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Anderson A, Stankovic A, Cowan D, Fellows A, Buckey J. Natural Scene Virtual Reality as a Behavioral Health Countermeasure in Isolated, Confined, and Extreme Environments: Three Isolated, Confined, Extreme Analog Case Studies. Hum Factors 2023; 65:1266-1278. [PMID: 35604867 DOI: 10.1177/00187208221100693] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Isolated, confined, extreme (ICE) environments are accompanied by a host of stress-inducing circumstances: operational pressure, interpersonal dynamics, limited communication with friends and family, and environmental hazards. We evaluated the effectiveness of attention-restoration-therapy-based immersive Virtual Reality (VR) in three ICE environments: the Canadian Forces Station-Alert (CFS Alert), the 12-month HI-SEAS IV expedition, and the 8-month HI-SEAS V expedition. METHODS Thirty-one individuals (29 male, 2 female) at CFS Alert, and 12 total crewmembers (7 male, 5 female, six crewmembers per sessions) at HI-SEAS participated. All participants viewed immersive VR scenes, but scene content varied by deployment. Data collection included pre- and post-intervention surveys and semi-structured post-mission interviews. Survey data were analyzed by scene content within each analog using nonparametric approaches. RESULTS Acceptability and desirability of the VR content varied significantly by ICE analog, as well as by participants within a given analog. The two initial exploratory protocols enabled a more directed study in HI-SEAS V to identify the importance of differences in scene content. DISCUSSION Use and perceived utility of the VR varied considerably across participants, indicating that psychological support needs to be individualized. Overall, natural scene VR was broadly considered restorative, but after long periods of isolation, dynamic and familiar scenes including those with people were also appealing. Immersive, nature-based VR was highly valued by some, but not all participants, suggesting that this intervention tool holds promise for use in ICE settings but needs to be tailored to the setting and individual.
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Affiliation(s)
| | | | - Devin Cowan
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | | | - Jay Buckey
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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Mondal S, Kelkar AS, Singh R, Jayadev C, Saravanan VR, Kelkar JA. What do retina fellows-in-training think about the vitreoretinal surgical simulator: A multicenter survey. Indian J Ophthalmol 2023; 71:3064-3068. [PMID: 37530282 PMCID: PMC10538810 DOI: 10.4103/ijo.ijo_381_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023] Open
Abstract
Purpose To profile vitreoretinal (VR) fellows-in-training from India exposed to the Eyesi surgical simulator, to identify potential barriers to voluntary use, and enumerate the most preferred tools and tasks before incorporating them into a formal skill-transfer curriculum. Methods A questionnaire consisting of 22 questions was designed and circulated through an online portal (surveymonkey.com) to four different institutes of India having a VR surgical fellowship program and using a functional Eyesi (Haag-Streit) simulator. All fellows and trainees who were exposed to the simulator were eligible to participate, irrespective of time spent on the simulator and exposure to training steps on real patients. The responses collected were private and anonymous. Results Of the 37 respondents, most (n = 25, 68%) considered surgical simulators to be the best training tool before operating on the human eye. A majority (n = 35, 94.5%) of participants spent <3 h per week on the simulator, which, most (n = 30, 81%) felt was not enough time. The main reasons for this underutilization were work-hour limitations (54.8%), lack of a structured training program (19.3%), or a dedicated supervisor (16.1%). Again, the majority (n = 33, 89%) of participants responded that VR surgical skills acquired during simulator training were transferrable to the operating room, which was reflected by their response (n = 31, 83.7%) that simulator-based training should be made mandatory before operating room exposure. Conclusion This study gives an insight into the overall practice patterns and preferences in simulation training of surgical VR fellows-in-training across India. It indicates that the simulator is extremely helpful to fellows and if adopted, VR surgical simulators with organized, directed, and supervised sessions will considerably improve the surgical training experience.
