XRに基づく遠隔リハの研究・事業事例調査報告

XRに基づく（遠隔）リハの
研究・事業事例調査報告
蔵⽥武志123
1国⽴研究開発法⼈産業技術総合研究所⼈間拡張研究センター副研究センター⻑
2筑波⼤学システム情報系教授（連携⼤学院）応⽤サービス⼯学研究室
（システム情報⼯学研究群知能機能システム学位プログラム）
3名古屋⼤学未来社会創造機構客員教授
遠隔ヘルスケアのための多感覚XR-AIに関するシンポジウム
XR-AI for THC 2022

発表内容
• XRに基づくリハビリの研究・事業事例
• サーベイ⽂献・論⽂
• 遠隔リハビリの潜在利⽤者向け定性調査
2

3
XRに基づくリハビリの研究・事業事例リスト
Name Features Users Target body part Which XR How to use XR
People
involved in XR
Organization Country Notes URL
Physical rehab
Service/Product
IREX
(1) A patientʼs real-time image is projected into virtual environments where
they perform individualised gesture-based exercise games designed by their
clinician to each patientʼs ability and recovery level
(2) The biometrics for quantitative evaluation are collected by the video
camera tracking and analysis systems
Broad
Broad (upper and lower-
limbs, cognitive
capabilities)
MR
(Monitor)
Playing VR games desiend for rehabilitation
programs
User (and
clinician)
GestureTek Health Canada None https://gesturetekhealth.com/products/irex
XRHealth
(1) Assigned physical therapists proposing VR rehab programs for each
disease
(2) Improving physical functions through VR games
(3) FDA-registered medical VR applications
Broad
Broad (physical,
neurological or behavioral
symptoms)
VR (HMD)
programs
User XRHealth USA INC USA Telerehabilitation https://www.xr.health/
SaeboVR
(1) Designed to engage the client involving daily functional activities through
a virtual ADL (activities of daily living)
rehabilitation system to help the brain “re-program” itself and form new
neural connections
(2) Virtual assistant appearing on the screen to educate and facilitate
performance by providing real-time feedback
(3) Using Microsoft Kinect
(4) FDA-cleared software system
Patients with
cognitive or upper
limb impairments
Upper limbs
VR
(Monitor)
Providing ADL-focused virtual world in which
the users incorporates their impaired upper limb
to perform simulated self-care tasks that involve
picking up, transferring and manipulating virtual
objects
User Saebo, Inc USA None https://www.saebo.com/shop/saebovr/
MindMotion GO
(1) Gamified neurorehabilitation therapy platform for medium and light
severity impairments able to be deployed in the patientʼs home
(2) Including rehabilitation exercises for the upper extremity, trunk, and
lower extremity; audio-visual feedback and graphic movement
representations for patients
(3) Using Microsoft Kinect and Leap Motion
Stroke survivors at
home
Broad(Upper limbs, torso,
lower limbs)
VR
(Monitor)
programs
User MindMaze SA Switzerland Telerehabilitation
https://mindmaze.com/digital-therapies-for-
neurorehabilitation/mindmotion-telerehab/
https://www.physiofunction.co.uk/rehabilitation-
technology/upper-limb-rehabilitation/mind-motion-go-
for-home-use
MindMotion Pro
(1) Designed for acute neurorehabilitation and ideally suited for delivering
table-top therapy to patients recovering from upper-limb hemiparesis
(2) Gamification of the exercises (levels of difficulty, rewards, real-time
feedback) to maintain patient motivation and to increase the amount of
practice
(3) FDA-cleared system
Acute stroke
patients at hospital
Upper limbs (or )
VR
(Monitor)
Project a CG depiction of the nonfunctional one
hand, which is controlled by the patient's
movement of the working another hand
User MindMaze SA Switzerland None
https://www.mindmaze.com/digital-therapies-for-
neurorehabilitation/
mediVR KAGURA
Seated reaching motion improving postural balance and dual-task cognitive
processing function
Stroke patients Upper limbs, torso (core) VR (HMD)
programs: horizontal/vertical/Mito-
Komon/vegetables/fruits
User mediVR inc. Japan None https://www.medivr.jp/
RehaVR
Gives the feeling of walking in a grassland or a place with beautiful scenery
to increase motivation
Elderly people who
wish to improve
their motor skills
Lower limbs
VR (HMD,
Foot Pedal
Exerciser)
