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Rich TL, Truty T, Muschler K, Gravely A, Marth LA, Barrett B, Mortimer D, Hansen AH. Virtual Reality Game Selection for Traumatic Brain Injury Rehabilitation: A Therapist's Wish List for Game Developers. Games Health J 2023; 12:445-449. [PMID: 37498203 DOI: 10.1089/g4h.2022.0174] [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: 07/28/2023] Open
Abstract
This project explored the selection process of commercially available virtual reality (VR) games for traumatic brain injury rehabilitation. Occupational therapy practitioners (OTPs) developed a classification framework that they used to evaluate VR games. The classification framework focused on movements required to effectively play the game, cognitive demand, position for game play, ease in menu navigation, and perceived therapeutic applications. OTPs used the ratings to aid in game selection and identified relevant game examples that allowed customizable settings and basic navigation with a game focus on functional activities. The OTPs and the research team identified the need for further work on accessibility and adaptability of game features (e.g., difficulty and limb usage) allowing for more individualization to optimize outcomes of VR-enhanced rehabilitation. The classification framework was useful in evaluating the potential therapeutic benefit of commercially available VR games. However, trial of the game by clinicians prior to use was still warranted.
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Affiliation(s)
- Tonya L Rich
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
- University of Minnesota, Division of Rehabilitation Medicine, Minneapolis, Minnesota, USA
| | - Timothy Truty
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, Minnesota, USA
| | - Katherine Muschler
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, Minnesota, USA
| | - Amy Gravely
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, Minnesota, USA
| | - Lindsay A Marth
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
| | - Benjamin Barrett
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
| | - Diane Mortimer
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
- University of Minnesota, Division of Rehabilitation Medicine, Minneapolis, Minnesota, USA
| | - Andrew H Hansen
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
- University of Minnesota, Division of Rehabilitation Medicine, Minneapolis, Minnesota, USA
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, Minnesota, USA
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Wilson PH, Rogers JM, Vogel K, Steenbergen B, McGuckian TB, Duckworth J. Home-based (virtual) rehabilitation improves motor and cognitive function for stroke patients: a randomized controlled trial of the Elements (EDNA-22) system. J Neuroeng Rehabil 2021; 18:165. [PMID: 34823545 PMCID: PMC8613521 DOI: 10.1186/s12984-021-00956-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Home-based rehabilitation of arm function is a significant gap in service provision for adult stroke. The EDNA-22 tablet is a portable virtual rehabilitation-based system that provides a viable option for home-based rehabilitation using a suite of tailored movement tasks, and performance monitoring via cloud computing data storage. The study reported here aimed to compare use of the EDNA system with an active control (Graded Repetitive Arm Supplementary Program—GRASP training) group using a parallel RCT design. Methods Of 19 originally randomized, 17 acute-care patients with upper-extremity dysfunction following unilateral stroke completed training in either the treatment (n = 10) or active control groups (n = 7), each receiving 8-weeks of in-home training involving 30-min sessions scheduled 3–4 times weekly. Performance was assessed across motor, cognitive and functional behaviour in the home. Primary motor measures, collected by a blinded assessor, were the Box and Blocks Task (BBT) and 9-Hole Pegboard Test (9HPT), and for cognition the Montreal Cognitive Assessment (MoCA). Functional behaviour was assessed using the Stroke Impact Scale (SIS) and Neurobehavioural Functioning Inventory (NFI). Results One participant from each group withdrew for personal reasons. No adverse events were reported. Results showed a significant and large improvement in performance on the BBT for the more-affected hand in the EDNA training group, only (g = 0.90). There was a mild-to-moderate effect of training on the 9HPT for EDNA (g = 0.55) and control (g = 0.42) groups, again for the more affected hand. In relation to cognition, performance on the MoCA improved for the EDNA group (g = 0.70). Finally, the EDNA group showed moderate (but non-significant) improvement in functional behaviour on the SIS (g = 0.57) and NFI (g = 0.49). Conclusion A short course of home-based training using the EDNA-22 system can yield significant gains in motor and cognitive performance, over and above an active control training that also targets upper-limb function. Intriguingly, these changes in performance were corroborated only tentatively in the reports of caregivers. We suggest that future research consider how the implementation of home-based rehabilitation technology can be optimized. We contend that self-administered digitally-enhanced training needs to become part of the health literacy of all stakeholders who are impacted by stroke and other acquired brain injuries. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR) Number: ACTRN12619001557123. Registered 12 November 2019, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378298&isReview=true
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Affiliation(s)
- Peter H Wilson
- Healthy Brain and Mind Research Centre (HBMRC) and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia.