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Affiliation(s)
- Sukanya Mondal
- National Institute of Ophthalmology, Pune, Maharashtra, India
| | - Aditya S Kelkar
- National Institute of Ophthalmology, Pune, Maharashtra, India
| | - Ramandeep Singh
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Chaitra Jayadev
- Narayana Nethralaya Eye Institute, Bengaluru, Karnataka, India
| | | | - Jai A Kelkar
- National Institute of Ophthalmology, Pune, Maharashtra, India
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Toader AC, Regalado JM, Li YR, Terceros A, Yadav N, Kumar S, Satow S, Hollunder F, Bonito-Oliva A, Rajasethupathy P. Anteromedial thalamus gates the selection and stabilization of long-term memories. Cell 2023; 186:1369-1381.e17. [PMID: 37001501 PMCID: PMC10169089 DOI: 10.1016/j.cell.2023.02.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/16/2022] [Accepted: 02/16/2023] [Indexed: 04/03/2023]
Abstract
Memories initially formed in hippocampus gradually stabilize to cortex over weeks-to-months for long-term storage. The mechanistic details of this brain re-organization remain poorly understood. We recorded bulk neural activity in circuits that link hippocampus and cortex as mice performed a memory-guided virtual-reality task over weeks. We identified a prominent and sustained neural correlate of memory in anterior thalamus, whose inhibition substantially disrupted memory consolidation. More strikingly, gain amplification enhanced consolidation of otherwise unconsolidated memories. To gain mechanistic insights, we developed a technology for simultaneous cellular-resolution imaging of hippocampus, thalamus, and cortex throughout consolidation. We found that whereas hippocampus equally encodes multiple memories, the anteromedial thalamus preferentially encodes salient memories, and gradually increases correlations with cortex to facilitate tuning and synchronization of cortical ensembles. We thus identify a thalamo-cortical circuit that gates memory consolidation and propose a mechanism suitable for the selection and stabilization of hippocampal memories into longer-term cortical storage.
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Affiliation(s)
- Andrew C Toader
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Josue M Regalado
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Yan Ran Li
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Andrea Terceros
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Nakul Yadav
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Suraj Kumar
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Sloane Satow
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Florian Hollunder
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Alessandra Bonito-Oliva
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA
| | - Priya Rajasethupathy
- Laboratory of Neural Dynamics & Cognition, The Rockefeller University, New York, NY 10065, USA.
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Michela A, van Peer JM, Brammer JC, Nies A, van Rooij MMJW, Oostenveld R, Dorrestijn W, Smit AS, Roelofs K, Klumpers F, Granic I. Deep-Breathing Biofeedback Trainability in a Virtual-Reality Action Game: A Single-Case Design Study With Police Trainers. Front Psychol 2022; 13:806163. [PMID: 35222194 PMCID: PMC8868154 DOI: 10.3389/fpsyg.2022.806163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Abstract
It is widely recognized that police performance may be hindered by psychophysiological state changes during acute stress. To address the need for awareness and control of these physiological changes, police academies in many countries have implemented Heart-Rate Variability (HRV) biofeedback training. Despite these trainings now being widely delivered in classroom setups, they typically lack the arousing action context needed for successful transfer to the operational field, where officers must apply learned skills, particularly when stress levels rise. The study presented here aimed to address this gap by training physiological control skills in an arousing decision-making context. We developed a Virtual-Reality (VR) breathing-based biofeedback training in which police officers perform deep and slow diaphragmatic breathing in an engaging game-like action context. This VR game consisted of a selective shoot/don’t shoot game designed to assess response inhibition, an impaired capacity in high arousal situations. Biofeedback was provided based on adherence to a slow breathing pace: the slower and deeper the breathing, the less constrained peripheral vision became, facilitating accurate responses to the in-game demands. A total of nine male police trainers completed 10 sessions over a 4-week period as part of a single-case experimental ABAB study-design (i.e., alternating sessions with and without biofeedback). Results showed that eight out of nine participants showed improved breathing control in action, with a positive effect on breathing-induced low frequency HRV, while also improving their in-game behavioral performance. Critically, the breathing-based skill learning transferred to subsequent sessions in which biofeedback was not presented. Importantly, all participants remained highly engaged throughout the training. Altogether, our study showed that our VR environment can be used to train breathing regulation in an arousing and active decision-making context.
