Necknasium: A Virtual Reality Rehabilitation Game for Managing Faulty Neck Posture (2312.14371v1)

Abstract: This study is concerned with the application of virtual reality (VR) in rehabilitation programs for faulty neck posture which is a primary source of neck pain (NP). The latter is a highly prevalent musculoskeletal disorder that is associated with serious societal and economic burden. VR has been shown to be effective in the physical rehabilitation of various diseases. Specifically, it has been shown to improve the adherence of patients and engagement to carry out physical exercises on a regular basis. Many games have been used to manage NP with different immersion levels. Towards this goal, we present a VR-based system that targets a specific neck problem, the so called forward head posture (FHP), which is a faulty head position that abnormally stresses neck structures. The system can also generalize well to other neck-related disorders and rehabilitation goals. We show the steps for designing and developing the system, and we highlight the aspects of interaction between usability and various game elements. Using a three-point scale for user experience, we also present preliminary insights on the evaluation of the system prototype, and we discuss future enhancement directions based on the feedback from users.

• The paper introduces Necknasium, a virtual reality game utilizing Oculus Quest sensors for rehabilitating faulty neck posture by engaging deep neck flexor muscles through distinct strength and endurance exercise levels.
• Necknasium's design allows for manual and automatic calibration, incorporates six levels targeting neck retraction strength and endurance, and initial user feedback indicated a preference for VR over traditional methods despite identifying areas for improved engagement and clarity.
• This work demonstrates the potential of a VR-based system like Necknasium to offer an engaging alternative for neck posture correction and other related disorders, emphasizing the importance of user feedback for iterative development and enhanced user experience.

This paper introduces "Necknasium™," a virtual reality (VR) game designed for rehabilitation of faulty neck posture, specifically forward head posture (FHP), which is a major contributor to neck pain (NP). The authors argue that NP is a prevalent musculoskeletal disorder with significant societal and economic impact and that VR can enhance patient engagement in physical therapy.

The paper details the design and development process of Necknasium™, emphasizing the interaction between usability and various game elements. The system aims to improve both strength and endurance of deep neck flexor (DNF) muscles, which are crucial for correcting FHP.

The design requirements are based on user experience (for both therapists and patients), exercise dynamics for FHP correction, and the level of customization needed. The system is intended to allow users to set ranges of motion, perform automatic calibration to accommodate different movement ranges (particularly useful in remote rehabilitation scenarios), and provide a realistic, motivating exercise environment.

Initially, the researchers attempted to use custom-built inertial motion units (IMUs) for motion tracking. However, due to issues with noise and instability, they switched to utilizing the embedded motion sensors within the Oculus Quest 1 VR headset. They found that device position could be reliably used to detect neck retraction movements. Angular velocity and acceleration were also used to detect erroneous movements.

The system offers both manual and automatic calibration options. Manual calibration allows therapists to personalize the range of motion, while automatic calibration provides a means for remote validation. The VR environment is a gymnasium where users perform repetitions of lifting a weight bar through neck retraction movements. The system has six levels, with the first three focusing on strength by requiring users to reach 30%, 60%, and 90% of their maximum retraction range for 30 repetitions. The next three levels are similar but also require users to hold the retracted position for a specified duration to improve endurance. The VR environment includes visual and auditory feedback cues.

The authors highlight that the system, while targeting FHP, can be generalized to other neck-related disorders due to its ability to track various neck movements in three dimensions.

A preliminary prototype evaluation was conducted with three healthy, asymptomatic male participants. The evaluation focused on two settings: Level 3 (strength) and Level 6 (endurance). Participants provided subjective ratings on engagement and preference for the VR-based intervention, as well as a rating of their user experience.

The results indicated that while the exercise was engaging, it wasn't necessarily "fun." Participants suggested more variety in tasks. All the participants indicated a preference for VR exercises versus traditional methods, especially with the motivating factors of a health concern. The user experience ratings highlighted areas for improvement, particularly in clarity of instructions and the level of "interesting-ness" of the activity. The authors conclude that while the system has potential, further development is needed to improve user engagement and the overall experience. Future work will be guided by the feedback obtained from the preliminary prototype evaluation.