Project 1
Student id: h15
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<title>Writing Project 1: Producing Annotated Bibliographies, a Problem-Seeking
Project</title>
<author xml:id="h15">Tammy Huynh</author>
<version n="1" date="2016-07-13"/>
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</docHead>
<annotated_bib>
<problem_stmt>Virtual reality (VR) is a technology that places users in an interactive
simulated environment. Today VR is used beyond entertainment purposes to treat various
psychological conditions, including social anxiety and PTSD, by simulating situations
that trigger targeted symptoms. Expanding upon this, VR can be leveraged in
motor-related rehabilitation. Computer engineering focuses on the development of
physical devices that reliably gather and relay data as well as software that interprets
and displays data in meaningful ways. In relation to VR motor-related therapy, the
discipline<note type="instructor">by 'discipline' here you mean VR? because earlier
you called it a technology, but I could also see calling it a discipline/field of
research</note> is responsible for syncing users’ movement virtually to a viewable
device, interpreting the results based on specified criteria, adjusting settings
accordingly, and iterating procedures. It is also concerned with the cost efficiency and
comfort of such devices. Game development can be considered a branch of CS (or perhaps
its own discipline) and is the coding and design (level layout, adjusted difficulty
settings, art assets) of games. Motor disorders afflict patients from various age groups
from children with cerebral palsy to post-stroke elders. Thus, it is important to tailor
the virtual environments to the individual to encourage interactivity, especially for
children and those with attention deficiencies. Additionally, designing and adjusting
difficulty settings in relation to performance is vital to prevent frustration or
boredom and further promote self-engagement. Leveraging VR in motor-related
rehabilitation has a promising outlook in that it engages users, provides real-time
feedback and progress tracking, cuts setup times, is tailored to the patient, and can
potentially move therapies to a home setting.<note type="instructor">really nice problem statement that frames your disciplinary interest in VR for motor-related therapy</note></problem_stmt>
<!-- Citation 1 -->
<citation n="1" style="APA"><author n="1">Lange, B.</author>, <author n="2">Koenig,
S.</author>, <author n="3">Chang, C.</author>, <author n="4">Mcconnell, E.</author>,
<author n="5">Suma, E.</author>, <author n="6">Bolas, M.</author>, & <author
n="7">Rizzo, A.</author> (2012). <title level="a">Designing informed game-based
rehabilitation tasks leveraging advances in virtual reality</title>. <title
level="j">Disability and Rehabilitation</title>, 34(22), 1863-1870.
doi:10.3109/09638288.2012.670029</citation>
<annotation>
<background type="source">This article provided by USC, Institute for Creative
Technologies, in the journal Disability and Rehabilitation, </background>
<summary type="general">highlights the benefits and challenges of implementing VR in
therapeutic strategies. VR can be implemented in various ways. Sometimes head-mounts
are used to display the view to the user and adjust in relation to his orientation.
Body-tracking sensors can also provide a wider range of interactivity. Other times
6-wall rooms with projections called Cave Automatic Virtual Environments (CAVEs) are
implemented to provide a less restrained, though more expensive, experience.
Additionally, VR allows for varied perspectives by offering 1st or 3rd person views,
which may give new insights to how patients respond to therapy. VR in therapy has
long been hindered by costs of equipment, but commercial technology, such as the Wii
and Kinect provide affordable ways to introduce rehabilitation to a home setting. </summary>
<summary type="interpretation">Still, commercial technologies were not initially
intended for therapeutic practices; therefore, they must be adjusted accordingly;
else they may promote improper motor skills.<note type="instructor">this is an important point, especially for a game developer, perhaps developing across a range of platforms</note> </summary>
<relevance type="value_stmt">This source is relevant in that it provides a good
introduction to VR in therapy and some associated problems<note type="instructor">with implementation?</note>.</relevance>
</annotation>
<!-- Citation 2 -->
<citation n="2" style="APA"><author n="1">Merians, A.</author>, <author n="2">Jack, D.
</author>, <author n="3">Boian, R.</author>, <author n="4">Tremaine, M.</author>,
<author n="5">Burdea, G.</author>, <author n="6"> Adamovich, S.</author>, <author
n="7">Reece, M.</author>, & <author n="8"> Poizner, H.</author> (2002). <title
level="a">Virtual Reality–Augmented Rehabilitation for Patients Following
Stroke</title>. <title level="j">Physical Therapy</title>, 82(9),
898-915.</citation>
<annotation>
<background type="source">This article from Physical Therapy, a journal that focuses on
improving patient care, </background>
<summary type="general"> presents a case study following three elderly (50’s, 80’s)
post-stroke patients who participated in a 2-week long VR motor training program. </summary>
<summary type="approach">For 3.5 hours each training day, the patients practiced 4 VR
exercises to test their hand’s: (1) range of movement, measured by how much of a
image they could uncover by “wiping” their hand across the screen; (2) speed of
movement measured by how fast they could close their hand; (3) finger fractionation
measured by their ability to depress a single key on a keyboard piano; and (4)
strength of movement measured by how much they could resist pressure applied to
their glove. </summary>
<summary type="general">At the end of the program, each improved in all tested areas
though those with more severe defects improved less so. Overall, the patients
responded positively to the exercises but reported frustration over the length,
response times, and clarity in information of the display. </summary>
<summary type="interpretation">This implies that clear, real-time feedback is vital in
keeping users engaged. </summary>
<relevance type="value_stmt">The results of the study show the promise of VR in
improving mobility in damaged upper extremities, even for elderly patients. However,
a larger patient population is needed to test the validity of the findings
accurately. </relevance><note type="instructor">this is a really interesting source for thinking, too, about how VR can be a two-way system, it can help patients (by keeping them engaged, etc.) and also help hysical therapists and clinicians, by gathering data and measuring improvement quantitatively</note>
</annotation>
<!-- Citation 3 -->
<citation n="3" style="APA"><author n="1">Sveistrup, H.</author> (2004). <title level="a"
>Motor rehabilitation using virtual reality</title>. <title level="j">Journal of
NeuroEngineering and Rehabilitation</title>, 1(1), 10.
