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Terruzzi S, Albini F, Massetti G, Etzi R, Gallace A, Vallar G. The Neuropsychological Assessment of Unilateral Spatial Neglect Through Computerized and Virtual Reality Tools: A Scoping Review. Neuropsychol Rev 2024; 34:363-401. [PMID: 36913099 PMCID: PMC10009867 DOI: 10.1007/s11065-023-09586-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 09/28/2022] [Indexed: 03/14/2023]
Abstract
Unilateral Spatial Neglect is a disabling neuropsychological deficit. Patients with spatial neglect fail to detect and report events, and to perform actions in the side of space contralateral to a hemispheric cerebral lesion. Neglect is assessed by evaluating the patients' abilities in daily life activities and by psychometric tests. Computer-based, portable and Virtual Reality technologies may provide more and precise data, and be more sensitive and informative, compared to current paper-and-pencil procedures. Studies since 2010, in which such technologies have been used, are reviewed. Forty-two articles meeting inclusion criteria are categorized according to their technological approaches (computer-, graphics tablet or tablet-, virtual reality-based assessment, and other). The results are promising. However, a definite golden standard, technologically based procedure cannot be still established. Developing technologically based tests is a laborious process, which requires technical and user experience improvements as well as normative data, to increase the evidence of efficacy for clinical evaluation of at least some of the tests considered in this review.
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Affiliation(s)
- Stefano Terruzzi
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neurocognitive Rehabilitation Center (CeRiN), University of Trento, Rovereto, Italy.
| | - Federica Albini
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Gemma Massetti
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Roberta Etzi
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Alberto Gallace
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, 20126, Italy.
- Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy.
- Neuropsychological Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Auxologico Italiano, Milan, Italy.
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Thuilier E, Carey J, Dempsey M, Dingliana J, Whelan B, Brennan A. Virtual rehabilitation for patients with osteoporosis or other musculoskeletal disorders: a systematic review. VIRTUAL REALITY 2024; 28:93. [PMID: 38595908 PMCID: PMC10999384 DOI: 10.1007/s10055-024-00980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 02/25/2024] [Indexed: 04/11/2024]
Abstract
This study aims to identify effective ways to design virtual rehabilitation to obtain physical improvement (e.g. balance and gait) and support engagement (i.e. motivation) for people with osteoporosis or other musculoskeletal disorders. Osteoporosis is a systemic skeletal disorder and is among the most prevalent diseases globally, affecting 0.5 billion adults. Despite the fact that the number of people with osteoporosis is similar to, or greater than those diagnosed with cardiovascular disease and dementia, osteoporosis does not receive the same recognition. Worldwide, osteoporosis causes 8.9 million fractures annually; it is associated with substantial pain, suffering, disability and increased mortality. The importance of physical therapy as a rehabilitation strategy to avoid osteoporosis fracture cannot be over-emphasised. However, the main rehabilitation challenges relate to engagement and participation. The use of virtual rehabilitation to address such challenges in the delivery of physical improvement is gaining in popularity. As there currently is a paucity of literature applying virtual rehabilitation to patients with osteoporosis, the authors broadened the search parameters to include articles relating to the virtual rehabilitation of other skeletal disorders (e.g. Ankylosing spondylitis, spinal cord injury, motor rehabilitation, etc.). This systematic review initially identified 130 titles, from which 23 articles (involving 539 participants) met all eligibility and selection criteria. Four groups of devices supporting virtual rehabilitation were identified: a head-mounted display, a balance board, a camera and more specific devices. Each device supported physical improvement (i.e. balance, muscle strength and gait) post-training. This review has shown that: (a) each device allowed improvement with different degrees of immersion, (b) the technology choice is dependent on the care need and (c) virtual rehabilitation can be equivalent to and enhance conventional therapy and potentially increase the patient's engagement with physical therapy.
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Affiliation(s)
- Eléa Thuilier
- School of Computer Science, University of Galway, Galway, Ireland
| | - John Carey
- School of Medicine, University of Galway, Galway, Ireland
| | - Mary Dempsey
- School of Engineering, University of Galway, Galway, Ireland
| | - John Dingliana
- School of Computer Science and Statistics, Trinity College Dublin, Dublin, Ireland
| | - Bryan Whelan
- School of Medicine, University of Galway, Galway, Ireland
| | - Attracta Brennan
- School of Computer Science, University of Galway, Galway, Ireland
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Burin-Chu S, Baillet H, Leconte P, Lejeune L, Thouvarecq R, Benguigui N. Effectiveness of virtual reality interventions of the upper limb in children and young adults with cerebral palsy: A systematic review with meta-analysis. Clin Rehabil 2024; 38:15-33. [PMID: 37499213 DOI: 10.1177/02692155231187858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVE To examine the characteristics and the effectiveness of virtual reality systems on upper limb impairments in children and young adults with cerebral palsy. DATA SOURCES An electronic search was conducted on PubMed, PEDro, Web of Science, Central, and EMBASE. METHODS The protocol of this review was prospectively registered in the PROSPERO database (CRD42022302271). Randomized controlled trials that tested the effects of virtual reality-based interventions on the upper limb of participants with cerebral palsy were included. The methodological quality of the studies was measured by the PEDro scale. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation. The data of the studies were analyzed in meta-analysis and presented in forest plots and narrative synthesis. RESULTS Twenty-two studies involving 746 participants were included. Ten different virtual reality systems were used in the interventions, of which six were designed specifically for rehabilitation and four commercial video games. We found an effect in favor of virtual reality when it was used in combination with conventional therapy for upper limb activity (SMD = 0.65; 95% CI (0.19 to 1.11)). However, the certainty of the evidence of the comparisons ranged from very low to low. CONCLUSION Virtual reality seems to be an effective tool for upper limb activity in children and young adults with cerebral palsy. Nevertheless, future studies should present a better methodological quality, a larger sample size, and well-defined rehabilitation programs to reduce the inconsistency of the evidence in this domain.
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Affiliation(s)
| | - Héloïse Baillet
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, Caen, France
| | | | - Laure Lejeune
- Normandie Univ, UNICAEN, ENSICAEN, CNRS, GREYC, Caen, France
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da Silva Jaques E, Figueiredo AI, Schiavo A, Loss BP, da Silveira GH, Sangalli VA, da Silva Melo DA, Xavier LL, Pinho MS, Mestriner RG. Conventional Mirror Therapy versus Immersive Virtual Reality Mirror Therapy: The Perceived Usability after Stroke. Stroke Res Treat 2023; 2023:5080699. [PMID: 37275507 PMCID: PMC10234727 DOI: 10.1155/2023/5080699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/17/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Background Stroke is a widespread and complex health issue, with many survivors requiring long-term rehabilitation due to upper-limb impairment. This study is aimed at comparing the perceived usability of two feedback-based stroke therapies: conventional mirror therapy (MT) and immersive virtual reality mirror therapy (VR). Methods The study involved 45 participants, divided into three groups: the stroke survivors (n = 15), stroke-free older adults (n = 15), and young controls (n = 15). Participants performed two tasks using both MT and VR in a semirandom sequence. Usability instruments (SUS and NASA-TLX) were applied at the end of the activities, along with two experience-related questions. Results The results indicated that both MT and VR had similar levels of perceived usability, with MT being more adaptable and causing less overall discomfort. Conversely, VR increased the perception of task difficulty and prevented participants from diverting their attention from the mirror-based feedback. Conclusion While VR was found to be less comfortable than MT, both systems exhibited similar perceived usability. The comfort levels of the goggles may play a crucial role in determining the usability of VR for upper limb rehabilitation after stroke.
