Posts Tagged virtual reality

[WEB SITE] Rutgers VR spinoff moves to NJEDA incubator

New Jersey Economic Development Authority
The New Jersey Economic Development Authority’s Commercialization Center for Innovative Technologies in North Brunswick.

Virtual reality is mostly known as a platform for gamers — allowing its users to escape from the real world by commanding the Enterprise, rescuing their child from a post-apocalyptic wasteland or being transported smack-dab into the middle of a murder mystery.

However, there’s another angle at play.

It can also help alleviate symptoms and improve the health of people who’ve suffered illnesses and injuries.

Patients who have suffered stroke, dementia and traumatic brain injuries are using virtual reality as part of their rehabilitation therapy, thanks to technology developed by Bright Cloud International Corp.

BCI, a Rutgers University spinoff, announced earlier this month it moved its operations into the New Jersey Economic Development Authority’s Commercialization Center for Innovative Technologies in North Brunswick. The move will expand the CCIT’s footprint in New Jersey as a life sciences incubator.

“Having spent the past 30 years here, I know the intrinsic value that New Jersey offers entrepreneurs, including its strong academic institutions and its dynamic life sciences community. I also wanted to maintain strong ties with Rutgers and to offer jobs for students and graduates. In return for the decades of support I have received from the university, I wanted to strengthen BCI while also benefitting Rutgers,” said Grigore “Greg” Burdea, BCI founder and president.

The rehabilitation system, known as BrightBrainer, is a self-contained and mobile rehabilitation medical device that has custom virtual reality therapy games.

The system, which is available for lease or purchase, targets motor skills such as motor control, speed of movement, endurance, hand-eye coordination and task sequencing. It also targets cognitive abilities, including attention, short-term visual and auditory memory, working memory, reading comprehension and dual tasking.

The virtual reality system, according to BCI, is useful in a variety of health care settings, including outpatient clinics, skilled nursing facilities and medical adult day programs.

“Our biggest success to date is the BrightBrainer rehabilitation system. I am proud that it reduces care costs, increases access to care and improves therapy outcomes,” Burdea said.

A team of researchers, engineers, physicians, therapists and game developers created the games, which adapt to each individual patient.

According to BCI, BrightBrainer has been found to benefit a patient’s motor and cognitive skills, as well as a patient’s emotional state, leading to an increased quality of life.

“We know that the brain can rewire itself to bypass non-working neurons, so our technology helps patients build that bypass to regain use of their bodies,” Burdea said. “It also puts a new and interactive spin on the monotony of occupational therapy, bringing an age-old industry into the 21st century.”

Burdea said he moved the incubator to CCIT because of its environment, access to networking and investors, and opportunities for increased visibility.

“Understanding and responding to the needs of the market is imperative to the state’s ability to retain and attract innovative companies and top talent,” EDA CEO Tim Sullivan said. “Nurturing early-stage companies is just one facet of Gov. (Phil) Murphy’s vision of a more robust and equitable economy, and CCIT offers a model of what can be achieved through collaboration between the private, public and academic sectors.”

via Rutgers VR spinoff moves to NJEDA incubator – ROI-NJ


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[ARTICLE] Quantification of upper limb position sense using an exoskeleton and a virtual reality display – Full Text



Proprioceptive sense plays a significant role in the generation and correction of skilled movements and, consequently, in most activities of daily living. We developed a new proprioception assessment protocol that enables the quantification of elbow position sense without using the opposite arm, involving active movement of the evaluated limb or relying on working memory. The aims of this descriptive study were to validate this assessment protocol by quantifying the elbow position sense of healthy adults, before using it in individuals who sustained a stroke, and to investigate its test-retest reliability.


