Audiovisual Feedback Research Articles

The effect of standalone audio-visual feedback devices on the quality of chest compressions during laypersons' cardiopulmonary resuscitation training: a systematic review and meta-analysis.

Individual studies that investigated the effect of standalone audio-visual feedback (AVF) devices during laypersons' cardiopulmonary resuscitation (CPR) training have yielded conflicting results. This review aimed to evaluate the effect of standalone AVF devices on the quality of chest compressions during laypersons' CPR training. Randomized controlled trials of simulation studies recruiting participants without actual patient CPR experience were included. The intervention evaluated was the quality of chest compressions with standalone AVF devices vs. without AVF devices. Databases, such as PubMed, Cochrane Central, Embase, Cumulative Index to Nursing & Allied Health Literature (CINAHL), Web of Science, and PsycINFO, were searched from January 2010 to January 2022. The risk of bias was assessed using the Cochrane risk of bias tool. A meta-analysis alongside a narrative synthesis was used for examining the effect of standalone AVF devices.Sixteen studies were selected for this systematic review. A meta-analysis revealed an increased compression depth of 2.22 mm [95% CI (Confidence Interval), 0.88-3.55, P = 0.001] when participants performed CPR using the feedback devices. Besides, AVF devices enabled laypersons to deliver compression rates closer to the recommended range of 100-120 per min. No improvement was noted in chest recoil and hand positioning when participants used standalone AVF devices. The quality of the included studies was variable, and different standalone AVF devices were used. Standalone AVF devices were instrumental in guiding laypersons to deliver deeper compressions without compromising the quality of compression rates. However, the devices did not improve the quality of chest recoil and placement of the hands. PROSPERO: CRD42020205754.

Development of a compensation-aware virtual rehabilitation system for upper extremity rehabilitation in community-dwelling older adults with stroke

BackgroundCompensatory movements are commonly observed in older adults with stroke during upper extremity (UE) motor rehabilitation, which could limit their motor recovery.AimThis study aims to develop a compensation-aware virtual rehabilitation system (VRS) that can detect compensatory movements and improve the outcome of UE rehabilitation in community-dwelling older adults with stroke.MethodsThe VRS development includes three main components: (1) the use of thresholds for determining compensatory movements, (2) the algorithm for processing the kinematic data stream from Kinect to detect compensation in real-time, and (3) the audio-visual feedback to assist older adults with stroke to be aware of the compensation. Two studies were conducted following the VRS development, where Study 1 identified the value of thresholds for determining compensatory movements in two planar motor exercises, and Study 2 provided preliminary validation for the developed VRS by comparing two groups undergoing VR training or conventional training (CT) in a community rehabilitation center.ResultsThe VRS could effectively detect all determined compensatory movements and timely trigger feedback in response to the detected compensatory movements. The VR participants showed significant improvements in Fugl-Meyer Assessment-Upper Extremity (FMA-UE, p = 0.045) and Wolf Motor Function Test (WMFT, p = 0.009). However, the VR and CT groups had no significant differences in outcome measures.ConclusionThe VRS demonstrates the ability to detect compensation and the potential of assisting older adults with stroke to improve motor functions. Suggestions are given for further improvements of the VRS to support the older adult with stroke to reduce compensation.

An analysis of clinical outcomes and essential parameters for designing effective games for upper limb rehabilitation: A scoping review.

