Usability of an Immersive Augmented Reality Based Telerehabilitation System with Haptics (ARTESH) for Synchronous Remote Musculoskeletal Examination
Keywords:Augmented-reality, Haptics, Telerehabilitation, Telemedicine
This study describes the features and utility of a novel augmented reality based telemedicine system with haptics that allows the sense of touch and direct physical examination during a synchronous immersive telemedicine consultation and physical examination. The system employs novel engineering features: (a) a new force enhancement algorithm to improve force rendering and overcoming the “just-noticeable-difference” limitation; (b) an improved force compensation method to reduce the delay in force rendering; (c) use of the “haptic interface point” to reduce disparity between the visual and haptic data; and (d) implementation of efficient algorithms to process, compress, decompress, transmit and render 3-D tele-immersion data. A qualitative pilot study (n=20) evaluated the usability of the system. Users rated the system on a 26-question survey using a seven-point Likert scale, with percent agreement calculated from the total users who agreed with a given statement. Survey questions fell into three main categories: (1) ease and simplicity of use, (2) quality of experience, and (3) comparison to in-person evaluation. Average percent agreements between the telemedicine and in-person evaluation were highest for ease and simplicity of use (86%) and quality of experience (85%), followed by comparison to in-person evaluation (58%). Eighty-nine percent (89%) of respondents expressed satisfaction with the overall quality of experience. Results suggest that the system was effective at conveying audio-visual and touch data in real-time across 20.3 miles, and warrants further development.
Agostini, M., Moja, L., Banzi, R., Pistotti, V., Tonin, P., Venneri, A., & Turolla, A. (2015). Telerehabilitation and recovery of motor function: A systematic review and meta-analysis. Journal of Telemedicine and Telecare, 21, 202-213. doi: 10.1177/1357633x15572201
Amatya, B., Galea, M. P., Kesselring, J., & Khan, F. (2015). Effectiveness of telerehabilitation interventions in persons with multiple sclerosis: A systematic review. Multiple Sclerois and Related Disorders, 4, 358-369. doi: 10.1016/j.msard.2015.06.011
Aukstakalnis, S., Blatner, D., & Roth, S. (1992). Silicon Mirage: The Art and Science of Virtual Reality. Berkeley, CA: Peachpit Press.
Burdea, G. (2003). Virtual rehabilitation - benefits and
challenges. Yearbook of Medical Informatics, 1, 170-176.
Chen, J., Jin, W., Zhang, X. X., Xu, W., Liu, X. N., & Ren, C. C. (2015). Telerehabilitation approaches for stroke patients: Systematic review and meta-analysis of randomized controlled trials. Journal of Stroke & Cerebrovascular Diseases, 24, 2660-2668. doi: 10.1016/j.jstrokecerebrovasdis.2015.09.014
Cottrell, M. A., Galea, O. A., O'Leary, S. P., Hill, A. J., & Russell, T. G. (2017). Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: A systematic review and meta-analysis. Clinical Rehabilitation, 31, 625-638. doi: 10.1177/0269215516645148
Holden, M. K. (2005). Virtual environments for motor rehabilitation: Review. Cyberpsychology Behavior, 8, 187-211; discussion 212-189. doi: 10.1089/cpb.2005.8.187
Howard, M. C. (2017). A meta-analysis and systematic literature review of virtual reality rehabilitation programs. Computers in Human Behavior, 70, 317-327. doi: https://doi.org/10.1016/j.chb.2017.01.013
Iruthayarajah, J., McIntyre, A., Cotoi, A., Macaluso, S., & Teasell, R. (2017). The use of virtual reality for balance among individuals with chronic stroke: A systematic review and meta-analysis. Topics in Stroke Rehabilitation, 24, 68-79. doi: 10.1080/10749357.2016.1192361
Koceski, S., & Koceska, N. (2016). Evaluation of an assistive telepresence robot for elderly healthcare. Journal of Medical Systems, 40, 121. doi: 10.1007/s10916-016-0481-x
Larson, E. B., Feigon, M., Gagliardo, P., & Dvorkin, A. Y. (2014). Virtual reality and cognitive rehabilitation: A review of current outcome research. NeuroRehabilitation, 34, 759-772. doi: 10.3233/nre-141078
Lundell, S., Holmner, A., Rehn, B., Nyberg, A., & Wadell, K. (2015). Telehealthcare in COPD: A systematic review and meta-analysis on physical outcomes and dyspnea. Respiratory Medicine, 109(1), 11-26. doi: 10.1016/j.rmed.2014.10.008
O'Carroll, C. B., Hentz, J. G., Aguilar, M. I., & Demaerschalk, B. M. (2015). Robotic telepresence versus standardly supervised stroke alert team assessments. Telemedicine Journal and E-Health, 21, 151-156. doi: 10.1089/tmj.2014.0064
Parmanto, B., Lewis, A. N., Jr., Graham, K. M., & Bertolet, M. H. (2016). Development of the Telehealth Usability Questionnaire (TUQ). International Journal of Telerehabilitation, 8(1), 3-10. doi: 10.5195/ijt.2016.6196
Parmanto, B., Saptono, A., Pramana, G., Pulantara, W., Schein, R. M., Schmeler, M. R., . . . Brienza, D. M. (2010). VISYTER: Versatile and integrated system for telerehabilitation. Telemedicine Journal and E-Health, 16, 939-944. doi: 10.1089/tmj.2010.0033
Piggott, L., Wagner, S., & Ziat, M. (2016). Haptic neurorehabilitation and virtual reality for upper limb paralysis: A review. Critical Reviews in Biomedical Engineering, 44(1-2), 1-32. doi: 10.1615/CritRevBiomedEng.2016016046
Rizzo, A. (1997). Virtual reality and cognitive rehabilitation: A brief review of the future. The Journal of Head Trauma Rehabilitation, 12, 1-15.