Providing virtual environments with beatiful
scenary such as sightseeing spots
User silvereye Inc. Japan None https://rehavr.com
KiNvis system
Using KiNvis (KiNesthetic illusion induced by visual stimulation) described
as the feeling of oneʼs body moving during sensory input, even though the
body is actually in a resting state; cognitive stimulation to the embodied
brain system for body ownership, a sense of agency, and kinesthetic
perception
Patients with
chronic stroke
Upper limbs
VR/AR
(Monitor/
HMD)
(1) Providing visual stimulation which is
recorded hand moviment in the movement task
involving hand opening and closing
(2) Applying electrical stimulation while
watching the movie during the finger-extension
phase.
User Inter Reha Co.,Ltd. Japan None
https://doi.org/10.3389/fnsys.2019.00076
https://www.irc-web.co.jp/kinvis
https://keio-rehab.jp/efforts/kinvis/
Prototype/Research
Phantom motor
execution facilitated by
ML and AR
Novel plasticity-based, non-invasive treatment for phantom limb pain, in
which phantom motor execution is decoded via machine learning, while
visualisation of the phantom is accomplished via augmented and virtual
reality.
Patients with
phantom limb pain
Upper limbs
AR/VR
(Monitor)
Preserving the virtual arm in the anatomically
correct placement
User
Chalmers University of
Technology
Sweden None
https://doi.org/10.1016/S0140-6736(16)31598-7
https://www.youtube.com/watch?v=ek7JHGC-T4E
Walk Again Project
(WAP)
(1) BMI with VR makes the patient's brain reacquire the notion of walking.
(2) By walking in a custom-designed exoskeleton with BMI, patients are
eventually able to rekindle their remaining nerves to send signals back to
brain, and reactivate some voluntary movement and sensitivity.
Paraplegics Lower limbs VR (HMD)
Presenting visually the virtual lower limbs
through the HMD and the sense of touching the
ground through haptic display attached on
forearms
User Duke University USA None
https://qz.com/757516/paraplegics-are-learning-to-
walk-again-with-virtual-reality/
https://www.youtube.com/watch?v=pb36O-Yotac
Name Features Users Target symptoms Type of XR How to use XR
People
involved in XR
Organization Country Notes URL
Mental health/Phobia
Product/Service
Immersive simulation
system for overcoming
fear of heights
Standing on top of a vitrual skyscraper to alleviate fear
People with a fear
of heights
(acrophobia)
Acrophobia VR (HMD)
Providing virtual environments on top of a
skyscraper
User CRESCENT,INC Japan None https://www.youtube.com/watch?v=AR-VAImfFXI
Prototype/Research
RECOVER: Virtual
Reality in Rehab
Providing valid contexts for people to practise their communication skills,
build confidence interacting with others and generalise their communication
skills to various environments
People with
communication
disorders
Communication disorder VR (HMD)
Simulating social communication situations that
are difficult to create within the clinic in realistic,
personally relevant and safe environments
(Cooking etc.)
User and other
people
interacting
with the user
The University of
Queensland
Australia
Speech
pathologists
https://www.uq.edu.au/news/article/2021/03/virtual-
reality-help-patients-speak
https://www.tandfonline.com/doi/abs/10.1080/096382
88.2021.1895333?journalCode=idre20
Bravemind
Supporting exposure therapy, in which a patient with PTS(Post-Traumatic
Stress) ‒ guided by a trained therapist ‒ confronts their trauma memories
through a retelling of the experience
Veterans with
urgently needed
options for PTS
treatment
PTS and depression VR (HMD)
Providing 14 different worlds from a crowded
Iraqi marketplace to a remote Afghan village, a
checkpoint in the desert to a forward operating
base in the mountains
User
The University of
Southern California
Institute for Creative
Technologies
USA None
https://www.soldierstrong.org/bravemind/
https://www.youtube.com/watch?v=dVmxmDFCMlQ

