New Approaches to Exciting Exergame-Experiences for People with Motor Function Impairments.

The work presented here suggests new ways to tackle exergames for physical rehabilitation and to improve the players' immersion and involvement. The primary (but not exclusive) purpose is to increase the motivation of children and adolescents with severe physical impairments, for doing their required exercises while playing. The proposed gaming environment is based on the Kinect sensor and the Blender Game Engine. A middleware has been implemented that efficiently transmits the data from the sensor to the game. Inside the game, different newly proposed mechanisms have been developed to distinguish pure exercise-gestures from other movements used to control the game (e.g., opening a menu). The main contribution is the amplification of weak movements, which allows the physically impaired to have similar gaming experiences as the average population. To test the feasibility of the proposed methods, four mini-games were implemented and tested by a group of 11 volunteers with different disabilities, most of them bound to a wheelchair. Their performance has also been compared to that of a healthy control group. Results are generally positive and motivating, although there is much to do to improve the functionalities. There is a major demand for applications that help to include disabled people in society and to improve their life conditions. This work will contribute towards providing them with more fun during exercise.

AEKF-SLAM: A New Algorithm for Robotic Underwater Navigation.

In this work, we focus on key topics related to underwater Simultaneous Localization and Mapping (SLAM) applications. Moreover, a detailed review of major studies in the literature and our proposed solutions for addressing the problem are presented. The main goal of this paper is the enhancement of the accuracy and robustness of the SLAM-based navigation problem for underwater robotics with low computational costs. Therefore, we present a new method called AEKF-SLAM that employs an Augmented Extended Kalman Filter (AEKF)-based SLAM algorithm. The AEKF-based SLAM approach stores the robot poses and map landmarks in a single state vector, while estimating the state parameters via a recursive and iterative estimation-update process. Hereby, the prediction and update state (which exist as well in the conventional EKF) are complemented by a newly proposed augmentation stage. Applied to underwater robot navigation, the AEKF-SLAM has been compared with the classic and popular FastSLAM 2.0 algorithm. Concerning the dense loop mapping and line mapping experiments, it shows much better performances in map management with respect to landmark addition and removal, which avoid the long-term accumulation of errors and clutters in the created map. Additionally, the underwater robot achieves more precise and efficient self-localization and a mapping of the surrounding landmarks with much lower processing times. Altogether, the presented AEKF-SLAM method achieves reliably map revisiting, and consistent map upgrading on loop closure.

An Improved Otsu Threshold Segmentation Method for Underwater Simultaneous Localization and Mapping-Based Navigation.

The main focus of this paper is on extracting features with SOund Navigation And Ranging (SONAR) sensing for further underwater landmark-based Simultaneous Localization and Mapping (SLAM). According to the characteristics of sonar images, in this paper, an improved Otsu threshold segmentation method (TSM) has been developed for feature detection. In combination with a contour detection algorithm, the foreground objects, although presenting different feature shapes, are separated much faster and more precisely than by other segmentation methods. Tests have been made with side-scan sonar (SSS) and forward-looking sonar (FLS) images in comparison with other four TSMs, namely the traditional Otsu method, the local TSM, the iterative TSM and the maximum entropy TSM. For all the sonar images presented in this work, the computational time of the improved Otsu TSM is much lower than that of the maximum entropy TSM, which achieves the highest segmentation precision among the four above mentioned TSMs. As a result of the segmentations, the centroids of the main extracted regions have been computed to represent point landmarks which can be used for navigation, e.g., with the help of an Augmented Extended Kalman Filter (AEKF)-based SLAM algorithm. The AEKF-SLAM approach is a recursive and iterative estimation-update process, which besides a prediction and an update stage (as in classical Extended Kalman Filter (EKF)), includes an augmentation stage. During navigation, the robot localizes the centroids of different segments of features in sonar images, which are detected by our improved Otsu TSM, as point landmarks. Using them with the AEKF achieves more accurate and robust estimations of the robot pose and the landmark positions, than with those detected by the maximum entropy TSM. Together with the landmarks identified by the proposed segmentation algorithm, the AEKF-SLAM has achieved reliable detection of cycles in the map and consistent map update on loop closure, which is shown in simulated experiments.

