Posts Tagged physical rehabilitation
Physical rehabilitation often involves using expensive, over-engineered equipment that does its job well but is often difficult to afford. It’s one reason the overall cost of rehab can be steep, as buying and maintaining pricey equipment can quickly add up. Some of the more advanced systems for analyzing people’s motion involve multiple cameras that track how the arms, legs, and every other part of the body move in relation to each other. These can be tens of thousands of dollars per room, which means you’re often just better off hiring another rehab specialist. Researchers at University of Missouri have developed a body motion analysis system that uses a Microsoft Kinect 2.0 depth-sensing camera and a laptop that analyzes the incoming data.
The team compared the performance of their tinkered-together body analysis system versus a high-end commercial one, that uses reflective tags placed on different parts of the body, at monitoring lower body movements, specifically when performing drop vertical jumps and lateral leg raises. They found that the two systems provided comparable data and that the new system showed enough detail to be clinically useful by rehab specialists.
Sadly, Microsoft is ending production of the Kinect cameras, but surely there will be other affordable depth sensing cameras with similar capabilities.
Here’s a video from University of Missouri with more about the technology:
Study in Human Kinetics Journal: Comparison of 3D Joint Angles Measured With the Kinect 2.0 Skeletal Tracker Versus a Marker-Based Motion Capture System…
Physical rehabilitation can be tedious and boring, and evaluation of a patient’s progress fraught by poor metrics and subjectivity. At the recent CES 2018 in Las Vegas we discovered a new virtual reality-based evaluation, rehab, and follow-up platform that makes it fun and convenient to assess patients, administer various game-based training regimens, and to assess how those exercise routines are working.
The KineQuantum system, developed by a French firm of the same name, relies on the VIVE virtual reality platform and a couple optional hand-held joysticks. The patient is asked to follow objects on the screen with one’s head, touch them with the hands, or play more exciting games such as swatting flies and shooting cannonballs at pirate ships. The activities are made to be fun and to take the mind away from the fact that it’s a therapy. While the user is playing the games and doing virtual tasks, the system measures different characteristics such as response time, range of motion, and other related parameters.
Check out this video from KineQuantum presenting their virtual reality rehab system:
Marketing text: This innovative book explores how games can be serious, even though most people generally associate them with entertainment and fun. It demonstrates how videogames can be a valuable tool in clinics and demonstrates how clinicians can use them in physical rehabilitation for various pathologies. It also describes step by step their integration in rehabilitation, from the (gaming) technology used to its application in clinics. Further, drawing on an extensive literature review, it discusses the pros and cons of videogames and how they can help overcome certain obstacles to rehabilitation.
The last part of the book examines the main challenges and barriers that still need to be addressed to increase and improve the use and efficacy of this new technology for patients. The book is intended for physiotherapists and clinicians alike, providing a useful tool for all those seeking a comprehensive overview of the field of serious games and considering adding it to conventional rehabilitation treatment.
Virtual Reality for Physical and Motor Rehabilitation
While virtual reality (VR) has influenced fields as varied as gaming, archaeology, and the visual arts, some of its most promising applications come from the health sector. Particularly encouraging are the many uses of VR in supporting the recovery of motor skills following accident or illness.
Virtual Reality for Physical and Motor Rehabilitation reviews two decades of progress and anticipates advances to come. It offers current research on the capacity of VR to evaluate, address, and reduce motor skill limitations, and the use of VR to support motor and sensorimotor function, from the most basic to the most sophisticated skill levels. Expert scientists and clinicians explain how the brain organizes motor behavior, relate therapeutic objectives to client goals, and differentiate among VR platforms in engaging the production of movement and balance. On the practical side, contributors demonstrate that VR complements existing therapies across various conditions such as neurodegenerative diseases, traumatic brain injury, and stroke. Included among the topics:
- Neuroplasticity and virtual reality.
- Vision and perception in virtual reality.
- Sensorimotor recalibration in virtual environments.
- Rehabilitative applications using VR for residual impairments following stroke.
- VR reveals mechanisms of balance and locomotor impairments.
- Applications of VR technologies for childhood disabilities.