Upper limb disabilities are one of the most common disabilities among different groups of people who always need rehabilitation. One of the important methods in helping to carry out efficient rehabilitation processes and exercises is the use of games. The aim of this study is to identify the parameters necessary to design a successful rehabilitation game and the outcomes of using these games in upper limb disabilities rehabilitation. This scoping review was conducted by searching the Web of Science, PubMed, and Scopus. The eligibility criteria were: any form of game-based upper limb rehabilitation, published in a peer-reviewed journal, published in English, and not include articles that did not focus upper limb disabilities rehabilitation games, review, meta-analysis, or conference papers. Analysis of collected data was done using descriptive statistics (frequency and percentage). The search strategy retrieved 537 relevant articles. Finally, after removing irrelevant and repetitive articles, 21 articles were included in this study. Among the six categories of diseases or complications of upper limb disabilities, games were mostly designed for stroke patients. Smart wearables, robots and telerehabilitation were three technologies that were used for rehabilitation along with games. Sports and shooters were the most used games for upper limb disability rehabilitation. Among 99 necessary parameters for designing and implementing a successful rehabilitation game in ten categories. "Increasing the patient's motivation to perform rehabilitation exercises", "Game difficulty levels", "Enjoying and the attractiveness of the game for patients", and "Providing positive or negative audiovisual feedback" were the most important parameters. "Improvement in musculoskeletal performance" and "Increasing users' enjoyment/joy of therapeutic exercises and their motivation to perform these exercises" were the most important positive outcomes, and "Mild discomfort such as nausea and dizziness when using games" was the only negative outcome. The successful design of a game according to the parameters identified in the present study can lead to an increase in the positive outcomes of using games in the rehabilitation of disabilities. The study results indicate that upper limb therapeutic exercise augmented with virtual reality games may be highly effective in enhancing motor rehabilitation outcomes.

Mixed-reality-based human-animal interaction can relieve mental stress.

Interacting with animals has been demonstrated to possess the healing benefits to humans. However, there are limitations in physical interaction due to COVID-19 and safety issues. Therefore, as an alternative, we created mixed-reality (MR)-based human-animal interaction (HAI) content and experimentally verified its effect on mental stress reduction. We created three types of interactive content: observing the movement of a non-reactive virtual cat, interacting with a virtual cat whose responses can be seen, and interacting with a virtual cat whose responses can be both seen and heard. The experiment was performed by 30 healthy young women, and a mental arithmetic task was used to induce mild mental stress before experiencing each content. During the experiment, the subject's electrocardiogram was continuously recorded, and the psychological state was evaluated through a questionnaire. The results showed that MR-based virtual cat content significantly reduces mental stress and induces positive emotions after stressful situations. In particular, when the virtual cat provided audiovisual feedback, the activation amount of the parasympathetic nervous system and the increase of positive emotions were the greatest. Based on this encouraging research result, this method should be further investigated to see if it can replace real HAI for human mental health management.

Gaze-based attention refocusing training in virtual reality for adult attention-deficit/hyperactivity disorder

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is characterized by substantial interindividual heterogeneity that challenges the systematic assessment and treatment. Considering mixed evidence from previous neurofeedback research, we present a novel feedback system that relies on gaze behavior to detect signs of inattention while performing a neuropsychological attention task in a virtual seminar room. More specifically, an audiovisual feedback was given whenever participants averted their gaze from the given task.MethodsEighteen adults with ADHD and 18 healthy controls performed a continuous performance task (CPT) in virtual reality under three counterbalanced conditions in which either gaze-based feedback, sham feedback, or no feedback was provided. In all conditions, phases of high and low virtual distraction alternated. CPT errors and reaction times, proportions of gaze dwell times (e.g., task focus or distraction focus), saccade characteristics, EEG theta/beta ratios, head movements, and an experience sampling of ADHD symptoms were analyzed.ResultsWhile patients can be discriminated well from healthy controls in that they showed more omission errors, higher reaction times, higher distraction-related dwell times, and more head movements, the feedback did not immediately improve task performance. It was also indicated that sham feedback was rather associated with an aggravation of symptoms in patients.ConclusionsOur findings demonstrate sufficient suitability and specificity for this holistic ADHD symptom assessment. Regarding the feedback, a single-session training was insufficient to achieve learning effects based on the proposed metacognitive strategies. Future longitudinal, multi-session trials should conclusively examine the therapeutic efficacy of gaze-based virtual reality attention training in ADHD.Trial registrationdrks.de (identifier: DRKS00022370).

