Gamified VR Rehabilitation for CRPS

Open Human-Computer Interaction Computer Science Games Engineering Master Project Thesis Internship Embodiment Lab Industry Cooperation

Background

Chronic pain is a major public health challenge. Epidemiological studies report that about one fifth of the total population is affected in both the US and Europe. Particularly challenging is the treatment of neuropathic pain, which affects about 7% to 8% of the European population. Signs of neuropathic pain are also found in the context of Complex Regional Pain Syndrome (CRPS). CRPS affects extremities and occurs mainly after trauma or surgery. Patients suffer from excessive pain and hypersensitivity, autonomic as well as motor and trophic changes. Interestingly, around 75% of CRPS patients report at least one neglect-like symptom. Similarly, 54-88% of CRPS patients report disturbances of body perception. Altered body perception (BP) and neglect-like symptoms are associated with more pain, anxiety as well as pain catastrophizing and ultimately unfavorable outcome.

Recent advances in avatar technology significantly increase the potential of VR-based therapies. Avatar technology allows to exploit virtual body ownership (VBO) effects which open-up novel approaches for the diagnosis and treatment of BP-related disorders and diseases. For example, frequent exposure to modified bodies and body part representations not only changes movement patterns and behavior during the VR-exposure, the Proteus effect makes these changes last through-out but also after the stimulus, i.e., after participants leave the VR back to the real world. Such avatar and body ownership interventions directly target BP. They carry the potential to normalize disturbed BPs in reality and to modify and correct pathological misconceptions for BP-related disorders and diseases.

Task

The goal of this topic is to design, implement, and evaluate a prototype of a gamified VR rehabilitation application for people with Complex Regional Pain Syndrome (CRPS). The prototype will combine hand tracking and gesture recognition with evidence-informed, configurable virtual hand representations and Beat Saber-inspired game mechanics to create an engaging rehabilitation experience, drawing on current research on virtual embodiment and body perception.

The project covers the complete development cycle, from literature review and prototype development to technical and user evaluation.

The task is broken-down as follows:

1. Review VR-based pain rehabilitation with a focus on virtual embodiment and body perception.

2. Design and implement an evidence-informed VR prototype:

   • Gesture recognition using an existing hand-tracking solution (e.g., Meta XR).
   • Evidence-informed hand visualizations to influence body perception.
   • Beat Saber-inspired game mechanics to increase engagement.

3. Technical evaluation.

4. Evaluation with healthy participants.

5. Pilot evaluation with CRPS patients.

The described tasks can be carried out by master’s students in Human-Computer Interaction, Games Engineering, Computer Science, or Human-Computer Systems. The tasks and project focus will be tailored to the respective program of study and final goal (project, internship, MSc thesis).

The project offers the opportunity to work on a real-world problem of high significance together with colleagues from the University Hospital Würzburg.

Prerequisites

• Reliability and professionalism when working with external partners.
• Good programming skills.
• Experience with Unity3D.
• Experience in conducting user studies.

Favorable

Experience in one or several of

• Hand tracking and gesture recognition
• Principles of Real-time Interactive Systems
• Computer Graphics

References

Bruehl, S. (2015). Complex regional pain syndrome. BMJ, 351, h2730.

Colloca, L., Raghuraman, N., Wang, Y., Akintola, T., Brawn-Cinani, B., Colloca, G., … & Murthi, S. (2020). Virtual reality: physiological and behavioral mechanisms to increase individual pain tolerance limits. Pain, 161(9), 2010-2021.

Lewis, J. S., Kellett, S., McCullough, R., Tapper, A., Tyler, C., Viner, M., & Palmer, S. (2019). Body perception disturbance and pain reduction in longstanding complex regional pain syndrome following a multidisciplinary rehabilitation program. Pain Medicine, 20(11), 2213-2219.

Matamala-Gomez, M., Gonzalez, A. M. D., Slater, M., & Sanchez-Vives, M. V. (2019). Decreasing pain ratings in chronic arm pain through changing a virtual body: different strategies for different pain types. The Journal of Pain, 20(6), 685-697.

Roth, D., Latoschik, M. E. (2020). Construction of the Virtual Embodiment Questionnaire (VEQ). In IEEE Transactions on Visualization and Computer Graphics (TVCG), 26(12):3546-3556.

Waltemate, T., Gall, D., Roth, D., Botsch, M., & Latoschik, M. E. (2018). The impact of avatar personalization and immersion on virtual body ownership, presence, and emotional response. In IEEE Transactions on Visualization and Computer Graphics (TVCG), 24(4):1643-1652.

Contact Persons at the University Würzburg