Features Users Target body part Which XR How to use XR
(1) A patientʼs real-time image is projected into virtual
environments where they perform individualised gesture-based
exercise games designed by their clinician to each patientʼs
ability and recovery level
(2) The biometrics for quantitative evaluation are collected by the
video camera tracking and analysis systems
Broad
Broad (upper and
lower-limbs,
cognitive
capabilities)
MR
(Monitor)
Playing VR games designed for
rehabilitation programs
IREX GestureTek Health
4
Service/Product
Physical rehab
Mental health/Phobia Prototype/Research
☑ ☑
Telerehabilitation

(1) Assigned physical therapists proposing VR rehab programs for
each disease
(2) Improving physical functions through VR games
(3) FDA-registered medical VR applications
Broad
Broad (physical,
neurological or
behavioral
symptoms)
VR (HMD)
XRHealth XRHealth USA INC
5
Service/Product
Physical rehab
☑ ☑
Telerehabilitation
☑

国⽴研究開発法⼈産業技術総合研究所
6
(1) Designed to engage the client involving daily functional
activities through a virtual ADL (activities of daily living)
rehabilitation system to help the brain “re-program” itself and
form new neural connections
(2) Virtual assistant appearing on the screen to educate and
facilitate performance by providing real-time feedback
(3) Using Microsoft Kinect
(4) FDA-cleared software system
Patients with
cognitive or
upper limb
impairments
Upper limbs
VR
(Monitor)
Providing ADL-focused virtual world in
which the users incorporates their
impaired upper limb to perform
simulated self-care tasks that involve
picking up, transferring and
manipulating virtual objects
SaeboVR Saebo, Inc
Service/Product
Physical rehab
☑ ☑
Telerehabilitation

(1) Gamified neurorehabilitation therapy platform for medium and
light severity impairments able to be deployed in the patientʼs
home
(2) Including rehabilitation exercises for the upper extremity,
trunk, and lower extremity; audio-visual feedback and graphic
movement representations for patients
(3) Using Microsoft Kinect and Leap Motion
Stroke
survivors at
home
Broad(Upper
limbs, torso, lower
limbs)
VR
(Monitor)
MindMotion GO MindMaze SA
7
Service/Product
Physical rehab
☑ ☑
Telerehabilitation
☑

8
(1) Designed for acute neurorehabilitation and ideally suited for
delivering table-top therapy to patients recovering from upper-
limb hemiparesis
(2) Gamification of the exercises (levels of difficulty, rewards,
real-time feedback) to maintain patient motivation and to
increase the amount of practice
Acute stroke
patients at
hospital
Upper limbs
VR
(Monitor)
Project a CG depiction of the
nonfunctional one hand, which is
controlled by the patient's movement
of the working another hand
MindMotion Pro MindMaze SA
Service/Product
Physical rehab
☑ ☑
Telerehabilitation

9
Seated reaching motion improving postural balance and dual-task
cognitive processing function
Stroke
patients
Upper limbs, torso
(core)
VR (HMD)
rehabilitation programs:
horizontal/vertical/Mito-
Komon/vegetables/fruits
mediVR KAGURA mediVR inc.
Service/Product
Physical rehab
☑ ☑
Telerehabilitation

10
Gives the feeling of walking in a grassland or a place with
beautiful scenery to increase motivation
Elderly people
who wish to
improve their
motor skills
Lower limbs
VR (HMD,
Foot Pedal
Exerciser)
Providing virtual environments with
beatiful scenary such as sightseeing
spots
RehaVR silvereye Inc.
Service/Product
Physical rehab
☑ ☑
Telerehabilitation

