Virtual rehabilitation games have gained increased clinical acceptance in the therapy of patients post stroke or traumatic brain injury. This is due to their ability to motivate, as well as intrinsic large number of movement repetitions that are keys to inducing brain plasticity and facilitating recovery. Unfortunately, bi-manual therapy, while potentially more efficacious, is less developed at this time. The novel RABIT system combines physical and cognitive training in integrative game-play sessions. Using the Razer Hydra game interface, the patients playa series of custom games designed to improve focusing, decision making (executive function), short-term and long-term memory, progressing in difficulty over 6 weeks of therapy.

The convergence of game technology, the Internet, and rehabilitation science forms the second-generation virtual rehabilitation framework. This paper presents the first pilot study designed to look at the feasibility of at-home use of gaming technology adapted to address hand impairments in adolescents with hemiplegia due to perinatal stroke or intraventricular hemorrhage. Three participants trained at home for approximately 30 min/day, several days a week, for six to ten months. During therapy, they wore a fifths dimension technologies ultra sensing glove and played custom-developed Java 3D games on a modified PlayStation 3. The games were designed to accommodate the participants' limited range of motion, and to improve finger range and speed of motion. Trials took place in Indiana, while monitoFring/data storage took place at Rutgers Tele-Rehabilitation Institute (New Jersey). Significant improvements in finger range of motion (as measured by the sensing glove) were associated with self- and family-reported improvements in activities of daily living. In online subjective evaluations, participants indicated that they liked the system ease of use, clarity of instructions, and appropriate length of exercising. Other telerehabilitation studies are compared to this study and its technology challenges. Directions for future research are included.

Summary form only for tutorial. This tutorial is intended for those new to the VR/VE field. It will present topics related to Input Devices (such as and Gesture Interfaces), Output Devices (such as Haptic Displays and auto-stereoscopic displays), Computing Architectures for VR, Modeling of virtual objects, VR Programming issues, Human Factors in VR (user performance evaluations and cybersickness) and VR Applications. The tutorial is based on the textbook published by the Instructor and class slides from his courses at Rutgers University.

Guest Editorial: Special Issue on Haptics, Virtual, and Augmented Reality

Provides an abstract of the tutorial presentation and a brief professional biography of the presenter. The complete presentation was not made available for publication as part of the conference proceedings.

Virtual Reality (VR) technology continues to evolve from the realm of an “expensive toy” into that of a functional technology. Although media hype may have oversold VR’s potential during the early 90’s, data has now emerged that supports its use as a valuable tool for cognitive, behavioral, physical, mental health and medical applications. Much like an aircraft simulator serves to test and train pilots under a variety of controlled conditions, VE simulations can model processes that are vital in the assessment, rehabilitation and treatment of clinical populations. In this regard, a growing number of laboratories are developing research programs investigating the use of VEs for these patient purposes and some of these systems have now made the transition into clinical practice. The presenters for this workshop have all developed and/or implemented VR applications that have shown promise for addressing fear reduction with phobic clients, pain and stress reduction for cancer patients, post traumatic stress disorder, physical therapy, anger management, driving abilities with Multiple Sclerosis and brain injury patients, and in the assessment and rehabilitation of motor skills, attention, memory, and vis uospatial processing in persons with central nervous system dysfunction and the elderly. These therapeutic targets reflect an informed appreciation of the unique assets that are available when using VR technology and provide a foundation of work that is supportive of the further development of these “healing” applications. The presenters will detail their work and support the case that these areas represent the “Kinder Killer App”!

A PC based desktop Virtual Reality system was developed for rehabilitating hand function in stroke patients. The system uses two hand input devices, a CyberGlove and a RMII force feedback glove, to allow the user to interact with one of four rehabilitation exercises. Each of which is designed to exercise one specific parameter of hand movement, namely range, speed, fractionation or strength. The therapy program is semi-automated and personalized to each user through the use of performance-based target levels. These are adapted between sessions in order to induce the user to improve. Feedback is provided to each user throughout the exercise sessions. To further motivate the user to continue the exercise program, screen displays are designed as interactive games. The system is described and sample data is presented from preliminary studies performed on control subjects.

