Archive for category Virtual Reality

[Abstract + References] Virtual fine rehabilitation in patients with carpal tunnel syndrome using low-cost devices

Carpal tunnel syndrome (CTS) happens when there is a compression of the median nerve between the forearm and the hand. This disorder causes an influence on basic and instrumental Activities of Daily Living. The motor disruptions are muscle weakness, tingling, and heaviness in the hand. The main disorder which subjects suffer with CTS is pain. To alleviate or mitigate pain in CTS, there are different techniques such as pharmacologic treatments, splints to immobilize the wrist, surgery, and physical therapy. Novel and customizable low-cost devices together with Virtual Environments are a good complement in rehabilitation sessions for this syndrome. The aim of this present study is to test a novel system, Virtual Rehabilitation Carpal Tunnel (VRCT), in patients with CTS. For this purpose, we have tested our system with four CTS patients (experimental group). At the same time, four CTS patients were tested using traditional rehabilitation. Phalen and Tinel test were used to analyze the results. The results obtained showed greater improvement in the experimental group during the intervention period. Future research will be focused on the analysis of the follow-up period.

References

Note: OCR errors may be found in this Reference List extracted from the full text article. ACM has opted to expose the complete List rather than only correct and linked references.

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Kostopoulos D. Treatment of carpal tunnel syndrome: a review of the non-surgical approaches with emphasis in neural mobilization. J Bodyw Mov Ther 2004; 8:2–8.  [doi>10.1016/S1360-8592(03)00068-8]
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Heuser A, Kourtev H, Winter S, Fensterheim D, Burdea G, Hentz V, Forducey P. Telerehabilitation using the Rutgers Master II glove following carpal tunnel release surgery: proof-of-concept. IEEE Trans Neural Syst Rehabil Eng. 2007Mar;15(1):43–9.  [doi>10.1109/TNSRE.2007.891393]
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Thiese MS, Gerr F, Hegmann KT, Harris-Adamson C, Dale AM, Evanoff B, Eisen EA, Kapellusch J, Garg A, Burt S, Bao S, Silverstein B, Merlino L, Rempel D. Effects of varying case definition on carpal tunnel syndrome prevalence estimates in a pooled cohort. Arch Phys Med Rehabil. 2014 Dec;95(12):2320–6.  [doi>10.1016/j.apmr.2014.08.004]
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Castro, A. do A. e, Skare, TL, Nassif PAN, Sakuma AK, Barros WH Sonographic diagnosis of carpal tunnel syndrome: a study in 200 hospital workers. Radiologia Brasileira. 2015;48(5), 287–291.  [doi>10.1590/0100-3984.2014.0069]
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Alfonso C, Jann S, Massa R, Torreggiani A. Diagnosis, treatment and follow-up of the carpal tunnel syndrome: a review. Neurol Sci. 2010 Jun;31(3):243–52.  [doi>10.1007/s10072-009-0213-9]
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Newington L, Harris EC,Walker-Bone K. Carpal tunnel syndrome and work. Best Practice & Research. Clinical Rheumatology. 2015; 29(3), 440–453.  [doi>10.1016/j.berh.2015.04.026]
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Fu T, Cao M, Liu F, Zhu J, Ye D, Feng X, Xu Y, Wang G, Bai Y. Carpal tunnel syndrome assessment with ultrasonography: value of inlet-to-outlet median nerve area ratio in patients versus healthy volunteers. PLoS One. 2015 Jan 24;10(1):e0116777.  [doi>10.1371/journal.pone.0116777]
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Phalen GS.The carpal-tunnel syndrome. Seventeen years’ experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg Am 1966; 48: 2112228.  [doi>10.2106/00004623-196648020-00001]
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Madenci E, Altindag O, Koca I, Yilmaz M, Gur A. Reliability and efficacy of the new massage technique on the treatment in the patients with carpal tunnel syndrome. Rheumatol Int. 2012 Oct;32(10):3171–9.  [doi>10.1007/s00296-011-2149-7]
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Fernández-de-Las Peñas C, Ortega-Santiago R, de la Llave-Rincón AI, Martínez-Perez A, Fahandezh-Saddi Díaz H, Martínez-Martín J, Pareja JA, Cuadrado-Pérez ML. Manual Physical Therapy Versus Surgery for Carpal Tunnel Syndrome: A Randomized Parallel-Group Trial. J Pain. 2015 Nov;16(11):1087–94.  [doi>10.1016/j.jpain.2015.07.012]
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Johansson BB. Multisensory stimulation in stroke rehabilitation. Front Hum Neurosci. 2012 Apr 9;6:60.  [doi>10.3389/fnhum.2012.00060]
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Brunner I, Skouen JS, Hofstad H, Strand LI, Becker F, Sanders AM, Pallesen H, Kristensen T, Michielsen M, Verheyden G. Virtual reality training for upper extremity in subacute stroke (VIRTUES): study protocol for a randomized controlled multicenter trial. BMC Neurol. 2014 Sep 28;14:186.  [doi>10.1186/s12883-014-0186-z]
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Albiol-Pérez S, Gil-Gómez JA, Llorens R, Alcañiz M, Font CC. The role of virtual motor rehabilitation: a quantitative analysis between acute and chronic patients with acquired brain injury. IEEE J Biomed Health Inform. 2014 Jan;18(1):391–8.  [doi>10.1109/JBHI.2013.2272101]
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Albiol-Pérez S, Forcano-García M, Muñoz-Tomás MT, Manzano-Fernández P, Solsona-Hernández S, Mashat MA, Gil-Gómez JA. A novel virtual motor rehabilitation system for Guillain-Barré syndrome. Two single case studies. Methods Inf Med. 2015;54(2):127–34.  [doi>10.3414/ME14-02-0002]
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Merians AS, Poizner H, Boian R, Burdea G, Adamovich S. Sensorimotor training in a virtual reality environment: does it improve functional recovery poststroke? Neurorehabil Neural Repair 2006; 20:252–267.  [doi>10.1177/1545968306286914]
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Tansel H, Sinan K, Doga D, Marc W., Kyle E. MoMiReS: Mobile mixed reality system for physical & occupational therapies for hand and wrist ailments. Innovations in Technology Conference (InnoTek), 2014 IEEE.
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Gil-Gómez J.-A., Gil-Gómez H., Lozano-Quilis J.-A., Manzano-Hernández P., Albiol-Pérez S., Aula-Valero C.: SEQ: suitability evaluation questionnaire for virtual rehabilitation systems. Application in a virtual rehabilitation system for balance rehabilitation. In Proceedings of the 7th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth ’13). 335–338 (2013).