Elbow joint position sense was quantified using a robotic device and a virtual reality system. Two assessments were performed, by the same evaluator, with a one-week interval. While the participant’s arms and hands were occluded from vision, the exoskeleton passively moved the dominant arm from an initial to a target position. Then, a virtual arm representation was projected on a screen placed over the participant’s arm. This virtual representation and the real arm were not perfectly superimposed, however. Participants had to indicate verbally the relative position of their arm (more flexed or more extended; two-alternative forced choice paradigm) compared to the virtual representation. Each participant completed a total of 136 trials, distributed in three phases. The angular differences between the participant’s arm and the virtual representation ranged from 1° to 27° and changed pseudo-randomly across trials. No feedback about results was provided to the participants during the task. A discrimination threshold was statistically extracted from a sigmoid curve fit representing the relationship between the angular difference and the percentage of successful trials. Test-retest reliability was evaluated with 3 different complementary approaches, i.e. a Bland-Altman analysis, an intraclass correlation coefficient (ICC) and a standard error of measurement (SEm).


Thirty participants (24.6 years old; 17 males, 25 right-handed) completed both assessments. The mean discrimination thresholds were 7.0 ± 2.4 (mean ± standard deviation) and 5.9 ± 2.1 degrees for the first and the second assessment session, respectively. This small difference between assessments was significant (− 1.1 ± 2.2 degrees), however. The assessment protocol was characterized by a fair to good test-retest reliability (ICC = 0.47).


This study demonstrated the potential of this assessment protocol to objectively quantify elbow position sense in healthy individuals. Futures studies will validate this protocol in older adults and in individuals who sustained a stroke.



Proprioception is defined as the ability to perceive body segment positions and movements in space [1]. Sensory receptors involved in proprioception are mostly located in muscle [234], joint [56] and skin [37]. Proprioceptive sense is known to play a significant role in motor control [891011] and learning [812], particularly in the absence of vision. The importance of proprioceptive inputs has been demonstrated while studying individuals who presented lack of proprioception due to large-fiber sensory neuropathy [1112]. Despite an intact motor system, somatosensory deafferentation may lead to limitations in several activities involving motor skills, such as eating or dressing [12]. These disabilities may also be observed in individuals with proprioceptive impairments due to a stroke. Indeed, approximately half of the individuals who sustained a stroke present proprioceptive impairments in contralesional upper limb [13]. After a stroke, proprioception is known to be related to recovery of functional mobility and independence in activities of daily living (ADL; [14]). Fewer individuals with significant proprioceptive and motor losses (25%) were independent in ADL than individuals with motor deficits alone (78%). Moreover, fewer individuals with proprioceptive deficits (60%) after a stroke are discharged from the hospital directly to home compared to those without proprioceptive deficits (92%) [15].

Although the negative impact of proprioceptive impairments on motor and functional recovery is known, a large proportion of clinicians (70%) report not using standardised assessment to evaluate somatosensory deficits in patients with a stroke [16]. In clinical and research settings, proprioception is most frequently assessed with limb-matching tasks. Two types of matching tasks have commonly been used: the ipsilateral remembered matching task and the contralateral concurrent matching task [17]. In an ipsilateral remembered matching task, the evaluator or robotic device brings the patient’s limb to a target joint position, when the patient’s eyes are closed, keeps the limb in this position for several seconds, and then moves back the limb to the initial position. The patient needs to memorize the reference position and replicate it with the same (ipsilateral) limb. This task cannot, however, be used to evaluate proprioception in individuals with working memory issues, which represent around 25% of individuals who sustained a stroke [18]. In such cases, the matching error observed could reflect memory deficits, rather than proprioceptive impairments. Moreover, upper limb paresis affects 76% of individuals who sustained a stroke [19], making the task’s execution difficult or impossible. Assessing proprioception with the less affected arm as the indicator arm is therefore frequently considered in patients with hemiparesis. Indeed, in a contralateral concurrent matching task, the patient has to reproduce a mirror image of the evaluated limb position with the opposite (contralateral) limb [17]. However, considering that 20% of individuals who sustained a stroke also presents proprioceptive impairment on the ipsilateral side of the lesion [13], it would be difficult to ascertain whether the error is due to deficits in the evaluated arm, the opposite arm or both. In addition, interhemispheric communication is required in a contralateral concurrent matching task. Individuals with asymmetric stroke or with transcallosal degeneration would therefore be particularly disadvantaged while being assessed with a contralateral concurrent matching task [17].

