Department of Electrical and Information Engineering (DEI), Polytechnic University of Bari, 70126 Bari, Italy.
Apulian Bioengineering s.r.l., 70026 Modugno, Italy.
Sensors (Basel). 2023 May 24;23(11):5017. doi: 10.3390/s23115017.
The study of visuomotor adaptation (VMA) capabilities has been encompassed in various experimental protocols aimed at investigating human motor control strategies and/or cognitive functions. VMA-oriented frameworks can have clinical applications, primarily in the investigation and assessment of neuromotor impairments caused by conditions such as Parkinson's disease or post-stroke, which affect the lives of tens of thousands of people worldwide. Therefore, they can enhance the understanding of the specific mechanisms of such neuromotor disorders, thus being a potential biomarker for recovery, with the aim of being integrated with conventional rehabilitative programs. Virtual Reality (VR) can be entailed in a framework targeting VMA since it allows the development of visual perturbations in a more customizable and realistic way. Moreover, as has been demonstrated in previous works, a serious game (SG) can further increase engagement thanks to the use of full-body embodied avatars. Most studies implementing VMA frameworks have focused on upper limb tasks and have utilized a cursor as visual feedback for the user. Hence, there is a paucity in the literature about VMA-oriented frameworks targeting locomotion tasks. In this article, the authors present the design, development, and testing of an SG-based framework that addresses VMA in a locomotion activity by controlling a full-body moving avatar in a custom VR environment. This workflow includes a set of metrics to quantitatively assess the participants' performance. Thirteen healthy children were recruited to evaluate the framework. Several quantitative comparisons and analyses were run to validate the different types of introduced visuomotor perturbations and to evaluate the ability of the proposed metrics to describe the difficulty caused by such perturbations. During the experimental sessions, it emerged that the system is safe, easy to use, and practical in a clinical setting. Despite the limited sample size, which represents the main limitation of the study and can be compensated for with future recruitment, the authors claim the potential of this framework as a useful instrument for quantitatively assessing either motor or cognitive impairments. The proposed feature-based approach gives several objective parameters as additional biomarkers that can integrate the conventional clinical scores. Future studies might investigate the relation between the proposed biomarkers and the clinical scores for specific disorders such as Parkinson's disease and cerebral palsy.
视动适应（VMA）能力的研究已经包含在各种旨在研究人类运动控制策略和/或认知功能的实验方案中。面向 VMA 的框架具有临床应用价值，主要用于研究和评估帕金森病或中风等疾病引起的运动神经损伤，这些疾病影响着全球数以万计的人的生活。因此，它们可以增强对这些运动神经障碍特定机制的理解，从而成为恢复的潜在生物标志物，旨在与传统康复计划相结合。虚拟现实（VR）可以包含在针对 VMA 的框架中，因为它可以以更可定制和更现实的方式开发视觉干扰。此外，正如之前的工作所证明的那样，由于使用了全身体现实化身，严肃游戏（SG）可以进一步提高参与度。大多数实施 VMA 框架的研究都集中在上肢任务上，并使用光标作为用户的视觉反馈。因此，文献中关于针对运动任务的 VMA 框架的内容很少。在本文中，作者提出了一种基于 SG 的框架的设计、开发和测试，该框架通过在定制的 VR 环境中控制全身移动化身来解决运动活动中的 VMA。该工作流程包括一组用于定量评估参与者表现的指标。作者招募了 13 名健康儿童来评估该框架。进行了一些定量比较和分析，以验证引入的不同类型的视动干扰，并评估所提出的指标描述此类干扰引起的难度的能力。在实验过程中，发现该系统安全、易于使用且在临床环境中实用。尽管样本量有限，这是研究的主要限制，可以通过未来的招募来弥补，但作者认为该框架具有作为定量评估运动或认知障碍的有用工具的潜力。所提出的基于特征的方法提供了几个客观参数作为附加生物标志物，可以与传统的临床评分相结合。未来的研究可能会研究所提出的生物标志物与特定疾病（如帕金森病和脑瘫）的临床评分之间的关系。