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Affiliation(s)
- Eliana da Silva Jaques
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Anelise Ineu Figueiredo
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Aniuska Schiavo
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Bianca Pacheco Loss
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Gabriel Hoff da Silveira
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Vicenzo Abichequer Sangalli
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Polytechnic School, Virtual Reality Research Group, Porto Alegre, Brazil
| | - Denizar Alberto da Silva Melo
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Léder Leal Xavier
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Márcio Sarroglia Pinho
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Polytechnic School, Virtual Reality Research Group, Porto Alegre, Brazil
| | - Régis Gemerasca Mestriner
- Biomedical Gerontology Program of the School of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- Neuroplasticity and Rehabilitation Research Group (NEUROPLAR), Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
- School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Lukacs MJ, Salim S, Katchabaw MJ, Yeung E, Walton DM. Virtual reality in physical rehabilitation: a narrative review and critical reflection. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2105077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Michael J. Lukacs
- Health and Rehabilitation Sciences, Western University, Canada
- Bone and Joint Institute, Western University, Canada
| | - Shahan Salim
- Public Health and Health Systems, University of Waterloo, Canada
| | | | - Euson Yeung
- Physical Therapy, University of Toronto, Canada
| | - David M. Walton
- Bone and Joint Institute, Western University, Canada
- School of Physical Therapy, Western University, Canada
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Kleschnitzki J, Beyer L, Beyer R, Großmann I. Does regularly playing serious gaming improve cognitive functioning of seniors in care facilities? Controlled Effectiveness Trial on a Representative German Sample. JMIR Serious Games 2022; 10:e33169. [PMID: 35172959 PMCID: PMC9015760 DOI: 10.2196/33169] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/25/2021] [Accepted: 02/17/2022] [Indexed: 12/24/2022] Open
Abstract
Background Serious games have been found to have enhancing and preventative effects on cognitive abilities in healthy older adults. Yet, there are few results on the effects in older seniors with age-related low cognitive impairments. Their special needs were considered when designing and using innovate technology in the area of prevention, which is especially relevant owing to the continuously aging population. Objective The objective of this study was to evaluate the impact of a serious game on the cognitive abilities of seniors in order to potentially implement innovative resource-oriented technological interventions that can help to meet future challenges. Methods In this controlled trial, we tested the serious game MemoreBox, which features modules specifically designed for seniors in nursing homes. Over a period of 1 year, we tested the cognitive abilities of 1000 seniors at 4 time points using the Mini-Mental Status Test. Only half of the participating seniors engaged with the serious game. Results The study included an intervention group (n=56) and a control group (did not play; n=55). Based on the in-game data collection, a second intervention group (n=38) was identified within the original intervention group, which exactly followed the planned protocol. There were no noteworthy differences between the demographic and main variables of the overall sample. The large reduction in the sample size was due to the effects of the COVID-19 pandemic (drop-out rate: 88.9%). The CI was set at 5%. Mixed analysis of variance (ANOVA) between the cognitive abilities of the intervention and control groups did not show a statistically significant difference between time and group (F2.710,295.379=1.942; P=.13; partial η²=0.018). We noted approximately the same findings for mixed ANOVA between the cognitive abilities of the second intervention and control groups (F3,273=2.574; P=.054; partial η²=0.028). However, we did observe clear tendencies and a statistically significant difference between the 2 groups after 9 months of the intervention (t88.1=−2.394; P=.02). Conclusions The results of this study show similarities with the current research situation. Moreover, the data indicate that the intervention can have an effect on the cognitive abilities of seniors, provided that they regularly play the serious game of MemoreBox. The small sample size means that the tendency toward improvement cannot be proven as statistically significant. However, the tendency shown warrants further research. Establishing an effective prevention tool as part of standard care in nursing homes by means of an easy-to-use serious game would be a considerable contribution to the weakened health care system in Germany as it would offer a means of activating senior citizens in partially and fully inpatient care facilities. Trial Registration German Clinical Trials Register DRKS00016633; https://tinyurl.com/2e4765nj
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Affiliation(s)
- Jana Kleschnitzki
- Department of Psychology, Humboldt-University of Berlin, Rudower Chaussee 18, Berlin, DE
| | | | - Reinhard Beyer
- Department of Psychology, Humboldt-University of Berlin, Rudower Chaussee 18, Berlin, DE
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Sadeghi H, Jehu DA. Exergaming to improve physical, psychological and cognitive health among home office workers: A COVID-19 pandemic commentary. Work 2021; 71:13-17. [PMID: 34924430 DOI: 10.3233/wor-211000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has resulted in increased sedentary behaviour and poorer health among office workers. Exergaming is a technology-driven mode of exercise that can improve health while physically distancing. OBJECTIVE The purpose of this commentary was to explain the benefits of exergaming on physical function, psychological health, and cognition among office workers. RESULTS Exergaming improves these health outcomes, reduces pain, and decreases the risk for chronic disease. It is easily accessible on smart devices and can be performed both indoors and outdoors. CONCLUSIONS Twenty-one minutes of exergaming per day can improve health outcomes and reduce the risk of pain and disease. Employers and policy-makers should consider promoting exergaming among office workers.
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Affiliation(s)
- Hassan Sadeghi
- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Sciences, KharazmiUniversity, Tehran, Iran.,Shiraz Geriatric Research Center, ShirazUniversity of Medical Sciences, Shiraz, Iran
| | - Deborah A Jehu
- Interdisciplinary Health Sciences Department, College of Allied Health Sciences, Augusta University, Augusta, GA, USA
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Exergames to Prevent the Secondary Functional Deterioration of Older Adults during Hospitalization and Isolation Periods during the COVID-19 Pandemic. SUSTAINABILITY 2021. [DOI: 10.3390/su13147932] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The COVID-19 pandemic is having an intense impact on the functional capacity of older adults, making them more vulnerable to frailty and dependency. The development of preventive and rehabilitative measures which counteract the consequences of confinement or hospitalization is an urgent need. Exergaming can promote physical activity, prevent falls, and maintain functional and cognitive capacity. However, although the use of exergames in health programs for the elderly is promising, their widespread use should not be considered without the supervision of a social health professional. Therefore, the objective of this work was to evaluate and analyze three video game consoles (Nintendo Wii®, Xbox-Kinect® and Play Station 4®) and 26 commercial exergames with the aim of identifying their usefulness for the prevention of functional deterioration. Three occupational therapists analyzed the data independently, and subsequently agreed on the results. The examination of the commercial consoles met three criteria: components, interaction channels and the type of the exergame. Each exergame was analyzed taking into account its ability to train postural control, balance, upper limb functionality and cognitive function. The results of the evaluation showed that exergames contain game activities that can be part of the rehabilitative treatment aimed at the prevention of the functional impairment of older people affected by COVID.
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Unibaso-Markaida I, Iraurgi I. Commercial videogames in stroke rehabilitation: systematic review and meta-analysis. Top Stroke Rehabil 2021; 29:551-567. [PMID: 34176453 DOI: 10.1080/10749357.2021.1943798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: The aim of this article was to perform a systematic review of all studies (both observational and experimental) wherein commercial video games were used in comprehensive rehabilitation (both physical and cognitive areas) after stroke.Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed, and all observational and experimental studies that met at least six PEDro scale criteria were included. A total of 50 studies were included in the Meta-Analysis. Data analysis was performed using RevMan 5.3 and the bias with JAMOVI.Results: In observational studies, results favored intervention with video games in terms of functionality such as Fulg-Meyer Assessment scores [standard mean difference (SMD) = -0.45; 95% CI = -0.74 to -0.15; p = .94; I2 = 0%)] and when measured in the upper limbs using the Wolf Motor Function Test (SMD = 0.41; 95% CI = 0.07 to 0.74; p = .47; I2 = 0%). Other results showed heterogeneity. In the experimental group, most results tended to favor the experimental group and showed homogeneity, but they were not significant. Fail Safe N was calculated, and the results were not biased.Conclusions: Results tend to favor intervention with commercial video games, but the heterogeneity of the measuring instruments and small sample size do not allow for significant results to be obtained. Future research should provide the number of participants, mean, and standard deviation to facilitate future meta-analyses. Commercial video games appear to be a feasible tool in physical and cognitive stroke rehabilitation.
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Affiliation(s)
| | - Ioseba Iraurgi
- Department of Psychology, University of Deusto, Bilbao, Spain
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Hwang NK, Choi JB, Choi DK, Park JM, Hong CW, Park JS, Yoon TH. Effects of Semi-Immersive Virtual Reality-Based Cognitive Training Combined with Locomotor Activity on Cognitive Function and Gait Ability in Community-Dwelling Older Adults. Healthcare (Basel) 2021; 9:healthcare9070814. [PMID: 34203233 PMCID: PMC8305308 DOI: 10.3390/healthcare9070814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/05/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effects of semi-immersive virtual reality-based cognitive training (VRCT) combined with locomotor activity on cognitive function, balance, and gait ability in older adults. Eighteen community-dwelling older adults participated in this study. Subjects who met the selection criteria were assigned to an experimental group (n = 9) and a control group (n = 9). The experimental group received VRCT combined with locomotor activity for 30 min a day, three times a week, for 6 weeks. The control group received tabletop activity-based cognitive training for the same amount of time. Before and after the training, the Korean Mini-Mental State Examination (K-MMSE), Trail Making Test (TMT; A and B), and Digit Span Test (DST; forward and backward) were used to evaluate cognitive function; and the Timed Up and Go (TUG) test and 10-m Walking Test (10MWT) were used to evaluate the improvement in the balance and gait ability parameters. After the intervention, the experimental group showed a significantly greater improvement in the TMT-A (p = 0.045) and DST-backward (p = 0.012) scores compared with the control group. Regarding the gait ability variable, the experimental group showed a significant improvement in the 10MWT test (p = 0.001). This study confirmed that semi-immersive VRCT combined with locomotor activity is useful for improving cognitive function and gait ability in older adults. Therefore, VRCT combined with locomotor activity can be used as a simultaneous intervention for cognitive rehabilitation and functional capacity improvement in older adults.
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Affiliation(s)
- Na-Kyoung Hwang
- Department of Occupational Therapy, Seoul North Municipal Hospital, 38 Yangwonyeokro, Seoul 02062, Korea;
| | - Jong-Bae Choi
- Department of Occupational Therapy, Sangji University, 83 Sangjidae-gil, Wonju-si 26339, Korea;
| | - Dae-Kil Choi
- R&D Team, YOUCANSTAR Inc., 170 Gobun-ro, Yeonje-gu, Busan 47583, Korea; (D.-K.C.); (J.-M.P.); (C.-W.H.)
| | - Jae-Min Park
- R&D Team, YOUCANSTAR Inc., 170 Gobun-ro, Yeonje-gu, Busan 47583, Korea; (D.-K.C.); (J.-M.P.); (C.-W.H.)
| | - Chang-Wan Hong
- R&D Team, YOUCANSTAR Inc., 170 Gobun-ro, Yeonje-gu, Busan 47583, Korea; (D.-K.C.); (J.-M.P.); (C.-W.H.)
| | - Ji-Su Park
- Advanced Human Resource Development Project Group for Health Care in Aging Friendly Industry, Dongseo University, 47 Jurye-ro, Busan 47011, Korea
- Correspondence: (J.-S.P.); (T.-H.Y.)
| | - Tae-Hyung Yoon
- Department of Occupational Therapy, Dongseo University, 47 Jurye-ro, Busan 47011, Korea
- Correspondence: (J.-S.P.); (T.-H.Y.)
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Espy D, Reinthal A, Dal Bello-Haas V. A Clinical Decision-Making Framework for the Use of Video Gaming as a Therapeutic Modality. Front Neurol 2021; 12:610095. [PMID: 34122293 PMCID: PMC8193226 DOI: 10.3389/fneur.2021.610095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
Virtual reality and video gaming offer modulation of more exercise and motor learning parameters simultaneously than other modalities; however, there is a demonstrated need for resources to facilitate their effective use clinically. This article presents a conceptual framework to guide clinical-decision making for the selection, adaptation, modulation, and progression of virtual reality or gaming when used as a therapeutic exercise modality, and two cases as exemplars. This framework was developed by adapting the steps of theory derivation, whereby concepts and parent theories are brought together to describe a new structure or phenomenon of interest. Specifically, motor learning theory, integrated motor control theory, Gentile's Taxonomy of Tasks, and therapeutic exercise principles were integrated to develop this framework. It incorporates person (body segment), environmental, and task demands; each demand is comprised of realm, category, choice, and continuum parameters as motor training considerations and alternatives for decision-making. This framework: (1) provides structure to guide clinical decisions for effective and safe use of virtual reality or gaming to meet therapeutic goals and requirements, (2) is a concise and organized method to identify, document, and track the therapeutic components of protocols and client progression over time; (3) can facilitate documentation for reimbursement and communication among clinicians; and, (4) structures student learning, and (5) informs research questions and methods.
