Proof of concept of a single-channel EEG measure of engagement in virtual rehabilitation
Johnstone, S J
Rogers, J M
Valderrrama, Joaquin T
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Stroke rehabilitation suffers from low levels of patient engagement, impeding recovery. 2 Virtual rehabilitation (VR) approaches can improve outcomes, however there is limited 3 understanding of the participant’s user experience and the field lacks a validated, objective 4 measure of VR engagement. A neurophysiological measure of engagement in healthy adults 5 was therefore examined, to inform future clinical studies. Twenty-four participants (Mage 26.7 6 years, range 18-47) interacted with a tabletop VR system (Elements DNA, or EDNA), after 7 which they rated their experience on the Presence Questionnaire (PQ). Separately, participants 8 completed tasks eliciting low (resting eyes-open and -closed) and high (EDNA VR and 9 rollercoaster simulation) levels of engagement while continuous electroencephalogram (EEG) 10 was recorded from a single, left pre-frontal electrode. EEG differences between the resting 11 and simulation conditions included an increase in theta power (p < 0.01), and a decrease in 12 alpha power (p < 0.01). Importantly, theta power in simulation conditions correlated with PQ 13 scores expressing the hands-on EDNA VR experience (rs = 0.38-0.48). In conclusion, the 14 current results provide proof of concept that increased frontal theta power in healthy adults 15 provides a valid measure of user engagement in VR simulation and participation. As the 16 practical potential of VR is increasingly realised in stroke rehabilitation, objective EEG-based 17 measures of engagement may provide a convenient and sensitive technique to assist in 18 evaluating these interventions.