In order to study proprioception in individuals who sustained a stroke, we developed an assessment protocol, that combines the use of an exoskeleton and a virtual reality system, enabling the quantification of position sense without using the opposite arm, involving active movement of the evaluated limb or relying on working memory. The primary objective of the present study was to validate the assessment protocol by quantifying the elbow joint position sense of healthy adults, before using this protocol with individuals who sustained a stroke. As a secondary objective, test-retest reliability of the assessment protocol was investigated.[…]


Continue —> Quantification of upper limb position sense using an exoskeleton and a virtual reality display | Journal of NeuroEngineering and Rehabilitation | Full Text


Fig. 1KINARM Exoskeleton Lab. a Modified wheelchair with each arm supported against gravity by exoskeletons; (b) Virtual reality display; (c) Virtual arm and real arm positions (blue line; non-visible for the participant) where ∆Θ represents the angular difference between the real and the virtual arm. The white circle corresponds to the center of rotation, i.e. the elbow joint

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[Abstract] Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: a case study.



The complexity of upper extremity (UE) behavior requires recovery of near normal neuromuscular function to minimize residual disability following a stroke. This requirement places a premium on spontaneous recovery and neuroplastic adaptation to rehabilitation by the lesioned hemisphere. Motor skill learning is frequently cited as a requirement for neuroplasticity. Studies examining the links between training, motor learning, neuroplasticity, and improvements in hand motor function are indicated.


This case study describes a patient with slow recovering hand and finger movement (Total Upper Extremity Fugl-Meyer examination score = 25/66, Wrist and Hand items = 2/24 on poststroke day 37) following a stroke. The patient received an intensive eight-session intervention utilizing simulated activities that focused on the recovery of finger extension, finger individuation, and pinch-grasp force modulation.


Over the eight sessions, the patient demonstrated improvements on untrained transfer tasks, which suggest that motor learning had occurred, as well a dramatic increase in hand function and corresponding expansion of the cortical motor map area representing several key muscles of the paretic hand. Recovery of hand function and motor map expansion continued after discharge through the three-month retention testing.


This case study describes a neuroplasticity based intervention for UE hemiparesis and a model for examining the relationship between training, motor skill acquisition, neuroplasticity, and motor function changes. Implications for rehabilitation Intensive hand and finger rehabilitation activities can be added to an in-patient rehabilitation program for persons with subacute stroke. Targeted training of the thumb may have an impact on activity level function in persons with upper extremity hemiparesis. Untrained transfer tasks can be utilized to confirm that training tasks have elicited motor learning. Changes in cortical motor maps can be used to document changes in brain function which can be used to evaluate changes in motor behavior persons with subacute stroke.


via Motor skill changes and neurophysiologic adaptation to recovery-oriented virtual rehabilitation of hand function in a person with subacute stroke: … – PubMed – NCBI

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[Abstract] Virtual reality rehabilitation with functional electrical stimulation improves upper extremity function in patients with chronic stroke: a pilot randomized controlled study



To compare virtual reality (VR) combined with functional electrical stimulation (FES) to cyclic FES for improving upper extremity function and health-related quality of life in patients with a chronic stroke.


A pilot, randomized, single blinded, controlled trial.


Stroke rehabilitation inpatient unit


Forty-eight participants with a hemiplegia secondary to a unilateral stroke for >3 months, with a hemiplegic wrist extensor Medical Research Council (MRC) scale score of 1–3.


FES was applied to the wrist extensors and finger extensors. A virtual-reality(VR) based wearable rehabilitation device was used, combined with FES and virtual activity-based training. The control group received cyclic FES only. Both groups completed 20 sessions, over a 4-week period.

Main outcome measures

Primary outcomes were the change in the Fugl–Meyer Assessment: upper extremity (FMA) and Wolf Motor Function Test (WMFT) scores. Secondary outcomes were the change in the Box and Block test (BB), Jebsen Taylor Hand Function Test (JTT), and Stroke Impact Scale (SIS) scores. Assessments were performed at baseline (T0) and at 2 weeks (T1), 4 weeks (T4), and 8 weeks (T8). Between-group comparisons were evaluated using a repeated measures analysis of variance.


Forty-one participants were included in the analysis. Compared to FES alone, VR-FES produced greater increase in FMA–distal score (p=0.011) and marginal improvement in JTT–gross score (p=0.057). VR-FES produced greater, although non-significant, improvements in all other outcome measures, except in the SIS–ADL/IADL score.


