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- Is it necessary to show virtual limbs in action observation neurorehabilitation systems?Publication . Modroño, Cristián; Bermúdez, Sergi; Cameirão, Mónica; Pereira, Fábio; Paulino, Teresa; Marcano, Francisco; Hernández-Martín, Estefanía; Plata-Bello, Julio; Palenzuela, Nereida; Núñez-Pádron, Daniel; Pérez-González, José M; González-Mora, José LAction observation neurorehabilitation systems are usually based on the observation of a virtual limb performing different kinds of actions. In this way, the activity in the frontoparietal Mirror Neuron System is enhanced, which can be helpful to rehabilitate stroke patients. However, the presence of limbs in such systems might not be necessary to produce mirror activity, for example, frontoparietal mirror activity can be produced just by the observation of virtual tool movements. The objective of this work was to explore to what point the presence of a virtual limb impacts the Mirror Neuron System activity in neurorehabilitation systems.
- Augmented Human Assistance (AHA)Publication . Bermúdez i Badia, Sergi; Odekerken-Schröder, Gaby; Mahr, Dominik; Čaić, Martina; Lee, Min Hun; Siewiorek, Dan; Smailagic, Assim; Gamboa, Hugo; Belo, David; Carnide, Maria Filomena Araújo da Costa Cruz; Baptista, Maria de Fátima Marcelina; Simão, Hugo; Avelino, João; Sousa, Honorato; Paulino, Teresa; Gonçalves, Afonso; Cardona, John Muñoz; Cameirão, Mónica S.; Bernardino, Alexandre; Gouveia, Élvio RúbioAging and sedentarism are two main challenges for social and health systems in modern societies. To face these challenges a new generation of ICT based solutions is being developed to promote active aging, prevent sedentarism and find new tools to support the large populations of patients that suffer chronic conditions as result of aging. Such solutions have the potential to transform healthcare by optimizing resource allocation, reducing costs, improving diagno ses and enabling novel therapies, thus increasing quality of life. The primary goal of the “AHA: Augmented Human Assistance” project is to de velop novel assistive technologies to promote exercise among the elderly and patients of motor disabilities. For exercise programs to be effective, it is essential that users and patients comply with the prescribed schedule and perform the ex ercises following established protocols. Until now this has been achieved by hu man monitoring in rehabilitation and therapy session, where the clinicians or therapists permanently accompany users or patient. In many cases, exercises are prescribed for home performance, in which case it is not possible to validate their execution. In this context, the AHA project is an integrative and cross-discipli nary approach of 4 Portuguese universities, the CMU, and 2 Portuguese industry partners, that combines innovation and fundamental research in the areas of hu man-computer interaction, robotics, serious games and physiological computing (see partner list in Appendix A). In the project, we capitalize on recent innova tions and aim at enriching the capabilities and range of application of assistive devices via the combination of (1) assistive robotics; (2) technologies that use well-understood motivational techniques to induce people to do their exercises in the first place, and to do them correctly and completely; (3) tailored and relevant guidance in regard to health care and social support and activities; and (4) tech nologies to self-monitoring and sharing of progress with health-care provider enabling clinicians to fine-tune the exercise regimen to suit the participant’s ac tual progress. We highlight the development of a set of exergames (serious games controlled by the movement of the user’s body limbs) specifically designed for the needs of the target population according to best practices in sports and human kinetics sciences. The games can be adapted to the limitations of the users (e.g. to play in a sitting position) so a large fraction of the population can benefit from them. The games can be executed with biofeedback provided from wearable sensors, to pro duce more controlled exercise benefits. The games can be played in multi-user settings, either in cooperative or competitive mode, to promote the social rela tions among players. The games contain regional motives to trigger memories from the past and other gamification techniques that keep the users involved in the exercise program. The games are projected in the environment through aug mented reality techniques that create a more immersive and engaging experience than conventional displays. Virtual coach techniques are able to monitor the cor rectness of the exercise and provide immediate guidance to the user, as well as providing reports for therapists. A socially assistive robot can play the role of the coach and provide an additional socio-cognitive dimension to the experience to complement the role of the therapist. A web service that records the users’ per formances and allows the authorized therapists to access and configure the exer cise program provides a valuable management tool for caregivers and clinical staff. It can also provide a social network for players, increasing adherence to the therapies. We have performed several end-user studies that validate the proposed ap proaches. Together, or in isolation, these solutions provide users, caregivers, health professionals and institutions, valuable tools for health promotion, disease monitoring and prevention.
- " In search of light": enhancing touristic recommender services with local weather dataPublication . Dionisio, Mara; Paulino, Teresa; Suri, Trisha; Autzen, Nicolas; Schöning, JohannesMany destinations’ economies strongly rely on tourism. Therefore, it is crucial to meet tourists’ expectations, so they will return to the destination. The geographical formation of certain touristic islands often leads to local climates where it can be rainy and windy on one side of the island, whereas the other part is sunny. In this paper, we present a novel use for a network of sensors, LightBeam, a mobile location-based application aiming to improve the tourists’ experience. The application focuses on providing real-time guidance for tourists seeking sunlight to maximize their holiday experience by suggesting the closest points of interest (POIs) to the user with the “best sunlight”. To achieve this, we implemented and installed a network of geospatial sensors. The data from the sensor network is combined with the current location of the users to provide recommendations. We report on the initial design and prototype of LightBeam.