A resource of great immediate and future utility, Virtual Reality for Physical and Motor Rehabilitation distills a dynamic field to aid the work of neuropsychologists, rehabilitation specialists (including physical, speech, vocational, and occupational therapists), and neurologists.
Rohan O’Reilly is a movement therapist in Newcastle, New South Wales, who has been using alternative therapies involving virtual reality devices to help his clients with rehabilitation.
“It really came back to the point of listening to people’s stories who had had large-scale traumas, and their experiences of what they went through, from their initial accident through to therapy,” Mr O’Reilly said.
“For most of them it was really [boring] and quite uncomfortable and not inspiring.
“So we thought ‘We need to make this feel better’.
“Lucky for us we’re living in a time where there’s an amazing new array of technologies that are not widely known about.
“Virtual reality would be the one that’s hot at the moment, and essentially that is a game changer. It’s phenomenal what can be done with that as a platform for putting people in a state where they want to play.”
Making therapy fun
Mr O’Reilly said virtual reality helped clients to exercise their bodies in non-traditional ways.
“It’s about emotions,” he said.
“If your rehabilitation just tended to be based around the fact that you had to pick up an inanimate object, which you had no real emotional connection to, repetitively … for most people, they would think ‘OK, I can do this for a little while’, but they’re quickly going to run out of steam.
“If you put someone in virtual reality with everything that reminds them of the things that they love to do, they’re essentially just going to give themselves therapy.
“We’re just simply creating an environment where they can explore their own capabilities.”
Client notices big improvements in health
Almost four years ago, Angus McConnell had an accident that changed his life.
He was riding his bicycle down a hill in Newcastle when a car turned across him.
“I hit the windscreen, bumped off down the road, and ended up with a spinal cord injury — a C7 complete quadriplegic,” Mr McConnell said.
“It hits you on and off, and still does.”
Mr McConnell went through traditional hospital rehabilitation, but was looking for other options to continue his treatment.
“As your journey goes along, you want to work out whether you’re going to ignore the parts of the body that aren’t working, or you’re going to make them move,” he said.
Mr McConnell said he had noticed big improvements in his health after the alternative therapy.
“Originally we started on building up the muscles and hopefully a nerve signal that’s coming through,” he said.
“I can feel further down into my body, with electrodes on parts of my body where the nerves come close to the skin.
“I’m standing up now with the help of electrodes, and that’s something I hadn’t thought possible two-and-a-half years ago.”
Academic says VR effective, but people should be cautious
Associate Professor Coralie English, a stroke researcher at the University of Newcastle, said people should approach alternative therapies with a degree of cautiousness.
“There is a reasonable amount of evidence for the effectiveness of virtual reality training for people after stroke,” she said.
“This sort of therapy is useful for people who’ve already got some movement. There’s certainly no evidence to suggest that if you can’t move at all, trying to move within these environments is going to result in any recovery of function.
“It needs to ensure that the person is practising what they need to practice, and that it’s based on a thorough assessment by a qualified health professional.”
Physical and cognitive rehabilitation is usually a challenging activity as people with any kind of deficit has to carry out tasks difficult due to their abilities damaged. Moreover, such difficulties become even harder while they have to work at home in an isolated manner. Therefore, the development of collaborative rehabilitation systems emerges as one of the best alternatives to mitigate such isolation and turn a difficult task into a challenging and stimulating one. As any other collaborative system, the need of being aware of other participants (their actions, locations, status, etc.) is paramount to achieve a proper collaborative experience. This awareness should be provided by using those feedback stimuli more appropriate according to the physical and cognitive abilities of the patients. This has led us to define an awareness interpretation for collaborative cognitive and physical systems. This has been defined by extending an existing proposal that has been already applied to the collaborative games field. Furthermore, in order to put this interpretation into practice, a case study based on an association image-writing rehabilitation pattern is presented illustrating how this cognitive rehabilitation task has been extended with collaborative features and enriched
with awareness information
[ARTICLE] Computational architecture of a robot coach for physical exercises in kinaesthetic rehabilitation – Full Text PDF
The rising number of the elderly incurs growing concern about healthcare, and in particular rehabilitation healthcare. Assistive technology and and assistive robotics in particular may help to improve this process. We develop a robot coach capable of demonstrating rehabilitation exercises to patients, watch a patient carry out the exercises and give him feedback so as to improve his performance and encourage him. We propose a general software architecture for our robot coach, which is based on imitation learning techniques using Gaussian Mixture Models. Our system is thus easily programmable by medical experts without specific robotics knowledge, as well as capable of personalised audio feedback to patients indicating useful information to improve on their physical rehabilitation exercise.
