1
|
Rätz R, Conti F, Thaler I, Müri RM, Marchal-Crespo L. Enhancing stroke rehabilitation with whole-hand haptic rendering: development and clinical usability evaluation of a novel upper-limb rehabilitation device. J Neuroeng Rehabil 2024; 21:172. [PMID: 39334423 PMCID: PMC11437669 DOI: 10.1186/s12984-024-01439-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 08/05/2024] [Indexed: 09/30/2024] Open
Abstract
INTRODUCTION There is currently a lack of easy-to-use and effective robotic devices for upper-limb rehabilitation after stroke. Importantly, most current systems lack the provision of somatosensory information that is congruent with the virtual training task. This paper introduces a novel haptic robotic system designed for upper-limb rehabilitation, focusing on enhancing sensorimotor rehabilitation through comprehensive haptic rendering. METHODS We developed a novel haptic rehabilitation device with a unique combination of degrees of freedom that allows the virtual training of functional reach and grasp tasks, where we use a physics engine-based haptic rendering method to render whole-hand interactions between the patients' hands and virtual tangible objects. To evaluate the feasibility of our system, we performed a clinical mixed-method usability study with seven patients and seven therapists working in neurorehabilitation. We employed standardized questionnaires to gather quantitative data and performed semi-structured interviews with all participants to gain qualitative insights into the perceived usability and usefulness of our technological solution. RESULTS The device demonstrated ease of use and adaptability to various hand sizes without extensive setup. Therapists and patients reported high satisfaction levels, with the system facilitating engaging and meaningful rehabilitation exercises. Participants provided notably positive feedback, particularly emphasizing the system's available degrees of freedom and its haptic rendering capabilities. Therapists expressed confidence in the transferability of sensorimotor skills learned with our system to activities of daily living, although further investigation is needed to confirm this. CONCLUSION The novel haptic robotic system effectively supports upper-limb rehabilitation post-stroke, offering high-fidelity haptic feedback and engaging training tasks. Its clinical usability, combined with positive feedback from both therapists and patients, underscores its potential to enhance robotic neurorehabilitation.
Collapse
Affiliation(s)
- Raphael Rätz
- Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
| | | | - Irène Thaler
- Department of Neurology, University Neurorehabilitation, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland
| | - René M Müri
- Department of Neurology, University Neurorehabilitation, University Hospital Bern (Inselspital), University of Bern, Bern, Switzerland
| | - Laura Marchal-Crespo
- Motor Learning and Neurorehabilitation Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
- Department of Cognitive Robotics, Delft University of Technology, Delft, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
2
|
Machado F, Loureiro M, Bezerra M, Zimerer C, Mello R, Frizera A. Virtual Obstacle Avoidance Strategy: Navigating through a Complex Environment While Interacting with Virtual and Physical Elements. SENSORS (BASEL, SWITZERLAND) 2024; 24:6212. [PMID: 39409252 PMCID: PMC11479164 DOI: 10.3390/s24196212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/13/2024] [Accepted: 09/23/2024] [Indexed: 10/20/2024]
Abstract
Robotic walking devices can be used for intensive exercises to enhance gait rehabilitation therapies. Mixed Reality (MR) techniques may improve engagement through immersive and interactive environments. This article introduces an MR-based multimodal human-robot interaction strategy designed to enable shared control with a Smart Walker. The MR system integrates virtual and physical sensors to (i) enhance safe navigation and (ii) facilitate intuitive mobility training in personalized virtual scenarios by using an interface with three elements: an arrow to indicate where to go, laser lines to indicate nearby obstacles, and an ellipse to show the activation zone. The multimodal interaction is context-based; the presence of nearby individuals and obstacles modulates the robot's behavior during navigation to simplify collision avoidance while allowing for proper social navigation. An experiment was conducted to evaluate the proposed strategy and the self-explanatory nature of the interface. The volunteers were divided into four groups, with each navigating under different conditions. Three evaluation methods were employed: task performance, self-assessment, and observational measurement. Analysis revealed that participants enjoyed the MR system and understood most of the interface elements without prior explanation. Regarding the interface, volunteers who did not receive any introductory explanation about the interface elements were mostly able to guess their purpose. Volunteers that interacted with the interface in the first session provided more correct answers. In future research, virtual elements will be integrated with the physical environment to enhance user safety during navigation, and the control strategy will be improved to consider both physical and virtual obstacles.
