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Brouwer D, Morrin H, Nicholson TR, Terhune DB, Schrijnemaekers M, Edwards MJ, Gelauff J, Shotbolt P. Virtual reality in functional neurological disorder: a theoretical framework and research agenda for use in the real world. BMJ Neurol Open 2024; 6:e000622. [PMID: 38979395 PMCID: PMC11227774 DOI: 10.1136/bmjno-2023-000622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/01/2024] [Indexed: 07/10/2024] Open
Abstract
Functional neurological disorder (FND) is a common and disabling condition at the intersection of neurology and psychiatry. Despite remarkable progress over recent decades, the mechanisms of FND are still poorly understood and there are limited diagnostic tools and effective treatments. One potentially promising treatment modality for FND is virtual reality (VR), which has been increasingly applied to a broad range of conditions, including neuropsychiatric disorders. FND has unique features, many of which suggest the particular relevance for, and potential efficacy of, VR in both better understanding and managing the disorder. In this review, we describe how VR might be leveraged in the treatment and diagnosis of FND (with a primary focus on motor FND and persistent perceptual-postural dizziness given their prominence in the literature), as well as the elucidation of neurocognitive mechanisms and symptom phenomenology. First, we review what has been published to date on the applications of VR in FND and related neuropsychiatric disorders. We then discuss the hypothesised mechanism(s) underlying FND, focusing on the features that are most relevant to VR applications. Finally, we discuss the potential of VR in (1) advancing mechanistic understanding, focusing specifically on sense of agency, attention and suggestibility, (2) overcoming diagnostic challenges and (3) developing novel treatment modalities. This review aims to develop a theoretical foundation and research agenda for the use of VR in FND that might be applicable or adaptable to other related disorders.
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Affiliation(s)
- David Brouwer
- Department of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Hamilton Morrin
- Neuropsychiatry Research and Education Group, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Timothy R Nicholson
- Neuropsychiatry Research and Education Group, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Devin B Terhune
- Neuropsychiatry Research and Education Group, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
- Department of Psychology, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | | | - Mark J Edwards
- Neuropsychiatry Research and Education Group, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Jeannette Gelauff
- Department of Neurology, Amsterdam UMC Location AMC, Amsterdam, The Netherlands
| | - Paul Shotbolt
- Neuropsychiatry Research and Education Group, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, King's College London Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Tanabe T, Kaneko H. Illusory Directional Sensation Induced by Asymmetric Vibrations Influences Sense of Agency and Velocity in Wrist Motions. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1749-1756. [PMID: 38656862 DOI: 10.1109/tnsre.2024.3393434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Illusory directional sensations are generated through asymmetric vibrations applied to the fingertips and have been utilized to induce upper-limb motions in the rehabilitation and training of patients with visual impairment. However, its effects on motor control remain unclear. This study aimed to verify the effects of illusory directional sensations on wrist motion. We conducted objective and subjective evaluations of wrist motion during a motor task, while inducing an illusory directional sensation that was congruent or incongruent with wrist motion. We found that, when motion and illusory directional sensations were congruent, the sense of agency for motion decreased. This indicates an induction sensation of the hand being moved by the illusion. Interestingly, although no physical force was applied to the hand, the angular velocity of the wrist was higher in the congruent condition than that in the no-stimulation condition. The angular velocity of the wrist and electromyography signals of the agonist muscles were weakly positively correlated, suggesting that the participants may have increased their wrist velocity. In other words, the congruence between the direction of motion and illusory directional sensation induced the sensation of the hand being moved, even though the participants' wrist-motion velocity increased. This phenomenon can be explained by the discrepancy between the sensation of active motion predicted by the efferent copy, and that of actual motion caused by the addition of the illusion. The findings of this study can guide the design of novel rehabilitation methods.
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Cesari V, D’Aversa S, Piarulli A, Melfi F, Gemignani A, Menicucci D. Sense of Agency and Skills Learning in Virtual-Mediated Environment: A Systematic Review. Brain Sci 2024; 14:350. [PMID: 38672002 PMCID: PMC11048251 DOI: 10.3390/brainsci14040350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
Agency is central to remote actions, and it may enhance skills learning due to a partial overlap between brain structures and networks, the promotion of confidence towards a telemanipulator, and the feeling of congruence of the motor choice to the motor plan. We systematically reviewed studies aiming to verify the role of agency in improving learning. Fifteen studies were selected from MEDLINE and Scopus®. When a mismatch is introduced between observed and performed actions, the decrease in agency and learning is proportional to the intensity of the mismatch, which is due to greater interference with the motor programming. Thanks to multisensory integration, agency and learning benefit both from sensory and performance feedback and from the timing of feedback based on control at the goal level or the perceptual-motor level. This work constitutes a bedrock for professional teleoperation settings (e.g., robotic surgery), with particular reference to the role of agency in performing complex tasks with remote control.