- Open Rehab initiative: second development iterationPublication . Freitas, Diogo; Paulino, Teresa; Bermúdez i Badia, Sergi; Llorens, Roberto; Deutsch, Judith E.A substantial part of rehabilitation tools are developed in the context of research projects, which rarely reach their target audience, in particular clinicians and patients. To address this challenge, the Open Rehab Initiative (ORI) emerged as an international independent online portal with the goal of connecting clinicians, scientists, engineers, game developers, and end-users to interact and share virtual rehabilitation tools. The quality and efficacy of such platform can only be attained iteratively based on a user-centered design approach. This paper describes the design process and features implemented on the second development iteration subsequent to a formative evaluation of the first version of ORI. The main goal of the second iteration was to implement new features and make the platform functional and ready for a second evaluation process with beta testers, which will certainly prompt new features for improvement and will serve as a step toward the final release of the site.
- PhysioVR: a novel mobile virtual reality framework for physiological computingPublication . Muñoz, John Edison; Paulino, Teresa; Vasanth, Harry; Baras, KarolinaVirtual Reality (VR) is morphing into a ubiquitous technology by leveraging of smartphones and screenless cases in order to provide highly immersive experiences at a low price point. The result of this shift in paradigm is now known as mobile VR (mVR). Although mVR offers numerous advantages over conventional immersive VR methods, one of the biggest limitations is related with the interaction pathways available for the mVR experiences. Using physiological computing principles, we created the PhysioVR framework, an Open-Source software tool developed to facilitate the integration of physiological signals measured through wearable devices in mVR applications. PhysioVR includes heart rate (HR) signals from Android wearables, electroencephalography (EEG) signals from a low cost brain computer interface and electromyography (EMG) signals from a wireless armband. The physiological sensors are connected with a smartphone via Bluetooth and the PhysioVR facilitates the streaming of the data using UDP communication protocol, thus allowing a multicast transmission for a third party application such as the Unity3D game engine. Furthermore, the framework provides a bidirectional communication with the VR content allowing an external event triggering using a real-time control as well as data recording options. We developed a demo game project called EmoCat Rescue which encourage players to modulate HR levels in order to successfully complete the in-game mission. EmoCat Rescue is included in the PhysioVR project which can be freely downloaded. This framework simplifies the acquisition, streaming and recording of multiple physiological signals and parameters from wearable consumer devices providing a single and efficient interface to create novel physiologically-responsive mVR applications.
- The impact of positive, negative and neutral stimuli in a virtual reality cognitive-motor rehabilitation task: a pilot study with stroke patientsPublication . Cameirão, Mónica S.; Faria, Ana Lúcia; Paulino, Teresa; Alves, Júlio; Bermúdez i Badia, SergiBackground: Virtual Reality (VR) based methods for stroke rehabilitation have mainly focused on motor rehabilitation, but there is increasing interest in integrating motor and cognitive training to increase similarity to real-world settings. Unfortunately, more research is needed for the definition of which type of content should be used in the design of these tools. One possibility is the use of emotional stimuli, which are known to enhance attentional processes. According to the Socioemotional Selectivity Theory, as people age, the emotional salience arises for positive and neutral, but not for negative stimuli. Methods: For this study we developed a cognitive-motor VR task involving attention and short-term memory, and we investigated the impact of using emotional images of varying valence. The task consisted of finding a target image, shown for only two seconds, among fourteen neutral distractors, and selecting it through arm movements. After performing the VR task, a recall task took place and the patients had to identify the target images among a valence-matched number of distractors. Ten stroke patients participated in a within-subjects experiment with three conditions based on the valence of the images: positive, negative and neutral. Eye movements were recorded during VR task performance with an eye tracking system. Results: Our results show decreased attention for negative stimuli in the VR task performance when compared to neutral stimuli. The recall task shows significantly more wrongly identified images (false memories) for negative stimuli than for neutral. Regression and correlation analyses with the Montreal Cognitive Assessment and the Geriatric Depression Scale revealed differential effects of cognitive function and depressive symptomatology in the encoding and recall of positive, negative and neutral images. Further, eye movement data shows reduced search patterns for wrongly selected stimuli containing emotional content. Conclusions: The results of this study suggest that it is feasible to use emotional content in a VR based cognitivemotor task for attention and memory training after stroke. Stroke survivors showed less attention towards negative information, exhibiting reduced visual search patterns and more false memories. We have also shown that the use of emotional stimuli in a VR task can provide additional information regarding patient’s mood and cognitive status.
- The monarch room: an interactive system for visualization of global migration dataPublication . Caraban, Ana; Paulino, Teresa; Pereira, Ricardo; Spence, Robert; Campos, PedroRepresentation, presentation and interaction are subjects that require to be consciously contemplated while designing information visualization systems. This paper describes the ideation and design process of The Monarch Room, an information visualization system of global migration data. Our solution was designed to allow visitors of a museum to select, browse and interact with a visual interactive representation of migration flows in a unified view. Visitors can convey their learning purposes by seamlessly combining criteria such as time scales, location, and reasons behind migration, from either manual our automatic interactions. We believe our work contributes to the design of interfaces that enable a more in-depth understanding of global human migration patterns. In this paper, we describe our first design and research efforts.