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Affiliation(s)
- Debbie Espy
- School of Health Sciences, Cleveland State University, Cleveland, OH, United States
| | - Ann Reinthal
- School of Health Sciences, Cleveland State University, Cleveland, OH, United States
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Deutsch JE, James-Palmer A, Damodaran H, Puh U. Comparison of neuromuscular and cardiovascular exercise intensity and enjoyment between standard of care, off-the-shelf and custom active video games for promotion of physical activity of persons post-stroke. J Neuroeng Rehabil 2021; 18:63. [PMID: 33853608 PMCID: PMC8045246 DOI: 10.1186/s12984-021-00850-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 03/16/2021] [Indexed: 12/04/2022] Open
Abstract
Background Active video games have been embraced for the rehabilitation of mobility and promotion of physical activity for persons post-stroke. This study seeks to compare carefully matched standard of care stepping activities, off-the-shelf (non-custom) active video games and custom active video games that are either self-paced or game-paced for promoting neuromuscular intensity and accuracy, cardiovascular intensity, enjoyment and perceived effort. Methods Fifteen persons (ages 38–72) with mild to moderate severity in the chronic phase post-stroke (average 8 years) participated in a single group counter balanced repeated measures study. Participants were included if they were greater than 6 months post-stroke, who could walk 100 feet without assistance and stand unsupported for three continuous minutes. They were excluded if they had cardiac, musculoskeletal or neurologic conditions that could interfere with repeated stepping and follow instructions. In a single session located in a laboratory setting, participants executed for 8.5 min each: repeated stepping, the Kinect-light race game, two custom stepping games for the Kinect, one was repeated and self-paced and the other was random and game paced. Custom video games were adjusted to the participants stepping volume. Ten-minute rest periods followed the exercise during which time participants rested and completed the PACES an enjoyment questionnaire. Participants were instrumented with a metabolic cart and heart rate sensor for collection of cardiovascular intensity (METs and % of max HR) data. Stepping frequency, accuracy and pattern were acquired via video. Data were analyzed using a RMANOVA and post-hoc comparison with a Holm's/Sidak correction. Results Neuromuscular intensity (repetitions) was significantly greater for the off-the-shelf and self-paced custom game, however accuracy was greater for the custom games. Cardiovascular intensity for all activities took place in the moderate intensity exercise band. Enjoyment (measured with a questionnaire and rankings) was greater for the custom active video games and rate of perceived exertion was lower for the custom active video games. Conclusions Custom active video games provided comparable intensity but better accuracy, greater enjoyment and less perceived exertion than standard of care stepping activities and a carefully matched off-the-shelf (non-custom) video game. There were no differences between the game-paced and self-paced custom active video games. Trial registration: NCT04538326.
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Affiliation(s)
- Judith E Deutsch
- Rivers Lab, Department of Rehabilitation and Movement Science, Rutgers School of Health Professions, 65 Bergen Street, Newark, NJ, 07101, USA.
| | - Aurora James-Palmer
- Rivers Lab, Department of Rehabilitation and Movement Science, Rutgers School of Health Professions, 65 Bergen Street, Newark, NJ, 07101, USA.,Motor Behavior Lab, Department of Rehab and Movement Science, Rutgers School of Health Professions, 65 Bergen Street, Newark, NJ, 07101, USA
| | - Harish Damodaran
- Rivers Lab, Department of Rehabilitation and Movement Science, Rutgers School of Health Professions, 65 Bergen Street, Newark, NJ, 07101, USA
| | - Urska Puh
- Department of Physiotherapy, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
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13
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Kravtsova EN, Meigal AY. [Virtual reality technologies in the rehabilitation of patients with peripheral vestibular dysfunction]. Vestn Otorinolaringol 2021; 86:103-107. [PMID: 33720661 DOI: 10.17116/otorino202186011103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Review of articles published in peer-reviewed international journals devoted to the issues of rehabilitation of patients with peripheral vestibular dysfunction using virtual reality conditions. IN the review provides a neurophysiological rationale for the use of virtual reality techniques for rehabilitation, the technical methods used to recreate the virtual environment, as well as the published results of their clinical application. It is concluded that the application of virtual reality methods in clinical vestibulology is promising. The search was carried out using the search engines Google Scholar, PubMed, PMC, CrossRef, Science Direct.
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Affiliation(s)
| | - A Yu Meigal
- Petrozavodsk State University, Petrozavodsk, Russia
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14
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Mohd Jai NA, Mat Rosly M, Abd Razak NA. Physiological Responses of Exergaming Boxing in Adults: A Systematic Review and Meta-Analysis. Games Health J 2020; 10:73-82. [PMID: 33297818 DOI: 10.1089/g4h.2020.0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Objective: Studies investigating the effects of exergaming in available platforms are still limited. This review aims to systematically identify available studies on physiological intensities of exergaming boxing in able-bodied adults and recategorize them based on different platforms or environments. The meta-analysis further analyzes the physiological responses during exergaming boxing into a set of pooled data for any evidence of outliers, heterogeneity, or publication bias. Materials and Methods: A systematic search was conducted by using databases from Google Scholar, PubMed, and Web of Science. Population, intervention, comparison, and outcomes (PICO) and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were used in the study selection process for the review. Results: From the 1534 articles examined, 16 articles were included for further analyses. Results indicated that exergaming boxing exhibits a wide range of metabolic equivalent of task (MET) values and intensity, from very light to vigorous, with elements of heterogeneity and bias detected. The Xbox® Kinect boxing platform produced higher MET (mean = 5.3) compared with the Nintendo® Wii™ boxing (mean = 3.8). Conclusion: The results of this review suggest that boxing exergames can produce intensity-adequate physical activity among younger adults that are beneficial for cardiometabolic improvements, regardless of platforms used. Exergaming boxing may be employed as an effective exercise tool to increase energy expenditure and physical activity level in young adults.
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Affiliation(s)
- Nor Aina Mohd Jai
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Maziah Mat Rosly
- Department of Physiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Immersive Virtual Environments and Wearable Haptic Devices in rehabilitation of children with neuromotor impairments: a single-blind randomized controlled crossover pilot study. J Neuroeng Rehabil 2020; 17:144. [PMID: 33115487 PMCID: PMC7594483 DOI: 10.1186/s12984-020-00771-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 10/12/2020] [Indexed: 11/21/2022] Open
Abstract
Background The past decade has seen the emergence of rehabilitation treatments using virtual reality. One of the advantages in using this technology is the potential to create positive motivation, by means of engaging environments and tasks shaped in the form of serious games. The aim of this study is to determine the efficacy of immersive Virtual Environments and weaRable hAptic devices (VERA) for rehabilitation of upper limb in children with Cerebral Palsy (CP) and Developmental Dyspraxia (DD). Methods A two period cross-over design was adopted for determining the differences between the proposed therapy and a conventional treatment. Eight children were randomized into two groups: one group received the VERA treatment in the first period and the manual therapy in the second period, and viceversa for the other group. Children were assessed at the beginning and the end of each period through both the Nine Hole Peg Test (9-HPT, primary outcome) and Kinesiological Measurements obtained during the performing of similar tasks in a real setting scenario (secondary outcomes). Results All subjects, not depending from which group they come from, significantly improved in both the performance of the 9-HPT and in the parameters of the kinesiological measurements (movement error and smoothness). No statistically significant differences have been found between the two groups. Conclusions These findings suggest that immersive VE and wearable haptic devices is a viable alternative to conventional therapy for improving upper extremity function in children with neuromotor impairments. Trial registration ClinicalTrials, NCT03353623. Registered 27 November 2017-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03353623
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Modi N, Singh J. A survey of research trends in assistive technologies using information modelling techniques. Disabil Rehabil Assist Technol 2020; 17:605-623. [PMID: 32996798 DOI: 10.1080/17483107.2020.1817992] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite the rapid proliferation and emphasis on technology, the use of assistive technology among individuals with varying disabilities and age is different. This situation instigates the need for a systematic review to gain a realistic understanding of prominent issues, research trends and assistive technology applications with minimal bias. OBJECTIVE Identification of leading researchers and prominent publications in assistive technologies. Subsequently, semantic relation between qualitative and quantitative research literature on assistive technologies was explored to future research directions. METHODS A manual search across reputed research databases was done to find out relevant literature from January 2005 to April 2020. In this paper, latent semantic analysis (LSA) was done to develop an information model for achieving defined objectives. RESULTS A corpus of 367 research papers published during 2005-2020 was processed using LSA. Term frequency, inverse document frequency of high loading terms provided five major topic solutions. Marcia Scherer, Rory Cooper and Stefano Federici are most noticed authors in assistive technology research. "Smart Assistive Technologies" and "Wearable Technologies for Rehabilitation" came out as contemporary research trends within assistive technologies. CONCLUSIONS The manuscript concludes the fact that assistive technologies for rehabilitation are experiencing a transition from standalone mechanical devices towards smart, wearable and connected devices.Implications for RehabilitationCustomized assistive devices could be programmed for multiple uses.User data privacy and internet dependency of smart assistive technologies must be taken care of while designing smart assistive devices for rehabilitation.Fog devices could eliminate the latency issues associated with cloud-based rehabilitation services.