Source: Virtual fine rehabilitation in patients with carpal tunnel syndrome using low-cost devices

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[ARTICLE] Impact of virtual reality games on psychological well-being and upper limb performance in adults with physical disabilities: A pilot study – Full Text PDF

ABSTRACT

Introduction: There is limited information regarding the effects of interactive virtual reality (VR) games on psychological and physical well-being among adults with physical disabilities. We aimed to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities.

Methods: Fifteen participants completed the intervention using Wii VR games in this pilot study. Depressive, Anxiety and Stress Scales (DASS) and Capabilities of Upper Extremity (CUE) questionnaires were used to measure psychological well-being and upper limb motor function respectively. Upper limb reaction time was measured using reaction time test.

Results: Results showed that there was a significant difference (p<0.05) in DASS questionnaire and average reaction time score after intervention.

Conclusion: There is a potential for using interactive VR games as an exercise tool to improve psychological wellbeing and upper limb reaction time among adults with disabilities.

INTRODUCTION

Adults with disabilities around the world have been estimated to be around one billion, which consist of 15% of the world’s population.1 In Malaysia, there are approximately 300,000 adults with disabilities.2 Impairments in cardiovascular fitness, balance, motor control, sensation, proprioception and coordination are common in adults with physical disabilities.3 These impairments can lead to functional dependence, poor quality of life, limited mobility and decreased participation in leisure activities.