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Affiliation(s)
- Valentina Cesari
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (V.C.); (S.D.); (A.P.); (F.M.); (A.G.)
| | - Sveva D’Aversa
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (V.C.); (S.D.); (A.P.); (F.M.); (A.G.)
| | - Andrea Piarulli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (V.C.); (S.D.); (A.P.); (F.M.); (A.G.)
| | - Franca Melfi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (V.C.); (S.D.); (A.P.); (F.M.); (A.G.)
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (V.C.); (S.D.); (A.P.); (F.M.); (A.G.)
- Clinical Psychology Branch, Azienda Ospedaliero-Universitaria Pisana, 56126 Pisa, Italy
| | - Danilo Menicucci
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy; (V.C.); (S.D.); (A.P.); (F.M.); (A.G.)
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Flores-Cortes M, Guerra-Armas J, Pineda-Galan C, La Touche R, Luque-Suarez A. Sensorimotor Uncertainty of Immersive Virtual Reality Environments for People in Pain: Scoping Review. Brain Sci 2023; 13:1461. [PMID: 37891829 PMCID: PMC10604973 DOI: 10.3390/brainsci13101461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Decision making and action execution both rely on sensory information, and their primary objective is to minimise uncertainty. Virtual reality (VR) introduces uncertainty due to the imprecision of perceptual information. The concept of "sensorimotor uncertainty" is a pivotal element in the interplay between perception and action within the VR environment. The role of immersive VR in the four stages of motor behaviour decision making in people with pain has been previously discussed. These four processing levels are the basis to understand the uncertainty that a patient experiences when using VR: sensory information, current state, transition rules, and the outcome obtained. METHODS This review examines the different types of uncertainty that a patient may experience when they are immersed in a virtual reality environment in a context of pain. Randomised clinical trials, a secondary analysis of randomised clinical trials, and pilot randomised clinical trials related to the scope of Sensorimotor Uncertainty in Immersive Virtual Reality were included after searching. RESULTS Fifty studies were included in this review. They were divided into four categories regarding the type of uncertainty the intervention created and the stage of the decision-making model. CONCLUSIONS Immersive virtual reality makes it possible to alter sensorimotor uncertainty, but studies of higher methodological quality are needed on this topic, as well as an exploration into the patient profile for pain management using immersive VR.
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Affiliation(s)
- Mar Flores-Cortes
- Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
| | | | | | - Roy La Touche
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), 28008 Madrid, Spain
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
| | - Alejandro Luque-Suarez
- Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain
- Instituto de Investigacion Biomedica de Malaga (IBIMA), 29071 Malaga, Spain
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Banduni O, Saini M, Singh N, Nath D, Kumaran SS, Kumar N, Srivastava MVP, Mehndiratta A. Post-Stroke Rehabilitation of Distal Upper Limb with New Perspective Technologies: Virtual Reality and Repetitive Transcranial Magnetic Stimulation-A Mini Review. J Clin Med 2023; 12:jcm12082944. [PMID: 37109280 PMCID: PMC10142518 DOI: 10.3390/jcm12082944] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Upper extremity motor impairment is the most common sequelae in patients with stroke. Moreover, its continual nature limits the optimal functioning of patients in the activities of daily living. Because of the intrinsic limitations in the conventional form of rehabilitation, the rehabilitation applications have been expanded to technology-driven solutions, such as Virtual Reality and Repetitive Transcranial Magnetic Stimulation (rTMS). The motor relearning processes are influenced by variables, such as task specificity, motivation, and feedback provision, and a VR environment in the form of interactive games could provide novel and motivating customized training solutions for better post-stroke upper limb motor improvement. rTMS being a precise non-invasive brain stimulation method with good control of stimulation parameters, has the potential to facilitate neuroplasticity and hence a good recovery. Although several studies have discussed these forms of approaches and their underlying mechanisms, only a few of them have specifically summarized the synergistic applications of these paradigms. To bridge the gaps, this mini review presents recent research and focuses precisely on the applications of VR and rTMS in distal upper limb rehabilitation. It is anticipated that this article will provide a better representation of the role of VR and rTMS in distal joint upper limb rehabilitation in patients with stroke.