Using KiNvis (KiNesthetic illusion induced by visual stimulation)
described as the feeling of oneʼs body moving during sensory
input, even though the body is actually in a resting state;
cognitive stimulation to the embodied brain system for body
ownership, a sense of agency, and kinesthetic perception
Patients with
chronic stroke
Upper limbs
VR/AR
(Monitor/
HMD)
(1) Providing visual stimulation which
is recorded hand moviment in the
movement task involving hand
opening and closing
(2) Applying electrical stimulation
while watching the movie during the
finger-extension phase.
KiNvis system Inter Reha Co.,Ltd.
11
Service/Product
Physical rehab
☑ ☑
Telerehabilitation

12
Novel plasticity-based, non-invasive treatment for phantom limb
pain, in which phantom motor execution is decoded via machine
learning, while visualisation of the phantom is accomplished via
augmented and virtual reality.
Patients with
phantom limb
pain
Upper limbs
AR/VR
(Monitor)
Preserving the virtual arm in the
anatomically correct placement
Phantom motor execution facilitated by ML and AR Chalmers University of Technology
Service/Product
Physical rehab
☑
☑ Telerehabilitation

13
(1) BMI with VR makes the patient's brain reacquire the notion of
walking.
(2) By walking in a custom-designed exoskeleton with BMI,
patients are eventually able to rekindle their remaining nerves to
send signals back to brain, and reactivate some voluntary
movement and sensitivity.
Paraplegics Lower limbs VR (HMD)
Presenting visually the virtual lower
limbs through the HMD and the sense
of touching the ground through haptic
display attached on forearms
Walk Again Project (WAP) Duke University
Service/Product
Physical rehab
☑
☑ Telerehabilitation

14
Features Users Target symptoms Which XR How to use XR
Standing on top of a vitrual skyscraper to alleviate fear
People with a
fear of heights
(acrophobia)
Acrophobia VR (HMD)
Providing virtual environments on top
of a skyscraper
Immersive simulation system for overcoming fear of heights CRESCENT,INC
Service/Product
Physical rehab
☑
☑
Telerehabilitation

Providing valid contexts for people to practise their
communication skills, build confidence interacting with others
and generalise their communication skills to various
environments
People with
communicatio
n disorders
Communication
disorder
VR (HMD)
Simulating social communication
situations that are difficult to create
within the clinic in realistic, personally
relevant and safe environments
(Cooking etc.)
RECOVER: Virtual Reality in Rehab The University of Queensland
15
Service/Product
Physical rehab
☑ ☑ Telerehabilitation

16
Supporting exposure therapy, in which a patient with PTS(Post-
Traumatic Stress) ‒ guided by a trained therapist ‒ confronts
their trauma memories through a retelling of the experience
Veterans with
urgently
needed
options for
PTS
treatment
PTS and
depression
VR (HMD)
Providing 14 different worlds from a
crowded Iraqi marketplace to a remote
Afghan village, a checkpoint in the
desert to a forward operating base in
the mountains
Bravemind
The University of Southern California Institute for
Creative Technologies
Service/Product
Physical rehab
☑ ☑ Telerehabilitation

発表内容
17

市場調査：バーチャルリハビリ・遠隔リハビリシステム
18
https://www.360marketupdates.com/global‐virtual‐rehabilitation‐and‐telerehabilitation‐systems‐market‐18486215#

バーチャルリハビリシステムポータルサイト
20
https://www.medicalexpo.com/ja/seizomoto‐iryo/kiwado‐42522.html

脳卒中罹患経験者の
上肢運動リハビリのための
VR臨床応⽤に関する
サーベイ論⽂
Clinical Application of Virtual
Reality for Upper Limb Motor
Rehabilitation in Stroke:
Review of Technologies and
Clinical Evidence
21
https://www.mdpi.com/2077‐0383/9/10/3369

22
https://www.mdpi.com/2077‐0383/9/10/3369
サーベイ論⽂記載事例
• 当該リストでは、HMDを⽤いたI(Immersive)型よりも、NI (non‐immersive)型
の⽅が圧倒的に多い
• 脳卒中罹患経験者向けのサーベイだから？
• 2020年時点で商⽤化されているものだけだから？

