Telerehabilitation in Disabled People: Proposal for Practical Intervention With Virtual Reality

Instrument In this study, it will be used a platform called MoveHero, available for free use in https://movehero.com.br/. The individual needs access the internet, and once he gets online, he had to create his own account, inserting his name, email and creating a password. Considering that the platform presents different levels of difficulty, after the participant is connected to the platform, the researcher directed the participant to the protocol specially developed for cerebral palsy. MoveHero is considerate a timing coincident task and present several spheres falling down on the computer screen, with a musical rhythm to increase engagement. Thus, the participants will be positioned in front of a computer and when the game started the webcam captures the participant movements and a representation of the players appears on the computer screen as an avatar. The game goals are to intercept all falling spheres using upper limb wave movements in the exact moment the spheres reached their specific target in the bottom of computer screen. The game presented four columns with fixed targets in parallel allocated in two height levels (e.g. two on the left - targets A and B; two on the right - targets C and D). The game provides hit and miss feedback - if the individual reaches the spheres correctly, the game presented a feedback with the spheres changing the color for green (hit information). On the other hand, if the participant do not touch the spheres properly, the spheres changing the color for red and the letter X appears inside the target (miss information).

Software score During the game match (each game match lasts for 5 minutes) the participant can follow the score determined by the number of spheres hit (i.e. the information from each sphere hit appears in the bottom left side of the screen all the time) and at the end of each game match the participant had feedback with their total score (when the game match finished a total score appears in the middle of the computer screen). The game features 10 different and progressive phases of difficulty, considering the number of balls falling. In this study, all participants will start at the easiest phase (phase 1) and according to their own score, the researcher should move forward to a more difficult phase. The progression in the phase was established by the table below. Thus, each participant presents an individual progression, considering their performance.

Assessments

To characterize the participants it will be used some scales that characterize each disease and can be applied such as Pediatric Evaluation of Disability Inventory (PEDI) for children and Quality of Life and specific scales for adults. As well as sociodemographic Information: some questions will be asked, such as age, sex, income to understand the studied population.

To analyse the outcome Measures will be used: 1) Brunel Mood Scale (BRUMS) measures six identifiable affective states (Tension, Depression, Anger, Vigor, Fatigue, and Confusion) through a 24-item self-report inventory, with respondents rating a list of adjectives on a 5-point Likert scale ranging from 0 (not at all) to 4 (extremely), based on subjective feelings. The instructions refer to how participants have been feeling in the past week, including today. 2) BORG scale: is Rating of Perceived Exertion used to measure the subjective intensity of effort. It is based on the sensations felt during exercise, such as muscle fatigue, increased heart rate and increased breathing. 3) System Usability Scale (SUS), was proposed by John Brooke in 1986 as the usability test tool. It is a simple scale based on a questionnaire and has been widely adopted in product usability evaluations. The statements cover a variety of aspects of system usability such as the need for support, training, and complexity, and thus have a high level of face validity for measuring usability of a system. The SUS instrument is generally used after the respondent has had an opportunity to use the system being evaluated. This instrument is a highly robust and versatile tool for usability professionals.