| | - Jeffrey M Rogers
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Karin Vogel
- Prince of Wales Hospital, Sydney, NSW, Australia
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Thomas B McGuckian
- Healthy Brain and Mind Research Centre (HBMRC) and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Subramanian SK, Fountain MK, Hood AF, Verduzco-Gutierrez M. Upper Limb Motor Improvement after Traumatic Brain Injury: Systematic Review of Interventions. Neurorehabil Neural Repair 2021; 36:17-37. [PMID: 34766518 DOI: 10.1177/15459683211056662] [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: 11/16/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of adult morbidity and mortality. Individuals with TBI have impairments in both cognitive and motor domains. Motor improvements post-TBI are attributable to adaptive neuroplasticity and motor learning. Majority of the studies focus on remediation of balance and mobility issues. There is limited understanding on the use of interventions for upper limb (UL) motor improvements in this population. OBJECTIVE We examined the evidence regarding the effectiveness of different interventions to augment UL motor improvement after a TBI. METHODS We systematically examined the evidence published in English from 1990-2020. The modified Downs and Black checklist helped assess study quality (total score: 28). Studies were classified as excellent: 24-28, good: 19-23, fair: 14-18, and poor: ≤13 in quality. Effect sizes helped quantify intervention effectiveness. RESULTS Twenty-three studies were retrieved. Study quality was excellent (n = 1), good (n = 5) or fair (n = 17). Interventions used included strategies to decrease muscle tone (n = 6), constraint induced movement therapy (n = 4), virtual reality gaming (n = 5), non-invasive stimulation (n = 3), arm motor ability training (n = 1), stem cell transplant (n = 1), task-oriented training (n = 2), and feedback provision (n = 1). Motor impairment outcomes included Fugl-Meyer Assessment, Modified Ashworth Scale, and kinematic outcomes (error and movement straightness). Activity limitation outcomes included Wolf Motor Function Test and Motor Activity Log (MAL). Effect sizes for majority of the interventions ranged from medium (.5-.79) to large (≥.8). Only ten studies included retention testing. CONCLUSION There is preliminary evidence that using some interventions may enhance UL motor improvement after a TBI. Answers to emergent questions can help select the most appropriate interventions in this population.
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Affiliation(s)
- Sandeep K Subramanian
- Department of Physical Therapy, School of Health Professions, 14742UT Health San Antonio, San Antonio, TX, USA.,Department of Rehabilitation Medicine, Joe R. & Teresa Lozano Long School of Medicine, 14742UT Health San Antonio, San Antonio, TX, USA.,University Hospital-University Health System, San Antonio, TX, USA
| | - Melinda K Fountain
- Department of Physical Therapy, School of Health Professions, 14742UT Health San Antonio, San Antonio, TX, USA
| | - Ashley F Hood
- Department of Physical Therapy, School of Health Professions, 14742UT Health San Antonio, San Antonio, TX, USA
| | - Monica Verduzco-Gutierrez
- Department of Rehabilitation Medicine, Joe R. & Teresa Lozano Long School of Medicine, 14742UT Health San Antonio, San Antonio, TX, USA.,University Hospital-University Health System, San Antonio, TX, USA
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Maldonado-Díaz M, Vargas P, Vasquez R, Gonzalez-Seguel F, Rivero B, Hidalgo-Cabalín V, Gutierrez-Panchana T. Teleneurorehabilitation program (virtual reality) for patients with balance disorders: descriptive study. BMC Sports Sci Med Rehabil 2021; 13:83. [PMID: 34340687 PMCID: PMC8330090 DOI: 10.1186/s13102-021-00314-z] [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: 03/01/2021] [Accepted: 07/09/2021] [Indexed: 11/24/2022]
Abstract
Background Balance disorders are common in patients with neurological or vestibular diseases. Telerehabilitation program is a treatment to be as safe as conventional treatment. One of the most used methods to perform telerehabilitation is the incorporation of Virtual Reality. In general, rehabilitation programs train predictive postural control, so the patient does not always acquire the necessary autonomy to react to situations of instability. On the other hand, the objective and systematic supervision and measurement of these programs is limited, making it necessary to create clinical protocols with precise and measurable rehabilitation objectives. This study present the training selection methodology and clinical protocol for patients with balance disorders inserted in a Telerehabilitation Program based on Virtual Reality. Methods Descriptive study where physiotherapists were trained to use RehaMetrics®. To evaluate their level of agreement in the selection of the exercise clusters developed, the Interobserver Reliability was measured through the kappa statistic. Subsequently, the exercises were applied to a group of patients recruited with sedentary trunk control (Berg Balance Scale = 3 points in item 3), mild or normal cognitive level (Montreal Cognitive Assessment> 21 points), and prescribed