Platform Technology for Extended Reality Biofeedback Training Under Operant Conditioning for Functional Limb...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Human-Computer Interaction

Background:

• Functional neurological disorder (FND) disrupts the perception-action cycle, impairing motor control and sense of agency.
• FND significantly reduces quality of life due to physical disability and psychological distress.
• Extended reality (XR) offers a novel therapeutic approach for FND by integrating biofeedback for motor relearning.

Purpose of the Study:

• To coproduce and evaluate the usability of an XR technology platform for FND rehabilitation, specifically for functional limb weakness.
• To integrate biofeedback training with haptic and visual feedback for enhanced motor relearning and control.
• To ensure the XR platform is patient-centered, addressing needs for customization, comfort, and accessibility.

Main Methods:

• Employed an experience-based co-design framework involving patients, caregivers, and healthcare professionals.
• Utilized narrative interviews and co-design workshops to identify user needs and emotional touchpoints.
• Integrated XR training tasks (relaxation, position, force feedback) into a therapeutic game using Agile sprints and assessed usability via System Usability Scale and qualitative feedback.

Main Results:

• Achieved high usability scores (>85) for XR position feedback tasks in predesign evaluations.
• Identified interindividual variability in VR relaxation and XR force feedback, highlighting the need for personalization.
• Key user-identified themes for platform improvement included customization, comfort, accessibility, and technological quality.

Conclusions:

• Coproduction and iterative refinement are crucial for developing personalized XR gaming technology for FMD rehabilitation.
• Personalization and accessibility are key to optimizing usability and long-term clinical outcomes for at-home FND treatment.
• The developed XR platform shows promise as a scalable, at-home solution within the FND stepped care model.