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Affiliation(s)
- Nandini Modi
- Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, India
| | - Jaiteg Singh
- Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, India
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17
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Mubin O, Alnajjar F, Al Mahmud A, Jishtu N, Alsinglawi B. Exploring serious games for stroke rehabilitation: a scoping review. Disabil Rehabil Assist Technol 2020; 17:159-165. [PMID: 32508187 DOI: 10.1080/17483107.2020.1768309] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Aims and Objectives: Stroke is the main cause of long-term disability and happens mostly in the older population. Stroke affected patients experience either of the cognitive, visual or motor losses and recovery requires time and patience as they have to do physical exercises every day and at times repetitively. There are various types of stroke rehabilitation exercises focussing on technological solutions that include therapies performed using games. Motion-based games are popular in encouraging participants to perform repetitive tasks without being getting bored. Therefore, in this study, we have explored studies that included the use of games for stroke rehabilitation to understand the design principles and characteristics of the games used for these purposes. Method: A number of medical respositories were searched for relevant articles in a window of 2008-2018. 18 studies were chosen for the scoping review depending on the inclusion criteria, and design principles used in these studies are analysed and evaluated. Results and Conclusion: We present main findings from our review concerning the attributes of existing games for stroke rehabilitation such as meaningful play, handling of failures, emphasising challenge, and the value of feedback. We conclude with a list of design recommendations that future serious game developers can consider while designing interfaces for stroke patients.Implications for RehabilitationThis review exhibits that the usage of gaming technologies is a very effective interactive mechanism for stroke based rehabilitation.Further our review also shows that serious games provide an avenue and opportunity for customized and highly contextualized gameplayOur review also suggests that effective features to incorporate into serious games for rehabilitation includes; facilitating challenge and recovery from errors.
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Affiliation(s)
- Omar Mubin
- School of Computer, Data and Mathematical Sciences, Western Sydney University - Parramatta Campus, Rydalmere, Australia
| | - Fady Alnajjar
- College of Information Technology, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abdullah Al Mahmud
- Centre for Design Innovation, Swinburne University of Technology, Hawthorn, Australia
| | - Nalini Jishtu
- School of Computer, Data and Mathematical Sciences, Western Sydney University - Parramatta Campus, Rydalmere, Australia
| | - Belal Alsinglawi
- School of Computer, Data and Mathematical Sciences, Western Sydney University - Parramatta Campus, Rydalmere, Australia
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18
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Fan W, Zhang Y, Wang QM, Bai Y, Wu Y. An interactive motion-tracking system for home-based assessing and training reach-to-target tasks in stroke survivors-a preliminary study. Med Biol Eng Comput 2020; 58:1529-1547. [PMID: 32405968 DOI: 10.1007/s11517-020-02173-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/26/2020] [Indexed: 01/08/2023]
Abstract
Quantitative evaluation and training of the reach-to-target ability in stroke patients are needed for postdischarge rehabilitation, which can be achieved using a motion-tracking system. However, most of these systems are either costly, involve sophisticated parameter interpretation, or are not designed for rehabilitation. We developed an interactive reach-to-target assessment and training system (IRTATS) based on a camera and three marker straps to detect tracking signals. IRTATS supports audiovisual feedback, personal goal setting, and use in a small clinic or home without the internet. This study aims to evaluate the reliability, validity of IRTATS, and its measurement accuracy of the range of motion (ROM). Ninety-nine stroke patients and 20 healthy adults were recruited for the study. Kinematic variables and active joint ROM (AROM) were assessed using IRTATS. The AROM was measured by a universal goniometer, and scores from multiple clinical scales concerning motor and activity capability were calculated. Although the AROMs measured by IRTATS and the goniometer did not agree, IRTATS has clinically acceptable reliability and validity. Three variables in IRTATS could discriminate the motor performance of patients and healthy subjects. IRTATS may provide a new supplement to conventional physiotherapy in the assessment of the reach-to-target ability in stroke patients. Graphical abstract System configuration • The system is based on an infrared camera and the adjustable marker straps as a sensor module. • It is portable and compact, and has clinically acceptable reliability and validity. • It supports audiovisual feedback, personal goal setting, and use in regions without the internet. • It can be used as an adjunct to conventional physiotherapy in the assessment of the reach-to-target ability.
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Affiliation(s)
- Wenke Fan
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Yuling Zhang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
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19
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Leal AF, da Silva TD, Lopes PB, Bahadori S, de Araújo LV, da Costa MVB, de Moraes ÍAP, Marques RH, Crocetta TB, de Abreu LC, Monteiro CBDM. The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) - a cross-sectional randomized study. J Neuroeng Rehabil 2020; 17:59. [PMID: 32349752 PMCID: PMC7191706 DOI: 10.1186/s12984-020-00689-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/16/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Cerebral Palsy (CP) is characterised by variable difficulties in muscular action, resulting in inability of the individual to perform functional movement. An option to provide functionality to the individual with CP is the use of computer innovation. The aim of this paper was to verify if there was any performance improvement in a task performed in a virtual environment and if there was transfer to the task performed in the real environment and vice versa in this population. METHODS A computer program was developed comprising a motor task, but with two possibilities of user interaction: a) concrete interface (with physical contact): in which the individual touches the computer screen to finish the task and b) abstract interface (no physical contact): in which the individual performs a hand movement in front of the Kinect device. Participants were split into two groups. The experimental group consisted of 28 individuals with CP within the ages of 6 and 15 years old. The control group included 28 typically developing individuals mirroring the age and sex of the experimental group. RESULTS Individuals from both groups were able to improve task performance and retain acquired information. The CP group presented worse performance than the control group in all phases of the study. Further findings showed that the CP group presented better performance in the abstract interface than in the concrete interface, whereas, in the control group, the opposite occurred: their best performance was in the concrete. CONCLUSIONS Motor tasks performed by individuals with CP through an interface with a more virtual environment feature (abstract interface: Kinect) provided better performance when compared to an interface with a more real characteristic (concrete interface: Touchscreen). TRIAL REGISTRATION ClinicalTrials.gov Identifier - NCT03352440; Date of registration - November 17, 2017.
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Affiliation(s)
- Andréa Fernanda Leal
- Laboratório de Desenho e Escrita Científica, Departamento de Ciências Básicas, Faculdade de Medicina do ABC, Santo André, SP, Brazil
- Departamento de Cardiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Talita Dias da Silva
- Departamento de Cardiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação, Escola de Artes, Ciências e Humanidades - EACH - Universidade de São Paulo, São Paulo, SP, Brazil.
- Faculdade de Medicina, Universidade Cidade de São Paulo - UNICID, São Paulo, SP, Brazil.
- Programa de Pós-Graduação em Ciências da Reabilitação, Faculdade de Medicina da Universidade de São Paulo, Rua Cipotânea, 15, São Paulo, SP, CEP: 05360-160, Brazil.
| | - Priscila Bianchi Lopes
- Departamento de Cardiologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Shayan Bahadori
- Orthopaedic Research Institute, Bournemouth University, Executive Business Centre, Holdenhurst Road, Bournemouth, BH8 8EB, UK
| | - Luciano Vieira de Araújo
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação, Escola de Artes, Ciências e Humanidades - EACH - Universidade de São Paulo, São Paulo, SP, Brazil
| | - Murillo Vinicius Brandão da Costa
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação, Escola de Artes, Ciências e Humanidades - EACH - Universidade de São Paulo, São Paulo, SP, Brazil
| | - Íbis Ariana Peña de Moraes
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação, Escola de Artes, Ciências e Humanidades - EACH - Universidade de São Paulo, São Paulo, SP, Brazil
- Programa de Pós-Graduação em Ciências da Reabilitação, Faculdade de Medicina da Universidade de São Paulo, Rua Cipotânea, 15, São Paulo, SP, CEP: 05360-160, Brazil
| | | | - Tania Brusque Crocetta
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação, Escola de Artes, Ciências e Humanidades - EACH - Universidade de São Paulo, São Paulo, SP, Brazil
- Secretaria de Tecnologia da Informação e Comunicação, Universidade do Estado de Santa Catarina - UDESC, Florianópolis, SC, Brazil
| | - Luiz Carlos de Abreu
- Laboratório de Desenho e Escrita Científica, Departamento de Ciências Básicas, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Carlos Bandeira de Mello Monteiro
- Laboratório de Desenho e Escrita Científica, Departamento de Ciências Básicas, Faculdade de Medicina do ABC, Santo André, SP, Brazil
- Grupo de Pesquisa e Aplicações Tecnológicas em Reabilitação, Escola de Artes, Ciências e Humanidades - EACH - Universidade de São Paulo, São Paulo, SP, Brazil
- Programa de Pós-Graduação em Ciências da Reabilitação, Faculdade de Medicina da Universidade de São Paulo, Rua Cipotânea, 15, São Paulo, SP, CEP: 05360-160, Brazil
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20
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Balance and Dizziness Disorders in the Elderly: a Review. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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21
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Petrikov SS, Grechko AV, Shchelkunova IG, Zavaliy YP, Khat'kova SE, Zavaliy LB. [New perspectives of motor rehabilitation of patients after focal brain lesions]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2020; 83:90-99. [PMID: 32031172 DOI: 10.17116/neiro20198306190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rehabilitation of patients after focal brain lesions is one of the topical issues of modern medicine. Motor disorders are known to develop in more than 80% of survivors of stroke and traumatic brain injury and be one of the main causes of disability, which necessitates an active search for new effective techniques for correction of motor disorders. Modern rehabilitation includes both traditional techniques for recovery of patients with motor deficit (exercise therapy and physiotherapy) and botulinum therapy, kinesiotherapy, mechanotherapy, etc., which have been developed in recent years. Robotic technologies have been developed, improved, and implemented. Currently, due to progress in computerization, virtual reality-based rehabilitation of patients is of particular interest. The article reviews the key studies in this field. We describe various visualization methods and means of immersion in a virtual environment for recovery of upper and lower extremity function in patients with focal brain lesions. The study provides an assessment of the effectiveness and safety of various virtual reality-based rehabilitation programs in patients with motor disorders after stroke and traumatic brain injury.
