Virtual Reality Environments and Haptic Strategies to Enhance Implicit Learning and Motivation in Robot-Assisted Training.

Motivation plays a crucial role in motor learning and neurorehabilitation. Participants' motivation could decline to a point where they may stop training when facing a very difficult task. Conversely, participants may perform well and consider the training boring if the task is too easy. In this paper, we present a combination of a virtual reality environment with different robotic training strategies that modify task functional difficulty to enhance participants' motivation. We employed a pneumatically driven robotic stepper as a haptic interface. We first evaluated the use of disturbance observers as acceleration controllers to provide high robustness to varying system parameters, unmodeled dynamics and unknown disturbances associated with pneumatic control. The locomotor task to be learned in the virtual reality environment consisted of steering a recumbent bike to follow a desired path by changing the movement frequency of the dominant leg. The motor task was specially designed to engage implicit learning -i.e., learning without conscious recognition of what is learned. A haptic assistance strategy was developed in order to reduce the task functional difficulty during practice. In a feasibility study with eight healthy participants, we found that the haptic assistance provided by the robotic device successfully contributed to improve task performance during training, especially for less skilled participants. Furthermore, we found a negative correlation between participants' motivation and performance error when training with haptic assistance, suggesting that haptic assistance has a great potential to enhance motivation during motor training.