for tele-rehabilitation by a doctor. Results The agreement among the expert physiotherapists irrespective of the cluster exceeds 80%, which indicates a very good strength of agreement, while the novices reached a level of agreement of 45%, which suggests a moderate strength of agreement. All clinical outcomes showed statistically significant differences between the median times, as did the Maximum Width Left Side (MWLS) (cm). The average number of minutes of training was 485.81 (SD 246.49 min), and the number of sessions performed during the 4 weeks of intervention was 17 (SD 7.15 sessions). Conclusions This analysis what had excellent interobserver reliability with trained physiotherapists. Regarding the second phase of the study, the results show a statistically significant difference between the initial and final evaluation of the clinical tests, which could result in better performance in aspects such as: balance, gait functionality, meter walked and cognition. Telerehabilitation Program based on Virtual Reality is an excellent alternative to provide continuity of treatment to patients with balance disorders. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-021-00314-z.
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Affiliation(s)
- Marcos Maldonado-Díaz
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile.
| | - Patricia Vargas
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Ricardo Vasquez
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Felipe Gonzalez-Seguel
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Betel Rivero
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Viviane Hidalgo-Cabalín
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
| | - Tania Gutierrez-Panchana
- Clinica Alemana Universidad del Desarrollo, Vitacura 5951. Región Metropolitana, Santiago, Chile
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Brassel S, Power E, Campbell A, Brunner M, Togher L. Recommendations for the Design and Implementation of Virtual Reality for Acquired Brain Injury Rehabilitation: Systematic Review. J Med Internet Res 2021; 23:e26344. [PMID: 34328434 PMCID: PMC8367177 DOI: 10.2196/26344] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/25/2021] [Accepted: 05/24/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Virtual reality (VR) is increasingly being used for the assessment and treatment of impairments arising from acquired brain injuries (ABIs) due to perceived benefits over traditional methods. However, no tailored options exist for the design and implementation of VR for ABI rehabilitation and, more specifically, traumatic brain injury (TBI) rehabilitation. In addition, the evidence base lacks systematic reviews of immersive VR use for TBI rehabilitation. Recommendations for this population are important because of the many complex and diverse impairments that individuals can experience. OBJECTIVE This study aims to conduct a two-part systematic review to identify and synthesize existing recommendations for designing and implementing therapeutic VR for ABI rehabilitation, including TBI, and to identify current evidence for using immersive VR for TBI assessment and treatment and to map the degree to which this literature includes recommendations for VR design and implementation. METHODS This review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A comprehensive search of 11 databases and gray literature was conducted in August 2019 and repeated in June 2020. Studies were included if they met relevant search terms, were peer-reviewed, were written in English, and were published between 2009 and 2020. Studies were reviewed to determine the level of evidence and methodological quality. For the first part, qualitative data were synthesized and categorized via meta-synthesis. For the second part, findings were analyzed and synthesized descriptively owing to the heterogeneity of data extracted from the included studies. RESULTS In the first part, a total of 14 papers met the inclusion criteria. Recommendations for VR design and implementation were not specific to TBI but rather to stroke or ABI rehabilitation more broadly. The synthesis and analysis of data resulted in three key phases and nine categories of recommendations for designing and implementing VR for ABI rehabilitation. In the second part, 5 studies met the inclusion criteria. A total of 2 studies reported on VR for assessment and three for treatment. Studies were varied in terms of therapeutic targets, VR tasks, and outcome measures. VR was used to assess or treat impairments in cognition, balance, and anxiety, with positive outcomes. However, the levels of evidence, methodological quality, and inclusion of recommendations for VR design and implementation were poor. CONCLUSIONS There is limited research on the use of immersive VR for TBI rehabilitation. Few studies have been conducted, and there is limited inclusion of recommendations for therapeutic VR design and implementation. Future research in ABI rehabilitation should consider a stepwise approach to VR development, from early co-design studies with end users to larger controlled trials. A list of recommendations is offered to provide guidance and a more consistent model to advance clinical research in this area.