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Affiliation(s)
- S S Petrikov
- Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia; Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - A V Grechko
- Federal Research and Clinical Center for Resuscitation and Rehabilitation, Moscow, Russia
| | - I G Shchelkunova
- Federal Research and Clinical Center for Resuscitation and Rehabilitation, Moscow, Russia
| | - Ya P Zavaliy
- Federal Research and Clinical Center for Resuscitation and Rehabilitation, Moscow, Russia
| | - S E Khat'kova
- Treatment and Rehabilitation Center of the Ministry of Health of the Russia, Moscow, Russia
| | - L B Zavaliy
- Sklifosovsky Research Institute of Emergency Medicine, Moscow, Russia
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22
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Barak Ventura R, Rizzo A, Nov O, Porfiri M. A 3D printing approach toward targeted intervention in telerehabilitation. Sci Rep 2020; 10:3694. [PMID: 32111880 PMCID: PMC7048757 DOI: 10.1038/s41598-020-59927-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/05/2020] [Indexed: 01/11/2023] Open
Abstract
Neuromuscular impairment requires adherence to a rehabilitation regimen for maximum recovery of motor function. Consumer-grade game controllers have emerged as a viable means to relay supervised physical therapy to patients' homes, thereby increasing their accessibility to healthcare. These controllers allow patients to perform exercise frequently and improve their rehabilitation outcomes. However, the non-universal design of game controllers targets healthy people and does not always accommodate people with disability. Consequently, many patients experience considerable difficulty assuming certain hand postures and performing the prescribed exercise correctly. Here, we explore the feasibility of improving rehabilitation outcomes through a 3D printing approach that enhances off-the-shelf game controllers in home therapy. Specifically, a custom attachment was 3D printed for a commercial haptic device that mediates fine motor rehabilitation. In an experimental study, 25 healthy subjects performed a navigation task, with the retrofit attachment and without it, while simulating disability of the upper limb. When using the attachment, subjects extended their wrist range of motion, yet maintained their level of compensation. The subjects also showed higher motivation to repeat the exercise with the enhanced device. The results bring forward evidence for the potential of this approach in transforming game controllers toward targeted interventions in home therapy.
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Affiliation(s)
- Roni Barak Ventura
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, 11201, USA
| | - Alessandro Rizzo
- Dipartimento di Elettronica e Telecomunicazioni, Politecnico di Torino, Corso Duca degli Abruzzi 24, Torino, 10129, Italy.,Office of Innovation, New York University Tandon School of Engineering, Brooklyn, New York, 11201, USA
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Tandon School of Engineering, 5 MetroTech Center, Brooklyn, New York, 11201, USA
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, New York, 11201, USA. .,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, 11201, USA.
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Corregidor-Sánchez AI, Segura-Fragoso A, Rodríguez-Hernández M, Criado-Alvarez JJ, González-Gonzalez J, Polonio-López B. Can exergames contribute to improving walking capacity in older adults? A systematic review and meta-analysis. Maturitas 2019; 132:40-48. [PMID: 31883662 DOI: 10.1016/j.maturitas.2019.12.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/04/2019] [Accepted: 12/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The accessibility, low cost and motivation generated by exergames has fostered its rapid expansion as a rehabilitation technique. OBJECTIVE To estimate the effectiveness of rehabilitation programs using IVGT in improving walking capacity of people aged 60 years and over. MATERIALS AND METHODS The electronic data research following the PRISMA Statement (Scopus, Cochrane, Web of Science, OT Seeker, National Guideline Clearinghouse, Trip Database, CSIC Spanish National Research Council) was completed in September 2018. The results of randomized clinical trials using exergames for rehabilitation of walking capacity were combined. The calculations have followed the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the quality of the evidence. RESULTS We obtained data from 14 trials, including 11 meta-analysis studies. The size of exergames effects on walking capacity is moderate, but significant (SMD -0.56; 95 % CI: -0.90, -0.21; p = 0.002). Effectiveness was greater to recover the ability to transfer from one position or place to another (SMD -1.02; CI 95 %: -1.70, -0.35; P = 0.003). The intervention protocols, their duration and intensity varied considerably. The lack of masking, the allocation concealment, the absence of assessor blinding were the main causes of bias so the final grade of evidence has been low for walking and very low for transfers. CONCLUSIONS Positive clinical effects of exergames have been found to improve walking capacity, but the quality of evidence to refute its effectiveness is weak with risk of bias. Further research is needed in order to know the actual magnitude of its effect.
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Affiliation(s)
| | - Antonio Segura-Fragoso
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain; Health Sciences Institute, Talavera de la Reina, Toledo, Spain
| | - Marta Rodríguez-Hernández
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain
| | - Juan José Criado-Alvarez
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain; Health Service of Castilla La Mancha, SESCAM, Toledo Spain
| | - Jaime González-Gonzalez
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain; Health Service of Castilla La Mancha, SESCAM, Toledo Spain
| | - Begoña Polonio-López
- Faculty of Health Sciences, University of Castilla la Mancha (UCLM), Talavera de la Reina, Toledo, Spain
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Vision-based serious games and virtual reality systems for motor rehabilitation: A review geared toward a research methodology. Int J Med Inform 2019; 131:103909. [DOI: 10.1016/j.ijmedinf.2019.06.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 05/19/2019] [Accepted: 06/17/2019] [Indexed: 02/03/2023]
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25
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Yacoby A, Zeilig G, Weingarden H, Weiss R, Rand D. Feasibility of, Adherence to, and Satisfaction With Video Game Versus Traditional Self-Training of the Upper Extremity in People With Chronic Stroke: A Pilot Randomized Controlled Trial. Am J Occup Ther 2019; 73:7301205080p1-7301205080p14. [PMID: 30839263 DOI: 10.5014/ajot.2019.026799] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We compared the feasibility of, adherence to, and satisfaction with a newly developed upper extremity (UE) self-training protocol using commercial video games with a traditional self-training program for people with chronic stroke. METHOD Twenty-four participants with mild to moderate UE weakness were randomized to a video game (n = 13) or traditional (n = 11) self-training program. Participants were requested to train 60 min/day, 6×/wk. During the 5-wk self-training program and 4-wk follow-up, participants documented their self-training time and rated their perceived enjoyment and exertion. RESULTS Eleven participants completed video game training; 9 completed traditional self-training. During the follow-up period, 8 participants (72.7%) continued the video game training, and 4 (44.4%) continued traditional training. Perceived enjoyment, satisfaction, and benefit for UE improvement were relatively high. CONCLUSIONS Participants demonstrated high adherence to and satisfaction with both self-training programs. More participants continued to play video games after the intervention, indicating its potential to maintain ongoing activity.
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Affiliation(s)
- Anat Yacoby
- Anat Yacoby, MSc, OT, is Occupational Therapist. She was Master's Student, Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, at the time of the study
| | - Gabi Zeilig
- Gabi Zeilig, MD, is Director, Neurological Rehabilitation Department, Chaim Sheba Medical Center at Tel-HaShomer, Tel-HaShomer, Israel, and Chair, Department of Physical Medicine and Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Harold Weingarden
- Harold Weingarden, MD, is Senior Physician, Department of Neurological Rehabilitation, Chaim Sheba Medical Center at Tel-HaShomer, Tel-HaShomer, Israel
| | - Ronit Weiss
- Ronit Weiss, MSc, OT, is Occupational Therapist, Occupational Therapy Unit, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. She was Master's Student, Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, at the time of the study
| | - Debbie Rand
- Debbie Rand, PhD, OT, is Senior Lecturer and Chair, Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
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Shahar N, Schwartz I, Portnoy S. Differences in muscle activity and fatigue of the upper limb between Task-Specific training and robot assisted training among individuals post stroke. J Biomech 2019; 89:28-33. [PMID: 30982537 DOI: 10.1016/j.jbiomech.2019.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To compare the activity and fatigue of upper extremity muscles, pain levels, subject satisfaction levels, perceived exertion, and number of repetitions in Task-Specific Training (TST) compared with Robot-Assisted Training (RAT) in individuals post-stroke. METHODS Twenty sub-acute post stroke subjects (16 men; median (interquartile range) age 64.0 (71.5-57.0) years) received two 30-min treatment sessions, one TST and one RAT. Before each session, the Visual Analogue Scale (VAS) was administered. Activity levels and fatigue of six muscles were monitored using surface electromyography and the number of repetitions was counted. After each session, the subjective assessment questionnaire of treatment, the Borg scale and VAS were administered. RESULTS During TST, the Anterior Deltoid, Upper Trapezius and Biceps were more active, while during the RAT, the Triceps was more active. The Triceps activity increased during TST towards the end of the session. The pain levels increased after TST and the number of repetitions was higher compared to RAT. There were no significant differences in muscle fatigue, perceived physical exertion and subject satisfaction levels between both treatment sessions. CONCLUSION This is the first study to explore the biomechanics of both treatment methods and might therefore shed light on the mechanisms behind their positive outcomes. Due to the differences in the biomechanics of the treatments, a combination of both treatments may be beneficial to the activation of different muscle groups, thereby contributing to the rehabilitation program post stroke.
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Affiliation(s)
- Neta Shahar
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem, Israel
| | - Isabella Schwartz
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem, Israel
| | - Sigal Portnoy
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Barak Ventura R, Nakayama S, Raghavan P, Nov O, Porfiri M. The Role of Social Interactions in Motor Performance: Feasibility Study Toward Enhanced Motivation in Telerehabilitation. J Med Internet Res 2019; 21:e12708. [PMID: 31094338 PMCID: PMC6540723 DOI: 10.2196/12708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Robot-mediated telerehabilitation has the potential to provide patient-tailored cost-effective rehabilitation. However, compliance with therapy can be a problem that undermines the prospective advantages of telerehabilitation technologies. Lack of motivation has been identified as a major factor that hampers compliance. Exploring various motivational interventions, the integration of citizen science activities in robotics-based rehabilitation has been shown to increase patients' motivation to engage in otherwise tedious exercises by tapping into a vast array of intrinsic motivational drivers. Patient engagement can be further enhanced by the incorporation of social interactions. OBJECTIVE Herein, we explored the possibility of bolstering engagement in physical therapy by leveraging cooperation among users in an environmental citizen science project. Specifically, we studied how the integration of cooperation into citizen science influences user engagement, enjoyment, and motor performance. Furthermore, we investigated how the degree of interdependence among users, such that is imposed through independent or joint termination (JT), affects participation in citizen science-based telerehabilitation. METHODS We developed a Web-based citizen science platform in which users work in pairs to classify images collected by an aquatic robot in a polluted water canal. The classification was carried out by labeling objects that appear in the images and trashing irrelevant labels. The system was interfaced by a haptic device for fine motor rehabilitation. We recruited 120 healthy volunteers to operate the platform. Of these volunteers, 98 were cooperating in pairs, with 1 user tagging images and the other trashing labels. The other 22 volunteers performed both tasks alone. To vary the degree of interdependence within cooperation, we implemented independent and JTs. RESULTS We found that users' engagement and motor performance are modulated by their assigned task and the degree of interdependence. Motor performance increased when users were subjected to independent termination (P=.02), yet enjoyment decreased when users were subjected to JT (P=.005). A significant interaction between the type of termination and the task was found to influence productivity (P<.001) as well as mean speed, peak speed, and path length of the controller (P=.01, P=.006, and P<.001, respectively). CONCLUSIONS Depending on the type of termination, cooperation was not always positively associated with engagement, enjoyment, and motor performance. Therefore, enhancing user engagement, satisfaction, and motor performance through cooperative citizen science tasks relies on both the degree of interdependence among users and the perceived nature of the task. Cooperative citizen science may enhance motivation in robotics-based telerehabilitation, if designed attentively.