Efficient Forest Fire Detection Index for Application in Unmanned Aerial Systems (UASs).

This article proposes a novel method for detecting forest fires, through the use of a new color index, called the Forest Fire Detection Index (FFDI), developed by the authors. The index is based on methods for vegetation classification and has been adapted to detect the tonalities of flames and smoke; the latter could be included adaptively into the Regions of Interest (RoIs) with the help of a variable factor. Multiple tests have been performed upon database imagery and present promising results: a detection precision of 96.82% has been achieved for image sizes of 960 × 540 pixels at a processing time of 0.0447 seconds. This achievement would lead to a performance of 22 f/s, for smaller images, while up to 54 f/s could be reached by maintaining a similar detection precision. Additional tests have been performed on fires in their early stages, achieving a precision rate of p = 96.62%. The method could be used in real-time in Unmanned Aerial Systems (UASs), with the aim of monitoring a wider area than through fixed surveillance systems. Thus, it would result in more cost-effective outcomes than conventional systems implemented in helicopters or satellites. UASs could also reach inaccessible locations without jeopardizing people's safety. On-going work includes implementation into a commercially available drone.

A Survey on Underwater Acoustic Sensor Network Routing Protocols.

Underwater acoustic sensor networks (UASNs) have become more and more important in ocean exploration applications, such as ocean monitoring, pollution detection, ocean resource management, underwater device maintenance, etc. In underwater acoustic sensor networks, since the routing protocol guarantees reliable and effective data transmission from the source node to the destination node, routing protocol design is an attractive topic for researchers. There are many routing algorithms have been proposed in recent years. To present the current state of development of UASN routing protocols, we review herein the UASN routing protocol designs reported in recent years. In this paper, all the routing protocols have been classified into different groups according to their characteristics and routing algorithms, such as the non-cross-layer design routing protocol, the traditional cross-layer design routing protocol, and the intelligent algorithm based routing protocol. This is also the first paper that introduces intelligent algorithm-based UASN routing protocols. In addition, in this paper, we investigate the development trends of UASN routing protocols, which can provide researchers with clear and direct insights for further research.

Context Aware Middleware Architectures: Survey and Challenges.

Context aware applications, which can adapt their behaviors to changing environments, are attracting more and more attention. To simplify the complexity of developing applications, context aware middleware, which introduces context awareness into the traditional middleware, is highlighted to provide a homogeneous interface involving generic context management solutions. This paper provides a survey of state-of-the-art context aware middleware architectures proposed during the period from 2009 through 2015. First, a preliminary background, such as the principles of context, context awareness, context modelling, and context reasoning, is provided for a comprehensive understanding of context aware middleware. On this basis, an overview of eleven carefully selected middleware architectures is presented and their main features explained. Then, thorough comparisons and analysis of the presented middleware architectures are performed based on technical parameters including architectural style, context abstraction, context reasoning, scalability, fault tolerance, interoperability, service discovery, storage, security & privacy, context awareness level, and cloud-based big data analytics. The analysis shows that there is actually no context aware middleware architecture that complies with all requirements. Finally, challenges are pointed out as open issues for future work.

Personalized Use of an Adjustable Movement-Controlled Video Game in Obstetric Brachial Plexus Palsy during Physiotherapy Sessions at School: A Case Report.

This case study explores the use of a personalized, adjustable Kinect exergame in 10 physiotherapy sessions for a 10-year-old girl with incomplete right-sided obstetric brachial plexus palsy (OBPP). The aim was to observe the impact on the patient's upper limb mobility that could be achieved through maximization of the player's motivation, possibly due to continuous game parameter adjustments. It had been achieved that the patient was playing 87% of the total gaming time with a personally challenging setting that increased her arm speed from one to four movements. Strength in abduction and flexion were increased by 8 N and 7 N, respectively. Furthermore, the patient showed better muscular balance and an increase of 50% in speed of the Jebsen-Taylor hand function test (JTHFT). The patient reported high levels of motivation, low perception of fatigue, and just slight discomfort. The study found that the use of personalized video games as a complement to conventional physiotherapy can be successful in OBPP patients when the game allows for the adjustment of the difficulty level as a response to personal performance. Predefined difficulty levels and automatic performance analysis can be helpful. Results are promising; however, further research is needed to confirm the results.

