UBC Theses and Dissertations

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UBC Theses and Dissertations

Using error augmentation in immersive virtual reality for bimanual upper-limb rehabilitation Shum, Leia Carmel


A common treatment for people with motor disabilities due to neurological injuries, such as Cerebral Palsy, is physiotherapy. However, the repetitive nature of clinical upper-limb rehabilitation exercises can lead to a decrease in patient adherence, and so, there is a need for more engaging methods of motor task training that can be used in inexpensive at-home programs. One such alternate solution is the use of exergaming technology, which harnesses commercially available motion-tracking gaming hardware to administer rehabilitative exercises that provide automated real-time feedback and engaging game mechanics. In addition to real-time feedback during exercises in the form of binary visual cues, reminders, and scores, Error augmentation (EA), or dynamic feedback based on deviation from desired movement patterns, has been shown to provide an increased rate of improvement in motor ability. The goal of this thesis study was to build upon the idea of training with EA and to evaluate the effectiveness of the amplification of asymmetry between the two upper limbs during a bilateral reaching movement. To test if this mode of error augmentation increases symmetry in the forward-reaching direction, a bimanual training task was developed in an immersive virtual reality environment. A single-session crossover study design was used to test if participants could reach with more bilateral symmetry when training with EA. Participants with hemiplegia and healthy age-matched participants completed training sets with and without EA. Results found a significant difference in symmetry between the two sets in the typically developing participant group. Both primary and secondary outcomes showed high variability in between-participant averages; it is suggested that a future study be conducted with a larger sample size of participants with hemiplegia. While statistically significant differences could not be found for the target clinical population, the effect of EA on the typically developing participant group provides a promising indication of a useful feedback modality that could be used in future upper-limb rehabilitation tools.

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