Virtual Reality and Assistive Technologies: A Survey <s> Summary and analysis of haptic VEs <s> A personal computer (PC)-based desktop virtual reality (VR) system was developed for rehabilitating hand function in stroke patients. The system uses two input devices, a CyberGlove and a Rutgers Master II-ND (RMII) force feedback glove, allowing user interaction with a virtual environment. This consists of four rehabilitation routines, each designed to exercise one specific parameter of hand movement: range, speed, fractionation or strength. The use of performance-based target levels is designed to increase patient motivation and individualize exercise difficulty to a patient's current state. Pilot clinical trials have been performed using the above system combined with noncomputer tasks, such as pegboard insertion or tracing of 2D patterns. Three chronic stroke patients used this rehabilitation protocol daily for two weeks. Objective measurements showed that each patient showed improvement on most of the hand parameters over the course of the training. Subjective evaluation by the patients was also positive. This technical report focuses on this newly developed technology for VR rehabilitation. <s> BIB001 </s> Virtual Reality and Assistive Technologies: A Survey <s> Summary and analysis of haptic VEs <s> Abstract Broeren J, Rydmark M, Sunnerhagen KS. Virtual reality and haptics as a training device for movement rehabilitation after stroke: a single-case study. Arch Phys Med Rehabil 2004;85:1247–50. Objective To investigate whether training in a virtual environment with a haptic device will improve motor function in the left hemiparetic arm of a stroke subject. Design Single case, A-B-A design. Setting University hospital research laboratory. Participant A man in his late fifties (right handed), with a right-hemisphere lesion that caused a deficit in the left upper extremity. Intervention The subject trained with a 3-dimensional computer game during a 4-week period that consisted of twelve 90-minute sessions. Main outcome measures Three tests (Purdue pegboard test, dynamometer hand-grip strength, upper-extremity test) and a subjective interview were used to evaluate motor performance. Results Improvements were found in fine manual dexterity, grip force, and motor control of the affected upper extremity. The subject reported that there was a change in his day-to-day use of the upper extremity and that he was able to use it in activities that were previously impossible for him. Conclusions Training with virtual reality and haptics can promote motor rehabilitation. <s> BIB002 </s> Virtual Reality and Assistive Technologies: A Survey <s> Summary and analysis of haptic VEs <s> In this paper, a novel interface is described for enhancing human-human interpersonal interactions. Specifically, the device is targeted as an assistive aid to deliver the facial expressions of an interaction partner to people who are blind or visually impaired. Vibro-tactors, mounted on the back of a glove, provide a means for conveying haptic emoticons that represent the six basic human emotions and the neutral expression of the user's interaction partner. The detailed design of the haptic interface and haptic icons of expressions are presented, along with a user study involving a subject who is blind, as well as sighted, blind-folded participants. Results reveal the potential for enriching social communication for people with visual disabilities. <s> BIB003
As discussed above, a haptic VE enhances mobility and cognitive impairments and works towards the enrichment of the lives of the blind and visually impaired. Patients finger dexterity, grip force, endurance, and attention were found to have improved significantly after undergoing training with the haptic devices BIB002 . In motor-rehabilitation training, force feedbackbased VR therapy was found to be more effective and produced faster results in comparison with visual feedback-only VR systems BIB001 ). Grounded exoskeletons with their large workspace, ability to work in different modes (i.e., from initial passive mode to active assisted mode to fully active mode) and orthotic shells ensure gradual mo-tor recovery of an entire limb in a safe and engaging environment. A haptic VE improves the accessibility of educational materials for blind students and helps them mentally form an accurate representation of their surroundings (Gandhi, Ganesh, and Sinha 2014). Onset blindness produces alterations to spontaneous facial behavior and is found to be associated with symptoms like more closed eyes, open mouth, raised eyebrows, and more  ). Hence children with visual disabilities find it very difficult to learn social skills while growing amongst sighted peers BIB003 ). If applications like the haptic mirrors can be incorporated as a learning tool, as these children grow up, they can have a better understanding of the real world and be better able to communicate with their surroundings (Yasmin and Panchanathan 2016).