Visentin Nicola, Fairhurst Merle, Sun Wenhan, Niu Xinyao, Floessel Philipp, Wunderlich Freya Charlotte, Lüneburg Lisa-Marie, Teubner Stefan, Beyer Willy, Sudzius Benas, Lachman Doris, Malberg Hagen, Krzywinski Jens, Disch Alexander
Junior Professorship for Social Affective Touch, Technische Universität Dresden, Germany.
Centre for Tactile Internet with Human-in-the-Loop (CeTI), Technische Universität Dresden, Germany.
Comput Struct Biotechnol J. 2025 Sep 1;28:348-358. doi: 10.1016/j.csbj.2025.08.026. eCollection 2025.
Given the high prevalence of low back pain and its financial weight on the healthcare system, practicing physiotherapy exercises is crucial for sustainable therapy success. Effective rehabilitation requires high-quality movement execution, demanding technology that provides optimal feedback.
Our interdisciplinary approach, combining neuroscientific insights on body representation, sports science findings on motor learning, and user experience research on feedback perception aims to give a multifaceted insight into the different effects that varied feedback modalities (auditory, haptic, and combined), have on the performance of a physiotherapy exercise, and on the cognitive workload and body image representation of the patients during the exercise itself, in people with and without nonspecific back pain.
This study employs a mixed-methods design to investigate the impact of different feedback modalities (auditory, haptic, and combined) on physiotherapy exercises. In a quantitative Wizard-of-Oz experiment (n=57), participants performed bent knee side planks while receiving feedback-secretly provided by physiotherapists via a smart shirt. Outcome measures included cognitive workload (NASA TLX), body image representation (Body Map Task), and exercise improvement (physiotherapist evaluation). Control variables such as trust in technology (Surgical Robot Trust & Trust in Automation Questionnaires) and pain level (Chronic Pain Grade Scale) were also assessed. A semi-structured interview gathered qualitative insights into participants' feedback perception and usability.
Results indicate no significant differences in cognitive workload or body image representation across modalities, though qualitative data suggest a preference for haptic and combined feedback over auditory alone. Performance outcomes did not significantly vary across conditions, but qualitative insights highlight the benefits of multimodal feedback in enhancing movement perception and engagement.
Findings suggest no single optimal feedback modality, but combining haptic and auditory cues enhances usability and motor learning. Participants favor this approach, initially relying on auditory feedback and then switching to haptic feedback in the long-term. Despite not clearly emerging from quantitative statistical analysis, these results support the development of a multisensory feedback strategy. Our interdisciplinary approach demonstrates that multimodal feedback is not only beneficial but necessary for designing adaptive, accessible, and effective rehabilitation technologies.
鉴于腰痛的高患病率及其对医疗保健系统的经济负担，进行物理治疗锻炼对于可持续的治疗成功至关重要。有效的康复需要高质量的动作执行，这就需要能提供最佳反馈的技术。
我们的跨学科方法结合了关于身体表征的神经科学见解、关于运动学习的体育科学发现以及关于反馈感知的用户体验研究，旨在多方面深入了解不同反馈方式（听觉、触觉和组合式）对物理治疗锻炼表现的不同影响，以及对有和没有非特异性背痛的患者在锻炼过程中的认知负荷和身体意象表征的影响。
本研究采用混合方法设计来调查不同反馈方式（听觉、触觉和组合式）对物理治疗锻炼的影响。在一项定量的奥兹巫师实验（n = 57）中，参与者在进行屈膝侧平板支撑时接收由物理治疗师通过智能衬衫秘密提供的反馈。结果测量包括认知负荷（NASA TLX）、身体意象表征（身体图谱任务）和锻炼改善情况（物理治疗师评估）。还评估了诸如对技术的信任（手术机器人信任和自动化信任问卷）和疼痛程度（慢性疼痛分级量表）等控制变量。通过半结构化访谈收集了关于参与者反馈感知和可用性的定性见解。
结果表明，不同方式在认知负荷或身体意象表征方面没有显著差异，尽管定性数据表明比起单独的听觉反馈，参与者更偏好触觉和组合式反馈。不同条件下的表现结果没有显著差异，但定性见解突出了多模态反馈在增强运动感知和参与度方面的益处。
研究结果表明不存在单一的最佳反馈方式，但结合触觉和听觉线索可提高可用性和运动学习效果。参与者青睐这种方法，最初依赖听觉反馈，长期则转向触觉反馈。尽管这些结果在定量统计分析中未明确显现，但支持了多感官反馈策略的开发。我们的跨学科方法表明，多模态反馈不仅有益，而且对于设计适应性强、易用且有效的康复技术是必要的。