Purpose of Review
Ramachandran (Nature 377:489–490, 1995) showed that in amputees, phantom limb pain described as a spasming or immobile phantom limb can be alleviated by watching their reflection of the intact limb in a parasagittally placed mirror while moving the intact limb and the phantom simultaneously. This suggested that therapy via mirror visual feedback—mirror therapy—might be considered for other diseases and conditions characterized by poor mobility. We were the first to show that mirror therapy might be beneficial for hemiparesis following stroke. There have now been numerous case reports and studies of mirror therapy for hemiparesis following stroke.
Overall, the majority of studies done thus far on patients with hemiparesis in the subacute or chronic phase following stroke find mirror therapy to be more beneficial than control treatments. Even when mirror therapy is not superior to control therapy, the reason for this is there are similar improvements in both groups. There have not been adverse effects in patients that perform mirror therapy for hemiparesis following stroke.
There appears to be a benefit of mirror therapy for hemiparesis following stroke in the subacute and chronic phase. Trial of mirror therapy for hemiparesis may be warranted. Further study of mirror therapy for hemiparesis following stroke will be welcomed; in particular, it would be important to study different groups of patients given the heterogeneity of stroke.
By Susan B O’Sullivan, Thomas J Schmitz
Here is a practical, step-by-step guide to understanding the treatment process and selecting the most appropriate intervention for your patient. Superbly illustrated, in-depth coverage shows you how to identify functional deficits, determine what treatments are appropriate, and then to implement them to achieve the best functional outcome for your patients.
Michael Aratow is a clinician and health care executive who founded VRecover, which is health care startup making physical rehabilitation exercises more engaging with VR. He says that rehab is like homework, but that sometimes up to 90% of people don’t actually do the exercises. VRecover is betting that gamifying rehab exercises within immersive VR environments will help accelerate the healing process while making it more fun to do.
Michael says that governments are looking for ways to cut costs and save money, and he sees that improving the rehab process is a simple and easy way to do that. Not only can surgery be avoided all together in some cases, but it can help accelerate the healing process with both rehabilitation and prehabilitation exercises.
VRecover is planning on developing a number of different VR experiences targeting the most popular rehab exercises starting with issues with the back, arms, and legs. For example, in order to increase the range of motion on the arms, they created a VR experiences where you close blast doors on a space ship. There’s an endless number of possibilities for creating experiences that encourage physical motion and have a therapeutic benefit, and they’ll be using a data-driven approach in deciding which rehab exercises that they’ll be initially targeting.
Michael has been involved with medicine in VR for the past 15 years, and he says that there’s over a decade’s worth of research showing how effect VR treatments are. There’s one study in particular that provided bogus range of motion feedback, and was able to show that people were able to have a wider range of motion that went beyond what they were able to do without VR.
VR rehab has the potential to start to gather more specific data on motion than was possible before. Not only could more accurate range of motion measurements be made over time, but it also could open up new metrics that weren’t possible to measure before such as velocity of movement. This could represent a trend towards personalizing rehab exercises beyond the standardized regiment that has been traditionally been given.
Recover is also going to target physical therapy offices directly rather than the general consumer market. The idea would be that the people would have to come into the office to do rehab exercises within a room-scale VR environment. Their initial prototype was using a Kinect to measure the range of motion, but they haven’t settled on a specific technology stack just yet. Perhaps they’ll eventually sell directly to the consumer market once the adoption of consumer VR grows past the point of existing game consoles, but they’re keeping their customer service demand lower by taking a B2B approach.
Finally, Michael sees that VR provides a new gateway into the mind, and that presence from immersive technologies enable a lot of new healing capabilities through enhancing cognition, controlling pain, and being able to manipulate perception for good.