FES with VR-based rehabilitation may be more effective than cyclic FES to improve distal gross upper extremity function post-stroke.


via Virtual reality rehabilitation with functional electrical stimulation improves upper extremity function in patients with chronic stroke: a pilot randomized controlled study – Archives of Physical Medicine and Rehabilitation

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[BLOG POST] Traumatic Brain Injury- Virtual Reality Technology Used For Vision Therapy

February 12, 2018

So, here is a new subject that hints at hope for traumatic brain injury (TBI) patients. I have previously discussed the role of vision therapy in helping head injury patients, especially those who are having difficulty reading.
Vision therapy is a set of vision exercises and training performed by optometrists with unique equipment in their offices.

Vision therapy certainly has a role in rehabilitation but has numerous obstacles. Number one- patients must make regular appointments for a doctor’s office visit often located some distance from home. Two, only a few optometrist’s perform vision therapy. And third, the cost of therapy is usually not covered by medical insurance.

The future may lie in VIRTUAL REALITY– futuristic-looking goggles and head sets that allow individuals to play 3-D computer games in an immersive environment. The technology keeps improving and costs are coming down.

Forward-looking technology companies are also developing programs for traumatic brain injury (TBI) patients. Only early versions are currently available but the possibility of at-home rehabilitation will soon become a medical reality. All of medicine is moving in this direction.

Reading, depth perception, contrast sensitivity, and peripheral vision disorders can all be explored in virtual reality. The brain and the eye will truly come together in a revolution of new products to aid patients with ocular disease. There are already devices to help people who are blind, but the cost of such devices is considerable. The cost of virtual reality computer goggles and headsets will be coming down in price to sell to the general public- the same techniques that are being explored to develop entertainment are being developed by health companies to treat patients.

In the next year or two, the market will present these devices and an at-home device and therapy to treat TBI victims will be available. In my blog I have explained the many ways head injury can effect eyesight, but there are almost no cures. Cures may be a long way off, but programs to help people read again, reduce double vision, and regain their ability to judge depth are already in the pipeline. I’m not currently an investor in any device, and I will not discuss specific companies, but the research and data is on the internet.

Also, there are already programs you can get on a regular computer screen for vision training and I will discuss these in future blogs. Again, ophthalmologists interested in TBI and related visual disorders can be at a frontier of a whole new branch of ophthalmology. I examine and evaluate TBI patients in my practice everyday and I will keep those who read my blog posted on new information.

Stay tuned!

Steven H. Rauchman, M.D. is an eye physician and surgeon who has been in private practice for 30 years. He has served as an Traumatic Brain Injury (TBI) medical/legal expert for the last 6 years specializing in the area of personal injury and related traumatic brain injuries.


via Traumatic Brain Injury- Virtual Reality Technology Used For Vision Therapy

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[WEB SITE] How virtual reality is changing physiotherapy for the better

VR, disabilities
Several hospitals in the UAE have shown interest in adopting these technology-based therapies that can have significant impact on people with disabilities.

Virtual reality and 3D-based video games are fast becoming popular alternatives to physiotherapy.

Physiotherapists and clinicians are now working closely with computer experts to design computer games that would promote specific body movements – notably shoulder, elbow, knee and hip movements – needed in therapy. With proper instructions from therapists, the game developers also set instructions and create personalised exercise plans for patients, keeping in mind the movements and difficulty faced by specific patient.

Dr. Imad Afyouni, Assistant Professor in Computer Science at the University of Sharjah, introduced the interesting facts about the cutting-edge technology to the audience as he delivered a lecture on game-based physiotherapy solutions at the Sharjah Centre for Astronomy and Space Sciences as part of the UAE Innovation Month in Sharjah.

“It is catching fast because it is non-invasive, home-based, highly accurate, and laced with intelligent alerting and automatic correction system. Several hospitals in the UAE have shown interest in adopting these technology-based therapies that can have significant impact on people with disabilities, people injured badly due to accidents as well as people with special needs in our society,” he said.

