Developing an Integrated VR + Musical Feedback System for Stationary Biking in Endurance Training

Stationary biking is a common endurance training activity in the motor rehabilitation of neurological patients. Regular and intense training is crucial to eventual patient outcomes, but the activity itself is traditionally a monotonous one. In recent years, the potential of interactive virtual reality (VR) and musical feedback to enhance motor performance and motivation has been established, but there is a lack of proven training paradigms that optimally combine them to benefit patients. In this work, we iteratively developed an integrated multimodal interactive system to provide individualized VR and musical feedback in real time with the goal of boosting motivation and modulating pedaling intensity over a training session. The concept was initially realized by coupling two independent systems for VR and musical feedback on cumulative and instantaneous pedaling intensity respectively. The coupled systems were tested in a pilot study with 11 participants, and the overall paradigm was found to be usable and motivating with room for technical and design-specific improvement. In a second iteration of development, the systems were robustly integrated and the feedback design was streamlined to primarily inform on a single variable - cumulative pedaling intensity. With this new system built for individualized feedback delivery, the efficacy and clinical potential of the concept and system will be systematically evaluated in future work. The eventual results will, in our estimation, contribute to a growing body of knowledge on how best to leverage the potential of multimodal interactive systems in motor rehabilitation.