Posts Tagged Virtual Reality
“We have accomplished half of the work, which is creating the engineering systems to test this work and now we have to develop the protocol for using it for rehabilitation to see how well it works,” said Alba Perez-Gracia, ISU chair and associate professor of mechanical engineering, and a lead researcher on the project.
The ISU researchers, who are working on this collaborative project with Texas A&M and California State University, Fullerton, first mapped arm motions and digitalized them and then have created a virtual world where people wearing a portable virtual-reality device can use the system as a therapeutic intervention. The researchers will soon be testing the new tool with human subjects.
Subjects wear a virtual reality headset and use it to complete tasks created for the virtual world. The virtual reality system picks up the actual movements of their own arm and displays it as a cartoon figure within the virtual world. The subject may then participate in the virtual world task that include picking up balls and throwing them at a target or stacking cubes using their right or left hand. In addition, the system has been developed to reflect the image of the arm being used.
For example, if a person is using the right arm to complete the task, the virtual reality system reflects the image so that the cartoon arm actions being portrayed look as if it is the left arm performing the task. This reflected image of arm function has the potential to be used as a therapeutic intervention because previous research has shown that observing an action activates the same area of the brain as performing the action.
“It is called the mirror neuron system,” said Nancy Devine, associate dean of the ISU School of Rehabilitation and Communications Sciences, who is a co-researcher on the project. “When you observe body movements, the cells in the brain that would produce that movement are active even though that arm isn’t being used.”
She said if you just look at brain activity, in some areas of the brain you can’t distinguish an active movement from an observed movement.
“So, if you take someone who has had a stroke and can’t use one arm, you can take their arm that is still working and reflect it to the other arm by putting them in this engaging virtual environment and we can be providing an exercise that is effective in helping rehabilitate the damaged areas,” Devine added.
Although the work on this specific project ends at the end of the academic year, ISU’s work on this type of project may continue.
“We have created the portable virtual-reality device that the patient can wear, which projects the motion happening for the patients,” Perez-Gracia said. “We hope it will be a starting point for future projects on using virtual reality and robotics for helping in rehabilitation and training of human motion.”
This research has been taking place at the ISU Robotics Laboratory and the Bioengineering laboratory at the Engineering Research Complex. On this project, Perez-Gracia and Devine have been working with the third researcher of the team, Marco P. Schoen, professor of mechanical engineering, Omid Heidari, a doctoral student in mechanical engineering, master of science students A.J. Alriyadh, Asib Mahmud, Vahid Pourgharibshahi and John Roylance, and undergraduate students Dillan Hoy, Madhuri Aryal and Merat Rezai. Eydie Kendall, assistant professor of physical and occupational therapy, also collaborated on the project.
“We have very good equipment here that we can do experiments with and that is very appealing,” said Heidari, who said the laboratory has become his second home. “Instead of just writing code on computers and stuff, we are actually doing something here that is very practical and very interesting. We did the motion capture, the kinematic part, and now we are working on finishing the virtual reality part of the project. We are getting closer to having a good model of what we want.”
[Abstract] Fuzzy logic-based mobile computing system for hand rehabilitation after neurological injury.
Effective neurological rehabilitation requires long term assessment and treatment. The rapid progress of virtual reality-based assistive technologies and tele-rehabilitation has increased the potential for self-rehabilitation of various neurological injuries under clinical supervision.
The objective of this study was to develop a fuzzy inference mechanism for a smart mobile computing system designed to support in-home rehabilitation of patients with neurological injury in the hand by providing an objective means of self-assessment.
A commercially available tablet computer equipped with a Bluetooth motion sensor was integrated in a splint to obtain a smart assistive device for collecting hand motion data, including writing performance and the corresponding grasp force. A virtual reality game was also embedded in the smart splint to support hand rehabilitation. Quantitative data obtained during the rehabilitation process were modeled by fuzzy logic. Finally, the improvement in hand function was quantified with a fuzzy rule database of expert opinion and experience.
Experiments in chronic stroke patients showed that the proposed system is applicable for supporting in-home hand rehabilitation.
The proposed virtual reality system can be customized for specific therapeutic purposes. Commercial development of the system could immediately provide stroke patients with an effective in-home rehabilitation therapy for improving hand problems.