Usually patients go to rehabilitation centres or physiotherapy centres for conventional treatments like occupational therapies to make muscles and bones getting right positions. Now there are much more effective treatments available, which have been developed jointly by experts in computer science and physiotherapy.

“In many cases, patients are suggested to exercise at home after a few sessions at the therapy centre. But, people get bored by the repetitive exercises. Sometimes, it fails to show the desired results because it is not practiced under the supervision of a qualified therapist. Now we are making these therapies work effectively without invasive censors on the body,” he said.

“We develop games to engage them in virtual environment, so that they do the required exercise while playing games. It’s fun way to achieve a task that can be painful and boring if practiced in conventional manner,” he added.

The Sharjah Innovation Week is being celebrated from February 15th-21st as part of the UAE Innovation Month at Al Majaz Waterfront and the Sharjah Centre for Astronomy and Space Sciences.


via How virtual reality is changing physiotherapy for the better

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[WEB SITE] IIT Scientists Have A New Use For Virtual Reality– Helping Stroke Victims!

Researchers at IIT Gandhinagar have incorporated an ingenious solution—computer-based VR games—to address upper-limb movement disorder in post-stroke victims.


A stroke is a medical condition where due to certain reasons, inadequate blood flow to the brain results in cell death. Strokes are one of the leading cause of death and disability, not only in India but all over the world. They affect about 15 million people worldwide and have left almost 5 million disabled.

According to studies, almost 75% of stroke victims become physically disabled, and out of those, 77% suffer upper limb weakness, with muscle numbness and difficulties in carrying out daily activities. Therefore, stroke rehabilitation plays an integral part in preventing post-stroke disabilities and helping a person return to regular life.

Physiotherapy is often an essential part of rehabilitation after a stroke and helps the patient to recover muscle strength, joint movement and a range of vital capacity.

Researchers at IIT Gandhinagar have incorporated an ingenious solution—computer-based VR games—to address upper-limb movement disorder in post-stroke victims.

Virtual reality or VR gives users a sense of touch when augmented with add-on instruments. Putting advances in the field of VR to use in the recovery of stroke patients, Dr Uttama Lahiri and her group have developed a technique which is a computer-based exercise platform, which is a performance-sensitive platform that can intelligently adapt itself according to the performance of patients.

 VR games help post-stroke victims fight disability

This virtual gaming world is augmented with a sense of touch in which patients can feel objects in the game environment and can manipulate objects with their movements. Using this as a cornerstone, patients interacting with the simulated environment can help in practising reaching and coordination tasks.

“Computer game-assisted upper limb recovery seems to be a novel method for assisting recovery of brain functions after stroke. Such game-based recovery may help in precise motor unit activation which makes the recovery, rational and task-oriented,” commented Dr Vijaya Nath Mishra, a stroke specialist at Sir Sunderlal Hospital, Banaras Hindu University, who is not connected with the study to India Science Wire.

A unique aspect of this virtual-reality exercise is that it can intelligently adapt itself based upon the task performance capability of the patient, allowing the user to be more motivated to complete the challenges and simultaneously ensure that he or she gets treated in the process of playing the game itself.

The software of the platform consists of 48 templates of VR-based ‘reaching’ and ‘coordination’ tasks, like navigating a car through obstacles and popping balloons, which ease the movement of the shoulder joint and upper limbs as prescribed in physiotherapy guidelines.


VR Goes help post-stroke victims fight disability
Screenshots from the VR game from popping balloons to navigating cars through obstacles.

The technique has been tested in a set of six patients with chronic stroke, who interacted with the system for 30 mins per day for a week. The results showed drastic performance improvements in the following:

(i) Increase in performance score
(ii) Reduced task completion time
(iii) Reduced performance errors

All imply an increase in terms of agility in the upper limbs.

The user-friendly and easy to operate software is not only capable of providing real-time feedback but is also individualised and adaptive to one’s capabilities. With the scores being monitored by a physiotherapist while the patient can take up the test in his home.

“We designed and validated this exercise platform among post-stroke patients, and the results are promising,” said Prof Lahiri in India Science Wire.


via IIT Scientists Have A New Use For Virtual Reality– Helping Stroke Victims!

