Traumatic Brain Injury Patients Get a Grip Via Raviraj Nataraj’s Intelligent Glove VR Therapy
NSF CAREER Award winning professor integrates virtual reality sensory information into physical rehabilitation regimens
Raviraj Nataraj has been making waves in the burgeoning field of physical rehabilitation through virtual reality (VR) for years now. Two years ago, he earned a prestigious NSF CAREER Award in recognition of his research on motor skills therapy via gamification and VR.
Buoyed by that success, Nataraj, an associate professor in the Department of Biomedical Engineering, has continued down the same path. His recent work includes a published study in the National Center for Biotechnology Information regarding functional grasp control training for patients recovering from traumatic brain injury (TBI).
Nataraj’s Movement Control Rehabilitation (MOCORE) Laboratory has created a rehabilitation glove system compatible with VR. The glove has onboard sensors and processors that detect when a rehab patient has a secure grasp of an object.
"The idea is that for someone with compromised hand function, like after a traumatic brain injury, we can inform them when their grasp is secure during hand-function training," said Nataraj. "We use virtual reality to inform them with changes in color and richer sounds that are more cognitively engaging to accelerate gains in function with rehabilitation practice."
This work builds upon Nataraj’s previous rehabilitative training research, improving the synergy between augmented sensory feedback and movement training. Specifically, this study provided valuable information regarding the presentation of sensory cues through a VR interface. The timing, frequency and intensity of these sensory cues have shown a clear impact on performance. VR provides an ideal method in which Nataraj can customize the delivery of sensory cues to effect maximum positive impact on individual patients.
Early results challenge initial hypothesis
Additionally, there were some surprising results from this study. Before beginning the study, Nataraj and those in the MOCORE lab hypothesized that both the control group and persons with traumatic brain injury may improve movement performance with more intense cueing, but that there would be a difference as to which group improved more. It did not play out that way.
The control group improved performance with simpler cueing (audio cues only) compared to baseline (no cueing) but showed worsened performance with more intense (visual plus audio) cueing. This result suggests the control group may have experienced cognitive overloading while persons with traumatic brain injury benefited from, if not needed, the more intense cueing.
"This finding clearly demonstrates how sensitive each person can be to sensory-driven cueing, especially in the presence of neuro-injury, and how personalizing features of these cues – intensity and duration, for example – is critical to optimize rehabilitative outcomes with such approaches," said Nataraj.
In the continuation of Nataraj’s work with VR rehab, the MOCORE lab is currently creating new platforms, including an upper-body rehabilitation system based on similar principles, using virtual reality environments that are directly responding to movements and signals from the person’s muscles and brain.
"Again, we are observing how powerful sensory-based cueing is during training, even for different rehabilitation tasks, and how crucial it is to personalize training based on responses of each individual user," said Nataraj.
Given the success of his ongoing research, combined with the increased openness and enthusiasm toward VR among the patients with whom he has worked, Nataraj is excited about the future of VR rehabilitation methods.
"Virtual reality technology is becoming increasingly accessible – more affordable, easier to use, and broadly available for home use," he said. "Thus, physical therapists can more readily employ VR technologies with rehabilitative therapies at the clinic. It will also be viable for therapists to provide more remote supervision for patients using such systems at home."