How Mobile Touch Devices Foster Cognitive Offloading in the Elderly: The Effects of Input and Feedback

When the elderly have a working memory burden, the cognitive burden can be transferred to mobile touch devices. However, the decline of physical function and cognitive ability affects the ability of the elderly to interact with mobile devices. Optimizing the interaction of mobile touch devices is one of the effective ways to reduce the cognitive burden of the elderly. This study intended to investigate the effects of the input and feedback methods on mobile touch devices on cognitive offloading behaviors in older adults. The experiment adopts a 3 × 3 within-subject design, and the independent variables include 3 input methods (mouse, direct touch, and stylus) and 3 feedback methods (visual feedback, auditory feedback, and combined audiovisual feedback). Thirty elderly participants were invited to complete a visual working memory test and subjective preference questionnaires. The results of the study show that (i) the input methods have a significant effect on the cognitive offloading of the elderly, who, under the stylus condition, have the most offloaded working memory and lower cognitive load; (ii) the feedback methods have a significant effect on the cognitive offloading of the elderly, among which they, under the combined visual and auditory feedback, offload working memory more frequently and have lower cognitive load; and (iii) in terms of subjective evaluation, both the input and feedback methods affect the satisfaction of the elderly: among the 3 input methods, the elderly displayed the highest satisfaction with the stylus, and among the 3 feedback methods, the elderly have the highest satisfaction with the combined audio-visual feedback. Studies have shown that the input and feedback methods of mobile touch devices are important factors affecting the cognitive offloading behavior and subjective evaluation of the elderly. The conclusions of this research provide an important reference for designing interactive methods suitable for the elderly.

Medication safety in the perioperative setting: A comparison of methods for detecting medication errors and adverse medication events.

The purpose of this study was to evaluate perioperative medication-related incidents (medication errors (MEs) and/or adverse medication events (AMEs)) identified by 2 different reporting methods (self-report and direct observation), and to compare the types and severity of incidents identified by each method. We compared perioperative medication-related incidents identified by direct observation in Nanji et al's 2016 study[1] to those identified by self-report via a facilitated incident reporting system at the same 1046-bed tertiary care academic medical center during the same 8-month period. Incidents, including MEs and AMEs were classified by type and severity. In 277 operations involving 3671 medication administrations, 193 MEs and/or AMEs were observed (5.3% incident rate). While none of the observed incidents were self-reported, 10 separate medication-related incidents were self-reported from different (unobserved) operations that occurred during the same time period, which involved a total of 21,576 operations and approximately 280,488 medication administrations (0.004% self-reported incident rate). The distribution of incidents (ME, AME, or both) did not differ by direct observation versus self-report methodology. The types of MEs identified by direct observation differed from those identified by self-report (P = .005). Specifically, the most frequent types of MEs identified by direct observation were labeling errors (N = 37; 24.2%), wrong dose errors (N = 35; 22.9%) and errors of omission (N = 27; 17.6%). The most frequent types of MEs identified by self-report were wrong dose (N = 5; 50%) and wrong medication (N = 4; 40%). The severity of incidents identified by direct observation and self-report differed, with self-reported incidents having a higher average severity (P < .001). The procedure types associated with medication-related incidents did not differ by direct observation versus self-report methodology. Direct observation captured many more perioperative medication-related incidents than self-report. The ME types identified and their severity differed between the 2 methods, with a higher average incident severity in the self-reported data.

FeetBack-Redirecting touch sensation from a prosthetic hand to the human foot.

