Emotions and telerebabilitation: pilot clinical trials for virtual telerebabilitation application using haptic device and its impact on post stroke patients' mood and motivation

We describe a pilot clinical trial with a flexible telerehabilitation platform that allows a therapist to remotely monitor the exercise regimen and progress of a patient who previously suffered from a stroke. We developed virtual game environments which were host to a progressive set of training tasks from precise fine motor movements to reaching movements that involve full arm and shoulder activity. Concurrently, the therapist monitored the progress of the patient through a video channel. Assessment of psychosocial variables show that negative feelings (confusion, t(13)=2.54, p<.05, depression t(13)=2.58, p<.05, and tension, t(13)=2, p<.1) were significantly lessened after the game play. Patients' overall satisfaction with the telerehabilitation system was positively correlated with the feeling of co-presence of the therapist, r(8)=.770, p<.005. Patients felt less efficacious in continuing therapy after participating in the telerehabilitation game compared to their reported perseverance self-efficacy before the game, t(5)=2.71, p<.05 and showed decreased willingness to persist in therapy regardless of fatigue after the game play, t(5)=2.67, p<.05. However, when patients' pretest mood scores were taken into account, this trend was reversed. Patients' active mood before the game was positively correlated with their willingness to persist in the therapy after the game, r(14)=.699, p<.005. Telerehabilitation significantly enhanced stroke patients' psychological states.