title: The feasibility of using haptic devices to engage people with chronic traumatic brain injury in virtual 3D functional tasks.
abstract: BACKGROUND
  The primary aim of this study was to assess the level of engagement in computer-based simulations of functional tasks, using a haptic device for people with chronic traumatic brain injury. The objectives were to design functional tasks using force feedback device and determine if it could measure motor performance improvement.
  
  
  METHODS
  A prospective crosssectional study was performed in a biomedical research facility. The testing environment consisted of a single, interactive, stylus-driven computer session navigating virtual scenes in 3D space. Subjects had a haptic training session (TRAIN) and then had three chances to perform each virtual task: (i) remove tools from a workbench (TOOL), (ii) compose 3 letter words (SPELL), (iii) manipulate utensils to prepare a sandwich (SAND), and (iv) tool use (TUSE). Main Outcome Measures included self-report of engagement in the activities, improved performance on simulated tasks and observer estimate as measured by time to completion or number of words completed from baseline, correlations among performance measures and self-reports of boredom, neuropsychological symptom inventory (NSI), and The Purdue Peg Motor Test (PPT).
  
  
  RESULTS
  Participants were 19 adults from the community with a 1 year history of non-penetrating traumatic brain injury (TBI) and were able to use computers. Seven had mild, 3 moderate and 9 severe TBIs. Mean score on the Boredom Proneness Scale (BPS): 107 (normal range 81-117); mean NSI:32; mean PPT 54 (normal range for assembly line workers >67). Responses to intervention: 3 (15%)subjects did not repeat all three trials of the tasks; 100% reported they were highly engaged in the interactions; 6 (30%) reported they had a high level of frustration with the tasks, but completed them with short breaks. Performance measures: Comparison of baseline to post training: TOOL time decreased by (mean) 60 sec; SPELL increased by 2.7 words; TUSE time decreased by (mean) 68 sec; and SAND time decreased by (mean) 72 sec. PPT correlated with TOOL (r=-0.65, p=0.016) and TUSE time (r=-0.6, p=0.014). SPELL correlated with Boredom score (r=0.41, p=0.08) and NSI (r=-.49, p=0.05).
  
  
  CONCLUSIONS
  People with chronic TBI of various ages and severity report being engaged in using haptic devices that interact with 3D virtual environments. Haptic devices are able to capture objective data that provide useful information about fine motor and cognitive performance.
authors.affiliation: Center for the Study of Chronic Illness and Disability, George Mason University, 4400 University Dr,, 22030 Fairfax, VA, USA. ngerber1@gmu.edu.
authors.forename: Lynn H
authors.initials: LH
authors.lastname: Gerber
authors.forename: Cody G
authors.initials: CG
authors.lastname: Narber
authors.forename: Nalini
authors.initials: N
authors.lastname: Vishnoi
authors.forename: Sidney L
authors.initials: SL
authors.lastname: Johnson
authors.forename: Leighton
authors.initials: L
authors.lastname: Chan
authors.forename: Zoran
authors.initials: Z
authors.lastname: Duric
mesh_terms: D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000534:rehabilitation*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014584:User-Computer Interface
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