Adding sensory feedback to myoelectric prosthetic hands was shown to enhance the user experience in terms of controllability and device embodiment. Often this is realized non-invasively by adding devices, such as actuators or electrodes, within the prosthetic shaft to deliver the desired feedback. However, adding a feedback system in the socket adds more weight, steals valuable space, and may interfere with myoelectric signals. To circumvent said drawbacks we tested for the first time if force feedback from a prosthetic hand could be redirected to another similarly sensitive part of the body: the foot. We developed a vibrotactile insole that vibrates depending on the sensed force on the prosthetic fingers. This self-controlled clinical pilot trial included four experienced users of myoelectric prostheses. The participants solved two types of tasks with the artificial hands: 1) sorting objects depending on their plasticity with the feedback insole but without audio-visual feedback, and 2) manipulating fragile, heavy, and delicate objects with and without the feedback insole. The sorting task was evaluated with Goodman-Kruskal's gamma for ranked correlation. The manipulation tasks were assessed by the success rate. The results from the sorting task with vibrotactile feedback showed a substantial positive effect. The success rates for manipulation tasks with fragile and heavy objects were high under both conditions (feedback on or off, respectively). The manipulation task with delicate objects revealed inferior success with feedback in three of four participants. We introduced a novel approach to touch sensation in myoelectric prostheses. The results for the sorting task and the manipulation tasks diverged. This is likely linked to the availability of various feedback sources. Our results for redirected feedback to the feet fall in line with previous similar studies that applied feedback to the residual arm. Name: Sensor Glove and Non-Invasive Vibrotactile Feedback Insole to Improve Hand Prostheses Functions and Embodiment (FeetBack). Date of registration: 23 April 2019. Date the first participant was enrolled: 3 September 2021. ClinicalTrials.gov Identifier: NCT03924310.

Multi-Institutional Validation of a Smartphone-Based Surface Guided Radiation Therapy (SGRT) Tracking System for Respiratory Monitoring in Radiation Therapy

<h3>Purpose/Objective(s)</h3> Surface guidance radiation therapy (SGRT) systems are becoming standard-of-care for patient setup and motion monitoring. However, commercial systems remain inaccessible to resource-limited clinics around the world. The iOS Surface Audiovisual Biofeedback (iSAVB) system implements ubiquitous mobile technology as a versatile tool for surface imaging in resource-strapped clinics. The purpose of this study is to establish a robust validation platform, commission iSAVB at multiple participating institutions, and validate iSAVB using phantom motion and against commercial systems during patient treatments. <h3>Materials/Methods</h3> Three participating institutions are implementing, validating, and comparing the iSAVB system against current clinical SGRT systems. The iSAVB system consists of depth camera enabled iOS device, to acquire real-time point-cloud data for surface rendering, a 3D printed stand capable of mounting and indexing on a treatment couch, and aa tablet (or external workstation) for audio-visual feedback and signal processing. Validation of the iSAVB system was performed against commercial optical systems at each center using a respiratory motion phantom. Motion traces were analyzed using linear regressions and Bland-Altman analysis. <h3>Results</h3> The iSAVB system was successfully installed at an initial institution and tested on phantoms and healthy volunteers. For free-breathing traces, iSAVB was significantly correlated to phantom input motion (r=0.99, p<0.0001; bias=0.00±0.05cm, 95%CI=−0.1cm,0.1cm) and commercial system motion (r=0.99, p<0.0001; bias=0.00±0.07cm, 95%CI=−0.14cm,0.14cm). Systems are currently being installed at the two additional institutions that will perform similar commissioning and validation. <h3>Conclusion</h3> A multi-center validation shows the iSAVB system can be used for surface motion monitoring and provides SGRT capabilities similar to current high-end clinical systems. The iSAVB system can be used for 3D/IMRT/VMAT treatments, although future validation is required for SBRT treatments. Future work includes establishing reliable commissioning protocols that follow TG-302 guidelines for resource-strapped departments to benefit from affordable and accurate surface imaging guidance. Reference:

Effect of real-time feedback on patient's outcomes and survival after cardiac arrest: A systematic review and meta-analysis.