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Affiliation(s)
- Sophie Brassel
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Andrew Campbell
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melissa Brunner
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Aulisio MC, Han DY, Glueck AC. Virtual reality gaming as a neurorehabilitation tool for brain injuries in adults: A systematic review. Brain Inj 2020; 34:1322-1330. [PMID: 32791020 DOI: 10.1080/02699052.2020.1802779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Evidence of the effectiveness of virtual reality (VR) in motor and cognitive rehabilitation for traumatic brain injury (TBI) continues to be mixed. Therefore, we conducted a systematic literature review in accordance with PRISMA guidelines to strategically evaluate the strength of evidence supporting the use of VR as a rehabilitation tool for motor function and cognition in patients with TBI. METHOD The van Tulder criteria were modified to determine the quality of the outcomes of studies deemed eligible for inclusion in the review. OUTCOMES AND RESULTS Twelve studies were considered eligible for inclusion in the systematic review. These studies utilized methods of varying quality such as case and quasi-experimental studies and found moderately positive support for the effectiveness of VR-enhanced rehabilitation for both motor skills and cognitive deficits. CONCLUSIONS AND IMPLICATIONS The varying quality of the included studies provides moderate support for use of VR-enhanced rehabilitation techniques per the van Tulder criteria. This highlights the continued gap in the literature for robust studies that enable providers, policy makers, and the public to draw conclusions about the effectiveness of VR-enhanced rehabilitation for traumatic brain injury. Continued pursuit of analyses in the context of newer immersive VR-enhanced rehabilitation is recommended.
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Affiliation(s)
- Madeline C Aulisio
- Department of Health Management and Policy, College of Public Health , Lexington, KY, USA
| | - Dong Y Han
- Department of Neurology, College of Medicine , Lexington, KY, USA
| | - Amanda C Glueck
- Department of Neurology, College of Medicine , Lexington, KY, USA
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Rogers JM, Duckworth J, Middleton S, Steenbergen B, Wilson PH. Elements virtual rehabilitation improves motor, cognitive, and functional outcomes in adult stroke: evidence from a randomized controlled pilot study. J Neuroeng Rehabil 2019; 16:56. [PMID: 31092252 PMCID: PMC6518680 DOI: 10.1186/s12984-019-0531-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/03/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Virtual reality technologies show potential as effective rehabilitation tools following neuro-trauma. In particular, the Elements system, involving customized surface computing and tangible interfaces, produces strong treatment effects for upper-limb and cognitive function following traumatic brain injury. The present study evaluated the efficacy of Elements as a virtual rehabilitation approach for stroke survivors. METHODS Twenty-one adults (42-94 years old) with sub-acute stroke were randomized to four weeks of Elements virtual rehabilitation (three weekly 30-40 min sessions) combined with treatment as usual (conventional occupational and physiotherapy) or to treatment as usual alone. Upper-limb skill (Box and Blocks Test), cognition (Montreal Cognitive Assessment and selected CogState subtests), and everyday participation (Neurobehavioral Functioning Inventory) were examined before and after inpatient training, and one-month later. RESULTS Effect sizes for the experimental group (d = 1.05-2.51) were larger compared with controls (d = 0.11-0.86), with Elements training showing statistically greater improvements in motor function of the most affected hand (p = 0.008), and general intellectual status and executive function (p ≤ 0.001). Proportional recovery was two- to three-fold greater than control participants, with superior transfer to everyday motor, cognitive, and communication behaviors. All gains were maintained at follow-up. CONCLUSION A course of Elements virtual rehabilitation using goal-directed and exploratory upper-limb movement tasks facilitates both motor and cognitive recovery after stroke. The magnitude of training effects, maintenance of gains at follow-up, and generalization to daily activities provide compelling preliminary evidence of the power of virtual rehabilitation when applied in a targeted and principled manner. TRIAL REGISTRATION this pilot study was not registered.
