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Hasnan N, Hamzaid NA, Magenthran V, Davis GM. Exercise Responses During Outdoor Versus Virtual Reality Indoor Arm+FES-Leg Cycling in Individuals with Spinal Cord Injury. Games Health J 2024. [PMID: 38709784 DOI: 10.1089/g4h.2023.0047] [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: 05/08/2024] Open
Abstract
Background: Virtual reality (VR)-enhanced indoor hybrid cycling in people with spinal cord injury (SCI) can be comparable to outdoor hybrid cycling. Method: Eight individuals with chronic thoracic-lesion SCI performed voluntary arm and electrically assisted leg cycling on a hybrid recumbent tricycle. Exercises were conducted outdoors and indoors incorporating VR technology in which the outdoor environment was simulated on a large flat screen monitor. Electrical stimulation was applied bilaterally to the leg muscle groups. Oxygen uptake (VO2), heart rate, energy expenditures, and Ratings of Perceived Exertion were measured over a 30-minute outdoor test course that was also VR-simulated indoors. Immediately after each exercise, participants completed questionnaires to document their perceptual-psychological responses. Results: Mean 30-minute VO2 was higher for indoor VR exercise (average VO2-indoor VR-exercise: 1316 ± mL/min vs. outdoor cycling: 1255 ± 53 mL/min; highest VO2-indoor VR-exercise: 1615 ± 67 mL/min vs. outdoor cycling: 1725 ± 67 mL/min). Arm and leg activity counts were significantly higher during indoor VR-assisted hybrid functional electrical stimulation (FES) cycling than outdoors; 42% greater for the arms and 23% higher for the legs (P < 0.05). Similar responses were reported for exercise effort and perceptual-psychological outcomes during both modes. Conclusion: This study proposes that combining FES and VR technology provides new opportunities for physical activity promotion or exercise rehabilitation in the SCI population, since these modes have similar "dose-potency" and self-perceived effort. Human Research Ethics Committee of the University of Sydney Ref. No. 01-2010/12385.
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Affiliation(s)
- Nazirah Hasnan
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nur Azah Hamzaid
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Vhinoth Magenthran
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Glen M Davis
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health. The University of Sydney, Sydney, New South Wales, Australia
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Seo EY, Kim YS, Lee YJ, Hur MH. Virtual Reality Exercise Program Effects on Body Mass Index, Depression, Exercise Fun and Exercise Immersion in Overweight Middle-Aged Women: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:900. [PMID: 36673656 PMCID: PMC9859405 DOI: 10.3390/ijerph20020900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Background: This study explored the effects of a virtual reality exercise program on overweight middle-aged women. Methods: This randomized controlled trial included women 40−65 years of age with a body mass index (BMI) of 23 kg/m2 or more living in Daejeon City. The virtual reality environment was set up by attaching an IoT sensor to an indoor bicycle and linking it with a smartphone, enabling exercise in an immersive virtual reality through a head-mounted display. Results: In the virtual reality exercise group, the BMI was significantly decreased after the 8-week intervention compared with the baseline value (F = 59.491, p < 0.001). The depression scores were significantly different among the three groups, with the intervention effect being more significant in the virtual reality exercise group than in the indoor bicycle exercise and control groups (F = 3.462, p < 0.001). Furthermore, the levels of exercise fun (F = 12.373, p < 0.001) and exercise immersion (F = 14.629, p < 0.001) were significantly higher in the virtual reality exercise group than in the indoor bicycle exercise and control groups. Conclusions: The virtual reality exercise program positively affected the BMI and the levels of depression, exercise fun, and exercise immersion in overweight middle-aged women. It is an effective home exercise program for obesity management in this population.