Opportunities to participate in regular exercise are especially important for groups that are less physically active than the
general population. This is because adults with disabilities are more prone to secondary complications such as pain, fatigue and de-conditioning.4 Virtual reality (VR) games are games played in a stimulated 3-dimensional (3D) environment. VR games have been developed for leisure activities but we found VR to be beneficial for rehabilitation in our local studies.5-7

Involvement in physical activity among people with disabilities is limited. Utilisation of technology may promote adherence, motivation and participation in physical activity and exercise programmes. However, as opposed to conventional rehabilitation and physiotherapy for adults with disabilities, evidence of VR games in improving function is limited. Therefore, the aim of this study was to examine the impact of VR games on psychological well-being, upper limb motor function and reaction time in adults with physical disabilities. …

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[ARTICLE] Movement visualisation in virtual reality rehabilitation of the lower limb: a systematic review – Full Text

Abstract

Background

Virtual reality (VR) based applications play an increasing role in motor rehabilitation. They provide an interactive and individualized environment in addition to increased motivation during motor tasks as well as facilitating motor learning through multimodal sensory information. Several previous studies have shown positive effect of VR-based treatments for lower extremity motor rehabilitation in neurological conditions, but the characteristics of these VR applications have not been systematically investigated. The visual information on the user’s movement in the virtual environment, also called movement visualisation (MV), is a key element of VR-based rehabilitation interventions. The present review proposes categorization of Movement Visualisations of VR-based rehabilitation therapy for neurological conditions and also summarises current research in lower limb application.

Methods

A systematic search of literature on VR-based intervention for gait and balance rehabilitation in neurological conditions was performed in the databases namely; MEDLINE (Ovid), AMED, EMBASE, CINAHL, and PsycInfo. Studies using non-virtual environments or applications to improve cognitive function, activities of daily living, or psychotherapy were excluded. The VR interventions of the included studies were analysed on their MV.

Results

In total 43 publications were selected based on the inclusion criteria. Seven distinct MV groups could be differentiated: indirect MV (N = 13), abstract MV (N = 11), augmented reality MV (N = 9), avatar MV (N = 5), tracking MV (N = 4), combined MV (N = 1), and no MV (N = 2). In two included articles the visualisation conditions included different MV groups within the same study. Additionally, differences in motor performance could not be analysed because of the differences in the study design. Three studies investigated different visualisations within the same MV group and hence limited information can be extracted from one study.

Conclusions

The review demonstrates that individuals’ movements during VR-based motor training can be displayed in different ways. Future studies are necessary to fundamentally explore the nature of this VR information and its effect on motor outcome.

Background

Virtual reality (VR) in neurorehabilitation has emerged as a fairly recent approach that shows great promise to enhance the integration of virtual limbs in one`s body scheme [1] and motor learning in general [2]. Virtual Rehabilitation is a “group [of] all forms of clinical intervention (physical, occupational, cognitive, or psychological) that are based on, or augmented by, the use of Virtual Reality, augmented reality and computing technology. The term applies equally to interventions done locally, or at a distance (tele-rehabilitation)” [3]. The main objectives of intervention for facilitating motor learning within this definition are to (1) provide repetitive and customized high intensity training, (2) relay back information on patients’ performance via multimodal feedback, and (3) improve motivation [24]. VR therapies or interventions are based on real-time motion tracking and computer graphic technologies displaying the patients’ behaviour during a task in a virtual environment.

The interaction of the user and Virtual environment can be described as a perception and action loop [5]. This motor performance is displayed in the virtual environment and subsequently, the system provides multimodal feedback related to movement execution. Through external (e.g. vision) and internal (proprioception) senses the on-line sensory feedback is integrated into the patient’s mental representation. If necessary, the motor plan is corrected in order to achieve the given goal [5].

A previous Cochrane Review from Laver, George, Thomas, Deutsch, and Crotty [2] on Virtual Reality for stroke rehabilitation showed positive effects of VR intervention for motor rehabilitation in people post-stroke. However, grouped analysis from this review on recommendation for VR intervention provides inconclusive evidence. The author further comments that “[…] virtual reality interventions may vary greatly […], it is unclear what characteristics of the intervention are most important” ([2], p. 14).

