Efficacy of different interaction devices using non-immersive virtual tasks in individuals with Amyotrophic Lateral Sclerosis: a cross-sectional randomized trial

Isabela Lopes Trevizan, Talita Dias Silva, Helen Dawes, Thais Massetti, Tânia Brusque Crocetta, Francis Meire Favero, Acary Souza Bulle Oliveira, Luciano Vieira de Araújo, Ana Carolina Costa Santos, Luiz Carlos de Abreu, Shelly Coe, Carlos Bandeira de Mello Monteiro, Isabela Lopes Trevizan, Talita Dias Silva, Helen Dawes, Thais Massetti, Tânia Brusque Crocetta, Francis Meire Favero, Acary Souza Bulle Oliveira, Luciano Vieira de Araújo, Ana Carolina Costa Santos, Luiz Carlos de Abreu, Shelly Coe, Carlos Bandeira de Mello Monteiro

Abstract

Background: Amyotrophic Lateral Sclerosis (ALS) is a rapid progressive neurodegenerative disease, characterized by a selective loss of motor neurons, brain stem and spinal cord which leads to deterioration of motor abilities. Devices that promote interaction with tasks on computers can enhance performance and lead to greater independence and utilization of technology.

Objective: To evaluate performance on a computer task in individuals with ALS using three different commonly used non-immersive devices.

Method: Thirty individuals with ALS (18 men and 12 women, mean age 59 years, range 44-74 years) with a mean score of 26, (minimum score of 14 and maximum 41) on the Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R) and 30 healthy controls matched for age and gender, participated. All participants were randomly divided into three groups, each using a different device system (motion tracking, finger motion control or touchscreen) to perform three task phases (acquisition, retention and transfer).

Results: Both the ALS and control group (CG) showed better performance on the computer task when using the touchscreen device, but there was limited transfer of performance onto the task performed on the Finger Motion control or motion tracking. However, we found that using the motion tracking device led to transfer of performance to the touchscreen.

Conclusion: This study presents novel and important findings when selecting interaction devices for individuals with ALS to access technology by demonstrating immediate performance benefits of using a touchscreen device, such as improvement of motor skills. There were possible transferable skills obtained when using virtual systems which may allow flexibility and enable individuals to maintain performance overtime.

Trial registration: Registration name: Virtual Task in Amyotrophic Lateral Sclerosis; Registration number: NCT03113630 ; retrospectively registered on 04/13/2017. Date of enrolment of the first participant to the trial: 02/02/2016.

Keywords: Amyotrophic lateral sclerosis; Motor activity; Rehabilitation; User-computer Interface; Virtual reality exposure therapy.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Ethics Committee for Research Project Analysis of the School of Medicine, University of São Paulo (Comitê de Ética em Pesquisa da Faculdade de Medicina da Universidade de São Paulo – CEP FMUSP) under the number CAEE: 43456015.0.0000.0065. All participants signed an informed consent form and received written and verbal information before participation of this study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Graphic representation of an individual with ALS using the motion tracking (a), the finger motion control (b) and the touchscreen interface (c) during a proposed virtual task. a (upper left) initial screen of the task with 126 bubbles; (middle left) individual defines the skill zone by touching the screen for 10 s; (bottom left) researcher defines a target bubble in the center of bottom of the range line; (upper right) individual touches the bubble that appears randomly (in the chase area); (middle right) a return to bubble target; (bottom right) some touches are in a bubble outside the chase area, challenging the limits of the individual. The protocol was the same for all interfaces
Fig. 2
Fig. 2
Study design. ALS Amyotrophic Lateral Sclerosis group, CG Control group
Fig. 3
Fig. 3
Representation (mean and standard error) of touched bubbles in all phases of the study in both groups: ALS and control. MT: Motion Tracking interface used; TS: Touchscreen interface used; FMC: Finger Motion Control interface used; FA: First attempt in the acquisition phase; LA: Last attempt in the acquisition phase; R: Tentative of retention phase; T1: First attempt at transfer phase with interface change; T2: Second attempt at transfer phase with the third interface; ALS: Amyotrophic Lateral Sclerosis group; Control: healthy control group

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