BuzzwireVR: An Immersive Game to Supplement Fine-Motor Movement Therapy

Abstract

Recovery of upper-body fine-motor skills after brain trauma, e.g. after a stroke, involves a long process of movement rehabilitation. When the arms and hands are affected patients often spend many hours exercising in order to regain control of their movements, often using children's toys. This paper describes the process of development of a Virtual Reality (VR) system designed to supplement rehabilitation by encouraging hand movements while playing a fun game. The system is based on the well-known Buzzwire children's toy that requires steady hand-eye coordination to pass a ring along a wire without touching the wire. The toy has in the past been used in a variety of research studies, but we considered it ideal for motor rehabilitation because it requires steady hand and finger movements. In our virtualised version of the toy the wire consists of a parametric spline curve with cylindrical cross-section positioned in front of the player. Cylinders at the ends of the 'wire' change colour to indicate which hand to use. The parametric nature of the wire allows us to record performance variables which are not readily available in the physical version. We report on two initial experiments which tested and evaluated various aspects of performance on able-bodied participants and stroke patients, followed by a description of how we developed the toy into a multi-level game that encourages increasingly intricate hand movements. In the first evaluation we tested if performance variables (such as average speed, and distance from the wire) could distinguish between dominant and non-dominant hands of able-bodied participants. We also compared performance with and without binocular viewing. Results showed that our metrics could distinguish between the players dominant versus non-dominant hand. We also noted a dramatic disruption of performance when binocular stereopsis was not available. The second experiment was a usability study involving a sample of stroke-affected participants with post-stroke hemiparesis. Results showed positive acceptance of the technology with no fatigue or nausea. Our gamified version of the task utilizes learnings from the previous studies to create an enjoyable multi-level game involving auditory guidance as feedback. Results are discussed in terms of potential benefits of using such technology in addition to conventional therapy.