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[ARTICLE] Enhancing visual performance in individuals with cortical visual impairment (homonymous hemianopsia): Tapping into blindsight – Full Text


Patients with occipital lobe damage may have blind areas in their visual field.

Other non-cortical areas of the brain still process visual information.

Modifying visual input can stimulate non-cortical visual processing areas.

Augmented virtual reality goggles as a therapy for cortical blindness is proposed.


Homonymous hemianopsia is a type of cortical blindness in which vision is lost completely or partially in the left half or the right half of the field of vision. It is prevalent in approximately 12% of traumatic brain injury and 35% of strokes. Patients often experience difficulty with activities such as ambulating, eating, reading, and driving. Due to the high prevalence of homonymous hemianopsia and its associated difficulties, it is imperative to find methods for visual rehabilitation in this condition. Traditional methods such as prism glasses can cause visual confusion and result in patient noncompliance. There is a large unmet medical need for improving this condition. In this article, we propose that modifying visual stimuli to activate non-cortical areas of visual processing, such as lateral geniculate nucleus and superior colliculus, may result in increased visual awareness. Presenting high contrast and low spatial frequency visual stimuli can increase visual detection in patients with cortical blindness, a phenomenon known as blindsight. Augmented virtual reality goggles have the potential to alter real-time visual input to high contrast and low spatial frequency images, possibly improving visual detection in the blind hemifield and providing an alternative therapy for homonymous hemianopsia.

Graphical abstract


Cortical visual impairment comprises a significant component of strokes and traumatic brain injury. Cortical visual impairment includes homonymous hemianopsia, in which vision is lost completely or partially in the left half or the right half of the field of vision. Homonymous hemianopsia is prevalent in approximately 12% of traumatic brain injury and 35% of strokes [1–3]. Individuals with this vision loss usually have difficulties with activities of daily living such as ambulating, eating, reading, and driving [4,5]. Due to the high prevalence of homonymous hemianopsia and its associated difficulties, it is imperative to find methods for visual rehabilitation in this condition. Traditional methods of visual rehabilitation for homonymous hemianopsia include fitting spectacles with prisms to shift the visual field from the blind hemifield to the intact visual field. This is accomplished by placing the base of the prism in the blind hemifield, which shifts the image toward the apex of the prism into the intact hemifield. Many patients discontinue treatment with prisms because the prisms may induce visual confusion and double vision [1–4]. Another technique used is to train individuals with hemianopsia to make quick eye movements in the direction of the blind hemifield, though there is not much evidence supporting efficacy [6]. Although these methods may provide some compensation for the visual field loss, they do not restore the impaired visual field. Accordingly, other methods of improving vision are needed.

Individuals with homonymous hemianopsia do not consciously see vision in the blind hemifield. However, there is evidence of a ‘blindsight’ phenomenon, whereby some affected individuals can detect objects in their blind visual field, albeit without conscious awareness of being able to see the object. Functional magnetic resonance imaging (fMRI) studies have indicated that visual processing occurs in other parts of the brain, such as the lateral geniculate nucleus (LGN) and superior colliculus (SC) (Fig. 1). Visual processing in these regions provides the neural network that enables patients with blindsight to see [7–11]. Blindsight has been manipulated in some individuals to enhance visual awareness. Sahraie et al. studied a patient with homonymous hemianopsia and well-documented blindsight over a long period of time [7]. The patient reported increased awareness of visual stimuli in his blind visual field when the stimulus was presented with high contrast and low spatial frequency. Spatial frequency refers to the level of detail in an image appearing within a degree of the visual field. Temporal frequency, the number of times a stimulus is flashed within a second, also modulates detection. Multiple studies have shown that within a temporal frequency range of 5–20 Hz (cycles/s), detection of visual stimuli in a forced-choice test is significantly better than chance [7–11]. The time of stimulus onset also affects the rate of detection. Patients with parietal lobe injury often cannot detect a visual stimulus in the neglected hemifield when it is presented simultaneously in the intact hemifield, but can detect the stimulus when it is presented by itself in the neglected hemifield only, a phenomenon known as visual extinction [12,13]. It is thought that visual extinction reflects an attentional deficit as opposed to primarily a sensory deficit, although this remains an area of active research [14]. Despite that visual extinction is primarily studied in patients with hemi-neglect, patients with hemianopsia also can have hemi-neglect from injury to both the occipital and parietal lobes [15]. Therefore, the relevant visual variables for increasing visual detection in hemianopsia are stimuli contrast, spatial frequency, temporal frequency and stimulus onset asynchrony.