Finding Effective Adjustment Levels for Upper Limb Exergames: Focus Group Study With Children With Physical Disabilities.

BACKGROUND: We developed the Blexer system consisting of a database and a web interface for therapists that can host different types of adaptive and personally configurable virtual reality exergames based on Kinect (Microsoft Corp) motion capture to provide entertaining exercises for children with motor disabilities. It allows for parameter adjustment and the monitoring of results remotely, thereby providing a useful tool to complement traditional physical therapy sessions with home exercises. OBJECTIVE: The aim of this study was to observe the motor benefits achieved through the use of a video exergame and the importance and implications of correctly setting the game's difficulty parameters. METHODS: This was an observational case study of 6 children with different physical disabilities receiving physical therapy at school combined with the use of a fully configurable exergame under research that forms a part of the Blexer environment. The game integrates 4 repeatedly appearing upper limb exercises with individually adjustable difficulties (intermittent arm rising, arm forward and backward movement, rising and holding of one arm, and trunk control in all directions). The outcomes were 3 assessments of 2 efficacy measures: Box and Block Test and Jebsen Taylor Hand Function Test. RESULTS: A total of 5 children with cerebral palsy (mean 8.4, SD 2.7 years; Gross Motor Function Classification II-2/5, 40%; III-2/5, 40%; and IV-1/5, 20%) and 1 child with obstetric brachial plexus palsy (aged 8 years; Mallet Classification III) received between 8 and 11 sessions of training (10-20 minutes per session), depending on age, motivation, and fatigue. Significant associations were observed between game parameter settings and improvements in motor function, on the one hand, and between the type of improvement and disability severity, on the other: with adjusted game parameters goal and time in the range of 70% to 100%, only less affected children improved in the Box and Block Test (+11 blocks vs -1 block), and more affected children improved more in the Jebsen Taylor Hand Function Test (+90 seconds vs +27 seconds). CONCLUSIONS: When defining the difficulty parameters for an exergame, we suggest a classification in levels ranging from very easy to very hard. For practical use, we suggest setting the difficulty for the player to an easy or medium level rather than high-commitment goals, as this leads to a longer playtime with more fun and, therefore, seems to improve the results of the game and, consequently, mobility.

Use of Virtual Reality and Videogames in the Physiotherapy Treatment of Stroke Patients: A Pilot Randomized Controlled Trial.

A stroke is a neurological condition with a high impact in terms of physical disability in the adult population, requiring specific and effective rehabilitative approaches. Virtual reality (VR), a technological approach in constant evolution, has great applicability in many fields of rehabilitation, including strokes. The aim of this study was to analyze the effects of a traditional neurological physiotherapy-based approach combined with the implementation of a specific VR-based program in the treatment of patients following rehabilitation after a stroke. Participants (n = 24) diagnosed with a stroke in the last six months were randomly allocated into a control group (n = 12) and an experimental group (n = 12). Both groups received one-hour sessions of neurological physiotherapy over 6 weeks, whilst the experimental group was, in addition, supplemented with VR. Patients were assessed through the Daniels and Worthingham Scale, Modified Ashworth Scale, Motor Index, Trunk Control Test, Tinetti Balance Scale, Berg Balance Scale and the Functional Ambulation Classification of the Hospital of Sagunto. Statistically significant improvements were obtained in the experimental group with respect to the control group on the Motricity Index (p = 0.005), Trunk Control Test (p = 0.008), Tinetti Balance Scale (p = 0.004), Berg Balance Scale (p = 0.007) and the Functional Ambulation Classification of the Hospital of Sagunto (p = 0.038). The use of VR in addition to the traditional physiotherapy approach is a useful strategy in the treatment of strokes.

