S Y Hadad J Fung P L Weiss C Perez B Mazer M F Levin and R Kizony

Rehabilitation Tools along the Reality Continuum:

From Mock-up to Virtual Interactive Shoppingto Living Lab

In collaboration with

1. Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa, Israel

2. Department of Occupational Therapy, Sheba Medical Center, Tel Hashomer, Israel.

3. School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.

4. Feil/Oberfeld/CRIR Research Centre, Jewish Rehabilitation Hospital, Laval, Quebec, Canada

Why Shopping?

Meaningful

IADL

Significant

Many new motor and cognitive difficulties after neurological injury

Difficult to return to similar function, especially the elderly

Only small percentage of post-stroke population continues to participate in complex life tasks.

During rehabilitation, difficult to assess and practice shopping tasks at a real supermarket

Importance of Practicing Shopping Task After Stroke

Why Shopping?

VR Desktop Based

Virtual Supermarkets

Therefore we have many virtual supermarkets

Castelnuovo , et al., 2003;

Josman et al., 2008; Klinger et al., 2004; Lee et al., 2003

IREX- VMall: Video Capture

VR System

Rand, et al., 2007; 2009; 2010

Virtual supermarkets

limited options of changing task

complexity

More complex set-up needed for

operation

integrating & assessing motor

and cognitive aspects

IREX - VMall: Video Capture

VR System

(Rand, et al., 2007)

Budget Management

integrating & assessing motor

and cognitive aspects

different stores that can be

changed & adapted

Virtual Interactive Shopper

SeeMe VIS

Video Capture is used without the

need of chroma key background

http://www.virtual-reality-rehabilitation.com/products/seeme/what-is-seeme

Virtual Supermarket

?

A Real Environment

The continuum between the Environments

Virtual Supermarket:

Physical MockUp Store:

A Real Environment:

The continuum between the Environments

VIS

“SuperModel”

“In-hospital Cafeteria”

Virtual Interactive Shopper

Virtual Interactive Shopper

Virtual Supermarket:

Physical MockUp Store:

A Real Environment:

The continuum between the Environments

VIS

“SuperModel”

“In-hospital Cafeteria”

Mock-up

Virtual Supermarket:

Physical MockUp Store:

A Real Environment:

The continuum between the Environments

VIS

“SuperModel”

“In-hospital Cafeteria”

Cafeteria

To explore the performance of shopping tasks in three different environments: a real environment, a physical mock-up and a virtual environment of post –stroke subjects as compared to healthy controls

To examine the relationship between performance of shopping tasks in the 3 environments

Objectives

Rationale The three environments (Virtual, MockUp, Real)

complement one another for the purposes of assessment and treatment of performance of complex IADL tasks during the rehabilitation process

The findings will lead to better understanding of how to use VEs in clinical settings for training skills needed for participation in everyday activities

Population:

6 Healthy Adults 5 female 1 male

Age (years) range: 56-77 mean ± SD: 63.5 ± 9.3

5 Inpatients After Stroke 2 female, 3 male

Age (years) range: 65-82 mean ± SD: 74.8 ± 6.6

Time since stroke (months): 1-7.5

FIM: 88.4 ± 19.5

MMSE: 26.4 ± 4.8

Experimental Task Experimental Task

Original Task: (Rand et al., 2007)•List is visible during test•Performed in VIS and MockUp•Outcome measures• Time to complete test• Number of errors (wrong item, not buying an item)

•Does not involve budget management.

Modified Task:•Performed in all 3 environments (VIS, MockUp & Cafeteria)•Involved budget handling (Type of error if incorrect)control subject.avi post stroke subject.AVI

“4 Items”

Time to complete both versions of the 4-item tests in all environments, for two groups

Results

Modified test in the

Cafeteria and VIS

Modified test in the

Mock-up and VIS

Performance of individuals

Post-stroke Control

Locations visited by one subject with stroke and one control within the virtual supermarket during the modified 4-item

test

Trajectory

Total Number of Errors

Number of Errors

Environment Task Post stroke (n=5)

Control (n=6)

VIS Original 12(5 subjects)

8(6 subjects)

Modified 4(1 subject)

2(2 subjects)

MockUp Original 1 0

Modified 5(3 subjects)

3(2 subjects)

Cafeteria Modified 1(1 subject)

4(2 subjects)

Total 23 17

Conclusions

VIS appears to be well suited for the assessment and training of the higher cognitive abilities needed for shopping

Shopping tasks may be adapted and graded Requires motor and cognitive aspects

VIS Performance results suggest that it is sensitive to differences between post-stroke subjects and healthy controls

Performance ability in 3 environments related For the post-stroke group, times to complete the modified 4-

item test in the VIS appear to correlate with both the times of the store mock-up and the cafeteria

Conclusions (Con’t)

Positive responses of all participants to VIS (n=11) according to Short Feedback Questionnaire -SFQ (Kizony et al., 2006) :

enjoyed the task (mean ± SD = 4.2 ± 0.9) reported that it appeared to be realistic (mean ± SD = 4.2 ± 0.9)

Further analysis needed to discern types of errors and ability of participants to self-correct.

Give a hand to shopping

Acknowledgements

Supported by :

Fonds de Recherche du Québec - Santé awarded to the Montreal Centre of Interdisciplinary Research in Rehabilitation (CRIR) to the "Living Lab“strategic innovative project: www.crir-livinglabvivant.com

Jewish Rehabilitation Hospital Foundation

Many thanks to:

Mr. Arie Burstin and Mrs. Riki Brown

My Supervisors: Dr Racheli Kizony and Prof Tamar Weiss

Bibliography

G Castelnuovo, C Lo Priore, D Liccione, G Cioffi (2003), Virtual reality based tools for the rehabilitation of cognitive and executive functions: The V- STORE, PsychNology, 1,3, pp. 310-325.

N Josman, E Klinger and R Kizony (2008), Performance within the virtual action planning supermarket (VAP-S): an executive function profile of three different populations suffering from deficits in the central nervous system, Proc. of 7th ICDVRAT with ArtAbilitation, pp.33- 38.

R Kizony, N Katz, D Rand and P L Weiss (2006), A Short Feedback Questionnaire (SFQ) to enhance client-centered participation in virtual environments, Proc. of 11th Annual Cybertherapy Conf. Virtual Healing: Designing Reality, Gatineau, Canada.

E Klinger, I Chemin, S Lebreton and R. M Marié (2004), A Virtual Supermarket to Assess Cognitive Planning, Cyberpsychol. Behav, 7, 3, pp.292-293.

J H Lee, J Ku, W Cho, W Y Hahn, I Y Kim, S Lee, Y M Kang, D Young-Kim, T Yu, B K Wiederhold, M D Wiederhold and S I Kim (2003), A virtual reality system for the assessment and rehabilitation of the activities of daily living, Cyberpsychol. Behav., 6, 4, pp.383-388.

Mitchell The Living Lab http://livinglabs.mit.edu/

D Rand, N Katz and P L Weiss (2007), Evaluation of virtual shopping in the VMall: Comparison of post-stroke participants to healthy control groups, Disabil. Rehabil., 29 ,22, pp. 1710-1719.

Virtual Reality Rehabilitation, SeeMe System. Retrieved September 4th , 2012 from: http://www.virtual-reality- rehabilitation.com/products/seeme/what- is-seeme

Bibliography