Figure 1. 3-D representation of tracts overlaid on T1-weighted fMRI images between the lateral geniculate nucleus (LGN) and human motion complex (hMT+), adapted from Ajina and colleagues (eLife. 2015;4:e08935. doi: 10.7554/eLife.08935[26]. (A) Dark green tracts are in the ipsilesional hemisphere, light green tracts are in the contralesional hemisphere and in controls. (B) Fractional anisotropy, reflecting neuronal damage, demonstrates increased impaired tissue microstructure in the ipsilesional tract in blindsight negative patients as compared with blindsight positive patients and controls.


Continue —>  Enhancing visual performance in individuals with cortical visual impairment (homonymous hemianopsia): Tapping into blindsight – ScienceDirect

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[BOOK] Emerging Therapies in Neurorehabilitation II – [Chapter] Virtual Rehabilitation – Request PDF


This chapter addresses the current state of the art of virtual rehabilitation by summarizing recent research results that focus on the assessment and remediation of motor impairments using virtual rehabilitation technology. Moreover, strengths and weaknesses of the virtual rehabilitation approach and its technical and clinical implications will be discussed. This overview is an update and extension of a previous virtual rehabilitation chapter with a similar focus. Despite tremendous advancements in virtual reality hardware in the past few years, clinical evidence for the efficacy of virtual rehabilitation methods is still sparse. All recent meta-analyses agree that the potential of virtual reality systems for motor rehabilitation in stroke and traumatic brain injury populations is evident, but that larger clinical trials are needed that address the contribution of individual aspects of virtual rehabilitation systems on different patient populations in acute and chronic stages of neurorehabilitation.

Virtual Rehabilitation | Request PDF. Available from:

via Virtual Rehabilitation | Request PDF

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[Abstract] Virtual reality for upper limb rehabilitation in sub-acute and chronic stroke: a randomized controlled trial


  • Combined RFVE with CR treatment provided clinically meaningful improvements
  • Effectiveness of RFVE is comparable for ischemic and hemorrhagic post-stroke patients
  • Effectiveness of virtual therapy remains sensitive to time since stroke onset
  • Effectiveness of virtual therapy do not dependent on age and sex



To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke aetiology (i.e. ischemic or hemorrhagic).


Randomized controlled trial.


Inpatients in a hospital facility for intensive rehabilitation.


136 patients within one year from onset of a single stroke.


The experimental treatment was based on the combination of RFVE with CR, while control treatment was based on the same amount of CR. Both treatments lasted 2 hours daily, 5 days a week, for 4 weeks.

Main Outcome Measures

Fugl-Meyer upper extremity (F-M UE) scale (primary outcome), Functional Independence Measure (FIM), National Institutes of Health Stroke Scale (NIHSS), and Edmonton Symptom Assessment Scale (ESAS) (secondary outcomes). Kinematic parameters of requested movements: duration (Time), mean linear velocity (Speed), number of submovements (Peak) (secondary outcomes).


136 patients (ischemic=78, hemorrhagic=58) were randomized in two groups (RFVE=68, CR=68) and stratified by stroke aetiology (ischemic, hemorrhagic). Both groups improved after treatment, but the experimental group had better results than the control group (Mann-Whitney U test) at: F-M UE (p<0.001), FIM (p<0.001), NIHSS (p≤0.014), ESAS (p≤0.022), Time (p<0.001), Speed (p<0.001), Peak (p<0.001). Stroke aetiology did not have significant effects on patient outcomes.


The RFVE therapy combined with CR treatment promotes better outcomes for upper limb than the same amount of CR, regardless of stroke aetiology (Clinical Trial Registration – NCT01955291).


via Virtual reality for upper limb rehabilitation in sub-acute and chronic stroke: a randomized controlled trial – Archives of Physical Medicine and Rehabilitation

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