Research Article
Massage Therapy of the Back Using a Real-Time
Haptic-Enhanced Telerehabilitation System
Cristina Ram´ ırez-Fern´ andez,
1
Victoria Meza-Kubo,
2
Elo´ ısa Garc´ ıa-Canseco,
2
Alberto L. Mor´ an,
2
Oliver Pabloff,
2
David Bonilla,
2
and Nirvana Green
2
1
Instituto Tecnol´ ogico de Ensenada, Ensenada, BC, Mexico
2
Facultad de Ciencias, Universidad Aut´ onoma de Baja California, Ensenada, BC, Mexico
Correspondence should be addressed to Cristina Ram´ ırez-Fern´ andez; cramirezf@gmail.com
Received 29 July 2017; Accepted 15 November 2017; Published 31 December 2017
Academic Editor: Pino Caballero-Gil
Copyright © 2017 Cristina Ram´ ırez-Fern´ andez et al. is is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.
We present the usability evaluation of a haptic-enhanced telerehabilitation system for massage therapy of the back using the
Vybe haptic gaming pad and the gesture sensor LEAP motion controller. e evaluated system includes features that allow for
(i) administering online therapy programs, (ii) providing self-adjustable and safety treatment of back massages using a virtual
environment, and (iii) saving and replaying massage sessions according to a patient’s therapy program. e usability evaluation
with 25 older adults and 10 specialists suggests that the haptic telerehabilitation system is perceived with high usability and
pleasurable user experience, while providing personalized intensity of haptic therapy in a supervised, real-time, and secure way to
treat the patient. Moreover, the specialists totally agree that the system design features, such as save and play, and delimiting
therapy zones are the most important for back massage therapy, while the features of regulating feedback intensity and
providing/receiving a massage remotely are also important. Finally, based on their comments, five design insights aiming at
improving the current version of the system were generated.
1. Introduction
Due to a combination of demographic changes and the lack of
resources in the field of public health and technology im-
provement, the development of new rehabilitative practices
seems mandatory to build sustainable models for re-
habilitation from the clinical, organizational, and economic
perspectives [1]. In recent years, haptic feedback has proven to
enhance user experience in telerehabilitation [2]. However,
current telerehabilitation systems have yet to exploit the
richness of haptic modality within its content. e lack of
haptic methods that provide real-time rehabilitation in a su-
pervised and remote way inhibits the attention of patients that
require massage treatment of the back. Massage therapy has
become one of the most popular complementary and alter-
native medical (CAM) therapies for back pain, the condition
for which CAM therapies are most commonly used [3]. A
massage is defined as “a mechanical manipulation of body
tissues with rhythmical pressure and stroking for the purpose
of promoting health and wellbeing” [4]. Despite the avail-
ability of novel mechanical support tools for back massage
intervention, for example, [5–7], massage therapy is still
provided in a traditional way, where both the patient and the
therapist need to be in the same place [8].
In [9], we introduced a novel real-time haptic-enhanced
telerehabilitation system for massage therapy that consists of
a web application and a local virtual environment (VE) in
which the interaction is performed using the Leap Motion
Controller (LMC) gesture sensor [10] and the Vybe haptic
gaming pad [11]. e system, called GoodVybesConnect, al-
lows the therapy input parameters to be individualized and
calibrated according to the patient’s characteristics. It also
allows the execution of the therapy to be dependent on the
therapist’s hand movement in the VE, so that multimodal
feedback (i.e., visual, audible, and vibrotactile feedback) is sent
to patients in real time depending on the availability of the
Hindawi
Mobile Information Systems
Volume 2017, Article ID 5253613, 10 pages
https://doi.org/10.1155/2017/5253613