Purpose:This study investigated the effect of real-time feedback on the restoration of spontaneous circulation, survival to hospital discharge, and favorable functional outcomes after hospital discharge.Methods:PubMed, ScienceDirect, and China National Knowledge Infrastructure databases were searched to screen the relevant studies up to June 2020. Fixed-effects or random-effects model were used to calculate the pooled estimates of relative ratios (RRs) with 95% confidence intervals (CIs).Results:Ten relevant articles on 4281 cardiac arrest cases were identified. The pooled analyses indicated that real-time feedback did not improve restoration of spontaneous circulation (RR: 1.13, 95% CI: 0.92–1.37, and P = .24; I2 = 81%; P < .001), survival to hospital discharge (RR: 1.27, 95% CI: 0.90–1.79, and P = .18; I2 = 74%; P < .001), and favorable neurological outcomes after hospital discharge (RR: 1.09, 95% CI: 0.87–1.38; P = .45; I2 = 16%; P = .31). The predefined subgroup analysis showed that the sample size and arrest location may be the origin of heterogeneity. Begg’s and Egger’s tests showed no publication bias, and sensitivity analysis indicated that the results were stable.Conclusion:The meta-analysis had shown that the implementation of real-time audiovisual feedback was not associated with improved restoration of spontaneous circulation, increased survival, and favorable functional outcomes after hospital discharge.

From text to audiovisual feedback: enhancing clarity, usefulness and satisfaction

&#x0D; &#x0D; &#x0D; Research demonstrates that students generally find digitally recorded assessment feedback comments to be more satisfying than text-based feedback comments. However, positive perceptions of digitally recorded feedback may be impacted by the confidence and experience of the educator who is providing the comments. As such, this paper reports on an exploratory study in which we compare students’ perceptions of the text-based and digitally recorded feedback created by five tutors in the same subject. Survey data were collected from 81 students, of which 58 received text-based and 23 received digitally recorded feedback comments. Students who received digitally recorded feedback comments provided consistently higher ratings for feedback clarity, usefulness, and satisfaction than students who received text- based feedback comments. It is proposed that the media enables these effects, but the structure of the feedback design is also important.&#x0D; &#x0D; &#x0D;

Do pupillary responses during authentic slot machine use reflect arousal or screen luminance fluctuations? A proof-of-concept study.

Modern slot machines are among the more harmful forms of gambling. Psychophysiological measures may provide a window into mental processes that underpin these harms. Here we investigated pupil dilation derived from eye tracking as a means of capturing changes in sympathetic nervous system arousal following outcomes on a real slot machine. We hypothesized that positively reinforcing slot machine outcomes would be associated with increases in arousal, reflected in larger pupil diameter. We further examined the contribution of game luminance fluctuations on pupil diameter. In Experiment 1A, experienced slot machine gamblers (N = 53) played a commercially-available slot machine in a laboratory for 20 minutes while wearing mobile eye tracking glasses. Analyses differentiated loss outcomes, wins, losses-disguised-as-wins, and (free-spin) bonus features. Bonus features were associated with rapid increases in pupil diameter following the onset of outcome-related audiovisual feedback, relative to losses. In Experiment 1B, luminance data were extracted from captured screen videos (derived from Experiment 1A) to characterize on-screen luminance changes that could modulate pupil diameter. Bonus features and wins were associated with pronounced and complex fluctuations in screen luminance (≈50 L and ≈25L, respectively). However, the pupil dilation that was observed to bonus features in Experiment 1A coincided temporally with only negligible changes in screen luminance, providing partial evidence that the pupil dilation to bonus features may be due to arousal. In Experiment 2, 12 participants viewed pairs of stimuli (scrambled slot machine images) at luminance difference thresholds of ≈25L, ≈50L, and ≈100L. Scrambled images presented at luminance differences of ≈25L and greater were sufficient to cause pupillary responses. Overall, pupillometry may detect event-related changes in sympathetic nervous system arousal following gambling outcomes, but researchers must pay careful attention to substantial in-game luminance changes that may confound arousal-based interpretations.