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Affiliation(s)
- Abele Michela
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | | | - Jan C Brammer
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Anique Nies
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Marieke M J W van Rooij
- Faculty of Behavioral, Management and Social Sciences, University of Twente, Twente, Netherlands
| | - Robert Oostenveld
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.,NatMEG, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | | | - Annika S Smit
- Police Academy of the Netherlands, Apeldoorn, Netherlands.,Humanism and Social Resilience, University of Humanistic Studies, Utrecht, Netherlands
| | - Karin Roelofs
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Floris Klumpers
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
| | - Isabela Granic
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands.,Faculty of Social Sciences, McMaster University, Hamilton, ON, Canada
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Daibert-Nido M, Pyatova Y, Cheung K, Nayomi C, Markowitz SN, Bouffet E, Reber M. Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness. Front Neurol 2021; 12:680211. [PMID: 34354660 PMCID: PMC8333276 DOI: 10.3389/fneur.2021.680211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background/Objectives: Visual field loss is frequent in patients with brain tumors, worsening their daily life and exacerbating the burden of disease, and no supportive care strategies exist. In this case series, we sought to characterize the feasibility and potential effectiveness of a home-based visual rehabilitation program in hemianopia patients using immersive virtual-reality stimulation. Subjects/Methods: Two patients, one with homonymous hemianopia and the other with bitemporal hemianopia, consecutive to pediatric brain tumors, with no prior visual rehabilitation performed 15 min of home-based audiovisual stimulation every 2 days for 6 weeks (case 2) and 7 weeks (case 1) between February and August 2020. Patients used a virtual-reality, stand-alone, and remotely controlled device loaded with a non-commercial audiovisual stimulation program managed in real time from the laboratory. Standard visual outcomes assessed in usual care in visual rehabilitation were measured at the clinic. Following a mixed method approach in this pragmatic study of two cases, we collected quantitative and qualitative data on feasibility and potential effectiveness and compared the results pre- and post-treatment. Results: Implementation and wireless delivery of the audiovisual stimulation, remote data collection, and analysis for cases 1 and 2 who completed 19/20 and 20/20 audiovisual stimulation sessions at home, respectively, altogether indicated feasibility. Contrast sensitivity increased in both eyes for cases 1 and 2. Visual fields, measured by binocular Esterman and monocular Humphrey full-field analyses, improved in case 1. A minor increase was observed in case 2. Cases 1 and 2 enhanced reading speed. Case 2 strongly improved quality of life scores. Conclusion: This is the first report of a home-based virtual-reality visual rehabilitation program for adult patients with hemianopia consecutive to a pediatric brain tumor. We show the feasibility in real-world conditions and potential effectiveness of such technology on visual perception and quality of life.
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Affiliation(s)
- Monica Daibert-Nido
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Yulia Pyatova
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Kyle Cheung
- Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Camilus Nayomi
- Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Samuel N Markowitz
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada
| | - Eric Bouffet
- Division of Hematology/Oncology, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michael Reber
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada.,Donald K. Johnson Eye Institute, Krembil Research Institute, University Health Network, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, Cell and System Biology, University of Toronto, Toronto, ON, Canada
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Lowry E, Puthusseryppady V, Coughlan G, Jeffs S, Hornberger M. Path Integration Changes as a Cognitive Marker for Vascular Cognitive Impairment?-A Pilot Study. Front Hum Neurosci 2020; 14:131. [PMID: 32372934 PMCID: PMC7186341 DOI: 10.3389/fnhum.2020.00131] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
Path integration spatial navigation processes are emerging as promising cognitive markers for prodromal and clinical Alzheimer’s disease (AD). However, such path integration changes have been less explored in Vascular Cognitive Impairment (VCI), despite neurovascular change being a major contributing factor to dementia and potentially AD. In particular, the sensitivity and specificity of path integration impairments in VCI compared to AD is unclear. In the current pilot study, we explore path integration performance in early-stage AD and VCI patient groups and hypothesize that: (i) medial parietal mediated egocentric processes will be more affected in VCI; and (ii) medial temporal mediated allocentric processes will be more affected in AD. This cross-sectional study included early-stage VCI patients (n = 9), AD patients (n = 10) and healthy age-matched controls (n = 20). All participants underwent extensive neuropsychological testing, as well as spatial navigation testing. The spatial navigation tests included the virtual reality “Supermarket” task assessing egocentric (body-based) and allocentric (map-based) navigation as well as the “Clock Orientation” test assessing egocentric and path integration processes. Results showed that egocentric integration processes are only impaired in VCI, potentially distinguishing it from AD. However, in contrast to our prediction, allocentric integration was not more impaired in AD compared to VCI. These preliminary findings suggest limited specificity of allocentric integration deficits between VCI and AD. By contrast, egocentric path integration deficits emerge as more specific to VCI, potentially allowing for more specific diagnostic and treatment outcome measures for vascular impairment in dementia.
