Driver in the Loop Simulator for Clinical Rehabilitation: Design and Development

In the last decades, improvements in quality of life and medical advances have led to increased life expectancy and a growing elderly population. With advancing age, the decline in cognitive abilities calls for the development of rehabilitation therapies aimed at mitigating the physiological aging process, with the objective of preserving physical and cognitive health. In this context, rehabilitation faces two main challenges: first, the need for objective methods to assess a patient’s condition; and second, the repetitive and time-consuming nature of traditional rehabilitation programs, which often result in reduced engagement and decreased therapeutic effectiveness. The scientific community has increasingly focused on the integration of new technologies into rehabilitation practice. Technological devices allow clinicians to quantify a patient condition through objective parameters and indicators, making assessments more accurate and less dependent on subjective evaluation. Moreover, the combination of therapeutic exercises with game-like tasks, known as exergames, helps maintaining user motivation by reducing monotony and increasing engagement during therapy. Within this framework, Human in the Loop (HIL) simulations have gained importance. In this paradigm, the user is an active component of the simulation process, allowing the study of motor and cognitive behaviors under controlled conditions. This closed-loop interaction relies on feedback devices that convey information about the virtual environment, and on measurement systems that feed the user’s responses back into the simulation. In the automotive field, this approach is specifically referred to as Driver in the Loop and currently represents the most advanced application of HIL concept. DIL simulators are mechatronic platforms that safely reproduce complex or hazardous driving scenarios in a virtual environment. Over time, they have evolved into sophisticated tools for research and virtual prototyping, supporting the development and validation of new vehicle technologies and Advanced Driver Assistance Systems. Since driving is a highly complex, multitasking activity involving motor, perceptual, and cognitive functions, driving simulators are increasingly being used in clinical and rehabilitative contexts as instruments for training and assessing neuromotor skills. However, the literature highlights a significant technological gap between industrial simulators, featuring immersive multisensory feedback (visual, haptic, and inertial), and clinical simulators, which are typically limited to performance monitoring through exergames, without providing immersive feedback. This thesis work aims to bridge this gap through the design of a dynamic driving simulator for rehabilitation, which represents a trade-off between the compactness, safety, and usability required in clinical settings, and the integration of advanced technologies typical of professional simulators, capable of stimulating the user in a comprehensive way. The developed system is designed to provide multiple sensory feedback channels that can be selectively combined to stimulate user perception and motor coordination, allowing the assessment of how different feedback combinations affect physical and cognitive abilities. It was developed in all its aspect, including a parallel kinematic platform for generating inertial feedback, a modular software architecture for real-time multibody vehicle dynamics simulation and flexible integration of peripherals and sensors, support for Head Mounted Displays for immersive visualization and a custom rehabilitation application, designed in collaboration with medical specialists, which incorporates exergames to motivate users and evaluate their driving related performance. The complete prototype is now ready for clinical testing on patients with neurological disorders.