Usability of Three-dimensional Augmented Visual Cues Delivered by Smart Glasses on (Freezing of) Gait in Parkinson's Disease.

External cueing is a potentially effective strategy to reduce freezing of gait (FOG) in persons with Parkinson's disease (PD). Case reports suggest that three-dimensional (3D) cues might be more effective in reducing FOG than two-dimensional cues. We investigate the usability of 3D augmented reality visual cues delivered by smart glasses in comparison to conventional 3D transverse bars on the floor and auditory cueing via a metronome in reducing FOG and improving gait parameters. In laboratory experiments, 25 persons with PD and FOG performed walking tasks while wearing custom-made smart glasses under five conditions, at the end-of-dose. For two conditions, augmented visual cues (bars/staircase) were displayed via the smart glasses. The control conditions involved conventional 3D transverse bars on the floor, auditory cueing via a metronome, and no cueing. The number of FOG episodes and percentage of time spent on FOG were rated from video recordings. The stride length and its variability, cycle time and its variability, cadence, and speed were calculated from motion data collected with a motion capture suit equipped with 17 inertial measurement units. A total of 300 FOG episodes occurred in 19 out of 25 participants. There were no statistically significant differences in number of FOG episodes and percentage of time spent on FOG across the five conditions. The conventional bars increased stride length, cycle time, and stride length variability, while decreasing cadence and speed. No effects for the other conditions were found. Participants preferred the metronome most, and the augmented staircase least. They suggested to improve the comfort, esthetics, usability, field of view, and stability of the smart glasses on the head and to reduce their weight and size. In their current form, augmented visual cues delivered by smart glasses are not beneficial for persons with PD and FOG. This could be attributable to distraction, blockage of visual feedback, insufficient familiarization with the smart glasses, or display of the visual cues in the central rather than peripheral visual field. Future smart glasses are required to be more lightweight, comfortable, and user friendly to avoid distraction and blockage of sensory feedback, thus increasing usability.

Subliminal Reorientation and Repositioning in Immersive Virtual Environments using Saccadic Suppression.

Virtual reality strives to provide a user with an experience of a simulated world that feels as natural as the real world. Yet, to induce this feeling, sometimes it becomes necessary for technical reasons to deviate from a one-to-one correspondence between the real and the virtual world, and to reorient or reposition the user's viewpoint. Ideally, users should not notice the change of the viewpoint to avoid breaks in perceptual continuity. Saccades, the fast eye movements that we make in order to switch gaze from one object to another, produce a visual discontinuity on the retina, but this is not perceived because the visual system suppresses perception during saccades. As a consequence, our perception fails to detect rotations of the visual scene during saccades. We investigated whether saccadic suppression of image displacement (SSID) can be used in an immersive virtual environment (VE) to unconsciously rotate and translate the observer's viewpoint. To do this, the scene changes have to be precisely time-locked to the saccade onset. We used electrooculography (EOG) for eye movement tracking and assessed the performance of two modified eye movement classification algorithms for the challenging task of online saccade detection that is fast enough for SSID. We investigated the sensitivity of participants to translations (forward/backward) and rotations (in the transverse plane) during trans-saccadic scene changes. We found that participants were unable to detect approximately ±0.5m translations along the line of gaze and ±5° rotations in the transverse plane during saccades with an amplitude of 15°. If the user stands still, our approach exploiting SSID thus provides the means to unconsciously change the user's virtual position and/or orientation. For future research and applications, exploiting SSID has the potential to improve existing redirected walking and change blindness techniques for unlimited navigation through arbitrarily-sized VEs by real walking.

Geometric calibration of head-mounted displays and its effects on distance estimation.

Head-mounted displays (HMDs) allow users to observe virtual environments (VEs) from an egocentric perspective. However, several experiments have provided evidence that egocentric distances are perceived as compressed in VEs relative to the real world. Recent experiments suggest that the virtual view frustum set for rendering the VE has an essential impact on the user's estimation of distances. In this article we analyze if distance estimation can be improved by calibrating the view frustum for a given HMD and user. Unfortunately, in an immersive virtual reality (VR) environment, a full per user calibration is not trivial and manual per user adjustment often leads to mini- or magnification of the scene. Therefore, we propose a novel per user calibration approach with optical see-through displays commonly used in augmented reality (AR). This calibration takes advantage of a geometric scheme based on 2D point - 3D line correspondences, which can be used intuitively by inexperienced users and requires less than a minute to complete. The required user interaction is based on taking aim at a distant target marker with a close marker, which ensures non-planar measurements covering a large area of the interaction space while also reducing the number of required measurements to five. We found the tendency that a calibrated view frustum reduced the average distance underestimation of users in an immersive VR environment, but even the correctly calibrated view frustum could not entirely compensate for the distance underestimation effects.