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Affiliation(s)
- Ellen Lowry
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom.,School of Psychology, University of East Anglia, Norwich, United Kingdom
| | | | - Gillian Coughlan
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Stephen Jeffs
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Michael Hornberger
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Vourvopoulos A, Jorge C, Abreu R, Figueiredo P, Fernandes JC, Bermúdez I Badia S. Efficacy and Brain Imaging Correlates of an Immersive Motor Imagery BCI-Driven VR System for Upper Limb Motor Rehabilitation: A Clinical Case Report. Front Hum Neurosci 2019; 13:244. [PMID: 31354460 PMCID: PMC6637378 DOI: 10.3389/fnhum.2019.00244] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/28/2019] [Indexed: 11/13/2022] Open
Abstract
To maximize brain plasticity after stroke, a plethora of rehabilitation strategies have been explored. These include the use of intensive motor training, motor-imagery (MI), and action-observation (AO). Growing evidence of the positive impact of virtual reality (VR) techniques on recovery following stroke has been shown. However, most VR tools are designed to exploit active movement, and hence patients with low level of motor control cannot fully benefit from them. Consequently, the idea of directly training the central nervous system has been promoted by utilizing MI with electroencephalography (EEG)-based brain-computer interfaces (BCIs). To date, detailed information on which VR strategies lead to successful functional recovery is still largely missing and very little is known on how to optimally integrate EEG-based BCIs and VR paradigms for stroke rehabilitation. The purpose of this study was to examine the efficacy of an EEG-based BCI-VR system using a MI paradigm for post-stroke upper limb rehabilitation on functional assessments, and related changes in MI ability and brain imaging. To achieve this, a 60 years old male chronic stroke patient was recruited. The patient underwent a 3-week intervention in a clinical environment, resulting in 10 BCI-VR training sessions. The patient was assessed before and after intervention, as well as on a one-month follow-up, in terms of clinical scales and brain imaging using functional MRI (fMRI). Consistent with prior research, we found important improvements in upper extremity scores (Fugl-Meyer) and identified increases in brain activation measured by fMRI that suggest neuroplastic changes in brain motor networks. This study expands on the current body of evidence, as more data are needed on the effect of this type of interventions not only on functional improvement but also on the effect of the intervention on plasticity through brain imaging.
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Affiliation(s)
- Athanasios Vourvopoulos
- Neural Plasticity and Neurorehabilitation Laboratory, University of Southern California, Los Angeles, CA, United States
| | - Carolina Jorge
- Madeira Interactive Technologies Institute, Universidade da Madeira, Funchal, Portugal
| | - Rodolfo Abreu
- Institute for Systems and Robotics, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Patrícia Figueiredo
- Institute for Systems and Robotics, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Jean-Claude Fernandes
- Central Hospital of Funchal, Physical Medicine and Rehabilitation Service, Funchal, Portugal
| | - Sergi Bermúdez I Badia
- Madeira Interactive Technologies Institute, Universidade da Madeira, Funchal, Portugal.,Faculdade de Ciências Exatas e da Engenharia, Universidade da Madeira, Funchal, Portugal
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Østergaard ML, Konge L, Kahr N, Albrecht-Beste E, Nielsen MB, Nielsen KR. Four Virtual-Reality Simulators for Diagnostic Abdominal Ultrasound Training in Radiology. Diagnostics (Basel) 2019; 9:diagnostics9020050. [PMID: 31064080 PMCID: PMC6627565 DOI: 10.3390/diagnostics9020050] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 04/27/2019] [Accepted: 05/01/2019] [Indexed: 12/04/2022] Open
Abstract
Ultrasound exams need skilled examiners, and simulation-based training could provide standardized and safe skill training. This study aims to give an overview of different types of virtual-reality simulators for use in abdominal diagnostic ultrasound training in radiology. Fifteen specialized radiologists and radiological residents were presented with two similar cases on four different simulators for abdominal ultrasound training. A feedback sheet for each individual simulator and for an overall comparison was filled out by all participants. All means of scores were compared, and simulators were ranked from least to most favorable. One simulator was ranked most favorable in seven out of nine questions, but none of the mean scores had statistically significant differences. All simulators were recommended for training radiologists, and all simulators were perceived to benefit trainees more than experienced ultra-sonographers.