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Affiliation(s)
- Roni Barak Ventura
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Shinnosuke Nakayama
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Preeti Raghavan
- Department of Rehabilitation Medicine, New York University School of Medicine, New York, NY, United States
| | - Oded Nov
- Department of Technology Management and Innovation, New York University Tandon School of Engineering, Brooklyn, NY, United States
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, NY, United States
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Text Input in Virtual Reality: A Preliminary Evaluation of the Drum-Like VR Keyboard. TECHNOLOGIES 2019. [DOI: 10.3390/technologies7020031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The drum-like virtual reality (VR) keyboard is a contemporary, controller-based interface for text input in VR that uses a drum set metaphor. The controllers are used as sticks which, through downward movements, “press” the keys of the virtual keyboard. In this work, a preliminary feasibility study of the drum-like VR keyboard is described, focusing on the text entry rate and accuracy as well as its usability and the user experience it offers. Seventeen participants evaluated the drum-like VR keyboard by having a typing session and completing a usability and a user experience questionnaire. The interface achieved a good usability score, positive experiential feedback around its entertaining and immersive qualities, a satisfying text entry rate (24.61 words-per-minute), as well as moderate-to-high total error rate (7.2%) that can probably be further improved in future studies. The work provides strong indications that the drum-like VR keyboard can be an effective and entertaining way to type in VR.
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VR Locomotion in the New Era of Virtual Reality: An Empirical Comparison of Prevalent Techniques. ADVANCES IN HUMAN-COMPUTER INTERACTION 2019. [DOI: 10.1155/2019/7420781] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The latest technical and interaction advancements within the virtual reality (VR) field have marked a new era, not only for VR, but also for VR locomotion. In this era, well-established, prevalent VR locomotion techniques are mostly used as points of comparison for benchmarking of new VR locomotion designs. At the same time, there is the need for more exploratory, comparative studies of contemporary VR locomotion techniques, so that their distinguished interaction aspects can be documented and guide the design process of new techniques. This article presents a comparative, empirical evaluation study of contemporary and prevalent VR locomotion techniques, examining the user experience (UX) they offer. First, the prevalent VR locomotion techniques are identified based on literature, i.e., walking-in-place, controller/joystick, and teleportation. Twenty-six adults are enrolled in the study and perform a game-like task using the techniques. The study follows a mixed methods approach, utilising the System Usability Scale survey, the Game Experience Questionnaire, and a semistructured interview to assess user experiences. Results indicate that the walking-in-place technique offers the highest immersion but also presents high levels of psychophysical discomfort. Controller/joystick VR locomotion is perceived as easy-to-use due to the users’ familiarity with controllers, whereas teleportation is considered to be effective due to its fast navigation, although its visual ‘jumps’ do break the users’ sense of immersion. Based on the interviews, the users focused on the following interaction dimensions to describe their VR locomotion experiences: (i) immersion and flow, (ii) ease-of-use and mastering, (iii) competence and sense of effectiveness, and (iv) psychophysical discomfort. The study implications for VR locomotion are discussed, along with the study limitations and the future direction for research.
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Abstract
Whole-body movement is required to interact (play) with Microsoft Xbox with the 3D Kinect sensor (Xbox-Kinect) and, therefore, may be suitable for encouraging and practicing movements as part of stroke rehabilitation. We aimed to describe (i) game analysis, (ii) clinical use, and (iii) to characterize the Xbox-Kinect game experience with individuals with chronic stroke. Four therapists played the Xbox-Kinect games and then carried out a games analysis on the basis of the categories suggested by Deutsch. Eleven participants (age 29-69 years) with chronic stroke and varying motor deficits played Xbox-Kinect games for 4-22 sessions as part of a video-game group intervention and the clinical use was documented. The game experience of 'Bowling' (Kinect-Sport) and '20 000 leaks' (Kinect Adventures) was characterized by self-report questionnaires. Detailed tables of game analysis are provided. The clinical use of the console with the participants is presented. Participants reported high enjoyment and 'somewhat-high' perceived exertion after playing the two games and stated that overall the console suited their therapeutic goals. This information can assist clinicians with their clinical reasoning and decision-making for incorporating the Xbox-Kinect into stroke rehabilitation. Potentially, the Xbox-Kinect could be used as an on-going tool to facilitate whole-body movement and physical activity of individuals with chronic stroke.
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Ding WL, Zheng YZ, Su YP, Li XL. Kinect-based virtual rehabilitation and evaluation system for upper limb disorders: A case study. J Back Musculoskelet Rehabil 2018; 31:611-621. [PMID: 29578471 DOI: 10.3233/bmr-140203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To help patients with disabilities of the arm and shoulder recover the accuracy and stability of movements, a novel and simple virtual rehabilitation and evaluation system called the Kine-VRES system was developed using Microsoft Kinect. METHODS First, several movements and virtual tasks were designed to increase the coordination, control and speed of the arm movements. The movements of the patients were then captured using the Kinect sensor, and kinematics-based interaction and real-time feedback were integrated into the system to enhance the motivation and self-confidence of the patient. Finally, a quantitative evaluation method of upper limb movements was provided using the recorded kinematics during hand-to-hand movement. RESULTS A preliminary study of this rehabilitation system indicates that the shoulder movements of two participants with ataxia became smoother after three weeks of training (one hour per day). CONCLUSION This case study demonstrated the effectiveness of the designed system, which could be promising for the rehabilitation of patients with upper limb disorders.
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Affiliation(s)
- W L Ding
- Laboratory of Pattern Recognition and Intelligent Systems, Key Laboratory of Industrial Computer Control Engineering of Hebei Province, Department of Automation, Institute of Electrical Engineering, Yanshan University, Qinghuangdao, Hebei, China
| | - Y Z Zheng
- Laboratory of Pattern Recognition and Intelligent Systems, Key Laboratory of Industrial Computer Control Engineering of Hebei Province, Department of Automation, Institute of Electrical Engineering, Yanshan University, Qinghuangdao, Hebei, China
| | - Y P Su
- Qinhuangdao First People's Hospital, Qinhuangdao, Hebei, China
| | - X L Li
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
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Givon Shaham N, Sternberg S, Rand D. Executive Functioning of Older Adults Correlates with Performance of Touchscreen App-Based Puzzles. Games Health J 2018; 7:271-276. [PMID: 30106643 DOI: 10.1089/g4h.2017.0118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of touchscreen tablets has become common in healthcare. This technology has the potential to be used as a motivational tool for cognitive training. Age-related decline in executive functioning (EF) and dexterity may lead to poor performance using tablet applications (apps), but the impact on performance of app-based puzzles has not been studied. OBJECTIVES (1) To characterize and compare the experience performance of playing tablet apps of older and younger adults, (2) To determine if EF and dexterity contribute to performance of app-based puzzles. MATERIALS AND METHODS We performed a cross-sectional study of community-dwelling healthy older (n = 35) and younger adults (n = 34). EF was measured by the Trail Making Test (part B) (TMT-B) and the Weekly Calendar Planning Activity. Dexterity was assessed using the Nine-Hole Peg Test. Participants played three unfamiliar app-based puzzles requiring EF and filled out the short feedback questionnaire. RESULTS All participants succeeded in playing the apps and reported enjoyment, however, older adults perceived less success and control. Significant differences in EF, dexterity, and performance were found between groups. EF of older adults (TMT-B) accounted for 17.7%-36.8% (P < 0.05) of the total variance of performance. CONCLUSION These findings have implications for the use of tablet apps for older adults. Longer instruction and training periods may be required for training EF among older adults.
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Affiliation(s)
- Noa Givon Shaham
- 1 Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Shelley Sternberg
- 2 Department of Geriatric Services, Ministry of Health , Jerusalem, Israel
| | - Debbie Rand
- 1 Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
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Gerber SM, Muri RM, Mosimann UP, Nef T, Urwyler P. Virtual reality for activities of daily living training in neurorehabilitation: a usability and feasibility study in healthy participants. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:1-4. [PMID: 30440283 DOI: 10.1109/embc.2018.8513003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
After severe injury or neurodegenerative disorders patients often experience long-term functional deficits, resulting in a reduction o performance in activities of daily living (ADL). Given their direct relevance to everyday functioning and quality of life, neurorehabilitative programs using simulated ADL's have seen increased interest recently. One of the core elements in simulated ADL's is the interface between the user and the virtual environment, which has a high impact on the therapeutic outcome. The aim of this study was to nalyze the feasibility of a simple virtual ADL (tea preparation task) using two different input devices. The tea preparation task setup consisted of a computer rendering the virtual environment, a head-mounted display (HMD) to visually present the ADL, and two input devices (mouse and handheld controller) to guide virtual hands in the virtual environment. A total of 24 healthyyoung adults performed the tea preparation task after which workload, usability, immersion and presence was rated. The handheld controller was rated significantly lower workload and higher usability than the mouse input device. Also, the sense of being there (immersion) and spatial presence ratings for the task and setup were close to the maximum score of 5. Thus, the handheld controller outperformed the mouse, suggesting that user interaction in the virtual environment with the handheld controller is similar to the real world and intuitive to use. Overall, the simulated ADL implemented with VR technology is feasible for diagnostic and rehabilitative purposes in patients experiencing long-term functional deficits.
