Numerous technological solutions have been proposed to promote piano learning and teaching, but very few with market success. We are convinced that users’ needs should be the starting point for an effective and transdisciplinary development process of piano-related Tactile Internet with Human-in-the-Loop (TaHIL) applications. Thus, we propose to include end users in the initial stage of technology development. We gathered insights from adult piano teachers and students through an online survey and digital interviews. Three potential literature-based solutions have been visualized as scenarios to inspire participants throughout the interviews. Our main findings indicate that potential end users consider posture and body movements, teacher–student communication, and self-practice as crucial aspects of piano education. Further insights resulted in so-called acceptance requirements for each scenario, such as enabling meaningful communication in distance teaching, providing advanced data on a performer’s body movement for increased well-being, and improving students’ motivation for self-practice, all while allowing or even promoting artistic freedom of expression and having an assisting instead of judging character. By putting the users in the center of the fuzzy front end of technology development, we have gone a step further toward concretizing TaHIL applications that may contribute to the routines of piano teaching and learning.

Background: Tissue handling is a crucial skill for surgeons and is challenging to learn. The aim of this study was to develop laparoscopic instruments with different integrated tactile vibration feedback by varying different tactile modalities and assess its effect on tissue handling skills. Methods: Standard laparoscopic instruments were equipped with a vibration effector, which was controlled by a microcomputer attached to a force sensor platform. One of three different vibration feedbacks (F1: double vibration > 2 N; F2: increasing vibration relative to force; F3: one vibration > 1.5 N and double vibration > 2 N) was applied to the instruments. In this multicenter crossover trial, surgical novices and expert surgeons performed two laparoscopic tasks (Peg transfer, laparoscopic suture, and knot) each with all the three vibration feedback modalities and once without any feedback, in a randomized order. The primary endpoint was force exertion. Results: A total of 57 subjects (15 surgeons, 42 surgical novices) were included in the trial. In the Peg transfer task, there were no differences between the tactile feedback modalities in terms of force application. However, in subgroup analysis, the use of F2 resulted in a significantly lower mean-force application (p-value = 0.02) among the student group. In the laparoscopic suture and knot task, all participants exerted significantly lower mean and peak forces using F2 (p-value < 0.01). These findings remained significant after subgroup analysis for both, the student and surgeon groups individually. The condition without tactile feedback led to the highest mean and peak force exertion compared to the three other feedback modalities. Conclusion: Continuous tactile vibration feedback decreases the mean and peak force applied during laparoscopic training tasks. This effect is more pronounced in demanding tasks such as laparoscopic suturing and knot tying and might be more beneficial for students. Laparoscopic tasks without feedback lead to increased force application.

Low back pain patients often have deficits in trunk stability. For this reason, many patients receive physiotherapy treatment, which represents an enormous socio-economic burden. Training at home could reduce these costs. The problem here is the lack of correction of the exercise execution. Therefore, this feasibility study investigates the applicability of a vibrotactile-controlled feedback system for trunk stabilisation exercises. A sample of 13 healthy adults performed three trunk stabilisation exercises. Exercise performance was corrected by physiotherapists using vibrotactile feedback. The NASA TLX questionnaire was used to assess the practicability of the vibrotactile feedback. The NASA TLX questionnaire shows a very low global workload 40.2 [29.3; 46.5]. The quality of feedback perception was perceived as good by the subjects, varying between 69.2% (anterior hip) and 92.3% (lower back). 80.8% rated the feedback as helpful for their training. On the expert side, the results show a high rating of movement quality. The positive evaluations of the physiotherapists and the participants on using the vibrotactile feedback system indicate that such a system can reduce the trainees fear of independent training and support the users in their training. This could increase training adherence and long-term success.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Effective treatment in physiotherapy requires hands-on therapy with therapists as well as hands-off treatment like home exercises. To compensate the lack of feedback for home exercising, various technical approaches are studied and developed. Well studied feedback strategies for this use case are missing, especially for tactile feedback. Objective: This paper combines principles of user-centered design and psychology of learning and aims to derive requirements for designing a vibrotactile feedback strategy for a wearable device for physiotherapy home exercises. Methods: The feedback behavior of nine physical therapists was observed in a simulated training session and recommendations for a technical feedback system were observed and collected in a guided interview. Data were analyzed along the categories of a deductively and inductively created category system. Frequency distributions of the quantified observation data were created, and qualitative interview data were evaluated using content structuring content analysis. Results: The present work highlights that reduced feedback frequency, differentiated feedback content, multimodal feedback, and trunk-proximal tactile feedback were recommended by physical therapists for a technical feedback system for the correct performance of physiotherapeutic home exercises in the treatment of unspecific low back pain Conclusions: This paper offers approaches for the design of a vibrotactile feedback strategy. These approaches should be tested in hypotheses driven research. Further patient studies should be conducted.

BACKGROUND Effective treatment in physiotherapy requires hands-on therapy with therapists as well as hands-off treatment like home exercises. To compensate the lack of feedback for home exercising, various technical approaches are studied and developed. Well studied feedback strategies for this use case are missing, especially for tactile feedback. OBJECTIVE This paper combines principles of user-centered design and psychology of learning and aims to derive requirements for designing a vibrotactile feedback strategy for a wearable device for physiotherapy home exercises. METHODS The feedback behavior of nine physical therapists was observed in a simulated training session and recommendations for a technical feedback system were observed and collected in a guided interview. Data were analyzed along the categories of a deductively and inductively created category system. Frequency distributions of the quantified observation data were created, and qualitative interview data were evaluated using content structuring content analysis. RESULTS The present work highlights that reduced feedback frequency, differentiated feedback content, multimodal feedback, and trunk-proximal tactile feedback were recommended by physical therapists for a technical feedback system for the correct performance of physiotherapeutic home exercises in the treatment of unspecific low back pain CONCLUSIONS This paper offers approaches for the design of a vibrotactile feedback strategy. These approaches should be tested in hypotheses driven research. Further patient studies should be conducted.

Patients with low back pain often have deficits in trunk stability. For this reason, many patients receive physiotherapy treatment, which represents an enormous socio-economic burden. Training at home could reduce these costs. The prob-lem here is the lack of correction of the exercise execution. This feasibility study therefore investigates the applicability of a vibrotactile-controlled feedback system for trunk stabilization exercises. A sample of 13 healthy adults performed three trunk stabilization exercises. Exercise performance was corrected by physiotherapists using vibrotactile feedback. The NASA TLX questionnaire was used to assess the practicability of the vibrotactile feedback. The Nasa TLX questionnaire show a very low global workload M = 37.96 (SD =11.63). The quality of feedback perception was perceived as good by the subjects, varying between 76.9 % and 92.3 % depending on the body part. 80.8 % rated the feedback as helpful for their training. On the expert side, the results show a high rating of movement quality. The positive evaluations of the physiotherapists and the participants on the use of the vibrotactile feedback system indi-cate that such a system can reduce the trainees fear of independent training and support the users in their training. This could increase training adherence and long-term success.