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Affiliation(s)
| | - Lars Konge
- Copenhagen Academy for Medical Education and Simulation, 2100 Copenhagen, Denmark.
| | - Niklas Kahr
- Department of Radiology, Rigshospitalet, 2100 Copenhagen, Denmark.
| | - Elisabeth Albrecht-Beste
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, 2100 Copenhagen, Denmark.
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Kizony R, Weiss PL, Harel S, Feldman Y, Obuhov A, Zeilig G, Shani M. Tele-rehabilitation service delivery journey from prototype to robust in-home use. Disabil Rehabil 2016; 39:1532-1540. [PMID: 28004980 DOI: 10.1080/09638288.2016.1250827] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to present a retrospective study on clients with Acquired Brain Injury (ABI) enrolled in a tele-motion-rehabilitation service program for two or more months. METHODS Data from 82 clients (46 males; 74 with ABI), aged 22-85 years, are reported. The Kinect-based CogniMotion System (ReAbility Online, Gertner Institute, Tel Hashomer, Israel) provided services that included 30-min biweekly sessions. Participants were evaluated prior to and 2 months following the commencement of service with clinical assessments that measured movements and function of the weaker upper extremity and cognitive abilities. RESULTS Clients enrolled in the service had intact or mild cognitive impairment, mild-moderate motor impairment but little use of their weak upper extremity for daily activities. They were satisfied with the service and reported high levels of system usability. Post-intervention clinical assessments were performed on about half of the participants after 2 months; significant improvements in active movements of the weak upper extremity, shoulder flexion range of motion and in the Trail Making Test were found (p < 0.05). CONCLUSIONS The service appears to be feasible for people with ABI and effective in important clinical outcomes related to improvements in upper extremity function. Implications for Rehabilitation Tele-rehabilitation provided with Microsoft Kinect 3D sensor virtual reality tracking system is feasible for people with Acquired Brain Injury. People with Acquired Brain Injury in the chronic stage were satisfied with the tele-rehabilitation service and perceived it as beneficial to improve their motor and cognitive abilities The CogniMotion System service appears to be effective in important clinical outcomes related to improvements in upper extremity function.
