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Since several years scientists are carrying on research about innovative systems, based on robotics, mechatronics devices and IT tools – especially the graphical ones – to support patients in rehabilitation programs for rescuing from various brain damages due to adverse events as stroke. Training sessions with a combination of robot and virtual reality (VR) lead to better rehabilitation outcomes than using only a robot and evidence from the field proved the importance of the use of VR interfaces in rehabilitation. The main aim of such a kind of environments is to monitor, motivate and drive the patient during the rehabilitation sessions. These systems mainly provide motor guidance and multimedia communication channels also measuring patients' performance and other observable variables. The approach implemented is usually based on gaming, where the patient has the key role to perform certain tasks or movements for controlling the game in the correct way and exercise the injured part. According to daily experience from physiotherapists, different aspects related to the physical and self-perceived patients' state revealed to have a fundamental role in influencing the rehabilitation session. Indeed, the treatment result depends not only on motor skills but also on patient's personal behavior and feelings that are not directly investigable, observable and measurable from outside. In other words this kind of elements can only be assessed by subjective measurements (as questions, interviews, narratives) revealing the point of view of the patient. Moreover, the emotional state has implications at different levels: on one hand, it is important to evaluate if the single rehabilitation session affects the emotional state of the patient, on the other, if the performance was influenced by this state. Some answers of a questionnaire administrated to post-stroke patients in a previous study underlined also the need for the patient to focus his/her attention on the trained body portion and the relevance of a visual feedback on movements to increase self-awareness on the action performed, avoiding any possible distraction derived from other kind of tasks and related visual/auditory stimuli. Patient-centered models of care are actually becoming increasingly common among rehabilitation clinical settings. They help to focus the therapy on improving the treatment of those deficiencies that most influence the quality of life of the patient. Another important aspect is represented by the relationship with the caregiver that in virtually assisted rehabilitation would not be direct anymore and will need to be mediated without completely loosing natural interaction. According to this patient centered vision, and in order to reduce possible side effects related to semi-automatic rehabilitation systems, it has been studied and developed a system which has not the aim of merely entertain the patient but to focalize the rehabilitation on him/her as a proactive character aware of what is happening and of the quality of the work performed.

An exploratory study aimed at testing CREC, a training programme designed for people with cognitive impairments caused by a stroke, is reported. The goal of the programme is to improve flexibility in thinking through a creative approach based on everyday problems. The programme includes two Serious Games (SGs) developed ad hoc, dealing with the transfer of the learned strategies to the home environment. The training was applied to six patients to test if it could bring beneficial effects to them. Before and after the training, patients’ neuropsychological functioning, emotional state and level of creativity were assessed. Results showed improvements in memory, logical reasoning and praxic skills. Improvements in quality of life and in creativity emerged as well. At the end of the training, the patients perceived themselves as more efficient in problem solving and recognised that the SGs led them to reflect critically on some aspects of their daily life that they usually took for granted. [ABSTRACT FROM AUTHOR]

This paper describes the planning and the implementation of a serious game (SG) for the improvement of attention skills in children with Attention Deficit-Hyperactivity Disorders (ADHD) to promote learning and autonomous management of impulsive behaviors and to inhibit irrelevant thoughts. The SG, called Antonyms, is a personal computer videogame consisting of a series of activities, each eliciting the tendency to respond in an immediate, inadequate way based on the Dual Pathway Model proposed by Sonuga-Barke. Children must block such a tendency, reflect upon the situation and find the nonintuitive solution to foster self-regulation skills. Antonyms consists of three mini-games in a single framework. It is designed for educational and rehabilitation settings. The expected outcome is an increase in the ability to keep attention focused on the relevant elements of situations that children face in their everyday life.

The Attention Deficit–Hyperactivity Disorder (ADHD) is a behavior-related disorder, already present in children in pre-scholar and scholar age, that mainly includes hyperactivity, lacks in attention skills, impulsivity (delay aversion). While several approaches have been studied and developed for modelling and facing the various aspects of ADHD, the Dual Pathway Model (DPM), by Sonuga-Barke, is an evidence-based model that synthetizes in the cognitive and motivational paths the key dysfunctions, the inhibitory and delay aversion ones. In this paper is presented the development of a prototype of a computer serious game, called Antonyms, based on the DPM model, that is aimed at promoting learning and autonomous management of impulsive behaviors and at inhibiting irrelevant thoughts in children with ADHD. The game is structured as a set of tasks, contextualized in a story, impelling the player to react in an inadequate and immediate way while the player, to win, has to enhance his/her own skills of self-regulation, waiting, reflecting upon a situation, finding a not-intuitive solution. Preliminary tests on a control group show that impulsivity and inattention are really addressed during gameplay.

Rehabilitation after stroke supported by mechatronic devices and digital environments is a matter of research since many years. It has been discovered that these technologies bring effective improvements in patients' life but clearer results are expected to come. The developed systems often focus their attention on games with the main aim of engaging the patients. In this paper a prototype of a robotic device coupled with a digital environment for rehabilitating at home the upper limb by focusing the attention both on the patient and on the quality of the performance is presented.

This paper presents a system called REAPP, a virtual environment aiming at supporting upper-limb robotic neurorehabilitation for post-stroke patients. In the last few years different systems using either or both virtual environments and robots have been developed. However, such advanced systems often lack attention on the physical and psychological conditions perceived by the patient, who should be the key focus in therapies. In this context, REAPP aims not to be just an entertaining interface but also a means to investigate patients’ feelings toward the therapy and to enhance their self-perception while performing the rehabilitation exercises. Before and after the rehabilitation session the patients are inquired about their emotional state, their physical condition and a self-evaluation of the performance is done. While performing the exercises patients look at a 2D/3D interface which has the aim of enhancing their self-awareness by showing them, through an avatar, the movements they are doing. Widgets and a virtual assistant provide additional feedback about the quality of the movements which is computed through a specifically developed arm model that can be customized on the residual capabilities of each patient.

The use of mechanical/robotic devices and of IT based applications in the post-stroke rehabilitation is one of the main challenges in applied research in health sector. Among the wide spectrum of systems, it seems that the focus is still much on the system itself, as a technological whole, and less on the key actor, that is the patient. In this paper a supporting system for post-stroke rehabilitation, based on a 2D/3D real time interface, is presented. It aims at enhancing the point of view of the patients by showing them the movements they are performing through an avatar and by presenting some qualitative aspects of the exercises that can help the patients to be more aware of, and eventually improve, their performance.

This paper presents an overview of the use of virtual reality in physical rehabilitation and some thoughts about implementations of the virtual environment (VE) applied to a rehab robot. The point of view is not just technical but also based on the aims of the technology itself from a user's point of view. Objective of this paper is to present an initial study on virtual reality interface applied to a robot for shoulder rehabilitation. A reflection about anxiety and boredom emotions guides through an analysis of possible improvements of a first simple environment that facilitates patients' movements.