Virtual rehabilitation system provides three different types of information to the patient: movement visualisation, performance feedback and context information [6]. During a motor task the patient’s movements are captured and represented in the virtual environment (movement visualisation). According to the task success, information about the accomplished goal or a required movement alteration is transmitted through one or several sensory modalities (performance feedback). Finally, these two VR features are embedded in a virtual world (context information) that can vary from a very realistic to an abstract, unrealistic or reduced, technical environment.

Performance feedback often relies on theories of motor learning and is probably the most studied information type within VR-based motor rehabilitation. Moreover, context information is primarily not designed with a therapeutic purpose. Movement observation, however, plays an important role for central sensory stimulation therapies, such as mirror therapy or mental training. The observation or imagination of body movements facilitates motor recovery [789] and provides new possibilities for cortical reorganization and enhancement of functional mobility. Thus, it appears that movement visualisation may also play an important role in motor rehabilitation [101112], although this aspect is yet to be systematically investigated [13].

The main goal of the present review is to identify various movement visualisation groups in VR-based motor interventions for lower extremities, by means of a systematic literature search. Secondarily, the included studies are further analysed for their effect on motor learning. This will help guide future research in rehabilitation using VR.

An interim analysis of the review published in 2013 showed six MV groups for upper and lower extremity training and additional two MV groups directed only towards lower extremity training. In this paper, we analysed only studies involving lower limb training, leading to a revision and expansion of the previously published MV groups findings [131415].

Continue —> Movement visualisation in virtual reality rehabilitation of the lower limb: a systematic review | BioMedical Engineering OnLine | Full Text

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[WEB SITE] ISVR Newsletter – International Society for Virtual Rehabilitation

ISVR Newsletter

Welcome to the newsletter of the International Society for Virtual Rehabilitation! The aim of this newsletter is to help fulfill the mission of the Society by providing regular information on activities and topics of interest in Virtual Rehabilitation relevant to current and potential future members.

The newsletter consists of four regular sections: a technological and a clinical profile of experienced virtual rehabilitation researchers, a feature article and the latest news from the society. We welcome your suggestions for future topics. Please let us know your feedback on newsletter@isvr.org, and join our mailing list!

Date Issue
April 2017 ISVR Newsletter Issue 10
December 2016 ISVR Newsletter Issue 9
September 2016 ISVR Newsletter Issue 8
April 2016 ISVR Newsletter Issue 7
November 2015 ISVR Newsletter Issue 6
August 2015 ISVR Newsletter Issue 5
April 2015 ISVR Newsletter Issue 4
December 2014 ISVR Newsletter Issue 3
August 2014 ISVR Newsletter Issue 2
March 2014 ISVR Newsletter Issue 1

Source: ISVR Newsletter | International Society for Virtual Rehabilitation

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[Conference paper] 3D Virtual System Using a Haptic Device for Fine Motor Rehabilitation -Abstract+References

Abstract

It is presented a 3D Virtual system with a haptic device that allows the interaction between a user and a virtual environment developed in Unity3D. This System was designed for rehabilitation of paretic hands in adult people with Stroke; the virtual environment was developed considering a daily life’s activity (watering plants in pots). The system was used by five people with mild and moderate Stroke according to ASWRTH 1+ scale, which completed the exercise showed in the virtual application. Patients performed a usability test SUS with outcomes (79, 5 ± 3, 67) this allows to define that the system has a good acceptance for rehabilitation.

Source: 3D Virtual System Using a Haptic Device for Fine Motor Rehabilitation | SpringerLink

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[Conference paper] Usage of VR Headsets for Rehabilitation Exergames – Abstract+References

Abstract

The work presented here is part of a large project aimed at finding new ways to tackle exergames used for physical rehabilitation. The preferred user group consists of physically impaired who normally cannot use commercially available games; our approach wants to fill a niche and allow them to get the same playing experience like healthy. Four exercises were implemented with the Blender Game engine and connected to a motion capture device (Kinect) via a modular middleware. The games incorporate special features that enhance weak user movements, such that the avatar reacts in the same way as for persons without physical restrictions. Additionally, virtual reality glasses have been integrated to achieve a more immersive feeling during play. In this work, we compare the results of preliminary user tests, performed with and without VR glasses. Test outcomes are good for motion amplification in some of the games but do not present generally better results when using the VR glasses.