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Affiliation(s)
- Jeffrey M Rogers
- The University of Sydney, Faculty of Health Sciences, Sydney, NSW, Australia.
| | | | - Sandy Middleton
- Nursing Research Institute, St Vincent's Health Australia and Australian Catholic University, Sydney, NSW, Australia
| | - Bert Steenbergen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Peter H Wilson
- Centre for Disability and Development Research (CeDDR) and School of Behavioural and Health Science, Australian Catholic University, Melbourne, VIC, Australia
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Aminov A, Rogers JM, Middleton S, Caeyenberghs K, Wilson PH. What do randomized controlled trials say about virtual rehabilitation in stroke? A systematic literature review and meta-analysis of upper-limb and cognitive outcomes. J Neuroeng Rehabil 2018; 15:29. [PMID: 29587853 PMCID: PMC5870176 DOI: 10.1186/s12984-018-0370-2] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 03/11/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Virtual-reality based rehabilitation (VR) shows potential as an engaging and effective way to improve upper-limb function and cognitive abilities following a stroke. However, an updated synthesis of the literature is needed to capture growth in recent research and address gaps in our understanding of factors that may optimize training parameters and treatment effects. METHODS Published randomized controlled trials comparing VR to conventional therapy were retrieved from seven electronic databases. Treatment effects (Hedge's g) were estimated using a random effects model, with motor and functional outcomes between different protocols compared at the Body Structure/Function, Activity, and Participation levels of the International Classification of Functioning. RESULTS Thirty-three studies were identified, including 971 participants (492 VR participants). VR produced small to medium overall effects (g = 0.46; 95% CI: 0.33-0.59, p < 0.01), above and beyond conventional therapies. Small to medium effects were observed on Body Structure/Function (g = 0.41; 95% CI: 0.28-0.55; p < 0.01) and Activity outcomes (g = 0.47; 95% CI: 0.34-0.60, p < 0.01), while Participation outcomes failed to reach significance (g = 0.38; 95% CI: -0.29-1.04, p = 0.27). Superior benefits for Body Structure/Function (g = 0.56) and Activity outcomes (g = 0.62) were observed when examining outcomes only from purpose-designed VR systems. Preliminary results (k = 4) suggested small to medium effects for cognitive outcomes (g = 0.41; 95% CI: 0.28-0.55; p < 0.01). Moderator analysis found no advantage for higher doses of VR, massed practice training schedules, or greater time since injury. CONCLUSION VR can effect significant gains on Body Structure/Function and Activity level outcomes, including improvements in cognitive function, for individuals who have sustained a stroke. The evidence supports the use of VR as an adjunct for stroke rehabilitation, with effectiveness evident for a variety of platforms, training parameters, and stages of recovery.
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Affiliation(s)
- Anna Aminov
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Jeffrey M Rogers
- South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Sandy Middleton
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia
| | - Karen Caeyenberghs
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
- Centre for Disability and Development Research (CeDDR), Australian Catholic University, Melbourne, VIC, Australia
| | - Peter H Wilson
- School of Psychology, Faculty of Health Sciences, Australian Catholic University, Sydney, NSW, Australia.
- School of Psychology, Australian Catholic University, Melbourne, VIC, Australia.