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Affiliation(s)
- Onika Banduni
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Megha Saini
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Neha Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Debasish Nath
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - S Senthil Kumaran
- Department of Nuclear Medicine and Resonance, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - M V Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
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Morita T, Zhu Y, Aoyama T, Takeuchi M, Yamamoto K, Hasegawa Y. Auditory Feedback for Enhanced Sense of Agency in Shared Control. SENSORS (BASEL, SWITZERLAND) 2022; 22:9779. [PMID: 36560147 PMCID: PMC9787405 DOI: 10.3390/s22249779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 12/01/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
There is a growing need for robots that can be remotely controlled to perform tasks of one's own choice. However, the SoA (Sense of Agency: the sense of recognizing that the motion of an observed object is caused by oneself) is reduced because the subject of the robot motion is identified as external due to shared control. To address this issue, we aimed to suppress the decline in SoA by presenting auditory feedback that aims to blur the distinction between self and others. We performed the tracking task in a virtual environment under four different auditory feedback conditions, with varying levels of automation to manipulate the virtual robot gripper. Experimental results showed that the proposed auditory feedback suppressed the decrease in the SoA at a medium level of automation. It is suggested that our proposed auditory feedback could blur the distinction between self and others, and that the operator attributes the subject of the motion of the manipulated object to himself.
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Affiliation(s)
- Tomoya Morita
- Department of Micro-Nano Mechanical Science and Engineering, Nagoya University, Nagoya 464-8601, Japan
| | - Yaonan Zhu
- Department of Micro-Nano Mechanical Science and Engineering, Nagoya University, Nagoya 464-8601, Japan
| | - Tadayoshi Aoyama
- Department of Micro-Nano Mechanical Science and Engineering, Nagoya University, Nagoya 464-8601, Japan
| | - Masaru Takeuchi
- Department of Micro-Nano Mechanical Science and Engineering, Nagoya University, Nagoya 464-8601, Japan
| | - Kento Yamamoto
- Department of Micro-Nano Mechanical Science and Engineering, Nagoya University, Nagoya 464-8601, Japan
| | - Yasuhisa Hasegawa
- Department of Micro-Nano Mechanical Science and Engineering, Nagoya University, Nagoya 464-8601, Japan
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Fu X, Zhang Z, Zhou Y, Chen Q, Yang LZ, Li H. The Split-Half Reliability and Construct Validity of the Virtual Reality-Based Path Integration Task in the Healthy Population. Brain Sci 2022; 12:brainsci12121635. [PMID: 36552095 PMCID: PMC9775933 DOI: 10.3390/brainsci12121635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The virtual reality (VR)-based path integration task shows substantial promise in predicting dementia risk. However, the reliability and validity in healthy populations need further exploration. The present study investigates the relationship between task indicators and brain structures in a healthy population using a VR-based navigation task, particularly the entorhinal cortex (EC) and hippocampus. METHODS Sixty healthy adults were randomly recruited to perform a VR-based path integration task, the digit span task (DST), and an MRI scan. The indicators of the VR-based path integration task were calculated, including the absolute distance error (ADE), degree of angle deviation (DAD), degree of path deviation (DPD), and return time (Time). The reliability of the above indicators was then estimated using the split-half method and Cronbach's alpha. Correlation and regression analyses were then performed to examine the associations between these indicators and age, general cognitive ability (DST), and brain structural measures. RESULTS ADE, DAD, and DPD showed reasonable split-half reliability estimates (0.84, 0.81, and 0.72) and nice Cronbach's alpha estimates (0.90, 0.86, and 0.96). All indicators correlated with age and DST. ADE and DAD were sensitive predictors of hippocampal volume, and return time was a predictor of EC thickness. CONCLUSION Our findings demonstrate that the VR-based path integration task exhibits good reliability and validity in the healthy population. The task indicators are age-sensitive, can capture working memory capacity, and are closely related to the integrity of individual EC and hippocampal structures.