doi:10.1186/1743-0003-1-10</citation>
<annotation>
<background type="author">Sveistrup is a professor at the University of Ottawa Brain and
Mind Institute at the University and focuses on traumatic brain injury, innovative
rehabilitation techniques, and motor learning. </background>
<summary type="general"> The article discusses various studies and different VR
strategies implemented by them. These include strategies targeting the following:
balance and posture using a fixed bicycle, posture platform, flat VR display, and
video-capture systems from VividGroup’s GX or IREX; locomotion using GaitMaster2 (a
technology that gives the user the illusion of forward movement), and a virtual
environment to track walking trajectories; and upper/lower extremities using a
CyberGlove (motion capturing glove) and Rutgers ankle/hand systems; exercise and
pain tolerance with a mounted bicycle and virtual scene. </summary>
<relevance type="application">The article is important in that it cites technologies
already used in VR motor-related rehabilitation, which can be implemented in other
settings. </relevance>
<relevance type="value_stmt">Additionally, it references real cases in which the
technology showed promise compared to regular therapies.<note type="instructor">it speaks also to some of the issues outlined in your first source (differences across platforms, etc.)</note></relevance>
</annotation>
<!-- Citation 4 -->
<citation n="4" style="APA"><author n="1">Barrett, N.</author>, <author n="2">Swain,
I.</author>, <author n="3">Gatzidis, C.</author>, & <author n="4">Mecheraoui,
C.</author> (2016). <title level="a">The use and effect of video game design theory
in the creation of game-based systems for upper limb stroke rehabilitation</title>.
<title level="j">Journal of Rehabilitation and Assistive Technologies
Engineering</title>, 3(0). doi:10.1177/2055668316643644</citation>
<annotation>
<background type="source">This article was published to the Journal of Rehabilitation
and Assistive Technologies Engineering this year.</background>
<summary type="general">Rehabilitating limb exercises often involve meaningful
repetitive motion to induce neural plasticity and to strengthen neural connections
associated with normal motor function. This piece discusses game design principles
vital in keeping patients motivated during these exercises. </summary>
<summary type="approach">Basic principles include a clear presentation of goals,
rewards, low learning curves, and motivational feedback. Adjusting difficulty in
response to improvement encourages users to continue play for mastery. Additionally,
use of a simple interface (muted colors, low sounds) is important <q>to avoid
cognitive overload and fatigue.</q> Multiplayer introduces a social aspect that
promotes collaboration and increases interest. It also induces competition, which
engages and entertains the user. Presenting varied tasks, tailoring genres, and
introducing storylines helps to break the monotony of the exercises. </summary>
<relevance type="application"> Overall, the layout of games in therapy is important, as
patients are more likely to exert effort continually, thus inducing neural
plasticity, if they are immersed in the activity.</relevance>
<relevance type="value_stmt">This sets therapeutic VR practices apart from regular
practices.</relevance><note type="instructor">this is a great source in terms of methodology--how does one actually design an effective game in this environment?</note>
</annotation>
<!-- Citation 5 -->
<citation n="5" style="APA"><author n="1">Koenig, S.</author>, <author n="2">Ardanza,
A.</author>, <author n="3">Cortes, C.</author>, <author n="4">Mauro, A. D.</author>,
& <author n="5">Lange, B.</author> (2013). <title level="a">Introduction to Low-Cost
Motion-Tracking for Virtual Rehabilitation</title>. <title level="j">Biosystems
& Biorobotics Emerging Therapies in Neurorehabilitation</title>, 287-303.
doi:10.1007/978-3-642-38556-8_15</citation>
<annotation>
<background type="source">An article in Emerging Therapies in Neurorehabilitation
(Biosystems & Biorobotics), a collection on the technological advances and
practices in neuro-rehabilitation, </background>
<summary type="general">this piece discusses how the Microsoft Kinect, a platform that
uses depth-sensing cameras, can be used in motor-related rehabilitation. Flexible
Action and Articulated Skeleton Toolkit (FAAST) is a middleware that maps body
movements from the Kinect skeleton to controls in games and VR applications. This
allows clinicians to map desired movements and adjust sensitivities to existing
games to match the patient’s needs and preferences. MiddleVR is another middleware
platform that can be integrated with the Kinect to integrate with custom games
created in Unity, an open-source game development engine. </summary>
<relevance type="application">Overall, this piece shows techniques on using middleware
with the Kinect to adjust existing games or integrate custom games for mobile
rehabilitation. Northeastern’s ReGame VR Lab is in the process of conducting studies
on children with cerebral palsy by creating tailored VR Kinect video games, so the
techniques in this article can be applied in a similar setting.<note type="instructor">wow, really interesting and relevant to your interest here</note></relevance>
</annotation>
</annotated_bib>
<docReview>
<reviewer type="instructor" xml:id="kgs"/>
<report type="instructor" resp="#kgs">
<p>This is a really important and interesting topic, one that I hope will continue to develop. In terms of sources, you have a nice mix of topical and methodological sources and range of general, field-wide surveys to specific implementations. Your annotations are well done, specifically the depth of your summaries and use of the @type 'summary'. The problem statement is clear and thorough and gives an overview of this field while also getting specific enough to see where your disciplinary interest would intervene on the level of game dev.</p>
</report>
</docReview>
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