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Kamińska MS, Miller A, Rotter I, Szylińska A, Grochans E. The effectiveness of virtual reality training in reducing the risk of falls among elderly people. Clin Interv Aging 2018; 13:2329-2338. [PMID: 30532523 PMCID: PMC6241865 DOI: 10.2147/cia.s183502] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Virtual reality (VR) training using modern game consoles is an innovative rehabilitation method for fall-prone elderly people. The aim of this study was to assess the effectiveness of VR training using the "Xbox 360 Kinect" in people over 60 years of age. Materials and methods The study involved 23 people, including 19 women and 4 men (mean age 75.74±8.09 years). The following functional tests were employed as research instruments: the 6-minute walking test (6MWT), the Dynamic Gait Index (DGI), the tandem stance test (TST), the tandem walk test (TWT), and the Beck Depression Inventory (BDI). A "spring hand dynamometer" was also used. The participants underwent 30-day VR training using an Xbox 360 Kinect. They trained 3 times a week, with each exercise lasting 30 minutes. Results The 6MWT (P<0.001), the DGI (P=0.008), the TST (P<0.001), the TWT (P=0.002), and the BDI (P<0.001) outcomes were significantly improved. There were differences in the results for the strength of the "pressing muscles" in the right (P=0.106) and left (P=0.043) hands of the participants. Both participants under 80 years of age and those aged 80 years and over had visibly better results on the 6MWT (P<0.001 and P=0.008, respectively), the TST (P<0.001 and P=0.008, respectively), and the BDI (P=0.003 and P=0.012, respectively). Conclusion Training based on VR increases the possibilities of motor training and can help reduce the risk of falls by improving the static and dynamic balance.
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Affiliation(s)
- Magdalena Sylwia Kamińska
- Department of Primary Health Care, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland,
| | | | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Aleksandra Szylińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
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Borrego A, Latorre J, Alcañiz M, Llorens R. Comparison of Oculus Rift and HTC Vive: Feasibility for Virtual Reality-Based Exploration, Navigation, Exergaming, and Rehabilitation. Games Health J 2018; 7:151-156. [DOI: 10.1089/g4h.2017.0114] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Adrián Borrego
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Jorge Latorre
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Mariano Alcañiz
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Roberto Llorens
- Neurorehabilitation and Brain Research Group, Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
- Servicio de Neurorrehabilitación y Daño Cerebral de los Hospitales NISA, Fundación Hospitales NISA, Valencia, Spain
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Rose T, Nam CS, Chen KB. Immersion of virtual reality for rehabilitation - Review. APPLIED ERGONOMICS 2018; 69:153-161. [PMID: 29477323 DOI: 10.1016/j.apergo.2018.01.009] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 01/10/2018] [Accepted: 01/21/2018] [Indexed: 05/14/2023]
Abstract
Virtual reality (VR) shows promise in the application of healthcare and because it presents patients an immersive, often entertaining, approach to accomplish the goal of improvement in performance. Eighteen studies were reviewed to understand human performance and health outcomes after utilizing VR rehabilitation systems. We aimed to understand: (1) the influence of immersion in VR performance and health outcomes; (2) the relationship between enjoyment and potential patient adherence to VR rehabilitation routine; and (3) the influence of haptic feedback on performance in VR. Performance measures including postural stability, navigation task performance, and joint mobility showed varying relations to immersion. Limited data did not allow a solid conclusion between enjoyment and adherence, but patient enjoyment and willingness to participate were reported in care plans that incorporates VR. Finally, different haptic devices such as gloves and controllers provided both strengths and weakness in areas such movement velocity, movement accuracy, and path efficiency.
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Affiliation(s)
- Tyler Rose
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Chang S Nam
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC 27695, USA.
| | - Karen B Chen
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC 27695, USA.
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Rand D, Givon N, Avrech Bar M. A video-game group intervention: Experiences and perceptions of adults with chronic stroke and their therapists: Intervention de groupe à l'aide de jeux vidéo : Expériences et perceptions d'adultes en phase chronique d'un accident vasculaire cérébral et de leurs ergothérapeutes. The Canadian Journal of Occupational Therapy 2018; 85:158-168. [PMID: 29614877 DOI: 10.1177/0008417417733274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ongoing physical activity is important for maintaining the functional level of individuals with chronic stroke. Video games in a group setting might be a cost-effective way for providing mobility and preventing physical inactivity. PURPOSE This study explores the experiences and perceptions of individuals with chronic stroke who participated in a novel community-based video-game group intervention and their therapists. METHOD A qualitative study, nested in a randomized controlled trial, was conducted using semistructured interviews with eight individuals with chronic stroke (four men and four women) ages 29 to 69 and a focus group of their three occupational therapists, following a video-game intervention. Data were analyzed using content analysis. FINDINGS Three main categories were identified by the study participants: (a) using video games, (b) the group/team experience, and (c) intervention outcomes/evolving understandings following the intervention. IMPLICATIONS Playing video games was perceived not as treatment but as a motivating tool to facilitate whole-body movement. Therefore, this intervention might be suitable to be used in the community for ongoing intervention.
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Demers M, Chan Chun Kong D, Levin MF. Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians. Disabil Rehabil Assist Technol 2018. [PMID: 29526122 DOI: 10.1080/17483107.2018.1449019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. METHODS A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15-20 or 20-45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted. RESULTS Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events. CONCLUSIONS Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities. Implications for Rehabilitation • Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation. • Input from end-users (therapists and individuals with stroke) is critical for the development and implementation of a virtual reality intervention.
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Affiliation(s)
- Marika Demers
- a School of Physical and Occupational Therapy, McGill University , Montreal , Canada.,b Feil and Oberfeld Research Center, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , Canada
| | - Daniel Chan Chun Kong
- a School of Physical and Occupational Therapy, McGill University , Montreal , Canada.,b Feil and Oberfeld Research Center, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , Canada
| | - Mindy F Levin
- a School of Physical and Occupational Therapy, McGill University , Montreal , Canada.,b Feil and Oberfeld Research Center, Jewish Rehabilitation Hospital, Center for Interdisciplinary Research in Rehabilitation of Greater Montreal , Montreal , Canada
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Shefer Eini D, Ratzon NZ, Rizzo AA, Yeh SC, Lange B, Yaffe B, Daich A, Weiss PL, Kizony R. Camera-tracking gaming control device for evaluation of active wrist flexion and extension. J Hand Ther 2017; 30:89-96. [PMID: 27899222 DOI: 10.1016/j.jht.2016.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 07/06/2016] [Accepted: 07/11/2016] [Indexed: 02/09/2023]
Abstract
STUDY DESIGN Cross sectional. INTRODUCTION Measuring wrist range of motion (ROM) is an essential procedure in hand therapy clinics. PURPOSE OF THE STUDY To test the reliability and validity of a dynamic ROM assessment, the Camera Wrist Tracker (CWT). METHODS Wrist flexion and extension ROM of 15 patients with distal radius fractures and 15 matched controls were assessed with the CWT and with a universal goniometer. RESULTS One-way model intraclass correlation coefficient analysis indicated high test-retest reliability for extension (ICC = 0.92) and moderate reliability for flexion (ICC = 0.49). Standard error for extension was 2.45° and for flexion was 4.07°. Repeated-measures analysis revealed a significant main effect for group; ROM was greater in the control group (F[1, 28] = 47.35; P < .001). The concurrent validity of the CWT was partially supported. CONCLUSION The results indicate that the CWT may provide highly reliable scores for dynamic wrist extension ROM, and moderately reliable scores for flexion, in people recovering from a distal radius fracture. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Dalit Shefer Eini
- Department of Occupational Therapy, Stanley Steyer School of Health Professions Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Occupational Therapy, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Navah Z Ratzon
- Department of Occupational Therapy, Stanley Steyer School of Health Professions Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Albert A Rizzo
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, USA
| | - Shih-Ching Yeh
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Belinda Lange
- Institute for Creative Technologies, University of Southern California, Los Angeles, CA, USA
| | - Batia Yaffe
- Department of Hand Surgery, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Alexander Daich
- Department of Orthopedic Rehabilitation, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Patrice L Weiss
- Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Rachel Kizony
- Department of Occupational Therapy, Chaim Sheba Medical Center, Ramat Gan, Israel; Department of Occupational Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
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Feasibility of using the RAPAEL Smart Glove in upper limb physical therapy for patients after stroke: A randomized controlled trial. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:3856-3859. [PMID: 29060739 DOI: 10.1109/embc.2017.8037698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We aim to assess the feasibility of using the RAPAEL Smart Glove as an assistive tool for therapists in clinical rehabilitation therapy settings and to investigate if it can be used to improve the motor recovery rate of stroke survivors. Our randomized controlled study involved 13 post-stroke inpatients. An experimental treatment consisted of one 30-minute game-assisted therapy and one 30-minute conventional therapy per day while the control treatment consisted of two 30-minute conventional therapies. Each therapy block consisted of 15 days over a period of 3 weeks. The measured outcomes were the scores on the Wolf Motor Function Test and the active range of motion for the forearm and the wrist. The mean Wolf Motor Function Test score for the group that received game therapies as well as conventional therapies was significantly higher than that for the group who received only conventional therapies. The results suggest that the motor recovery rate of the clinical rehabilitation therapies can be improved when wearable sensors and therapeutic games are used by therapists in their routine therapy practice.