A Smartphone application to provide real-time cardiopulmonary resuscitation quality feedback

BackgroundQuality of cardiopulmonary resuscitation (CPR) contributes significantly to outcomes. Key determinants of CPR quality pertaining to chest compressions are compression rate, compression depth, duration of interruptions, and chest recoil. Several studies have demonstrated that real-time audiovisual feedback improves CPR quality. We hypothesize that a mobile application using sensor data from built-in accelerometers in smartphones can provide accurate chest compression quality feedback in real time. This study aims to develop and validate an application for smartphone which can provide real-time audiovisual and haptic feedback on determinants of CPR quality. MethodsA mobile application was developed to detect the compression depth and compression rate in real time using data captured from a smartphone's intrinsic accelerometer. The mobile device was placed on an adult manikin's chest at the point of compressions. In a simulated environment, data obtained using the application was compared directly to data obtained from a validated standard CPR quality tool. ResultsCPR quality parameters were obtained from the application and industry standard for 60, 30s-long sessions. Bland-Altman plot analysis for compression depth showed agreement between the app measurements and standard within ±4 mm (<10% error). The interclass correlation for agreement in the measurement of compression count was 0.92 (95% CI: 0.88–0.95), indicative of very strong agreement. ConclusionsSmart device applications using acceleration sensor data derived from smart phones can accurately provide real-time CPR quality feedback. With further development and validation, they can provide a ubiquitously available CPR feedback tool valuable for out-of-hospital arrests and in-hospital arrests in under-privileged areas.

The impact of using different add-on devices to pressurized metered-dose-inhalers containing salbutamol in healthy adult volunteers: An in-vivo study

BackgroundImproper handling of pMDIs results in suboptimal delivery of the drug to the lungs and poor clinical outcomes in adult asthmatics. Forceful inhalation is one of the most critical errors in the pMDI inhalation technique. Using advanced tools to optimize the inhalation technique is required to enhance the inhalation flow and hence the drug delivery to the lungs. MethodsTwo newly adopted add-on devices; the Clip-Tone and the Flo-Tone CR, along with their respective smartphone applications were tested and compared to the normal pMDI inhalation. 12 healthy volunteers (6 females) were trained to use the pMDI alone, pMDI + Clip-Tone, and pMDI + Flo-Tone CR in a cross-over study design. Using the urinary salbutamol excretion pharmacokinetic model, urine samples of 30 min (USAL0.5) and collective urine of 24 h (USAL24) were collected for each experiment; the first represents the lung deposition and the latter represents the systemic bioavailability. Samples were solid-phase extracted and then assayed using HPLC to determine the amount of salbutamol in urine. Since subjects were trained to perform through 2 different add-on tools in addition to the pMDI alone, they reported their personal preference regarding the delivery method. Also, a correlation between inhalation time to USAL 0.5 was determined. ResultsComparing means (SD) of USAL0.5 among the 3 groups, pMDI + Clip-Tone, 22.2 (8.21), and pMDI + Flo-Tone CR, 19.83 (9.94), showed a significant increase (p < 0.01) compared to using pMDI alone, 10.68 (5.82). Comparing means (SD) of USAL24, no significant difference was found among salbutamol amounts in the urine of the pMDI + Clip-Tone group, 54.77 (20.18), and pMDI + Flo-Tone CR group, 49.76 (25.30), and pMDI sole use group, 56.48 (24.42). Studying the associations between the inhalation duration measured and the amount of salbutamol in urine after 30 min, there was a significantly high positive correlation (r = 0.72) (p < 0.001). 50% of the subjects preferred training using the Clip-Tone add-on tool while the other half felt comfortable using both add-on tools. ConclusionUsing advanced training tools that provide audio-visual feedback improved the inhalation technique compared to the sole use of pMDI, which was translated into improved lung deposition of salbutamol. The more preferred add-on tool by subjects, the Clip-Tone device, has not shown significant superiority to the Flo-Tone CR in terms of lung deposition of salbutamol.

