For this, AR based therapeutic games are developed to provide eye-hand coordination with inspiration in motivation via immediate audio and visual feedback. All the exercises in RehaBio are developed in a safe training environment for paralyzed patients. In addition to that, real-time biofeedback simulation is developed and integrated to serve in two ways: (1) from the patient’s point of view, the biofeedback simulation motivates the user to execute the movements since it will animate the different muscles in different colors, and (2) from the therapist’s point of view, the muscle simulations and EMG threshold level can be evaluated as patient’s muscle performance throughout the rehabilitation process. Secondly, a new technique that stimulates the human neural plasticity is proposed. This is a virtual human arm (VHA) model that driven by proposed continuous joint angle prediction in real time based on human biological signal, Electromyogram (EMG). The VHA model simulation aims to create the illusion environment in Augmented Reality-based Illusion System (ARIS). Finally, a complete novel upper limb rehabilitation system, Augmented Reality-based Illusion System (ARIS) is developed. The system incorporates some of the developments in RehaBio and real time VHA model to develop the illusion environment. By conducting the rehabilitation training with ARIS, user’s neural plasticity will be stimulated to re-establish the neural pathways and synapses that are able to control mobility. This is achieved via an illusion concept where an illusion scene is created in AR environment to remove the impaired real arm virtually and replace it with VHA model to be perceived as part of the user’s own body. The job of the VHA model in ARIS is when the real arm cannot perform the required task, it will take over the job of the real one and will let the user perceive the sense that the user is still able to perform the reaching movement by their own effort to the destination point. Integration with AR based therapeutic exercises and motivated immediate intrinsic and extrinsic feedback in ARIS leads to serve as a novel upper limb rehabilitation system in a clinical setting. The usability tests and verification process of the proposed systems are conducted and provided with very encouraging results. Furthermore, the developments have been demonstrated to the clinical experts in the rehabilitation field at Port Kembla Hospital. The feedback from the professionals is very positive for both the RehaBio and ARIS systems and they have been recommended to be used in the clinical setting for paralyzed patients.
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