Collapse
Affiliation(s)
- Fabiana Machado
- Graduate Program in Informatics, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil;
| | - Matheus Loureiro
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil; (M.L.); (M.B.); (C.Z.); (R.M.)
| | - Marcio Bezerra
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil; (M.L.); (M.B.); (C.Z.); (R.M.)
| | - Carla Zimerer
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil; (M.L.); (M.B.); (C.Z.); (R.M.)
| | - Ricardo Mello
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil; (M.L.); (M.B.); (C.Z.); (R.M.)
| | - Anselmo Frizera
- Graduate Program in Informatics, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil;
- Graduate Program in Electrical Engineering, Federal University of Espírito Santo, Vitória 29075-910, ES, Brazil; (M.L.); (M.B.); (C.Z.); (R.M.)
| |
Collapse
|
3
|
Ai X, Santamaria V, Agrawal SK. Characterizing the Effects of Adding Virtual and Augmented Reality in Robot-Assisted Training. IEEE Trans Neural Syst Rehabil Eng 2024; 32:2709-2718. [PMID: 39042524 PMCID: PMC11324333 DOI: 10.1109/tnsre.2024.3432661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Extended reality (XR) technology combines physical reality with computer synthetic virtuality to deliver immersive experience to users. Virtual reality (VR) and augmented reality (AR) are two subdomains within XR with different immersion levels. Both of these have the potential to be combined with robot-assisted training protocols to maximize postural control improvement. In this study, we conducted a randomized control experiment with sixty-three healthy subjects to compare the effectiveness of robot-assisted posture training combined with VR or AR against robotic training alone. A robotic Trunk Support Trainer (TruST) was employed to deliver assistive force at the trunk as subjects moved beyond the stability limits during training. Our results showed that both VR and AR significantly enhanced the training outcomes of the TruST intervention. However, the VR group experienced higher simulator sickness compared to the AR group, suggesting that AR is better suited for sitting posture training in conjunction with TruST intervention. Our findings highlight the added value of XR to robot-assisted training and provide novel insights into the differences between AR and VR when integrated into a robotic training protocol. In addition, we developed a custom XR application that suited well for TruST intervention requirements. Our approach can be extended to other studies to develop novel XR-enhanced robotic training platforms.
Collapse
|
4
|
Bosch-Barceló P, Masbernat-Almenara M, Martínez-Navarro O, Tersa-Miralles C, Pakarinen A, Fernández-Lago H. A gamified virtual environment intervention for gait rehabilitation in Parkinson's Disease: co-creation and feasibility study. J Neuroeng Rehabil 2024; 21:107. [PMID: 38915103 PMCID: PMC11194924 DOI: 10.1186/s12984-024-01399-6] [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] [Received: 02/14/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Treadmill gait training has been shown to improve gait performance in People with Parkinson's Disease (PwPD), and in combination with Virtual Reality, it can be an effective tool for gait rehabilitation. The addition of gamification elements can create a more stimulating and adherent intervention. However, implementation of new technologies in healthcare can be challenging. This study aimed to develop and evaluate the feasibility of a treadmill rehabilitation program in a Gamified Virtual Reality Environment (GVRE) for PwPD. METHODS The GVRE was developed following a user-centered design approach, involving both PwPD and physiotherapists in the development and evaluation of the intervention. The intervention consisted of a walking simulation in three different environments (countryside, city, and park), which had a progressive increase in difficulty. To test its feasibility, three sessions were carried out with four PwPD and four physiotherapists. To assess the usability, the System Usability Scale (SUS), Assistive Technology Usability Questionnaire for people with Neurological diseases (NATU Quest) and Simulator Sickness Questionnaire (SSQ) were used. To assess the intervention's acceptability, feedback and in-game performance was collected from participants. RESULTS Results showed the feasibility of the intervention, with a SUS score of 74.82 ± 12.62, and a NATU Quest score of 4.49 ± 0.62, and positive acceptability feedback. Participants showed clear preferences for naturalistic environments, and gamification elements were seen as positive. Difficulty settings worked as intended, but lowered enjoyment of the experience in some cases. CONCLUSIONS This intervention was successfully shown as a feasible option for the training of gait under Dual Task conditions for PwPD. It offers a safe and replicable environment in which complex situations can be trained. However, further iterations of the intervention need to be improved in order to guarantee accurate tracking and a more realistic training progression. TRIAL REGISTRATION NUMBER NCT05243394-01/20/2022.