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Affiliation(s)
- Eun-Young Seo
- Department of Nursing, Gyeongbuk College of Health, Gimcheon 39525, Republic of Korea
| | - Yeon-Suk Kim
- Department of Nursing, Chung Cheong University, Cheongju 28171, Republic of Korea
| | - Yu-Jin Lee
- College of Nursing, Eulji University, Uijeongbu 11759, Republic of Korea
| | - Myung-Haeng Hur
- College of Nursing, Eulji University, Uijeongbu 11759, Republic of Korea
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Jung S, Song S, Lee D, Lee K, Lee G. Effects of Kinect Video Game Training on Lower Extremity Motor Function, Balance, and Gait in Adolescents with Spastic Diplegia Cerebral Palsy: A Pilot Randomized Controlled Trial. Dev Neurorehabil 2021; 24:159-165. [PMID: 32981401 DOI: 10.1080/17518423.2020.1819458] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED The Kinect video game (KVG) has received attention as an intervention method for cerebral palsy (CP). However, evidence remains limited. PURPOSE To investigate the effects of training using Xbox Kinect on lower extremity motor function, balance, and gait in adolescents with spastic diplegia CP. METHODS This study was a pilot randomized controlled trial. Ten participants were randomly allocated to either the KVG training group (n = 5) or the conventional training (CT) group (n = 5). The Selective Control Assessment of the Lower Extremity (SCALE) tool, Pediatric Balance Scale (PBS), and GAITRite were used for the outcome measurements. RESULTS In the comparison between the groups, the KVG group showed significant improvements in all the items in the SCALE (except for right hip abduction) and PBS score as compared with the CT group. CONCLUSIONS KVG training might be an effective intervention for the rehabilitation of adolescents with spastic diplegia CP.
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Affiliation(s)
- SunHye Jung
- Graduate School of Kyungnam University, Changwon, Republic of Korea
| | - SunHae Song
- Graduate School of Kyungnam University, Changwon, Republic of Korea
| | - DongGeon Lee
- Graduate School of Kyungnam University, Changwon, Republic of Korea
| | - Kyeongbong Lee
- Kangwon National University, Samcheok, Republic of Korea
| | - GyuChang Lee
- Kyungnam University, Changwon, Republic of Korea
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Effect of virtual reality therapy on functional development in children with cerebral palsy: A single-blind, prospective, randomized-controlled study. Turk J Phys Med Rehabil 2019; 65:371-378. [PMID: 31893274 DOI: 10.5606/tftrd.2019.2388] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 10/08/2018] [Indexed: 11/21/2022] Open
Abstract
Objectives The aim of this study was to investigate the effect of virtual reality (VR) therapy on motor and functional development in children with cerebral palsy (CP). Patients and methods In this single-blind, prospective, randomized-controlled study, a total of 41 patients (28 males, 13 females; mean age 8.49 years; range, 5 to 15 years) receiving inpatient treatment for CP were included between April 2009 and September 2009. The patients were randomly divided into two groups as the study group (n=21) and control group (n=20). Neurophysiological and conventional treatment methods, and occupational therapy were applied to all patients. In addition, a total of 12 VR therapy sessions for one hour were administered three days a week for four weeks to the study group. Before and after treatment, the Bimanual Fine Motor Function (BFMF) test was performed to measure hand functioning, Gross Motor Function Classification System (GMFCS) for functional levels, and Functional Mobility Scale (FMS) for mobility. Results There was a significant increase in the BFMF, GMFCS, and FMS scores after treatment, compared to baseline values in the study group (p<0.05). There was a statistically significant results in favor of the study group for all parameters after treatment compared to pre-treatment values (p<0.05). Conclusion Our study results indicate that VR therapy is a useful treatment method which can be used in rehabilitation of CP with improved motor function. The addition of this method to conventional rehabilitation techniques may have a significant impact on treatment success.
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Levac DE, Huber ME, Sternad D. Learning and transfer of complex motor skills in virtual reality: a perspective review. J Neuroeng Rehabil 2019; 16:121. [PMID: 31627755 PMCID: PMC6798491 DOI: 10.1186/s12984-019-0587-8] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 09/05/2019] [Indexed: 12/11/2022] Open
Abstract
The development of more effective rehabilitative interventions requires a better understanding of how humans learn and transfer motor skills in real-world contexts. Presently, clinicians design interventions to promote skill learning by relying on evidence from experimental paradigms involving simple tasks, such as reaching for a target. While these tasks facilitate stringent hypothesis testing in laboratory settings, the results may not shed light on performance of more complex real-world skills. In this perspective, we argue that virtual environments (VEs) are flexible, novel platforms to evaluate learning and transfer of complex skills without sacrificing experimental control. Specifically, VEs use models of real-life tasks that afford controlled experimental manipulations to measure and guide behavior with a precision that exceeds the capabilities of physical environments. This paper reviews recent insights from VE paradigms on motor learning into two pressing challenges in rehabilitation research: 1) Which training strategies in VEs promote complex skill learning? and 2) How can transfer of learning from virtual to real environments be enhanced? Defining complex skills by having nested redundancies, we outline findings on the role of movement variability in complex skill acquisition and discuss how VEs can provide novel forms of guidance to enhance learning. We review the evidence for skill transfer from virtual to real environments in typically developing and neurologically-impaired populations with a view to understanding how differences in sensory-motor information may influence learning strategies. We provide actionable suggestions for practicing clinicians and outline broad areas where more research is required. Finally, we conclude that VEs present distinctive experimental platforms to understand complex skill learning that should enable transfer from therapeutic practice to the real world.
