Eliciting explainable AI (XAI) requirements from stroke survivors presents a methodological challenge with direct implications for the design of trustworthy brain-computer interfaces for rehabilitation. How can patients and caregivers articulate preferences about algorithmic transparency when they lack conceptual frameworks for explainability, and when standard elicitation approaches are structurally inadequate for users with acquired communication disorders? We present a video-based scaffolding protocol for XAI requirements elicitation, developed and piloted in a rehabilitation context. In a formative study with three stroke survivors (two with moderate-to-severe aphasia) and three caregivers, facilitators employed four scaffolding approaches alongside the videos: 1) analogical bridging mapping AI states to familiar systems, 2) projective personas depersonalising sensitive topics, 3) binary forcing reducing cognitive load, and 4) extended response time. These approaches successfully surfaced heterogeneous, sometimes conflicting XAI needs across participants. Reflexive analysis additionally revealed three systematic facilitation biases, namely, normative bias, hypothesis confirmation bias, and presence effect, where scaffolding inadvertently shaped responses. We present these as protocol risk guidelines for practitioners. Together, the protocol and guidelines constitute a reusable methodological contribution for eliciting patient-facing XAI requirements in rehabilitation, arguing that such elicitation is a necessary prerequisite for trustworthy human-machine systems design, not an optional preliminary.
Emmanuel C. Chukwu, Rianne M. Schouten, Monique Tabak +1cs.LG
Counterfactual explanations (CEs) for multivariate time-series classifiers are often difficult to interpret in domains where experts reason in terms of semantic feature groups rather than individual channels. In rehabilitation movement analysis with multi-sensor inertial measurement units (IMUs), clinicians interpret motion through muscle-group and joint-segment abstractions; yet, most existing counterfactual methods operate at the channel level, producing scattered and biomechanically incoherent explanations. We propose a two-stage framework for group-based counterfactual generation in high-dimensional IMU data. We first show that Shapley-Adaptive (SA) group ranking preserves counterfactual validity but fails to enforce group-level sparsity, motivating the need for explicit group selection. We then introduce Learnable Gate (LG) methods, which incorporate trainable per-group relevance gates jointly optimized with perturbation masks. Experiments on the KneE-PAD rehabilitation dataset demonstrate that LG substantially improves modality-group sparsity compared to the channel-level M-CELS baseline while maintaining or improving validity, temporal smoothness, and generation efficiency. Exercise-specific analyses further show that group-structured counterfactuals yield concise, muscle-level corrective guidance aligned with clinical reasoning. Overall, the proposed framework enhances interpretability without sacrificing counterfactual quality, enabling more actionable explanations for rehabilitation movement analysis.
Cognitive workload monitoring is important for adaptive rehabilitation and assistive interfaces, where task difficulty, pacing, and feedback should be adjusted according to the user's cognitive state to avoid overload and under-challenge. Emerging extended reality and robot-assisted rehabilitation environments provide controllable training tasks, but they require unobtrusive sensing methods that can capture rapid ocular dynamics during interaction. Existing eye-movement-based cognitive workload recognition methods mainly rely on frame-based eye trackers, which often suffer from limited temporal resolution and degraded robustness under rapid eye movements. In contrast, event cameras provide microsecond-level temporal resolution, high dynamic range and low latency, making them suitable for capturing fine-grained ocular dynamics. Many previous studies rely on free-viewing or similar paradigms, where gaze locations can vary across tasks. As a result, models may learn associations between gaze-location distributions and cognitive workload, rather than workload-related eye movement characteristics themselves. In this work, we introduce EveLoad, which, to the best of our knowledge, is the first event-based eye-movement dataset with graded cognitive workload annotations, collected from 20 healthy participants under spatially constrained and task-driven conditions using a controlled N-back-guided fixation paradigm. Based on this dataset, we establish a benchmark for cognitive workload recognition with six workload levels and propose a learning framework that encodes spatiotemporal event representations. Experimental results show that our approach achieves an average subject-specific accuracy of 96.36% and 96.13% under mixed random split evaluation. These results suggest that event-based eye movements may provide a useful sensing pathway for future workload-aware rehabilitation.
Damian M. Manzone, Mathew Szymanowski, Olga Taran +6cs.CV cs.HC
Mixed reality applications can be designed for hand rehabilitation. Augmented reality (AR) head mounted displays (HMDs) specifically allow for ecologically valid tasks because individuals can see their real environment and interact with real objects while receiving additional cues on the HMD. While these applications rely on accurate hand pose estimation, there is a gap in investigating the influence of hand impairment or occlusion from real-object interactions on pose estimation accuracy. Further, comparisons between AR HMD predictions and state-of-the-art pose estimation methods have not been established. The current study assessed pose estimation accuracy of the HoloLens 2 HMD and state-of-the-art pose estimation algorithms (WiLoR, HaMeR, WildHands, and MediaPipe) while individuals with cervical spinal cord injury (cSCI; n = 13, Neurological Level of Injury: C3-C6; American Spinal Injury Association Impairment Scale: A-D) and 15 uninjured controls interacted with clear and opaque objects. Ground truth estimates of 3D joint positions were generated via triangulation from a multi-camera setup. Pose estimation accuracy did not differ between the cSCI and uninjured control groups suggesting that 3D joint predictions from the HoloLens 2 and pose estimation algorithms can generalize to populations with hand impairment. Further, clear objects provided a small accuracy advantage over opaque objects (0.1 mm) and predictions from both WiLoR and HaMeR were slightly more accurate than the HoloLens 2 (2 mm). Overall, these results suggest that the HoloLens 2 may be viable for hand rehabilitation applications and the dataset generated can be used to refine pose estimation methods for hand-impaired populations.