- Centre for Disability and Development Research (CeDDR), Australian Catholic University, Melbourne, VIC, Australia.
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Chiang VCL, Lo KH, Choi KS. Rehabilitation of activities of daily living in virtual environments with intuitive user interface and force feedback. Disabil Rehabil Assist Technol 2016; 12:672-680. [PMID: 27782750 DOI: 10.1080/17483107.2016.1218554] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To investigate the feasibility of using a virtual rehabilitation system with intuitive user interface and force feedback to improve the skills in activities of daily living (ADL). METHOD A virtual training system equipped with haptic devices was developed for the rehabilitation of three ADL tasks - door unlocking, water pouring and meat cutting. Twenty subjects with upper limb disabilities, supervised by two occupational therapists, received a four-session training using the system. The task completion time and the amount of water poured into a virtual glass were recorded. The performance of the three tasks in reality was assessed before and after the virtual training. Feedback of the participants was collected with questionnaires after the study. RESULTS The completion time of the virtual tasks decreased during the training (p < 0.01) while the percentage of water successfully poured increased (p = 0.051). The score of the Borg scale of perceived exertion was 1.05 (SD = 1.85; 95% CI = 0.18-1.92) and that of the task specific feedback questionnaire was 31 (SD = 4.85; 95% CI = 28.66-33.34). The feedback of the therapists suggested a positive rehabilitation effect. The participants had positive perception towards the system. CONCLUSIONS The system can potentially be used as a tool to complement conventional rehabilitation approaches of ADL. Implications for rehabilitation Rehabilitation of activities of daily living can be facilitated using computer-assisted approaches. The existing approaches focus on cognitive training rather than the manual skills. A virtual training system with intuitive user interface and force feedback was designed to improve the learning of the manual skills. The study shows that system could be used as a training tool to complement conventional rehabilitation approaches.
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Affiliation(s)
| | - King-Hung Lo
- b Department of Occupational Therapy , Hong Kong Red Cross Princess Alexandra School , Kowloon , Hong Kong
| | - Kup-Sze Choi
- c Centre for Smart Health, School of Nursing , The Hong Kong Polytechnic University , Kowloon , Hong Kong
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Chang PFJ, Baxter MF, Rissky J. Effectiveness of Interventions Within the Scope of Occupational Therapy Practice to Improve Motor Function of People With Traumatic Brain Injury: A Systematic Review. Am J Occup Ther 2016; 70:7003180020p1-5. [PMID: 27089286 DOI: 10.5014/ajot.2016.020867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
After traumatic brain injury (TBI), many people experience significant motor function impairments. To help occupational therapy practitioners make informed decisions in choosing treatment strategies to improve clients' motor function, we undertook a systematic review and synthesized applicable findings of intervention studies. Of 2,306 articles identified in the literature search, we reviewed 47 full-text articles, of which 16 met approved criteria. We found moderate evidence that various exercise programs increase motor function and limited evidence that people with TBI can benefit from rehabilitation and computer-based programs. We offer implications for practice, education, and research.
