Usability of an immersive augmented reality based telerehabilitation system with haptics (Artesh) for synchronous remote musculoskeletal examination

Aleks Borresen, Cody Wolfe, Chung Kuang Lin, Yuan Tian, Suraj Raghuraman, Klara Nahrstedt, Balakrishnan Prabhakaran, Thiru Annaswamy

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


This study describes the features and utility of a novel augmented reality based telemedicine system with haptics that allows the sense of touch and direct physical examination during a synchronous immersive telemedicine consultation and physical examination. The system employs novel engineering features: (a) a new force enhancement algorithm to improve force rendering and overcoming the “just-noticeable-difference” limitation; (b) an improved force compensation method to reduce the delay in force rendering; (c) use of the “haptic interface point” to reduce disparity between the visual and haptic data; and (d) implementation of efficient algorithms to process, compress, decompress, transmit and render 3-D tele-immersion data. A qualitative pilot study (n=20) evaluated the usability of the system. Users rated the system on a 26-question survey using a seven-point Likert scale, with percent agreement calculated from the total users who agreed with a given statement. Survey questions fell into three main categories: (1) ease and simplicity of use, (2) quality of experience, and (3) comparison to in-person evaluation. Average percent agreements between the telemedicine and in-person evaluation were highest for ease and simplicity of use (86%) and quality of experience (85%), followed by comparison to in-person evaluation (58%). Eighty-nine percent (89%) of respondents expressed satisfaction with the overall quality of experience. Results suggest that the system was effective at conveying audio-visual and touch data in real-time across 20.3 miles, and warrants further development.

Original languageEnglish (US)
Pages (from-to)23-32
Number of pages10
JournalInternational Journal of Telerehabilitation
Issue number1
StatePublished - Mar 1 2019


  • Augmented-reality
  • Haptics
  • Telemedicine
  • Telerehabilitation

ASJC Scopus subject areas

  • Rehabilitation
  • Computer Science Applications
  • Health Informatics
  • Health Information Management


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