Collapse
Affiliation(s)
- Pere Bosch-Barceló
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 2, Lleida, 25198, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Lleida Institute for Biomedical Research Dr Pifarré Foundation, IRBLleida, Lleida, Spain
| | - Maria Masbernat-Almenara
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 2, Lleida, 25198, Spain.
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain.
- Consolidated Research Group: Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain.
| | - Oriol Martínez-Navarro
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 2, Lleida, 25198, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Consolidated Research Group: Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
| | - Carlos Tersa-Miralles
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 2, Lleida, 25198, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Lleida Institute for Biomedical Research Dr Pifarré Foundation, IRBLleida, Lleida, Spain
| | - Anni Pakarinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Helena Fernández-Lago
- Department of Nursing and Physiotherapy, University of Lleida, Montserrat Roig, 2, Lleida, 25198, Spain
- Health Care Research Group (GRECS), Lleida Institute for Biomedical Research Dr. Pifarré Foundation (IRBLleida), Lleida, Spain
- Lleida Institute for Biomedical Research Dr Pifarré Foundation, IRBLleida, Lleida, Spain
- Consolidated Research Group: Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
| |
Collapse
|
5
|
Eck J, Pfister R. Bound by Experience: Updating the Body Representation When Using Virtual Objects. HUMAN FACTORS 2024:187208241258315. [PMID: 38876982 DOI: 10.1177/00187208241258315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
OBJECTIVE Four web-based experiments investigated flexibility of disembodiment of a virtual object that is no longer actively controlled. Emphasis was on possibilities to modify the timescale of this process. BACKGROUND Interactions with virtual objects are commonplace in settings like teleoperation, rehabilitation, and computer-aided design. These objects are quickly integrated into the operator's body schema (embodiment). Less is known about how long such embodiment lasts. Understanding the dynamics of this process is crucial because different applied settings either profit from fast or slow disembodiment. METHOD To induce embodiment, participants moved a 2D virtual hand through operating a computer mouse or touchpad. After initial embodiment, participants either stopped or continued moving for a fixed period of time. Embodiment ratings were collected continuously during each trial. RESULTS Results across all experiments indicated that embodiment for the virtual hand gradually increased during active use and gradually decreased after stopping to use it. Disembodiment unfolded nearly twice as fast as embodiment and showed a curved decay pattern. These dynamics remained unaffected by anticipation of active control that would be required in an upcoming task. CONCLUSION The results highlight the importance of continuously experiencing active control in virtual interactions if aiming at inducing stable embodiment of a virtual object. APPLICATION Our findings suggest that applications of virtual disembodiment such as virtual tools or interventions to affect a person's body representation critically depend on continuous updating of sensorimotor experience. However, if switching between virtual objects, for example, during teleoperation or video gaming, after-effects are unlikely to affect performance.
Collapse
|
6
|
Salera C, Capua C, De Angelis D, Coiro P, Venturiero V, Savo A, Marinozzi F, Bini F, Paolucci S, Antonucci G, Iosa M. Michelangelo Effect in Cognitive Rehabilitation: Using Art in a Digital Visuospatial Memory Task. Brain Sci 2024; 14:479. [PMID: 38790457 PMCID: PMC11119589 DOI: 10.3390/brainsci14050479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/06/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The Michelangelo effect is a phenomenon that shows a reduction in perceived effort and an improvement in performance among both healthy subjects and patients when completing a motor task related to artistic stimuli, compared to performing the same task with non-artistic stimuli. It could contribute to the efficacy of art therapy in neurorehabilitation. In this study, the possible occurrence of this effect was tested in a cognitive task by asking 15 healthy subjects and 17 patients with a history of stroke to solve a digital version of the classical memory card game. Three different types of images were used in a randomized order: French cards, artistic portraits, and photos of famous people (to compensate for the possible effects of face recognition). Healthy subjects were involved to test the usability and the load demand of the developed system, reporting no statistically significant differences among the three sessions (p > 0.05). Conversely, patients had a better performance in terms of time (p = 0.014) and the number of attempts (p = 0.007) needed to complete the task in the presence of artistic stimuli, accompanied by a reduction in the perceived effort (p = 0.033). Furthermore, artistic stimuli, with respect to the other two types of images, seemed more associated with visuospatial control than linguistic functions.