Schutte, J., Gales, S., Filippone, A., Saptono, A., Parmanto, B., & McCue, M. (2012). Evaluation of a telerehabilitation system for community-based rehabilitation. International Journal of Telerehabilitation, 4(1), 15-24. doi: 10.5195/ijt.2012.6092
Segrelles Calvo, G., Gomez-Suarez, C., Soriano, J. B., Zamora, E., Gonzalez-Gamarra, A., Gonzalez-Bejar, M., . . . Ancochea, J. (2014). A home telehealth program for patients with severe COPD: the PROMETE study. Respiratory Medicine, 108, 453-462. doi: 10.1016/j.rmed.2013.12.003
Shull, P. B., & Damian, D. D. (2015). Haptic wearables as sensory replacement, sensory augmentation and trainer – a review. Journal of NeuroEngineering and Rehabilitation, 12(1), 59. doi: 10.1186/s12984-015-0055-z
Srinivasan, M. A., & Basdogan, C. (1997). Haptics in virtual environments: Taxonomy, research status, and challenges. Computers & Graphics, 21, 393-404. doi: https://doi.org/10.1016/S0097-8493(97)00030-7
Tian, Y., Raghuraman, S., Annaswamy, T., Borresen, A., Nahrstedt, K., & Prabhakaran, B. (2017). H-TIME: Haptic-enabled Tele-Immersive Musculoskeletal Examination. Paper presented at the Proceedings of the 25th ACM international conference on Multimedia, Mountain View, California, USA.
van Delden, A. L., Peper, C. L., Kwakkel, G., & Beek, P. J. (2012). A systematic review of bilateral upper limb training devices for poststroke rehabilitation. Stroke Research and Treatment, 2012, 972069. doi: 10.1155/2012/972069
Venkatraman, K., Raghuraman, S., Tian, Y., Prabhakaran, B., Nahrstedt, K., & Annaswamy, T. (2014, 10-12 Dec. 2014). Quantifying and Improving User Quality of Experience in Immersive Tele-Rehabilitation. Paper presented at the 2014 IEEE International Symposium on Multimedia.
How to Cite
Authors who publish with this journal agree to the following terms:
- The Author retains copyright in the Work, where the term “Work” shall include all digital objects that may result in subsequent electronic publication or distribution.
- Upon acceptance of the Work, the author shall grant to the Publisher the right of first publication of the Work.
- The Author shall grant to the Publisher and its agents the nonexclusive perpetual right and license to publish, archive, and make accessible the Work in whole or in part in all forms of media now or hereafter known under a Creative Commons Attribution 4.0 International License or its equivalent, which, for the avoidance of doubt, allows others to copy, distribute, and transmit the Work under the following conditions:
- Attribution—other users must attribute the Work in the manner specified by the author as indicated on the journal Web site;
- The Author is able to enter into separate, additional contractual arrangements for the nonexclusive distribution of the journal's published version of the Work (e.g., post it to an institutional repository or publish it in a book), as long as there is provided in the document an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post online a prepublication manuscript (but not the Publisher’s final formatted PDF version of the Work) in institutional repositories or on their Websites prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. Any such posting made before acceptance and publication of the Work shall be updated upon publication to include a reference to the Publisher-assigned DOI (Digital Object Identifier) and a link to the online abstract for the final published Work in the Journal.
- Upon Publisher’s request, the Author agrees to furnish promptly to Publisher, at the Author’s own expense, written evidence of the permissions, licenses, and consents for use of third-party material included within the Work, except as determined by Publisher to be covered by the principles of Fair Use.
- The Author represents and warrants that:
- the Work is the Author’s original work;
- the Author has not transferred, and will not transfer, exclusive rights in the Work to any third party;
- the Work is not pending review or under consideration by another publisher;
- the Work has not previously been published;
- the Work contains no misrepresentation or infringement of the Work or property of other authors or third parties; and
- the Work contains no libel, invasion of privacy, or other unlawful matter.
- The Author agrees to indemnify and hold Publisher harmless from Author’s breach of the representations and warranties contained in Paragraph 6 above, as well as any claim or proceeding relating to Publisher’s use and publication of any content contained in the Work, including third-party content.
Revised 7/16/2018. Revision Description: Removed outdated link.