Feasibility of a serious game system including a tangible object for post stroke upper limb rehabilitation: a pilot randomized clinical study.

Introduction: Serious games can be used to provide intensive rehabilitation through attractive exercises as part of post-stroke rehabilitation. However, currently available commercial and serious games systems primarily train shoulder and elbow movements. These games lack the grasping and displacement components that are essential to improve upper limb function. For this reason, we developed a tabletop device that encompassed a serious game with a tangible object to rehabilitate combined reaching and displacement movements: the Ergotact system. Objectives: The aim of this pilot study was to assess the feasibility and the short-term effects of a training program using the Ergotact prototype in individuals with chronic stroke. Methods: Participants were assigned to one of two groups: a serious game training group (Ergotact) or a control training group (Self). Results: Twenty-eight individuals were included. Upper limb function increased after the Ergotact training program, although not statistically significantly, and the program did not induce pain or fatigue, demonstrating its safety. Conclusion: The Ergotact system for upper limb rehabilitation was well accepted and induced participant satisfaction. It complies with current recommendations for people with stroke to autonomously perform intensive active exercises in a fun context, in addition to conventional rehabilitation sessions with therapists. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT03166020?term=NCT03166020&draw=2&rank=1, identifier NCT03166020.

Training haptic stiffness discrimination: time course of learning with or without visual information and knowledge of results.

OBJECTIVE: In this study, we explored the time course of haptic stiffness discrimination learning and how it was affected by two experimental factors, the addition of visual information and/or knowledge of results (KR) during training. BACKGROUND: Stiffness perception may integrate both haptic and visual modalities. However, in many tasks, the visual field is typically occluded, forcing stiffness perception to be dependent exclusively on haptic information. No studies to date addressed the time course of haptic stiffness perceptual learning. METHOD: Using a virtual environment (VE) haptic interface and a two-alternative forced-choice discrimination task, the haptic stiffness discrimination ability of 48 participants was tested across 2 days. Each day included two haptic test blocks separated by a training block Additional visual information and/or KR were manipulated between participants during training blocks. RESULTS: Practice repetitions alone induced significant improvement in haptic stiffness discrimination. Between days, accuracy was slightly improved, but decision time performance was deteriorated. The addition of visual information and/or KR had only temporary effects on decision time, without affecting the time course of haptic discrimination learning. CONCLUSION: Learning in haptic stiffness discrimination appears to evolve through at least two distinctive phases: A single training session resulted in both immediate and latent learning. This learning was not affected by the training manipulations inspected. APPLICATION: Training skills in VE in spaced sessions can be beneficial for tasks in which haptic perception is critical, such as surgery procedures, when the visual field is occluded. However, training protocols for such tasks should account for low impact of multisensory information and KR.