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Affiliation(s)
- Pei-Fen J Chang
- Pei-Fen J. Chang, PhD, OTR, is Associate Professor, School of Occupational Therapy, Texas Woman's University, Houston;
| | - Mary Frances Baxter
- Mary Frances Baxter, PhD, OT, FAOTA, is Associate Professor, School of Occupational Therapy, Texas Woman's University, Houston
| | - Jenna Rissky
- Jenna Rissky, MOT, was Graduate Student, Texas Woman's University, Houston, at the time of the study
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Effect of Virtual Reality–Based Rehabilitation on Upper-Extremity Function in Patients with Brain Tumor. Am J Phys Med Rehabil 2015; 94:449-59. [DOI: 10.1097/phm.0000000000000192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Resonance: An Interactive Tabletop Artwork for Co-located Group Rehabilitation and Play. UNIVERSAL ACCESS IN HUMAN-COMPUTER INTERACTION. ACCESS TO LEARNING, HEALTH AND WELL-BEING 2015. [DOI: 10.1007/978-3-319-20684-4_41] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Pietrzak E, Pullman S, McGuire A. Using Virtual Reality and Videogames for Traumatic Brain Injury Rehabilitation: A Structured Literature Review. Games Health J 2014; 3:202-14. [PMID: 26192369 DOI: 10.1089/g4h.2014.0013] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Eva Pietrzak
- Centre for Australian Military and Veterans' Health, School of Population Health, The University of Queensland, Herston, Queensland, Australia
| | - Stephen Pullman
- Centre for Australian Military and Veterans' Health, School of Population Health, The University of Queensland, Herston, Queensland, Australia
| | - Annabel McGuire
- Centre for Australian Military and Veterans' Health, School of Population Health, The University of Queensland, Herston, Queensland, Australia
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Ustinova KI, Perkins J, Leonard WA, Hausbeck CJ. Virtual reality game-based therapy for treatment of postural and co-ordination abnormalities secondary to TBI: a pilot study. Brain Inj 2014; 28:486-95. [PMID: 24702281 DOI: 10.3109/02699052.2014.888593] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE The study objective was to test the efficacy of game-based virtual reality (VR) therapy as a mean of correcting postural and co-ordination abnormalities in individuals with traumatic brain injury (TBI). Therapy was done with interactive customized VR games and scenarios, utilizing an Xbox Kinect sensor. RESEARCH DESIGN The study was a pilot project using the structure of a phase II clinical trial. METHODS AND PROCEDURES Fifteen participants with mild-to-moderate chronic TBI-related balance and motor co-ordination impairments participated in 15 sessions, each lasting ∼50-55 minutes, scheduled 2-3 times a week over 5-6 consecutive weeks. Participants were evaluated at baseline, immediately after the final session and in a 1-month follow-up with a battery of clinical tests (measuring postural stability, gait and co-ordination) and movement performance parameters. Movement parameters included arm-leg co-ordination, dynamic stability and arm precision, calculated from kinematic data recorded with Xbox Kinect sensor. RESULTS Following therapy, most participants improved their static and dynamic postural stability, gait and arm movements. These effects persisted over the retention interval. CONCLUSIONS Results will be used to improve the VR program, with the goal of producing a cost-effective, accessible and easy to individualize therapeutic approach. The pilot data will be used for designing a larger scale clinical trial.
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Affiliation(s)
- K I Ustinova
- The Herbert H. and Grace A. Dow College of Health Professions, Central Michigan University , MI , USA and
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Kozlowski DA, Leasure JL, Schallert T. The Control of Movement Following Traumatic Brain Injury. Compr Physiol 2013; 3:121-39. [DOI: 10.1002/cphy.c110005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Atwa A, Money AG, Spiliotopoulou G, Mcintyre A. Occupational therapists' perceptions about the clinical utility of the 3D interior design software. Disabil Rehabil Assist Technol 2012; 8:348-55. [PMID: 22992195 DOI: 10.3109/17483107.2012.713437] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The 3D interior design software (3DIDS) is a technology, which primarily allows users to simulate their homes and visualize any changes prior to implementing them. This feasibility study aimed to examine occupational therapists' perceptions about the clinical utility of the 3DIDS. A secondary aim was to explore the attitudes of occupational therapists towards technology in general. METHOD Three focus groups were conducted with 25 occupational therapists working with older people in the UK. The qualitative data were analysed using inductive thematic analysis. RESULTS The three main themes that were identified were usage and attitudes of technology, opportunities for realistic application of the 3DIDS and related threats and benefits for the occupational therapy profession. Occupational therapists had a positive attitude towards technology. They suggested that the 3DIDS could be used in discharge planning and in rehabilitation. They viewed it as a tool that could enhance their status within the health care profession and improve communication, but not as a tool that should replace the role of the occupational therapist. CONCLUSIONS This research offers new and important findings about the utilization of the 3DIDS by occupational therapists and provides information as to where this technology should be trialled.
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Affiliation(s)
- Anita Atwa
- School of Health Sciences and Social Care at Brunel University, Uxbridge, Middlesex UB8 3PH, UK.
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