Haptics is a recent enhancement to virtual environments, allowing users to "touch" and feel the simulated objects they interact with. Current commercial products allow tactile feedback through desktop interfaces (such as the FEELIt/sup TM/ mouse or the PHANToM/sup TM/ arm) and dextrous tactile and force feedback at the fingertips through haptic gloves (such as the CyberTouch/sup TM/ and the CyberGrasp/sup TM/). Virtual reality haptic programming requires good physical modeling of user interactions, primarily through collision detection, and of object responses, such as surface deformation, hard-contact simulation, slippage, etc. It is at present difficult to simulate complex virtual environments that have a realistic behavior. This task is added to by the recent introduction of haptic toolkits (such as Ghost/sup TM/ or VPS). Current technology suffers from a number of limitations, which go beyond the higher production cost of haptic interfaces. These technical drawbacks include the limited workspace of desktop interfaces, the large weight of force-feedback gloves, the lack of force feedback to the body, safety concerns, etc. Not to be neglected is the high bandwidth requirement of haptics, which is not met by current Internet technology. As a result, it is not possible at present to have a large number of remote participants interacting haptically in a shared virtual space.

A PC-based orthopedic rehabilitation system was developed for use at home, while allowing remote monitoring from the clinic. The home rehabilitation station has a Pentium II PC with graphics accelerator, a Polhemus tracker, and a multipurpose haptic control interface. This novel interface is used to sample a patient's hand positions and to provide resistive forces using the Rutgers Master II (RMII) glove. A library of virtual rehabilitation routines was developed using WorldToolKit software. At the present time, it consists of three physical therapy exercises (DigiKey, ball, and power putty) and two functional rehabilitation exercises (peg board and ball game). These virtual reality exercises allow automatic and transparent patient data collection into an Oracle database. A remote Pentium II PC is connected with the home-based PC over the Internet and an additional video conferencing connection. The remote computer is running an Oracle server to maintain the patient database, monitor progress, and change the exercise level of difficulty. This allows for patient progress monitoring and repeat evaluations over time. The telerehabilitation system is in clinical trails at Stanford Medical School (CA), with progress being monitored from Rutgers University (NJ). Other haptic interfaces currently under development include devices for elbow and knee rehabilitation connected to the same system.

The recent addition of force and touch feedback to virtual reality simulations has enhanced their realism. Research on haptics interfaces is now extended to physical modeling of contact surfaces, object hardness, surface deformation, etc. This is especially needed when dextrous manipulation of virtual objects is concerned. The paper describes a VR system using a haptic glove (Rutgels Master II) connected to a PC workstation, and a new method for modeling virtual hand haptic interactions. An application example presented here is an orthopedic rehabilitation library. The exercises in this library involve interactions with dynamic objects and physical modeling of plasticity.

To a large extent the robotics and the newer virtual reality (VR) research communities have been working in isolation. This article reviews three areas where integration of the two technologies can be beneficial. First, we consider VR-enhanced CAD design, robot programming, and plant layout simulation. Subsequently, we discuss how VR is being used in supervisory teleoperation, for single operator-single robot systems, single operator multiplexed to several slave robots, and collaborative control of a single robot by multiple operators. Here VR can help overcome problems related to poor visual feedback as well as system instabilities due to time delays. Finally, we show how robotics can be beneficial to VR in general, since robots can serve as force feedback interfaces to the simulation. Newer back-drivable manipulators offer increased safety for the user that closely interacts with the robot. The synergy between the fields of robotics and virtual reality is expected to grow in years to come.

Virtual reality (VR) involves multimodal interactions with computer‐simulated worlds through visual, auditory, and haptic feedback. This article reviews the state of the art in special‐purpose input‐output devices, such as trackers, sensing gloves, 3‐D audio cards, stereo displays, and haptic feedback masters. The integration of these devices in local and network‐distributed VR simulation systems is subsequently discussed. Finally, we present human‐factor studies that quantify the benefits of several feedback modalities on simulation realism and sensorial immersion. Specifically, we consider tracking and dextrous manipulation task performance in terms of error rates and learning times when graphics, audio, and haptic feedback are provided.

Dental subtraction radiography requires accurate repositioning of the patient and X-ray source in order to correctly diagnose decay, movement, or bone loss. Present mechanical repositioning systems do not allow the imaging of the teeth in the back of the mouth, and are uncomfortable for the patient. A new repositioning system that utilizes a six-degree-of-freedom position sensor and a robot arm with an X-ray source is proposed. A model for the system is given, and an error analysis is performed to determine the influence of sensor and robot errors. Experiments performed to determine sensor noise and accuracy are described. Further tests showed that there is no adverse effect due to the presence of metal work in the patient's mouth.>

An integrated vision-manipulation algorithm for assembly of apictorial jigsaw puzzles is presented. A discussion is presented of the solution of large jigsaw puzzles using vision, combinatorial optimization, and fine assembly techniques. The implementations of a vision algorithm for assembly of large jigsaw puzzles and a fully integrated robotic-vision algorithm for assembly of small puzzles are presented. The problem of assembling pieces with unpredictable shape is discussed.>