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Affiliation(s)
- Rachel Kizony
- a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.,b Center of Advanced Technologies in Rehabilitation , Sheba Medical Center , Tel Hashomer , Israel.,c Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel
| | - Patrice L Weiss
- a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel.,c Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences , University of Haifa , Haifa , Israel
| | - Sharon Harel
- a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Yoram Feldman
- a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
| | - Alexei Obuhov
- d Neurological Rehabilitation Department, Sheba Medical Center , Tel Hashomer , Israel
| | - Gabi Zeilig
- d Neurological Rehabilitation Department, Sheba Medical Center , Tel Hashomer , Israel.,e Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| | - Mordechai Shani
- a ReAbility Online, Gertner Institute for Epidemiology and Health Policy Research , Tel Hashomer , Israel
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Samuel GS, Oey NE, Choo M, Ju H, Chan WY, Kok S, Ge Y, Van Dongen AM, Ng YS. Combining levodopa and virtual reality-based therapy for rehabilitation of the upper limb after acute stroke: pilot study Part II. Singapore Med J 2016; 58:610-617. [PMID: 27311739 DOI: 10.11622/smedj.2016111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study aimed to evaluate the safety and efficacy of a combination of levodopa and virtual reality (VR)-based therapy for the enhancement of upper limb recovery following acute stroke. METHODS This was a pilot single-blinded case series of acute stroke patients with upper extremity hemiparesis. Patients were randomised to standard care with concomitant administration of either levodopa alone (control group) or combination therapy consisting of VR-based motivational visuomotor feedback training with levodopa neuromodulation (VR group). Main clinical outcome measures were the Fugl-Meyer Upper Extremity (FM-UE) assessment and Action Research Arm Test (ARAT). Kinematic measurements of affected upper limb movement were evaluated as a secondary measure of improvement. RESULTS Of 42 patients screened, four patients were enrolled in each of the two groups. Two patients dropped out from the control group during the trial. Patients receiving combination therapy had clinically significant improvements in FM-UE assessment scores of 16.5 points compared to a 3.0-point improvement among control patients. Similarly, ARAT scores of VR group patients improved by 15.3 points compared to a 10.0-point improvement in the control group. Corresponding improvements were noted in kinematic measures, including hand-path ratio, demonstrating that the quality of upper limb movement improved in the VR group. CONCLUSION Our results suggest that VR-based therapy and pharmacotherapy may be combined for acute stroke rehabilitation. Bedside acquisition of kinematic measurements allows accurate assessment of the quality of limb movement, offering a sensitive clinical tool for quantifying motor recovery during the rehabilitation process after acute stroke.
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Affiliation(s)
| | | | - Min Choo
- Duke-NUS Medical School, Singapore
| | - Han Ju
- Duke-NUS Medical School, Singapore
| | - Wai Yin Chan
- Department of Occupational Therapy, Singapore General Hospital, Singapore
| | - Stanley Kok
- Pillar of Information Systems Technology and Design, Singapore University of Technology and Design, Singapore
| | - Yu Ge
- A*STAR Institute for Infocomm Research, Singapore
| | | | - Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Singapore
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Abstract
Stroke is one of leading cause of death and disability worldwide. Early detection during golden hour and treatment of individual neurological dysfunction in stroke using easy-to-access biomarkers based on a simple-to-use, cost-effective, clinically-valid screening tool can bring a paradigm shift in healthcare, both urban and rural. In our research we have designed a quantitative automatic home-based oculomotor assessment tool that can play an important complementary role in prognosis of neurological disorders like stroke for the neurologist. Once the patient has been screened for stroke, the next step is to design proper rehabilitation platform to alleviate the disability. In addition to the screening platform, in our research, we work in designing virtual reality based rehabilitation exercise platform that has the potential to deliver visual stimulation and in turn contribute to improving one's performance.
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Affiliation(s)
- Deepesh Kumar
- Electrical Engineering, Indian Institute of Technology Gandhinagar , India
| | - Anirban Dutta
- Leibniz Research Center for Working Environment and Human Factors , TU Dortmund, Germany
| | - Abhijit Das
- Department of Neurorehabilitation, AMRI Institute of Neurosciences , Kolkata, India
| | - Uttama Lahiri
- Electrical Engineering, Indian Institute of Technology Gandhinagar , India
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Lahiri U, Bekele E, Dohrmann E, Warren Z, Sarkar N. A physiologically informed virtual reality based social communication system for individuals with autism. J Autism Dev Disord 2015; 45:919-31. [PMID: 25261247 PMCID: PMC4369156 DOI: 10.1007/s10803-014-2240-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Clinical applications of advanced technology may hold promise for addressing impairments associated with autism spectrum disorders (ASD). This project evaluated the application of a novel physiologically responsive virtual reality based technological system for conversation skills in a group of adolescents with ASD. The system altered components of conversation based on (1) performance alone or (2) the composite effect of performance and physiological metrics of predicted engagement (e.g., gaze pattern, pupil dilation, blink rate). Participants showed improved performance and looking pattern within the physiologically sensitive system as compared to the performance based system. This suggests that physiologically informed technologies may have the potential of being an effective tool in the hands of interventionists.
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Affiliation(s)
- Uttama Lahiri
- Electrical Engineering, Indian Institute of Technology, Gandhinagar, India,
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