Collapse
Affiliation(s)
- Claudia Salera
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Chiara Capua
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (F.M.); (F.B.)
| | - Domenico De Angelis
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Paola Coiro
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Vincenzo Venturiero
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Anna Savo
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Franco Marinozzi
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (F.M.); (F.B.)
| | - Fabiano Bini
- Department of Mechanical and Aerospace Engineering, Sapienza University of Rome, 00184 Rome, Italy; (C.C.); (F.M.); (F.B.)
| | - Stefano Paolucci
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
| | - Gabriella Antonucci
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Marco Iosa
- IRCCS Santa Lucia Foundation, 00143 Rome, Italy; (C.S.); (D.D.A.); (P.C.); (V.V.); (A.S.); (S.P.); (G.A.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| |
Collapse
|
7
|
Manship S, Hatzidimitriadou E, Moore J, Stein M, Towse D, Smith R. The experiences and perceptions of health-care professionals regarding assistive technology training: A systematic review. Assist Technol 2024; 36:123-146. [PMID: 37399518 DOI: 10.1080/10400435.2023.2219294] [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] [Accepted: 05/23/2023] [Indexed: 07/05/2023] Open
Abstract
Worldwide, there is an increasing demand for assistive technologies (ATs) that can support people to live independently for longer. Health-care professionals (HCPs) often recommend AT devices, however there exists a lack of availability of devices and appropriate training in the field. This systematic review aimed to synthesize the available evidence into the experiences and training needs of HCPs in relation to AT. Six electronic databases were searched without date restrictions: MEDLINE, PsycINFO, SPP, SSCI, CINAHL, and ASSIA. Journal handsearching, searching reference lists of included studies and relevant reviews, and contacting experts in the field of AT were also conducted. Findings were analyzed using narrative synthesis. Data from 7846 participants from 62 studies were synthesized, eliciting perceived challenges in access to and provision of training, resulting in knowledge gaps across disciplines and geographic locations. Mechanisms to mitigate these issues included ongoing support following training and tailoring education to meet individual needs since comprehensive training is essential to maintain and improve competence, knowledge, and confidence. Further research is required to explore the impact and effectiveness of AT training for HCPs to ensure that users of devices are supported to live independent and healthy lives.
Collapse
Affiliation(s)
- Sharon Manship
- Centre for Health Services Studies, University of Kent, Canterbury, Kent, UK
| | - Eleni Hatzidimitriadou
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Julia Moore
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Maria Stein
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Debra Towse
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Raymond Smith
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK
| |
Collapse
|
8
|
Naqvi WM, Naqvi I, Mishra GV, Vardhan V. The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients. Cureus 2024; 16:e56724. [PMID: 38646260 PMCID: PMC11032731 DOI: 10.7759/cureus.56724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.
