User-centered design of a multisensory power wheelchair simulator: towards training and rehabilitation applications

Evaluation of power wheelchair driving performance in simulator compared to driving in real-life situations: the SIMADAPT (simulator ADAPT) project-a pilot study

OBJECTIVE

The objective of this study was to evaluate users' driving performances with a Power Wheelchair (PWC) driving simulator in comparison to the same driving task in real conditions with a standard power wheelchair.

METHODS

Three driving circuits of progressive difficulty levels (C1, C2, C3) that were elaborated to assess the driving performances with PWC in indoor situations, were used in this study. These circuits have been modeled in a 3D Virtual Environment to replicate the three driving task scenarios in Virtual Reality (VR). Users were asked to complete the three circuits with respect to two testing conditions during three successive sessions, i.e. in VR and on a real circuit (R). During each session, users completed the two conditions. Driving performances were evaluated using the number of collisions and time to complete the circuit. In addition, driving ability by Wheelchair Skill Test (WST) and mental load were assessed in both conditions. Cybersickness, user satisfaction and sense of presence were measured in VR. The conditions R and VR were randomized.

RESULTS

Thirty-one participants with neurological disorders and expert wheelchair drivers were included in the study. The driving performances between VR and R conditions were statistically different for the C3 circuit but were not statistically different for the two easiest circuits C1 and C2. The results of the WST was not statistically different in C1, C2 and C3. The mental load was higher in VR than in R condition. The general sense of presence was reported as acceptable (mean value of 4.6 out of 6) for all the participants, and the cybersickness was reported as acceptable (SSQ mean value of 4.25 on the three circuits in VR condition).

CONCLUSION

Driving performances were statistically different in the most complicated circuit C3 with an increased number of collisions in VR, but were not statistically different for the two easiest circuits C1 and C2 in R and VR conditions. In addition, there were no significant adverse effects such as cybersickness. The results show the value of the simulator for driving training applications. Still, the mental load was higher in VR than in R condition, thus mitigating the potential for use with people with cognitive disorders. Further studies should be conducted to assess the quality of skill transfer for novice drivers from the simulator to the real world. Trial registration Ethical approval n∘ 2019-A001306-51 from Comité de Protection des Personnes Sud Mediterranée IV. Trial registered the 19/11/2019 on ClinicalTrials.gov in ID: NCT04171973.

Development of a lumbar puncture virtual simulator for medical students training: A preliminary evaluation

BACKGROUND

Lumbar puncture is an essential medical procedure whose objective is to obtain cerebrospinal fluid. Lumbar puncture is considered a complex procedure, mainly for novice residents who suffer from stress and low confidence, which may result in harm to the patient.

METHODS

The LPVirSim, has been developed in four stages: i) requirements analysis through user-centred design; ii) prototyping of the virtual environment and the haptic component; iii) preliminary tests with Ph.D. students and physicians using two haptic devices (Omega.7 and Sigma.7); iv) a user study where physicians evaluated the usability and user experience.

RESULTS

The LPVirSim integrates non-technical skills and the possibility of representing different patients for training. Usability increased from 61.76 to 68.75 in the preliminary tests to 71.43 in the user study.

CONCLUSIONS

All the results showed good usability and demonstrated that the simulator arouses interest and realistically represents a Lumbar puncture, through the force and visual feedback.

Clinical stakeholders' perspective for the integration of an immersive wheelchair simulator as a clinical tool for powered wheelchair training

This study aimed to investigate clinical stakeholders' acceptance of an immersive wheelchair simulator as a potential powered wheelchair skills training tool. Focus groups, conducted in four rehabilitation centers, were used to obtain a rich understanding of participants' experiences and beliefs. Then, a cross-sectional survey of the simulator acceptability for clinical practice was created. Twenty-three rehabilitation therapists and clinical program directors participated in the focus groups and thirty-three responded to the survey. Participants generally expressed that use of the simulator would be complementary to training in an actual powered wheelchair, and that it could be useful for challenging situations in rehabilitation centers (e.g. anxious clients; when there is uncertainty around their potential to drive a powered wheelchair; tasks that cannot be assessed in a real-life environment). They also provided suggestions to improve the simulator (e.g. more feedback during tasks; possibility of adjusting control settings such as speed and sensitivity; possibility of adding varied control interfaces). Feedback received from key stakeholders clearly indicated that the wheelchair simulator would be complementary to training provided in a real context of use. However, some important limitations must be addressed to improve the simulator and promote its adoption by clinical programs, therapists and clients.

Skills assessment metrics of electric powered wheelchair driving in a virtual environment: a survey

The purpose of this review is to present studies on the parameters for assessing the skills of users of electric wheelchair driving simulators in a virtual environment. In addition, this study also aims to identify the most widely used and validated parameters for the quantification of electric wheelchair driving ability in a virtual environment and to suggest challenges for future research. To carry out this research, the criteria of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were adopted. Literature searches in English, French, and Portuguese were conducted up to December 2020 in the PubMed, SciELO, Science Direct, World Wide Science, and Scopus databases. The keywords used were electric wheelchair, simulator, performance indicators, performance skills, driving skills, training platform, virtual environment, and virtual reality. We excluded studies involving "real" wheelchairs without a simulator in a virtual environment. We have selected a total of 42 items. In these studies, we identified 32 parameters (3 qualitative and 29 quantitative) that are used as parameters for the evaluation of the ability to control a powered wheelchair in a virtual environment. Although the amount of research in this area has increased significantly in recent years, additional studies are still needed to provide a more accurate and objective assessment of skills among the target population. A challenge for future work is the increasing application of artificial intelligence techniques and the exploration of biomedical data measurements, which may be a promising alternative to improve the quantification of user competencies.

Virtual Reality-Based Framework to Simulate Control Algorithms for Robotic Assistance and Rehabilitation Tasks through a Standing Wheelchair

The implementation of control algorithms oriented to robotic assistance and rehabilitation tasks for people with motor disabilities has been of increasing interest in recent years. However, practical implementation cannot be carried out unless one has the real robotic system availability. To overcome this drawback, this article presents the development of an interactive virtual reality (VR)-based framework that allows one to simulate the execution of rehabilitation tasks and robotic assistance through a robotic standing wheelchair. The virtual environment developed considers the kinematic and dynamic model of the standing human–wheelchair system with a displaced center of mass, since it can be displaced for different reasons, e.g.,: bad posture, limb amputations, obesity, etc. The standing wheelchair autonomous control scheme has been implemented through the Full Simulation (FS) and Hardware in the Loop (HIL) techniques. Finally, the performance of the virtual control schemes has been shown by means of several experiments based on robotic assistance and rehabilitation for people with motor disabilities.