User Engagement Correlates Better with Behavioral than Physiological Measures in a Virtual Reality Robotic Rehabilitation System

Robotic systems to assist with movement rehabil-itation are transitioning from providing fixed pre-programmed assistance towards adaptive challenge-oriented strategies that present patients with tasks that are demanding yet achiev-able. This promotes active engagement, which is crucial for stimulating neural plasticity and promoting recovery. While it has been well established that varying the challenge level can affect user engagement, measuring engagement during task performance has received less attention. To investigate this issue, we developed a virtual reality (VR) robotic system for upper limb rehabilitation using a line-tracing task that measures physiological and behavioral signals. Challenge level can be modulated by introducing force noise disturbance. We con-ducted a preliminary study on 12 participants, measuring user engagement and physiological/behavioral signals at different noise (challenge) levels. Our findings align with the predictions of flow channel theory. Engagement peaks at an intermediate challenge level. While past work considered only physiological measures, our results reveal that behavioral measures are better correlated with user engagement. Physiological measures correlate better with arousal. This work takes a step toward systems that dynamically adapt task parameters to optimize user engagement.