Collapse
Affiliation(s)
- Waqar M Naqvi
- Interdisciplinary Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, ARE
| | - Ifat Naqvi
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vishnu Vardhan
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
9
|
Albanese GA, Bucchieri A, Podda J, Tacchino A, Buccelli S, De Momi E, Laffranchi M, Mannella K, Holmes MWR, Zenzeri J, De Michieli L, Brichetto G, Barresi G. Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments. Front Robot AI 2024; 11:1335147. [PMID: 38638271 PMCID: PMC11025362 DOI: 10.3389/frobt.2024.1335147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/30/2024] [Indexed: 04/20/2024] Open
Abstract
The robotics discipline is exploring precise and versatile solutions for upper-limb rehabilitation in Multiple Sclerosis (MS). People with MS can greatly benefit from robotic systems to help combat the complexities of this disease, which can impair the ability to perform activities of daily living (ADLs). In order to present the potential and the limitations of smart mechatronic devices in the mentioned clinical domain, this review is structured to propose a concise SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of robotic rehabilitation in MS. Through the SWOT Analysis, a method mostly adopted in business management, this paper addresses both internal and external factors that can promote or hinder the adoption of upper-limb rehabilitation robots in MS. Subsequently, it discusses how the synergy with another category of interaction technologies - the systems underlying virtual and augmented environments - may empower Strengths, overcome Weaknesses, expand Opportunities, and handle Threats in rehabilitation robotics for MS. The impactful adaptability of these digital settings (extensively used in rehabilitation for MS, even to approach ADL-like tasks in safe simulated contexts) is the main reason for presenting this approach to face the critical issues of the aforementioned SWOT Analysis. This methodological proposal aims at paving the way for devising further synergistic strategies based on the integration of medical robotic devices with other promising technologies to help upper-limb functional recovery in MS.
Collapse
Affiliation(s)
| | - Anna Bucchieri
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Jessica Podda
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Stefano Buccelli
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Matteo Laffranchi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Kailynn Mannella
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | | | | | | | - Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
- AISM Rehabilitation Center Liguria, Italian Multiple Sclerosis Society (AISM), Genoa, Italy
| | - Giacinto Barresi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| |
Collapse
|
10
|
Dicianno BE, Salh A, Morris L, Xiang Y, Ding D. Rehabilitation clinicians' use of mainstream wireless technologies in practice: a scoping review. Disabil Rehabil Assist Technol 2024:1-19. [PMID: 38349177 PMCID: PMC11323212 DOI: 10.1080/17483107.2024.2316891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 02/06/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE This scoping review was conducted to understand the barriers, facilitators, and education and training needs of rehabilitation clinicians in their use of mainstream wireless technologies (MWT) to support people with disabilities and older adults. It was also conducted to understand the functional skills of clients that were targeted with MWT use. MATERIALS AND METHODS This scoping review was reported using PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) and the Population (or Participants)/Concept/Context) framework. We searched PubMed; ProQuest to access APA PsycINFO; Web of Science Core Collection; and EBSCOhost to access Cumulated Index to Nursing and Allied Health Literature (CINAHL), Ovid MEDLINE ALL, and Education Resources Information Center (ERIC). Articles published between 2015-2022 were retrieved. RESULTS A total of 90 articles were included. Most interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills. An infographic on barriers and facilitators was generated as a decision support tool for clinicians when implementing MWT. The topic, format, timing, and source of information clinicians need are also delineated. CONCLUSION MWT such as apps, smartphones and tablets are being used by rehabilitation clinicians to address motor, cognitive, and speech skills, most commonly in adults. Clinicians voice a need for more education and training. Barriers and facilitators exist at the clinician-, technology-, client-, institution-, and policy levels.Implications For RehabilitationA total of 90 articles from 2015-2022 were included in this scoping reviewMost interventions were apps, smartphones, and tablets; were geared toward adults; and targeted motor, cognitive and speech skills.An infographic was generated as a decision support tool for clinicians when implementing mainstream wireless technologies in clinical practice.Clinicians' education and training needs with regard to mainstream wireless technologies are broad. Materials on a variety of topics, in different formats, from multiple sources are needed.This review also discusses implications of findings on policy, technology development, and future research.
