Design and performance analysis of a virtual reality-based telerehabilitation system

In recent years the area of medical VR applications has continuously expanded, addressing new domains such as home healthcare, clinical neuropsychology, and rehabilitation. The research presented here explores the use of Virtual Reality (VR) for telerehabilitation applications. A prototype platform for VR-based telerehabilitation was defined first. The main component of the platform is the hand force feedback unit. A programming library—the Rutgers Haptic Library—was developed for modeling hand haptic interactions. The software was used to build real-time VR simulations that involve elastic and plastic deformations and physical modeling.; The VR-based platform was the basic component of the telerehabilitation architectures we developed. These architectures use Virtual Reality as an advance interface for therapy as well as to enable communication between the therapist at the clinic/hospital and the remote patient or group of patients. The first prototype supports offline interaction between the therapist and the VR-enabled patient site. This “store and forward” system uses a Client/Server architecture. The client (patient home) runs VR rehabilitation exercises with force feedback and collects patient data. The exercises simulate physical and functional rehabilitation routines. Patient data are forwarded to the server (clinic site), which stores medical records and runs data analysis software. System performance over several types of connections was measured in laboratory experiments. The guidelines extracted from these experiments help sizing the system in terms of recorded data and number of concurrent users. Clinical trials were conducted at the Stanford University Medical School. Data collected during these trials indicates that patient's level of effort and grasping strength increased after using the VR-based rehabilitation system.; “Store and forward” systems are insufficient for implementing the whole range of potential telerehabilitation services. The second architecture developed in this thesis uses a Shared Virtual Environment to enable real-time patient-therapist interaction. The prototype system allows the therapist to perform remote physical therapy and collect patient data. Simulated physical interactions between therapist and patient were implemented using force feedback.