John-John Cabibihan
Chapter 09Rehabilitation

Rehabilitation, VR and hydrotherapy

Rehabilitation exercises only help if people keep doing them, so the lab turns them into games and virtual worlds: a shoulder game played in front of a camera, a VR room where amputees learn to work a myoelectric hand before they get one, and robots for therapy in the pool.

26%of adults give up on a body-powered prosthetic hand
42studies of VR prosthesis training reviewed
23volunteers in the first shoulder game trial
10papers since 2013
VR training

Practise with a hand you do not have yet

A myoelectric prosthesis opens and closes when the wearer tenses muscles in the forearm. It takes practice, and many people give up. In VR, people can practise with a virtual prosthesis before the real one is ready. Hold the button to tense the muscle, and switch the vibration feedback on and off.

muscle signal (simulated)closevibration bandOpen
Vibration feedback

Electrodes on the forearm pick up the muscle signal. When its envelope crosses a threshold, the virtual hand closes. A tracker on the arm moves the hand in VR, and small vibration motors on the forearm buzz when it grips something. In tests with amputees and non-amputees, the people who felt the buzz did better.

Sources: IEEE VR Workshops 2021, SVR 2022 and IEEE VR Workshops 2024. The muscle signal here is simulated and the hand is a drawing, not the system's software.

Review

Why VR training has not reached the clinic

A review of 42 papers on extended reality for prosthesis training found benefits, and two gaps. Most systems were tested on a flat screen rather than in a headset, and most large studies never included an amputee.

26%of adults stop using a body-powered prosthetic hand23%stop using an electric one75%of whole-system tests used a non-immersive screen, not a headset71%of the large studies recruited no amputees at all

Source: IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2022.

Game

Thirty seconds of shoulder therapy

Shoulder exercises at home are dull, and therapy visits are expensive. A cheap camera and a simple game can do some of the work: follow a moving ball for 30 seconds using only the shoulder. Try a round with your pointer, or the arrow keys.

Press start, then keep the ring on the ball
Level
30 sleft in this round
0%of the time on the ball

In the study, a low-cost depth camera followed the shoulder alone, so the only way to steer was to lift and swing the arm. 23 healthy volunteers played for a few minutes a day over four days, and the game got harder each level. One person with a shoulder injury improved significantly.

Source: Qatar Foundation Annual Research Forum, 2013. The ball path and levels here are made for the browser and are not the original game.

Along the way

Mirrors, wheelchairs and water

2014

The healthy hand leads

After a stroke, muscle signals from the unaffected arm can drive an exoskeleton on the paralysed one, so both hands work together on tasks in VR.

Qatar Foundation Annual Research Conference

2016

Driving with the shoulders

A wearable interface turned shoulder and elbow movements into wheelchair commands. Its readings matched optical tracking (r = 0.86 to 0.94) in six people, and a spinal cord injury patient learned to drive a virtual wheelchair with it within a week.

International Journal of Advanced Robotic Systems

2023

Therapy at a distance

Hand tracking in VR so a therapist and a patient can share a rehabilitation game from different places.

Lecture Notes in Computer Science

2026

HydrotheraBots

Robots, AI and extended reality for rehabilitation that moves between land and water, funded by a 2025 QRDI grant.

IEEE CIS-RAM

Record

Papers and grants

10 papers

Grants

  • 2025HYDROTHERABOTS: HYDROTHERApy using RoBOTS, AI, and VR Technologies for Physical Rehabilitation
    US$745,312 · QRDI Council · Lead Principal Investigator
  • 2022A Comprehensive System for Clinical Rehabilitation of Upper-Limb Amputees in Virtual Reality
    US$297,613 · Qatar University · Lead Principal Investigator
  • 2012Load Configuration Physiotherapy System for the Upper Extremities for Patients with Hemiparesis
    US$7,852 · Mitsui Sumitomo · Sole Investigator