Collapse
Affiliation(s)
- Brad E. Dicianno
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Angad Salh
- College of Osteopathic Medicine, KS City University, Kansas City, MO, USA
| | - Lindsey Morris
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yifan Xiang
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Dan Ding
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
11
|
Alt Murphy M, Pradhan S, Levin MF, Hancock NJ. Uptake of Technology for Neurorehabilitation in Clinical Practice: A Scoping Review. Phys Ther 2024; 104:pzad140. [PMID: 37856528 PMCID: PMC10851848 DOI: 10.1093/ptj/pzad140] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE Technology-based interventions offer many opportunities to enhance neurorehabilitation, with associated research activity gathering pace. Despite this fact, translation for use in clinical practice has lagged research innovation. An overview of the current "state of play" regarding the extent of clinical uptake and factors that might influence use of technologies is required. This scoping review explored the uptake of technologies as neurorehabilitation interventions in clinical practice and factors that are reported to influence their uptake. METHODS This systematic scoping review was conducted with narrative synthesis and evidence mapping. Studies of any design reporting uptake or implementation of technology (wearable devices, virtual reality, robotics, and exergaming) for movement neurorehabilitation after stroke and other neurological conditions were sought via a formal search strategy in MEDLINE (Ovid), CINAHL, AMED, and Embase. Full-text screening and data extraction were completed independently by 2 reviewers. RESULTS Of 609 studies returned, 25 studies were included after title, abstract, and full-text screening. Studies investigated a range of technologies at various stages of development. Only 4 of the included studies explored the sustained use of technology in practice. The following 5 themes representing experiences of technology use emerged: perceived usefulness, technology design, social interaction, integration with services, and suggested improvements to enhance uptake. CONCLUSION Reporting of uptake and use of neurorehabilitation technologies in clinical practice is limited. The synthesis provided comprehensive knowledge of barriers to and facilitators of uptake to be considered in future protocols, including a steep learning curve required to engage with technology, a need for a supportive organizational culture, and a need for user involvement in both design and development. IMPACT This scoping review has provided indicators from current evidence of important factors to consider in the planning of research into and clinical implementation of technologies for neurorehabilitation. It serves to support an evidence-based, user-centered platform for improved research on and translation of technologies in neurorehabilitation clinical practice.
Collapse
Affiliation(s)
- Margit Alt Murphy
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sujata Pradhan
- Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Mindy F Levin
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Quebec, Canada
| | - Nicola J Hancock
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| |
Collapse
|
12
|
Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
Collapse
Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| |
Collapse
|
13
|
Moulaei K, Bahaadinbeigy K, Haghdoostd AA, Nezhad MS, Sheikhtaheri A. Overview of the role of robots in upper limb disabilities rehabilitation: a scoping review. Arch Public Health 2023; 81:84. [PMID: 37158979 PMCID: PMC10169358 DOI: 10.1186/s13690-023-01100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/29/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Neuromotor rehabilitation and improvement of upper limb functions are necessary to improve the life quality of patients who have experienced injuries or have pathological outcomes. Modern approaches, such as robotic-assisted rehabilitation can help to improve rehabilitation processes and thus improve upper limb functions. Therefore, the aim of this study was to investigate the role of robots in upper limb disability improvement and rehabilitation. METHODS This scoping review was conducted by search in PubMed, Web of Science, Scopus, and IEEE (January 2012- February 2022). Articles related to upper limb rehabilitation robots were selected. The methodological quality of all the included studies will be appraised using the Mixed Methods Appraisal Tool (MMAT). We used an 18-field data extraction form to extract data from articles and extracted the information such as study year, country, type of study, purpose, illness or accident leading to disability, level of disability, assistive technologies, number of participants in the study, sex, age, rehabilitated part of the upper limb using a robot, duration and frequency of treatment, methods of performing rehabilitation exercises, type of evaluation, number of participants in the evaluation process, duration of intervention, study outcomes, and study conclusions. The selection of articles and data extraction was made by three authors based on inclusion and exclusion criteria. Disagreements were resolved through consultation with the fifth author. Inclusion criteria were articles involving upper limb rehabilitation robots, articles about upper limb disability caused by any illness or injury, and articles published in English. Also, articles involving other than upper limb rehabilitation robots, robots related to rehabilitation of diseases other than upper limb, systematic reviews, reviews, and meta-analyses, books, book chapters, letters to the editor, and conference papers were also excluded. Descriptive statistics methods (frequency and percentage) were used to analyses the data. RESULTS We finally included 55 relevant articles. Most of the studies were done in Italy (33.82%). Most robots were used to rehabilitate stroke patients (80%). About 60.52% of the studies used games and virtual reality rehabilitate the upper limb disabilities using robots. Among the 14 types of applied evaluation methods, "evaluation and measurement of upper limb function and dexterity" was the most applied evaluation method. "Improvement in musculoskeletal functions", "no adverse effect on patients", and "Safe and reliable treatment" were the most cited outcomes, respectively. CONCLUSIONS Our findings show that robots can improve musculoskeletal functions (musculoskeletal strength, sensation, perception, vibration, muscle coordination, less spasticity, flexibility, and range of motion) and empower people by providing a variety of rehabilitation capabilities.
