Movement-controlled video games have potential to promote home-based practice of therapy activities. The success of therapy gaming interventions depends on the quality of the technology used and the presence of effective support structures. This study assesses the feasibility of a novel intervention that combines a co-created gaming technology integrating evidence-based biofeedback and solution-focused coaching (SFC) strategies to support therapy engagement and efficacy at home. Following feasibility and single-case reporting standards (CONSORT and SCRIBE), this was a non-blind, randomized, multiple-baseline, AB, design. Nineteen (19) young people with cerebral palsy (8–18 years old) completed the 4-week home-based intervention in France and Canada. Participant motivations, personalized practice goals, and relevance of the intervention to daily activities were discussed in a Solution Focused Coaching-style conversation pre-, post-intervention and during weekly check-ins. Participants controlled a video game by completing therapeutic gestures (wrist extension, pinching) detected via electromyography and inertial sensors on the forearm (Myo Armband and custom software). Process feasibility success criteria for recruitment response, completion and adherence rates, and frequency of technical issues were established a priori. Scientific feasibility, effect size estimates and variance were determined for Body Function outcome measures: active wrist extension, grip strength and Box and Blocks Test; and for Activities and Participation measures: Assisting Hand Assessment (AHA), Canadian Occupational Performance Measure (COPM) and Self-Reported Experiences of Activity Settings (SEAS). Recruitment response (31%) and assessment completion (84%) rates were good and 74% of participants reached self-identified practice goals. As 17% of technical issues required external support to resolve, the intervention was graded as feasible with modifications. No adverse events were reported. Moderate effects were observed in Body Function measures (active wrist extension: SMD = 1.82, 95%CI = 0.85–2.78; Grip Strength: SMD = 0.63, 95%CI = 0.65–1.91; Box and Blocks: Hedge’s g = 0.58, 95%CI = -0.11–1.27) and small-moderate effects in Activities and Participation measures (AHA: Hedge’s g = 0.29, 95%CI = -0.39–0.97, COPM: r = 0.60, 95%CI = 0.13–0.82, SEAS: r = 0.24, 95%CI = -0.25–0.61). A definitive RCT to investigate the effectiveness of this novel intervention is warranted. Combining SFC-style coaching with high-quality biofeedback may positively engage youth in home rehabilitation to complement traditional therapy. ClinicalTrials.gov, U.S. National Library of Medicine: NCT03677193.

SUMMARY: Over the past decade, research on human–robot collaboration has grown exponentially, motivated by appealing applications to improve the daily life of patients/operators. A primary requirement in many applications is to implement highly “transparent” control laws to reduce the robot impact on human movement. This impact may be quantified through relevant motor control indices. In this paper, we show that control laws based on careful identification procedures improve transparency compared to classical closed-loop position control laws. A new performance index based on the ratio between electromyographic activity and limb acceleration is also introduced to assess the quality of human exoskeleton interaction.

In sports science, the link between the experimental protocol and the subject's behaviour in real condition is a key issue. Virtual reality enables to examine this topic because of the reproducibility of situations and the total control of animated humanoids in situations similar to the real world. This study aimed to analyze the influence of the degree of perception-action coupling on the performance of handball goalkeepers in a virtual environment. 8 national handball goalkeepers were asked to react to the actions of a virtual handball thrower in two conditions: a perception-action uncoupled condition (defined as a judgment task) and a perception-action coupled condition (defined as a motor task). In the judgment condition, goalkeepers were asked to make a perceptual judgment with their hand in their own time after the virtual throw; in the motor task condition, goalkeepers had to react in real-time to the virtual throwing motion. Results showed that percentage of successful response was higher in the motor task condition and radial error (distance between the ball and the closest limb when trial was unsuccessful) was lower for the same condition. Implications of our findings are discussed, as well as suggestions for further research..

Time and effort are thought to be subjectively balanced during the planning of goal-directed actions, thereby setting the vigor of volitional movements. Theoretical models predicted that the value of time should then amount to high levels of effort. However, the time-effort trade-off has so far only been studied for a narrow range of efforts. To investigate the extent to which humans can invest in a time-saving effort, we used a robotic exoskeleton to substantially vary the energetic cost associated with a certain vigor during reaching movements. In this situation, minimizing the time-effort trade-off should lead to high and low human efforts for upward and downward movements, respectively. Consistently, all participants expended substantial amounts of energy upward and remained essentially inactive by harnessing the work of gravity downward, while saving time in both cases. A common time-effort trade-off may therefore determine the vigor of reaching movements for a wide range of efforts.