Source: Usage of VR Headsets for Rehabilitation Exergames | SpringerLink

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[WEB SITE] The Rehabilitation Gaming System

slideshow 1RGS is a highly innovative Virtual Reality (VR) tool for the rehabilitation of deficits that occur after brain lesions and has been successfully used for the rehabilitation of the upper extremities after stroke.
The RGS is based on the neurobiological considerations that plasticity of the brain remains  throughout life and therefore can be utilized to achieve functional reorganization of the brain areas affected by stroke. This can be realized by means of activation of secondary motor areas such as the so called mirror neurons system.

RGS deploys a deficit oriented training approach. Specifically, while training with RGS the patient is playing individualized games where movement execution is combined with the observation of correlated actions performed by a virtual body. The system optimizes the user’s training by analyzing the qualitative and quantitative aspects of the user’s performance. This warranties a detailed assessment of the deficits of the patient and their recovery dynamics.

Key articles and Recent publications

also see specs.upf.edu

Source: The Rehabilitation Gaming System | Rehabilitation Gaming System

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[Research Poster] Upper Limb Virtual Reality Training Provides Increased Activity Compared With Conventional Training for Severely Affected Subacute Patients After Stroke

To compare amount of activity of virtual reality (VR) and conventional task-oriented training (CT).

Source: Upper Limb Virtual Reality Training Provides Increased Activity Compared With Conventional Training for Severely Affected Subacute Patients After Stroke – Archives of Physical Medicine and Rehabilitation

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[VIDEO] SaeboVR – World’s First Virtual ADL Rehabilitation System

Δημοσιεύτηκε στις 21 Φεβ 2017

Saebo, Inc., is a leading global provider of innovative rehabilitation products for stroke survivors and other neurologically impaired individuals. Headquartered in Charlotte, NC, the company was founded in 2001 by two occupational therapists specializing in stroke rehabilitation. As the leading cause of long-term disability in the U.S., stroke affects over 700,000 Americans every year, leaving many with crippling side affects including the loss of hand function. Saebos pioneering treatment protocols are based on new research documenting the brains remarkable ability to re-program itself following injury.

The companys neurological orthotic devices, including the ground-breaking SaeboFlex and SaeboReach, allow patients with very little residual arm and hand function to immediately begin performing task-oriented, grasp and release activities, thereby forging new pathways in the brain. Named Most Valuable Product in 2008 by Therapy Times, the Saebo Program is now offered as a treatment option at over 2,000clinics and hospitals nationwide, including 22 of the Top 25 Rehabilitation Hospitals as ranked by U.S. News & World Report. The Saebo orthoses are also eligible for reimbursement by Medicare and most commercial insurers. With a network of over 6,000 trained clinicians spanning four continents, Saebo is committed to helping stroke survivors around the globe achieve a new level of independence.

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[Abstract] Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study

Abstract

Objectives

The YouGrabber (YG) is a new virtual reality training system that focuses on unilateral and bimanual activities. This nested study was part of a larger multicentre randomised controlled trial and explored experiences of people with chronic stroke during a 4 week intensive upper limb training with YG.

Design

A qualitative design using semi-structured, face-to-face interviews. A phenomenological descriptive approach was used, with data coded, categorized and summarized using a thematic analysis. Topics investigated included: the experience of YG training, perceived impact of YG training on arm function, and the role of the treating therapist.

Results

Five people were interviewed (1 female, age range 55-75yrs, 1-6yrs post-stroke). Seven main themes were identified: (1) general experience, (2) expectations, (3) feedback, (4) arm function, (5) physiotherapist’s role, (6) fatigue, (7) motivation. Key experiences reported included feelings of motivation and satisfaction, with positive factors identified as challenge, competition, fun and effort. The YG training appeared to trigger greater effort, however fatigue was experienced at the end of the training. Overall, patients described positive changes in upper limb motor function and activity level, e.g. automatic arm use. While the opportunity for self-practice was appreciated, input from the therapist at the start of the intervention was deemed important for safety and confidence.

Conclusions

Reported experiences were mostly positive and the participants were motivated to practice intensively. They enjoyed the challenging component of the games.

Source: Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study – Physiotherapy

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