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Bortone I, Leonardis D, Solazzi M, Procopio C, Crecchi A, Bonfiglio L, Frisoli A. Integration of serious games and wearable haptic interfaces for Neuro Rehabilitation of children with movement disorders: A feasibility study. IEEE Int Conf Rehabil Robot 2017; 2017:1094-1099. [PMID: 28813967 DOI: 10.1109/icorr.2017.8009395] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The past decade has seen the emergence of rehabilitation treatments using virtual reality environments. One of the advantages in using this technology is the potential to create positive motivation, by means of engaging environments and tasks shaped in the form of serious games. In this work, we propose a novel Neuro Rehabilitation System for children with movement disorders, that is based on serious games in immersive virtual reality with haptic feedback. The system design aims to enhance involvement and engagement of patients, to provide congruent multi-sensory afferent feedback during motor exercises, and to benefit from the flexibility of virtual reality in adapting exercises to the patient's needs. We present a feasibility study of the method conducted through an experimental rehabilitation session in a group of 4 children with Cerebral Palsy and Developmental Dyspraxia, 4 Typically Developing children and 4 healthy adults. Subjects and patients were able to accomplish the proposed rehabilitation session and average performance of the motor exercises in patients were lower, although comparable, to healthy subjects. Together with positive comments reported by children after the rehabilitation session, results are encouraging for application of the method in a prolonged rehabilitation treatment.
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Khurana M, Walia S, Noohu MM. Study on the Effectiveness of Virtual Reality Game-Based Training on Balance and Functional Performance in Individuals with Paraplegia. Top Spinal Cord Inj Rehabil 2017; 23:263-270. [PMID: 29339902 DOI: 10.1310/sci16-00003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: To determine whether there is any difference between virtual reality game-based balance training and real-world task-specific balance training in improving sitting balance and functional performance in individuals with paraplegia. Methods: The study was a pre test-post test experimental design. There were 30 participants (28 males, 2 females) with traumatic spinal cord injury randomly assigned to 2 groups (group A and B). The levels of spinal injury of the participants were between T6 and T12. The virtual reality game-based balance training and real-world task-specific balance training were used as interventions in groups A and B, respectively. The total duration of the intervention was 4 weeks, with a frequency of 5 times a week; each training session lasted 45 minutes. The outcome measures were modified Functional Reach Test (mFRT), t-shirt test, and the self-care component of the Spinal Cord Independence Measure-III (SCIM-III). Results: There was a significant difference for time (p = .001) and Time × Group effect (p = .001) in mFRT scores, group effect (p = .05) in t-shirt test scores, and time effect (p = .001) in the self-care component of SCIM-III. Conclusions: Virtual reality game-based training is better in improving balance and functional performance in individuals with paraplegia than real-world task-specific balance training.
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Affiliation(s)
| | - Shefali Walia
- ISIC Institute of Rehabilitation Sciences, New Delhi, India
| | - Majumi M Noohu
- Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India
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Carneiro MIS, Oliveira DMD, Maciel ABDR, Cardoso ACDA, Teichrieb V, Monte-Silva K. Applicability of a motor rehabilitation system in stroke victims. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/1980-5918.029.004.ao08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: The recovery of stroke patients is long and boring due to the repetitive nature of the exercises used and the length of treatment. Thus, we started using virtual reality as an alternative and, because of its advantages, health professionals are adapting video games for physical therapy. However, there are some limitations, such as the fact that games are designed for entertainment and not for therapeutic purposes. Objective: In order to mitigate gaps in assistive devices for physical therapy, this study describes the development and applicability of a computer support system for motor rehabilitation - Ikapp - in stroke victims. Methods: Twenty-seven stroke patients filled out a socioeconomic questionnaire, tested Ikapp during five minutes and answered a usability and satisfaction questionnaire about handling the tool. The chi-square test was used to analyze any association between sociodemographic factors and the features of the system. Results: The Ikapp system can be an excellent device to assist neurological rehabilitation of stroke patients, as participants questionnaires showed that 85.2% were satisfied in regard to motivation and inclusion of Ikapp in physiotherapy and 77.8% relative to ease of interaction with the tool. Conclusion: The Ikapp system proved to be an easy-to-use and accessible computer support system for patients with functional limitations.
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Park J, Yim J. A New Approach to Improve Cognition, Muscle Strength, and Postural Balance in Community-Dwelling Elderly with a 3-D Virtual Reality Kayak Program. TOHOKU J EXP MED 2016; 238:1-8. [PMID: 26656425 DOI: 10.1620/tjem.238.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aging is usually accompanied with deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity. Recently, intervention methods with virtual reality have been introduced, providing an enjoyable therapy for elderly. The aim of this study was to investigate whether a 3-D virtual reality kayak program could improve the cognitive function, muscle strength, and balance of community-dwelling elderly. Importantly, kayaking involves most of the upper body musculature and needs the balance control. Seventy-two participants were randomly allocated into the kayak program group (n = 36) and the control group (n = 36). The two groups were well matched with respect to general characteristics at baseline. The participants in both groups performed a conventional exercise program for 30 min, and then the 3-D virtual reality kayak program was performed in the kayak program group for 20 min, two times a week for 6 weeks. Cognitive function was measured using the Montreal Cognitive Assessment. Muscle strength was measured using the arm curl and handgrip strength tests. Standing and sitting balance was measured using the Good Balance system. The post-test was performed in the same manner as the pre-test; the overall outcomes such as cognitive function (p < 0.05), muscle strength (p < 0.05), and balance (standing and sitting balance, p < 0.05) were significantly improved in kayak program group compared to the control group. We propose that the 3-D virtual reality kayak program is a promising intervention method for improving the cognitive function, muscle strength, and balance of elderly.
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Affiliation(s)
- Junhyuck Park
- Department of Physical Therapy, The Graduate School of Sahmyook University
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Smartphone-Based Visual Feedback Trunk Control Training Using a Gyroscope and Mirroring Technology for Stroke Patients: Single-blinded, Randomized Clinical Trial of Efficacy and Feasibility. Am J Phys Med Rehabil 2016; 95:319-29. [PMID: 26829087 DOI: 10.1097/phm.0000000000000447] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the preliminary efficacy and feasibility of smartphone-based visual feedback trunk control training (SPVFTCT) for improving balance and trunk performance in stroke patients. DESIGN Twenty-four patients who had experienced a stroke more than 6 months previously and could sit and walk independently participated in the study. The participants were allocated to a SPVFTCT (n = 12) or to a control group (n = 12). Both groups completed five 80-minute sessions per week of conventional rehabilitation for 4 weeks. The SPVFTCT group additionally received three 20-minute sessions per week of SPVFTCT for 4 weeks. The outcome was assessed using static balance assessment, the modified functional reach test, the timed up and go test, and the trunk impairment scale. Feasibility of SPVFTCT was evaluated by retention, adherence, acceptability, and safety. RESULTS The static balance assessment, modified functional reach test, timed up and go test, and trunk impairment scale scores in the SPVFTCT group improved significantly compared to those in the control group (P < 0.05). In the SPVFTCT group, retention and adherence rates were 100% and 97%, respectively. All participants reported that SPVFTCT was enjoyable, easy to use, and helpful for their recovery. CONCLUSIONS The SPVFTCT approach is a feasible method to improve balance and trunk performance in stroke patients. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Understand the role of trunk control in postural stability and functional improvement; (2) Describe the benefits of smartphone-based visual feedback trunk control training (SPVFTCT); and (3)Discuss the feasibility of incorporating smartphone-based visual feedback trunk control training in stroke rehabilitation. LEVEL Advanced ACCREDITATION : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Barrett N, Swain I, Gatzidis C, Mecheraoui C. The use and effect of video game design theory in the creation of game-based systems for upper limb stroke rehabilitation. J Rehabil Assist Technol Eng 2016; 3:2055668316643644. [PMID: 31186903 PMCID: PMC6453078 DOI: 10.1177/2055668316643644] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 03/04/2016] [Indexed: 12/30/2022] Open
Abstract
Upper limb exercise is often neglected during post-stroke rehabilitation. Video
games have been shown to be useful in providing environments in which patients
can practise repetitive, functionally meaningful movements, and in inducing
neuroplasticity. The design of video games is often focused upon a number of
fundamental principles, such as reward, goals, challenge and the concept of
meaningful play, and these same principles are important in the design of games
for rehabilitation. Further to this, there have been several attempts for the
strengthening of the relationship between commercial game design and
rehabilitative game design, the former providing insight into factors that can
increase motivation and engagement with the latter. In this article, we present
an overview of various game design principles and the theoretical grounding
behind their presence, in addition to attempts made to utilise these principles
in the creation of upper limb stroke rehabilitation systems and the outcomes of
their use. We also present research aiming to move the collaborative efforts of
designers and therapists towards a model for the structured design of these
games and the various steps taken concerning the theoretical classification and
mapping of game design concepts with intended cognitive and motor outcomes.
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Affiliation(s)
- N Barrett
- Odstock Medical Limited, Salisbury District Hospital, Salisbury, UK.,Faculty of Science and Technology, Bournemouth University, Poole, UK
| | - I Swain
- Odstock Medical Limited, Salisbury District Hospital, Salisbury, UK.,Faculty of Science and Technology, Bournemouth University, Poole, UK
| | - C Gatzidis
- Faculty of Science and Technology, Bournemouth University, Poole, UK
| | - C Mecheraoui
- Odstock Medical Limited, Salisbury District Hospital, Salisbury, UK
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Lee M, Suh D, Son J, Kim J, Eun SD, Yoon B. Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty. ACTA ACUST UNITED AC 2016; 53:239-52. [DOI: 10.1682/jrrd.2014.07.0164] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 07/15/2015] [Indexed: 11/05/2022]
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Lin J, Kelleher CL, Engsberg JR. Developing Home-Based Virtual Reality Therapy Interventions. Games Health J 2015. [PMID: 26196552 DOI: 10.1089/g4h.2012.0033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke. SUBJECTS AND METHODS Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]). RESULTS Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL. CONCLUSIONS Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.
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Affiliation(s)
- Janice Lin
- 1 Program in Occupational Therapy, Washington University School of Medicine , St. Louis, Missouri
| | - Caitlin L Kelleher
- 2 Department of Computer Science and Engineering, Washington University in St. Louis , St. Louis, Missouri
| | - Jack R Engsberg
- 1 Program in Occupational Therapy, Washington University School of Medicine , St. Louis, Missouri
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