News flash — we’re all human, everyone ages, many people are already disabled or will become disabled at some point in their life, and most people want to feel happy and healthy in their lives.
Not Enough Exercise
Exercising for at least 30 minutes a day is linked to better physical and emotional health. With a third of adults aged 50 and up and 47% of people with disabilities ages 18 to 64 not getting enough exercise, there has to be something to get them moving and enjoying life to the fullest.
Seniors and people with disabilities are sometimes limited to what exercises they can do. Adaptive equipment like a wheelchair, walker, or cane are supposed to improve mobility but can become a hindrance to exercise for many. People with physical limitations may not even be able to stand, walk, or leave their bed due to medical reasons.
So what’s the solution? How do we get seniors and people who are disabled more access to activity and increase their wellbeing? The answer is virtual reality. VR allows anyone to put on a headset, pick a game that’s standing or sitting, and enjoy the combined benefits of physical and mental activity.
Getting cardio doesn’t have to mean going for a run or jog anymore, you can still get a workout and reap all the heart-healthy benefits from playing a VR game.
Rec Room is best played with a group of people because you’ll be playing games like paintball. The game won’t be too intense, you’re free to sit or stand while playing, and it will feel like the exercise equivalent to walking.
There’s also a faster paced drumming VR game called Music Inside: A VR Rhythm Game that can be played standing or sitting as you use your upper body to hit the drum to the beat and your core and lower body to stabilize.
VR Strength Training
Fruit Ninja is a great standing game that has you using the VR controllers as a machete to slice and dice fruit. You’ll be using your upper body to reach and slice fruit, your mid-body to reach towards different directions, and your lower body to position your body and to move frequently. This VR game is rated by the VR Health Institute as being an equal workout compared to using an elliptical.
Please note: If you have a strong upper body or lower body and want a challenge you can always add hand weights or ankle weights to boost the difficulty level. Please consult a trainer or doctor before adding weights to your exercise plan.
VR Flexibility for Mind and Body
Exercising your body while also using your mind can help promote happiness, lower stress, improve memory, and flexible thinking skills.
Everyone experiences stress, so playing games like Wise Mind is a great way for everyone to unwind from a long day or start the day off with a clear and calm mind. Wise Mind has you practicing Tai Chi, balancing stones, and gives you mindfulness and meditation exercises to choose from. Tai Chi is great for a low impact and low-stress exercise that can be done seated or standing. Balancing stones is great for hand-eye coordination practice as well as promoting patience and understanding with yourself and others. While the meditation and mindfulness activities will keep your mind clear and resilient.
Stretching muscles helps to prevent muscle atrophy, improve range of motion and flexibility, reduces injuries, and increases pain relief.
VR apps like Yoga Joint VR Experience are great for getting a slow to advanced paced stretch while also building muscle strength and tone. Yoga involves you using your own strength to hold poses using your own body weight. Many yoga poses can be modified to suit needs based on injuries and physical limitations. Some yoga stretches can even be modified while sitting in a chair or wheelchair.
VR Helps Everyone Get Healthy
Getting exercise, stretching, and being mindful using VR will improve your physical health but it will also make you feel happier overall. Getting VR headsets and games in the hands of the people who will benefit from using it the most is essential. Helping the disabled and the elderly gain access to VR helps them break through old limitations that used to hold them back.
Using VR to exercise and experience new ideas, environments, and people drastically improves the quality of people’s lives. So let’s do something about it — tell your neighbors, friends, coworkers, and family members about the physical and mental health benefits of VR.
[ARTICLE] Overcome Acrophobia with the Help of Virtual Reality and Kinect Technology – Full Text PDF
There are many people in this world who are feared of high places. In general, there are two types of people: the prior one is people that are afraid of height and the latter one is people who really cannot handle high places (i.e. acrophobia). The purpose of this research is to reduce acrophobia level of people. The methodology which is used in this research is experiment with the help of virtual reality to simulate virtual world of high places environment as the reality in the imagination of the user. The virtual environment helps the sufferer to reduce their fear of height in a safe and controllable environment. This research shows that virtual reality is able to mimic real high places and train the users to overcome their anxiety of high places. With virtual world, the users are able to confront their fear gradually based on the level progression in the virtual world. Thus, it gives the users more experience to handle their fear in the secured environment and gradually decrease their anxiety level of acrophobia.[…]
[Mini Review] No distance between disabled people and rehabilitation engineer in high-tech era – Full Text PDF
Traditional face to face diagnosis and treatment model has existed for thousands of years between doctors and patients. But now high technologies have brought people great convenience in many fields. When the disabled people concerned, many technologies such as internet, remote sensing, signal processing, Virtual Reality and so on, are already playing an important role in rehabilitation engineering. This paper introduces these emergency new technologies associated with the disabled people and engineers in recent years, which can eliminate the psychological and space distance between disabled people and rehabilitation engineer in high-tech era.