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Affiliation(s)
- Xiao Fu
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, China
| | - Zhenglin Zhang
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, China
- University of Science and Technology of China, Hefei 230026, China
| | - Yanfei Zhou
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, China
| | - Qi Chen
- Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei 230031, China
| | - Li-Zhuang Yang
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, China
- Correspondence: may
| | - Hai Li
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of Health and Medical Technology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei 230031, China
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Isenstein EL, Waz T, LoPrete A, Hernandez Y, Knight EJ, Busza A, Tadin D. Rapid assessment of hand reaching using virtual reality and application in cerebellar stroke. PLoS One 2022; 17:e0275220. [PMID: 36174027 PMCID: PMC9522266 DOI: 10.1371/journal.pone.0275220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/13/2022] [Indexed: 11/19/2022] Open
Abstract
The acquisition of sensory information about the world is a dynamic and interactive experience, yet the majority of sensory research focuses on perception without action and is conducted with participants who are passive observers with very limited control over their environment. This approach allows for highly controlled, repeatable experiments and has led to major advances in our understanding of basic sensory processing. Typical human perceptual experiences, however, are far more complex than conventional action-perception experiments and often involve bi-directional interactions between perception and action. Innovations in virtual reality (VR) technology offer an approach to close this notable disconnect between perceptual experiences and experiments. VR experiments can be conducted with a high level of empirical control while also allowing for movement and agency as well as controlled naturalistic environments. New VR technology also permits tracking of fine hand movements, allowing for seamless empirical integration of perception and action. Here, we used VR to assess how multisensory information and cognitive demands affect hand movements while reaching for virtual targets. First, we manipulated the visibility of the reaching hand to uncouple vision and proprioception in a task measuring accuracy while reaching toward a virtual target (n = 20, healthy young adults). The results, which as expected revealed multisensory facilitation, provided a rapid and a highly sensitive measure of isolated proprioceptive accuracy. In the second experiment, we presented the virtual target only briefly and showed that VR can be used as an efficient and robust measurement of spatial memory (n = 18, healthy young adults). Finally, to assess the feasibility of using VR to study perception and action in populations with physical disabilities, we showed that the results from the visual-proprioceptive task generalize to two patients with recent cerebellar stroke. Overall, we show that VR coupled with hand-tracking offers an efficient and adaptable way to study human perception and action.
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Affiliation(s)
- E. L. Isenstein
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States of America
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Center for Visual Science, University of Rochester, Rochester, NY, United States of America
| | - T. Waz
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States of America
| | - A. LoPrete
- Center for Visual Science, University of Rochester, Rochester, NY, United States of America
- Center for Neuroscience and Behavior, American University, Washington, DC, United States of America
- Bioengineering Graduate Group, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Y. Hernandez
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- The City College of New York, CUNY, New York, NY, United States of America
| | - E. J. Knight
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
| | - A. Busza
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - D. Tadin
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, NY, United States of America
- Department of Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
- Center for Visual Science, University of Rochester, Rochester, NY, United States of America
- Department of Ophthalmology, University of Rochester School of Medicine and Dentistry, Rochester, New York, United States of America
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Hurault JC, Tedesco A, Brunel L. « I know what you mean »: Investigating the sense of agency in learning an abstract mathematical knowledge using a constructivist method in virtual reality. ANNEE PSYCHOLOGIQUE 2021. [DOI: 10.3917/anpsy1.214.0443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Sakabe N, Altukhaim S, Hayashi Y, Sakurada T, Yano S, Kondo T. Enhanced Visual Feedback Using Immersive VR Affects Decision Making Regarding Hand Use With a Simulated Impaired Limb. Front Hum Neurosci 2021; 15:677578. [PMID: 34177496 PMCID: PMC8232051 DOI: 10.3389/fnhum.2021.677578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
The long-term effects of impairment have a negative impact on the quality of life of stroke patients in terms of not using the affected limb even after some recovery (i.e., learned non-use). Immersive virtual reality (IVR) has been introduced as a new approach for the treatment of stroke rehabilitation. We propose an IVR-based therapeutic approach to incorporate positive reinforcement components in motor coordination as opposed to constraint-induced movement therapy (CIMT). This study aimed to investigate the effect of IVR-reinforced physical therapy that incorporates positive reinforcement components in motor coordination. To simulate affected upper limb function loss in patients, a wrist weight was attached to the dominant hand of participant. Participants were asked to choose their right or left hand to reach toward a randomly allocated target. The movement of the virtual image of the upper limb was reinforced by visual feedback to participants, that is, the participants perceived their motor coordination as if their upper limb was moving to a greater degree than what was occurring in everyday life. We found that the use of the simulated affected limb was increased after the visual feedback enhancement intervention, and importantly, the effect was maintained even after gradual withdrawal of the visual amplification. The results suggest that positive reinforcement within the IVR could induce an effect on decision making in hand usage.
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Affiliation(s)
- Naoko Sakabe
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Samirah Altukhaim
- Biomedical Science and Biomedical Engineering, School of Biological Sciences, University of Reading, Reading, United Kingdom.,Physiotherapy Group in Stroke Unit, Alamiri Hospital, Kuwait City, Kuwait
| | - Yoshikatsu Hayashi
- Biomedical Science and Biomedical Engineering, School of Biological Sciences, University of Reading, Reading, United Kingdom
| | - Takeshi Sakurada
- College of Science and Engineering, Ritsumeikan University, Shiga, Japan
| | - Shiro Yano
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan
| | - Toshiyuki Kondo
- Department of Computer and Information Sciences, Graduate School of Engineering, Tokyo University of Agriculture and Technology, Tokyo, Japan
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