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Affiliation(s)
- Danielle E Levac
- Department of Physical Therapy, Movement and Rehabilitation Sciences, Northeastern University, 407c Robinson Hall, 360 Huntington Ave, Boston, MA, 02115, USA.
| | - Meghan E Huber
- Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Ave, Bldg 3, Rm 143, Cambridge, MA, 02139, USA
| | - Dagmar Sternad
- Biology, Electrical and Computer Engineering, and Physics, Northeastern University, 503 Richards Hall, 360 Huntington Avenue, Boston, MA, 02118, USA
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Development of an interactive game-based mirror image hand rehabilitation system. INTEL SERV ROBOT 2019. [DOI: 10.1007/s11370-018-00272-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Chen KB, Sesto ME, Ponto K, Leonard J, Mason A, Vanderheiden G, Williams J, Radwin RG. Use of Virtual Reality Feedback for Patients with Chronic Neck Pain and Kinesiophobia. IEEE Trans Neural Syst Rehabil Eng 2017; 25:1240-1248. [DOI: 10.1109/tnsre.2016.2621886] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Chen KB, Ponto K, Sesto ME, Radwin RG. Influence of altered visual feedback on neck movement for a virtual reality rehabilitative system. ACTA ACUST UNITED AC 2014. [DOI: 10.1177/1541931214581162] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This paper investigates altering visual feedback during neck movement through control-display (C-D) gain for a head-mounted display, for the purpose of determining the just noticeable difference (JND) for encouraging individuals with kinesiophobia (i.e. fear avoidance of movement due to chronic pain) to effectively perform therapeutic neck exercises. The JND was defined as .25 probability of detecting a difference from unity C-D gain (gain=1). A target-aiming task with two consecutive neck moves per trial was presented; one neck move had varying C-D gain and the other had unity gain. The VR system was able to influence neck moves without changing locations of the target. Participants indicated whether the two neck movements were the same or different. Logistic regression revealed that the JND gains were 0.903 (lower bound) and 1.159 (upper bound) as the participants could not discriminate a 55° turn, ranging from 49.7° to 63.7°. This preliminary study shows that immersive VR with altered visual feedback influenced movement. The feasibility for rehabilitation of individuals with kinesiophobia will next be assessed.
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The role of exergaming in Parkinson's disease rehabilitation: a systematic review of the evidence. J Neuroeng Rehabil 2014; 11:33. [PMID: 24602325 PMCID: PMC3984732 DOI: 10.1186/1743-0003-11-33] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 02/20/2014] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED Evidence for exercise based computer games (exergaming) as a rehabilitation tool for people with Parkinson's disease (PD) is only now emerging and is yet to be synthesised. To this end, we conducted a systematic review of the exergaming literature to establish what is known about the safety, feasibility and effectiveness of exergaming for rehabilitation of motor symptoms experienced by people with PD. Seven electronic databases were searched for key terms surrounding exergaming and PD. Data were extracted by two reviewers independently. From an initial yield of 1217 articles, seven were included in the review. Six studies used commercial games with the Nintendo Wii fit platform. The scientific quality of reporting was generally good, however the overall methodological design of studies was weak, with only one randomised controlled trial being reported. SAFETY Participant safety was not measured in any of the studies. Feasibility: People with PD were able to play exergames, improve their performance of gameplay and enjoyed playing. However, one study observed that people with PD had difficulty with fast and complex games. Effectiveness: Six studies showed that exergaming elicited improvements in a range of clinical balance measures or reduction in the severity of motor symptoms. Results from the only randomised controlled trial showed that exergaming was as effective as traditional balance training for people with PD to improve the UPDRS II, standing balance and cognition, with improvements in both groups retained 60 days after the training ended. In conclusion, exergaming is an emerging tool to help rehabilitate motor skills in people with PD. Although we were able to establish that exergaming is feasible in people with PD, more research is needed to establish its safety and clinical effectiveness, particularly in the home. The use of commercial games may be too difficult for some people with PD and exergames tailored specifically to the rehabilitation needs and capabilities of people with PD are required for optimal efficacy, adherence and safety.