Collapse
Affiliation(s)
- Khadijeh Moulaei
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoostd
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansour Shahabi Nezhad
- Department of Physical Therapy, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Guo K, Orban M, Lu J, Al-Quraishi MS, Yang H, Elsamanty M. Empowering Hand Rehabilitation with AI-Powered Gesture Recognition: A Study of an sEMG-Based System. Bioengineering (Basel) 2023; 10:557. [PMID: 37237627 PMCID: PMC10215961 DOI: 10.3390/bioengineering10050557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Stroke is one of the most prevalent health issues that people face today, causing long-term complications such as paresis, hemiparesis, and aphasia. These conditions significantly impact a patient's physical abilities and cause financial and social hardships. In order to address these challenges, this paper presents a groundbreaking solution-a wearable rehabilitation glove. This motorized glove is designed to provide comfortable and effective rehabilitation for patients with paresis. Its unique soft materials and compact size make it easy to use in clinical settings and at home. The glove can train each finger individually and all fingers together, using assistive force generated by advanced linear integrated actuators controlled by sEMG signals. The glove is also durable and long-lasting, with 4-5 h of battery life. The wearable motorized glove is worn on the affected hand to provide assistive force during rehabilitation training. The key to this glove's effectiveness is its ability to perform the classified hand gestures acquired from the non-affected hand by integrating four sEMG sensors and a deep learning algorithm (the 1D-CNN algorithm and the InceptionTime algorithm). The InceptionTime algorithm classified ten hand gestures' sEMG signals with an accuracy of 91.60% and 90.09% in the training and verification sets, respectively. The overall accuracy was 90.89%. It showed potential as a tool for developing effective hand gesture recognition systems. The classified hand gestures can be used as a control command for the motorized wearable glove placed on the affected hand, allowing it to mimic the movements of the non-affected hand. This innovative technology performs rehabilitation exercises based on the theory of mirror therapy and task-oriented therapy. Overall, this wearable rehabilitation glove represents a significant step forward in stroke rehabilitation, offering a practical and effective solution to help patients recover from stroke's physical, financial, and social impact.
Collapse
Affiliation(s)
- Kai Guo
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Mostafa Orban
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- Mechanical Department, Faculty of Engineering at Shoubra, Benha University, Cairo 11672, Egypt
| | - Jingxin Lu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- School of Mechanical and Electrical Engineering, Changchun University of Science and Technology, Changchun 130001, China
| | | | - Hongbo Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- School of Mechanical and Electrical Engineering, Changchun University of Science and Technology, Changchun 130001, China
| | - Mahmoud Elsamanty
- Mechanical Department, Faculty of Engineering at Shoubra, Benha University, Cairo 11672, Egypt
- Mechatronics and Robotics Department, School of Innovative Design Engineering, Egypt-Japan University of Science and Technology, Alexandria 21934, Egypt
| |
Collapse
|
15
|
Zanatta F, Farhane-Medina NZ, Adorni R, Steca P, Giardini A, D'Addario M, Pierobon A. Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients. Health Qual Life Outcomes 2023; 21:18. [PMID: 36810124 PMCID: PMC9942343 DOI: 10.1186/s12955-023-02097-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients' health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000-2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables. CONCLUSIONS Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology.