P8. The Development of a Smart Phone Application for Global Plastic Surgery Education and Mobile Electronic Medical Records

Background: Access to safe and timely surgical care is marked by inequities across the globe. This is particularly true in the specialized field of plastic and reconstructive surgery. Barriers to care include lack of human resource and limited surgical education. Covid-19 has alienated remote medical systems even further by reducing international missions. The Ohana One phone application is an innovative technology developed by plastic surgeons which aims to circumvent these barriers, all via a user-friendly smartphone interface Methods: Ohana One International Surgical Aid is a California-based global surgery non-profit organization. The Ohana One smartphone application (app) was designed and developed by the organization’s surgeon leaders, who recognized an opportunity to improve international collaboration and plastic surgery education. The free, HIPAA-compliant app provides a central location for surgeons to share challenging patient cases, network with international physicians and upload user-created surgical videos. Integration with VUZIX smart glasses also allows mentee surgeons to share surgeries and patient evaluations while receiving audiovisual feedback from remote mentor surgeons in real-time. Mentors can assess mentees using a surgical benchmark system developed for the app. Additional features include dictation and case logs for physicians without access to an electronic medical record Results: Beta-testing demonstrated a seamless design compatible with smartphone operating systems. The app has been disseminated across Ohana One’s global network comprised of 88 surgeons representing over 40 countries and now five additional surgical sub-specialties. Collaborations with other organizations like ReSurge International have expanded our reach in global plastic surgery. The app will be a valuable adjunct to international missions when they resume. Frequent needs assessments will be essential for maintaining success Conclusion: The Lancet Commission on Global Surgery recognizes the importance of novel technologies in the creation of sustainable global interventions. The Ohana One phone app exemplifies this concept by providing an accessible interface for surgeons to gain real-time training and professional support pre-operatively, intra-operatively, and post-operatively. It is also a remote electronic medical record. Providing surgeons with these tools all via their smartphones optimizes physician training in plastic surgery and, in turn, improves patient access to complex reconstruction around the world.

Virtual reality-based and eye tracking-assisted attention refocusing training for adult Attention-Deficit/Hyperactivity Disorder

IntroductionNeurofeedback regimes in the treatment of adult ADHD are commonly EEG-based and have several shortcomings, including a weak signal-to-noise ratio, low transfer rates from laboratory to everyday environments and ambiguous evidence in respect to adequate brain signals of interest.ObjectivesTo investigate, if an eyetracking-based real-time feedback in a virtual environment can enhance attentional performance, as measured by behavioral, EEG and eyetracking parameters.MethodsOverall, n=18 adult patients with ADHD and n=18 healthy controls (HC) performed a continuous performance task (CPT) in a virtual seminar room, while distracting virtual events occurred. In case the participant’s gaze drifted away from the task an automated audiovisual feedback indicated the participant to refocus on the task. Three 20-minutes blocks were presented in counter-balanced order, that differed in respect to whether real feedback, sham feedback or no feedback was additionally provided.ResultsMixed ANOVAs with within-subject factors ‘Condition’ (real feedback, sham feedback, no feedback) and ‘Phase’ (distractor phases vs. non-distractor phases) and a between-factor ‘Group’ (ADHD patients vs. HC) revealed better task performances in HC than ADHD patients in respect to omission errors (p = .023), mean reaction times (p = .042) and reaction time variabilities (p = .007; cf. Figure 1). Moreover, omission errors turned to be higher during distractor-present than distractor-absent trials (p = .007), especially in ADHD.Figure 1.CPT results. DP=distractor-phases, NDP=non-distractor-phasesConclusionsWhile the virtual CPT turns out to discriminate well between patients with ADHD and HC, the behavioral results do not indicate an attentional performance enhancement based on the gaze-dependent feedback.DisclosureNo significant relationships.