Serious Game for the Screening of Central Auditory Processing Disorder in School-Age Children: Development and Validation Study.

BACKGROUND: Currently, many central auditory processing disorder screening tests are available for children, and serious games (SGs) are frequently used as a tool for the diagnosis of different neural deficits and disorders in health care. However, it has not been possible to find a proposal that unifies both ideas. In addition, the validation and improvement of SGs, in general, does not take into account the player-game interaction, thus omitting valuable information about the playability and usability of the game. OBJECTIVE: This study presented Amalia's Planet, a game conceived for use in school environments, which allows a first assessment of a child through their performance of the proposed tasks related to different aspects of auditory performance. In addition, the game defines a series of events in relation to the execution of the tasks, which were evaluated for the subsequent optimization of its performance and the improvement of its usability. METHODS: Using screening tools based on the use of SG technologies, a total of 87 school-age children were evaluated to test the various hypotheses proposed in this study. By grouping users according to whether they had personal history of hearing pathologies, the discriminant power, playability, and usability of the final solution were examined using traditional statistical techniques and process mining (PM) algorithms. RESULTS: With a confidence level of 80% for test 2 (P=.19), there was no statistical evidence to reject the null hypothesis that a player's performance is affected by whether the player had a previous auditory pathology. Furthermore, the tool allowed the screening of 2 players initially categorized as healthy because of their low level of performance in the tests and the similarity of their behavior with that of the group of children with a previous pathology. With regard to the validation of the proposed solution, the use of PM techniques made it possible to detect the existence of events that lasted too long, which can lead to player frustration, and to discover small structural flaws in the game. CONCLUSIONS: SGs seem to be an appropriate tool for the screening of children at risk of central auditory processing disorder. Moreover, the set of PM techniques provides a reliable source of information regarding the playability and usability of the solution to the development team, allowing its continuous optimization.

A New Architecture for Customizable Exergames: User Evaluation for Different Neuromuscular Disorders.

This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to different diseases and states of disease. The game is based on motion capturing and integrates four example exercises that can be configured via our therapeutic web platform "Blexer-med". To prove the feasibility for a wide range of different users, evaluation tests were performed on 14 patients with various types and degrees of neuromuscular disorders, classified into three groups based on strength and autonomy. The users were free to choose their schedule and frequency. The game scores and three surveys (before, during, and after the intervention) showed similar experiences for all groups, with the most vulnerable having the most fun and satisfaction. The players were motivated by the story and by achieving high scores. The average usage time was 2.5 times per week, 20 min per session. The pure exercise time was about half of the game time. The concept has proven feasible and forms a reasonable basis for further developments. The full 3D exercise needs further fine-tuning to enhance the fun and motivation.

MoKey: A versatile exergame creator for everyday usage.

Currently, virtual applications for physical exercises are highly appreciated as rehabilitation instruments. This article presents a middleware called "MoKey" (Motion Keyboard), which converts standard off-the-shelf software into exergames (exercise games). A configurable set of gestures, captured by a motion capture camera, is translated into the key strokes required by the chosen software. The present study assesses the tool regarding usability and viability on a heterogeneous group of 11 participants, aged 5 to 51, with moderate to severe disabilities, and mostly bound to a wheelchair. In comparison with FAAST (The Flexible Action and Articulated Skeleton Toolkit), MoKey achieved better results in terms of ease of use and computational load. The viability as an exergame creator tool was proven with help of four applications (PowerPoint®, e-book reader, Skype®, and Tetris). Success rates of up to 91% have been achieved, subjective perception was rated with 4.5 points (from 0-5). The middleware provides increased motivation due to the use of favorite software and the advantage of exploiting it for exercise. Used together with communication software or online games, social inclusion can be stimulated. The therapists can employ the tool to monitor the correctness and progress of the exercises.