Virtual reality for pediatric neuro-rehabilitation: adaptive visual feedback of movement to engage the mirror neuron system.

Sensorimotor therapy gives optimal results when patients are cognitively engaged into highly repetitive tasks, a goal that most children find hard to pursue. This paper presents the key developments of our ongoing effort to design an interactive rehabilitation environment that motivates physically impaired children throughout their therapy. The continuous motivation is achieved by the system adapting fundamental therapeutic components to the performance of each child. The relevant movement is mirrored to an animated character projected in front of the child. We speculate that the visual observation of one's own movements will activate the "mirror neuron system", a brain system underlying the human capacity to learn by imitation. Our rehabilitation algorithm personalizes the difficulty of the tasks by adapting the difficulty of reaching virtual targets on the animated environment through changing the visual gain between real and animated movements. To track the sensorimotor performance, we estimated the time required to reach a target. To give a proof of concept for the adaptation of the visual gain, we developed a serious game driven by a Leap Motion device. In addition to becoming a testbed for studying sensorimotor integration and neuroplasticity, the proposed notion of visual gain can be integrated into a highly engaging environment in which physically impaired children will play their way to recovery.