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Glegg SMN, Holsti L, Velikonja D, Ansley B, Brum C, Sartor D. Factors influencing therapists' adoption of virtual reality for brain injury rehabilitation. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2014; 16:385-401. [PMID: 23713844 DOI: 10.1089/cyber.2013.1506] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Virtual reality (VR) is an important emerging technology that is increasingly being introduced in health centers as a rehabilitation intervention. Quantitative research is needed to identify the factors influencing therapists' adoption of VR for brain injury rehabilitation, including barriers and facilitators to VR use, in order to inform successful implementation strategies. A measure based on the decomposed theory of planned behavior (DTPB) was developed and administered to 42 therapists; early psychometric properties are reported. Mean or median composite scores and correlations were calculated for each DTPB construct. Overall, therapists had positive attitudes toward VR, perceived it as being useful, and had positive intentions to use it more in the future. The self-efficacy composite yielded the lowest scores. The most significant barrier to adoption was time, while social influences and knowledge were the primary facilitators. Future research will explore the impact of knowledge translation interventions on these mediators of VR adoption.
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Wille D, Eng K, Holper L, Chevrier E, Hauser Y, Kiper D, Pyk P, Schlegel S, Meyer-Heim A. Virtual reality-based paediatric interactive therapy system (PITS) for improvement of arm and hand function in children with motor impairment--a pilot study. Dev Neurorehabil 2009; 12:44-52. [PMID: 19283533 DOI: 10.1080/17518420902773117] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Rehabilitation of upper-limb sensorimotor function in children with motor dysfunctions is primarily based on movement training. This study developed a virtual-reality based, paediatric interactive therapy system (PITS) that allows children to practice specific movements of the upper limbs with immediate feedback about their motor performance. METHODS The system was tested on five children with motor dysfunctions over 3 weeks of training. Pre- and post-assessment was conducted before and after the training period. RESULTS Results of the pilot study show improvements of hand function in the test scores (except one patient). Patient motivation was high and maintained over the course of the therapy sessions. CONCLUSION PITS is an applicable VR-system which can be feasibly applied during the rehabilitation of children with upper limb motor dysfunctions. Further investigation is necessary to determine if the system provides significantly improved results compared to conventional therapies, both in terms of motor function outcomes and patient motivation.
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Affiliation(s)
- David Wille
- Rehabilitation Centre University Children's Hospital Zurich, Affoltern am Albis, Switzerland.
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Sveistrup H. Motor rehabilitation using virtual reality. J Neuroeng Rehabil 2004; 1:10. [PMID: 15679945 PMCID: PMC546406 DOI: 10.1186/1743-0003-1-10] [Citation(s) in RCA: 277] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2004] [Accepted: 12/10/2004] [Indexed: 11/14/2022] Open
Abstract
Virtual Reality (VR) provides a unique medium suited to the achievement of several requirements for effective rehabilitation intervention. Specifically, therapy can be provided within a functional, purposeful and motivating context. Many VR applications present opportunities for individuals to participate in experiences, which are engaging and rewarding. In addition to the value of the rehabilitation experience for the user, both therapists and users benefit from the ability to readily grade and document the therapeutic intervention using various systems. In VR, advanced technologies are used to produce simulated, interactive and multi-dimensional environments. Visual interfaces including desktop monitors and head-mounted displays (HMDs), haptic interfaces, and real-time motion tracking devices are used to create environments allowing users to interact with images and virtual objects in real-time through multiple sensory modalities. Opportunities for object manipulation and body movement through virtual space provide frameworks that, in varying degrees, are perceived as comparable to similar opportunities in the real world. This paper reviews current work on motor rehabilitation using virtual environments and virtual reality and where possible, compares outcomes with those achieved in real-world applications.
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Affiliation(s)
- Heidi Sveistrup
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Canada.
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