Motor and visual influences on auditory neural processing during speaking and listening

During speaking or listening, endogenous motor or exogenous visual processes have been shown to fine-tune the auditory neural processing of incoming acoustic speech signal. To compare the impact of these cross-modal effects on auditory evoked responses, two sets of speech production and perception tasks were contrasted using EEG. In a first set, participants produced vowels in a self-paced manner while listening to their auditory feedback. Following the production task, they passively listened to the entire recorded speech sequence. In a second set, the procedure was identical except that participants also watched online their own articulatory movements. While both endogenous motor and exogenous visual processes fine-tuned auditory neural processing, these cross-modal effects were found to act differentially on the amplitude and latency of auditory evoked responses. A reduced amplitude was observed on auditory evoked responses during speaking compared to listening, irrespective of the auditory or audiovisual feedback. Adding orofacial visual movements to the acoustic speech signal also speeded up the latency of auditory evoked responses, irrespective of the perception or production task. Taken together, these results suggest distinct motor and visual influences on auditory neural processing, possibly through different neural gating and predictive mechanisms.

System for Game-like Therapy in Balance Issues Using Audiovisual Feedback and Force Platform

Background: The aim of the work is to verify the usability of a stabilometric platform and audiovisual feedback in the group-based therapy of patients with vertebral algic syndrome, to analyze an immediate effect after a single therapeutic unit, and to analyze differences between male and female probands. Methods: The study included 189 patients (90 male, age 55 ± 12 and 89 female, age 52 ± 12). All patients received group balance therapy with a portable medical device, Homebalance MA. The intervention consisted of measurement of quiet stance and a reference training scene before and after 15 min of game-like balance training with audiovisual feedback. Results: A statistically significantly lower value of the body sway trajectory during quiet stance was detected in men than in women. After a single therapy session, there was a statistically significant improvement in quiet stance with visual feedback, and marginal statistically significant improvement in the time required to complete the reference training scene. Conclusions: Homebalance MA is a utilizable tool for group therapy. The use of group game-like balance training increases the availability of physiotherapeutic intervention for a larger number of patients, while maintaining the positive effect of the therapy.

Exploring the impact of teacher feedback modes and features on students' text revisions in writing

Whether and how feedback when provided in different modes affects students' text revisions continue to be important questions for research. Therefore, the present study investigates the quantity and quality of students' integration of teacher feedback in relation to its modes and features. The feedback was given through the oral/spoken mode in a face-to-face (FTF) classroom environment and in three digital modes: text, recorded audio and audio-visual modes. Feedback was classified into imperative, correction, question, suggestion, statement and combination. Data collected from the instructor's four modes of feedback and essays of 30 learners in a Saudi university were coded and analyzed. Findings show that students took up 83.52% of the teacher feedback provided to them with quality of integration measured at 68.46%. The quantity and quality of students' integration of teacher feedback varied across the four modes with the audio-visual feedback being most integrated in text revisions while the text feedback was least integrated. Results also show feedback features, including suggestions, questions and imperatives, were more integrated by students than others. Based on the findings, useful pedagogical and research implications are offered. • Quantity and quality of feedback integration differ in the four feedback modes. • Feedback modes play role in students' quantity and quality of feedback integration. • Screencast feedback leads to higher quantity and quality of feedback integration. • Video feedback is more integrated in text revisions while written feedback the least.

Measuring of the Energy Expenditure during Balance Training Using Wearable Electronics

Homebalance Stability medical device, based on audio-visual feedback and Nintendo Wii Balance Board, is a suitable tool for telerehabilitation of balance issues in patients with brain damage. The main goal was to expand the system by energy expenditure measurements and to verify the usability of the telemetric mobile device FlexiGuard. We used the FlexiGuard system (developed at our institute) and Oxycon (JAEGER® Oxycon Mobile, Germany) to measure the energy expenditure. We performed measurements on eight probands. Each proband underwent six activities for a total length of 90 min. During these activities, we measured energy expenditure using Oxycon and heart rate using the FlexiGuard system, from which we calculated the energy expenditure. By comparing the energy expenditure from measuring the heart rate with the FlexiGuard system with that from the Oxycon reference device, we verified the applicability of the FlexiGuard system for estimation energy expenditure. The average deviation from the reference instrument was under 30%. The conventional method, such as Oxycon, cannot be used during home therapy. Therefore, we upgraded the platform of our telemetry system (FlexiGuard), which can measure the heart rate and calculate the energy expenditure.