Augmented feedback modes during functional grasp training with an intelligent glove and virtual reality for persons with traumatic brain injury

Mingxiao Liu; Samuel Wilder; Sean Sanford; Michael Glassen; Sophie Dewil; Soha Saleh; Raviraj Nataraj

doi:10.3389/frobt.2023.1230086

Augmented feedback modes during functional grasp training with an intelligent glove and virtual reality for persons with traumatic brain injury

Front Robot AI. 2023 Nov 22:10:1230086. doi: 10.3389/frobt.2023.1230086. eCollection 2023.

Authors

Mingxiao Liu^{1

2}, Samuel Wilder^{1

2}, Sean Sanford^{1

2}, Michael Glassen³, Sophie Dewil^{1

2}, Soha Saleh³, Raviraj Nataraj^{1

2}

Affiliations

¹ Department of Biomedical Engineering, Stevens Institute of Technology, Hoboken, NJ, United States.
² Movement Control Rehabilitation (MOCORE) Laboratory, Altorfer Complex, Stevens Institute of Technology, Hoboken, NJ, United States.
³ Center for Mobility and Rehabilitation Engineering Research, Advanced Rehabilitation Neuroimaging Laboratory, Kessler Foundation, NJ, United States.

Abstract

Introduction: Physical therapy is crucial to rehabilitating hand function needed for activities of daily living after neurological traumas such as traumatic brain injury (TBI). Virtual reality (VR) can motivate participation in motor rehabilitation therapies. This study examines how multimodal feedback in VR to train grasp-and-place function will impact the neurological and motor responses in TBI participants (n = 7) compared to neurotypicals (n = 13). Methods: We newly incorporated VR with our existing intelligent glove system to seamlessly enhance the augmented visual and audio feedback to inform participants about grasp security. We then assessed how multimodal feedback (audio plus visual cues) impacted electroencephalography (EEG) power, grasp-and-place task performance (motion pathlength, completion time), and electromyography (EMG) measures. Results: After training with multimodal feedback, electroencephalography (EEG) alpha power significantly increased for TBI and neurotypical groups. However, only the TBI group demonstrated significantly improved performance or significant shifts in EMG activity. Discussion: These results suggest that the effectiveness of motor training with augmented sensory feedback will depend on the nature of the feedback and the presence of neurological dysfunction. Specifically, adding sensory cues may better consolidate early motor learning when neurological dysfunction is present. Computerized interfaces such as virtual reality offer a powerful platform to personalize rehabilitative training and improve functional outcomes based on neuropathology.

Keywords: hand grasp; motor rehabilitation; physical therapy; sensory feedback; traumatic brain injury; virtual reality.

Grants and funding

This work was made possible by support from the New Jersey Health Foundation (Research Grant, PC 53-19) and the Charles V. Schaefer, Jr. School of Engineering and Science at the Stevens Institute of Technology.