- TREINO COGNITIVO NO PÓS-AVC: UM ESTUDO-PILOTO COM A PLATAFORMA NEUROAIREH@BPublication . Câmara, Joana; Paulino, Teresa; Spínola, Mónica; Branco, Diogo; Cameirão, Mónica; Faria, Ana Lúcia; Ferreira, Luis; Moreira, André; Silva, Ana Rita; Vilar, Manuela; Simões, Mário; Bermúdez i Badia, Sergi; Fermé, EduardoO treino cognitivo (TC) através das novas tecnologias representa uma estratégia de intervenção promissora na mitigação dos défices cognitivos pós-AVC. Neste estudo-piloto, avaliamos o impacto a curto prazo de um novo sistema de TC com maior validade ecológica – a plataforma NeuroAIreh@b –, numa amostra de sobreviventes de AVC na fase crónica. Recrutámos dez sobreviventes de AVC que foram submetidos a uma avaliação neuropsicológica (ANP) pré intervenção. Posteriormente, iniciaram uma intervenção de TC implementada via tablet, com recurso à versão protótipo da plataforma NeuroAIreh@b, envolvendo oito sessões de 45 minutos. Nestas sessões, realizaram quatro tipos de tarefas de TC baseadas em atividades de vida diária (AVDs) (por ex., selecionar os ingredientes corretos para fazer uma receita, pagar as compras no supermercado). Foram efetuadas ANPs pós-intervenção para avaliar o impacto da intervenção a curto prazo. Uma análise intra-grupal com o teste de Wilcoxon revelou diferenças estatisticamente significativas no Montreal Cognitive Assessment (MoCA) e na pontuação total do Inventário de Avaliação Funcional de Adultos e Idosos (IAFAI). Globalmente, o TC através da plataforma NeuroAIreh@b parece ser benéfico na fase crónica do AVC, conduzindo a ganhos na cognição geral (MoCA) e na capacidade funcional (IAFAI). Estes resultados preliminares com a versão protótipo da plataforma NeuroAIreh@b são encorajadores e sugerem a generalização dos ganhos obtidos em contexto terapêutico para as AVDs.
- Reh@City v2.0: a comprehensive virtual reality cognitive training system based on personalized and adaptive simulations of activities of daily livingPublication . Paulino, Teresa; Faria, Ana Lúcia; Bermúdez i Badia, SergiCognitive impairments are among the most common age-related disabilities worldwide. Literature has shown that cognitive training using Virtual Reality (VR) systems can be a valid and effective solution for cognitive rehabilitation. Virtual environments can be easily customized to deliver very specific training by controlling the presentation of stimuli and keeping track of the user responses. Reh@City (RC) is a virtual reality simulation of a city where patients can train a variety of cognitive skills while performing simulated activities of daily living. An initial prototype of this city with four environments was clinically validated with a stroke sample, and the encouraging results motivated further iterations and improvements in the RC, in terms of its tasks, interaction with the content, and task adaptation. This paper presents the efforts of creating RC v2.0, a VR-based software system for cognitive rehabilitation that presents different cognitive training tasks that take place in 8 realistically modeled 3D environments, that are personalized to the patient clinical profile and also implements automatic difficulty adaptation.
- Design and implementation of an integrative system for configurable exergames targeting the senior populationPublication . Paulino, Teresa; Cameirão, Mónica da Silva; Bermúdez i Badia, SergiExergames have been proposed as a solution for the promotion of physical activity in the senior population. The diversity of needs and limitations of the target users demand that the exergaming systems allow the configuration and adjustment of game parameters according to each user profile. Such systems are ideal to use in nursing homes, senior gymnasiums, or even rehabilitation centers. Health and sports professionals are then the main interacting users with the interface of such exergaming systems. Configuration can be difficult and time-consuming when considering complex systems with a significant amount of parameter choices. Since professionals working on such places already have time constraints, if they face long-time configuration of these systems they might give up of using them. Therefore, there is an evident need for systems that assist professionals in two ways. First, providing management support for training sessions and plans with exergames. Second, providing automatic decision-making processes that assist in game selection and parameters configuration to fit the user needs. The acceptance and effectiveness of such systems can only be achieved if the main prospective interactors with the system are involved in the development process so that the system can fulfill the users’ needs and expectations. This thesis reports on the design, implementation, and usability evaluation of an integrative system using some of the most-known human-centric techniques, such as interviews, card sorting, and paper prototyping. Results of a usability study of the UI and the main functionalities of the system showed a considerable acceptance and interest by the professionals. The usability study revealed to be a great resource to find aspects of the system that should be further considered for improvement in future iterations. Furthermore, the high results of the USE (Usefulness, Satisfaction, and Ease of use) questionnaire confirm that this system is a promising tool that sports professionals may be willing to use in their daily practice.