発表内容
23

本研究開発の狙い：上肢の遠隔リハビリ
24

遠隔リハビリの潜在利⽤者向け定性調査
25
• 実施期間：2022年2⽉26（⼟）‐ 27（⽇）
• ⽅法：オンラインによる半構造化グループインタビュー
• 被験者：合計９名
• 機縁法によるリクルーティング
• 上肢（肩・腕・⼿⾸）・⾸・腰に⽣活に⽀障もしくは慢性的な
痛みがある
• 医者から運動を⽌められていない
• １回30分以上の運動頻度が週１回以下
• １⽇の平均歩数が７０００歩未満
• ⾮アクティブパーソンにおける「同調派」「雷同派」に所属
• 男性グループ４名
• 同調派３名／雷同派１名
• ４０代３名／５０代１名
• ⼥性グループ５名
• 同調派３名／雷同派２名
• ４０代１名／５０代４名

KJ法を⽤いてキーワード群の関係を整理
26

グループインタビューまとめ：
上肢・⾸・肩の痛みに関する課題
27
• ⽇常⽣活において、⾸や肩こりの痛みは“当たり前”になって
おり、⽣活に⽀障をきたす痛みだとは認識されていない。
• 頭痛や吐き気の症状が現れてから痛みやコリの緩和を⾏う。
• 上肢は可動域が確保される限りはなんとかなってしまう。
• 仕事への影響は、“集中⼒”を保てるかどうかが⼤きなポイントになる。
• 継続的なケアが必要な痛みは怪我と同等という認識をもって
いる。
• 腰痛は⽣活に即⽀障をきたすため、継続的にケアを⾏う。
• 上肢と異なり、下肢の痛みは⽣活に⽀障が出る。
上肢・⾸・肩の痛みは仕⽅がないと思っている。“解消したい”
と思ってもらえるサービス設計ができるかどうかが課題。
（運動が近道だが、⽇本⼈の約７割が“運動習慣なし”）
（仕事が⽣活の中⼼を占める世代の⽣活習慣の⾒直しは簡単で
はない）

遠隔リハビリ／トレーニングに関する課題
28
• 遠隔リハビリ／トレーニングは、オフラインを組み合わせるこ
とがポイント
• 専⾨家が直接触れる・指導することで、リハビリ／トレーニングの信頼性が向
上する。
• ⾃分⾃⾝で⾏うトレーニングでは限界を感じる。
• コストがかかっても信頼できる専⾨家の指導を受けたい。
• ⾃宅で気軽にできるオンラインのメリットも魅⼒的に感じている。
• コミュニケーションが感じられないものはYouTubeと同程度。
• 器具を⽤いたゲーム型フィットネス（例：リングフィットアドベンチャーな
ど）やVRトレーニングのように、楽しめる要素は必要と考えられる。
遠隔リハビリ／トレーニングのニーズは⼀定程度あるものと
想定されるが、“１対１”、“専⾨家が直接触れる”というような
体験を、遠隔でどのように再現できるかが課題。
（器具を多⽤すると使⽤時の怪我や不具合の発⽣、コスト増
加の懸念）
飽きさせない⼯夫も必要。

その他の課題
29
• ⾮アクティブパーソンの運動に関する⾏動変容を促す要素は、
「同調派」「雷同派」で異なることが明らかとなっている。
• 同時に、属性（性別／年代）は同じでも、家族構成によって
ライフステージが異なることも想定されることから、画⼀的
なサービスでは受容性が⾼まらないことが考えられる。
• リハビリ／トレーニングは経験財（または信頼財）であり、
事前の情報探索によるサービス評価が難しいことから、まず
は経験してもらえるかどうかが重要となる。
セグメント別に、サービス受容度を⾼めるための設計が重要に
なる。

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XRに基づく遠隔リハの研究・事業事例調査報告