Collapse
Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Naima Z Farhane-Medina
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
| |
Collapse
|
16
|
RONCONI G, FERRARA PE, NEGRINI F. Lights and shadows of robotic rehabilitation in neurological disorders. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2023. [DOI: 10.23736/s0393-3660.22.04943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
|
17
|
Zanatta F, Steca P, Fundarò C, Giardini A, Felicetti G, Panigazzi M, Arbasi G, Grilli C, D’Addario M, Pierobon A. Biopsychosocial effects and experience of use of robotic and virtual reality devices in neuromotor rehabilitation: A study protocol. PLoS One 2023; 18:e0282925. [PMID: 36897863 PMCID: PMC10004562 DOI: 10.1371/journal.pone.0282925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/18/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Robot-assisted therapy (RAT) and virtual reality (VR)-based neuromotor rehabilitation have shown promising evidence in terms of patient's neuromotor recovery, so far. However, still little is known on the perceived experience of use of robotic and VR devices and the related psychosocial impact. The present study outlines a study protocol aiming to investigate the biopsychosocial effects and the experience of use of robotic and non-immersive VR devices in patients undergoing neuromotor rehabilitation. METHODS Adopting a prospective, two-arm, non-randomized study design, patients with different neuromotor diseases (i.e., acquired brain injury, Parkinson's Disease, and total knee/hip arthroplasty) undergoing rehabilitation will be included. In a real-world clinical setting, short- (4 weeks) and long-term (6 months) changes in multiple patient's health domains will be investigated, including the functional status (i.e., motor functioning, ADLs, risk of falls), cognitive functioning (i.e., attention and executive functions), physical and mental health-related quality of life (HRQoL), and the psychological status (i.e., anxiety and depression, quality of life satisfaction). At post-intervention, the overall rehabilitation experience, the psychosocial impact of the robotic and VR devices will be assessed, and technology perceived usability and experience of use will be evaluated through a mixed-methods approach, including both patients' and physiotherapists' perspectives. Repeated measures within-between interaction effects will be estimated, and association analyses will be performed to explore the inter-relationships among the variables investigated. Data collection is currently ongoing. IMPLICATIONS The biopsychosocial framework adopted will contribute to expanding the perspective on patient's recovery within the technology-based rehabilitation field beyond motor improvement. Moreover, the investigation of devices experience of use and usability will provide further insight into technology deployment in neuromotor rehabilitation programs, thereby maximising therapy engagement and effectiveness. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05399043.
Collapse
Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Cira Fundarò
- Istituti Clinici Scientifici Maugeri IRCCS, Neurophysiopathology Unit of Montescano Institute, Montescano, Italy
- * E-mail:
| | - Anna Giardini
- Istituti Clinici Scientifici Maugeri IRCCS, Information Technology Department of Pavia Institute, Pavia, Italy
| | - Guido Felicetti
- Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit of Montescano Institute, Montescano, Italy
| | - Monica Panigazzi
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Physiatry and Ergonomics Unit of Montescano Institute, Montescano, Italy
| | - Giovanni Arbasi
- Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit of Montescano Institute, Montescano, Italy
| | - Cesare Grilli
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Physiatry and Ergonomics Unit of Montescano Institute, Montescano, Italy
| | - Marco D’Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
| |
Collapse
|
18
|
Marek K, Zubrycki I, Miller E. Immersion Therapy with Head-Mounted Display for Rehabilitation of the Upper Limb after Stroke-Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:9962. [PMID: 36560328 PMCID: PMC9785384 DOI: 10.3390/s22249962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/08/2022] [Accepted: 12/14/2022] [Indexed: 06/17/2023]
Abstract
Immersive virtual therapy technology is a new method that uses head-mounted displays for rehabilitation purposes. It offers a realistic experience that puts the user in a virtual reality. This new type of therapy is used in the rehabilitation of stroke patients. Many patients after this disease have complications related to the upper extremities that limit independence in their everyday life, which affects the functioning of society. Conventional neurological rehabilitation can be supplemented by the use of immersive virtual therapy. The system allows patients with upper limb dysfunction to perform a motor and task-oriented training in virtual reality that is individually tailored to their performance. The complete immersion therapy itself is researched and evaluated by medical teams to determine the suitability for rehabilitation of the upper limb after a stroke. The purpose of this article is to provide an overview of the latest research (2019-2022) on immersive virtual reality with head-mounted displays using in rehabilitation of the upper extremities of stroke patients.
Collapse
Affiliation(s)
- Klaudia Marek
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland
| | - Igor Zubrycki
- Institute of Automatic Control, Lodz University of Technology, Stefanowskiego 18, 90-537 Lodz, Poland
| | - Elżbieta Miller
- Department of Neurological Rehabilitation, Medical University of Lodz, Milionowa 14, 93-113 Lodz, Poland
| |
Collapse
|