The rehabilitation strategies are needed to optimize function and
reduce disability of disabled people. Many public plans are developed
in some countries . And now lots of specialized institutions for the
rehabilitation of disabled people have been established . The disabled
people is widely distributed , so many scholars are committed to
provide a rehabilitation approach to them . Remote rehabilitation
is a combination of rehabilitation medicine, computer technology,
internet technology, sensor technology, information processing
technology, etc., it is a new rehabilitation resources with a new concept
of rehabilitation, which can provide space for the further development
of rehabilitation engineering technology . Based on the realization
of cross-regional rehabilitation services, remote rehabilitation is
the integrated use of communication technology, remote sensing
technology, remote control technology. Remote rehabilitation allows
people to achieve rehabilitation cross the geographical area via the
information exchange. The value of remote rehabilitation is also
reflected in the fact that it can optimize the configuration of manpower
and materials. In fact, for individuals with disabilities, rehabilitation
affected by many factors such as their family, their mood, social
environment , especially today’s high technologies.
Rehabilitation engineers can hear the voice of distant people through
the microphone and touch the distant people via embedded artificial
sensors into skin to get the signal such as the surface temperature,
moisture distribution of disabled people . Rehabilitation engineers
can also operate medical and rehabilitation equipment by the remote
control system . With the aid of a remote rehabilitation system,
information interaction between rehabilitation engineers and disabled
people can be more flexible, efficient and convenient . In addition,
other technologies, such as wearable technology , gait analysis
technology , synchronous audio-visual technology  and so
on have been already implicated in the field of remote rehabilitation
engineering. In the following paper, several important high technologies
for remote rehabilitation will be systematically analyzed via contacting
the traditional rehabilitation engineering. […]
Virtual Reality Enhanced Robotic Systems for Disability Rehabilitation
The study of technology and its implications in the medical field has become an increasingly crucial area of research. By integrating technological innovations into clinical practices, patients can receive improved diagnoses and treatments, as well as faster and safer recoveries.
Virtual Reality Enhanced Robotic Systems for Disability Rehabilitation is an authoritative reference source for the latest scholarly research on the use of computer-assisted rehabilitation methods for disabled patients. Highlighting the application of robots, sensors, and virtual environments, this book is ideally designed for graduate students, engineers, technicians, and company administrators interested in the incorporation of auto-training methods in patient recovery.
[BLOG POST] Virtual reality for people with stroke or Parkinson’s disease: bringing therapy home – Evidently Cochrane
In this blog, neuropsychologist Marta Bieńkiewicz explores the potential of virtual reality to help people with Parkinson’s disease, and after stroke, and looks at the evidence from Cochrane reviews.
By 2020 it is estimated that there will be 120 million active users of Virtual Reality (VR) via mobile headsets; nearly a fifth of whom will be using it for healthcare solutions (ABI report, 2015). The hype about VR is currently reaching fever pitch, thanks mostly to the increased accessibility of it for the average Joe (via solutions such as smartphones add-ons spectacles). All over the globe VR setups are being tested and investigated as a novel means of enabling more fun and efficient physical exercise as part of rehabilitation. But is all the money that goes into research and development for this technology justifiable? Could it be better spent – for example on training more therapists or providing activity groups for patients?
In an attempt to answer this question, let’s walk through some facts to get a better picture as to what VR is and what it might hold for people with stroke and Parkinson’s disease (PD).
The virtual reality (VR) environment
My first exposure to VR was during my PhD days. My future husband (as it turned out 5 years later) was doing his doctorate on the non-clinical applications of what was, at the time, a technology in its infancy. In the simplest of definitions, VR is a computer designed environment that can be displayed in a headset glasses or a cave (special room) to create a feeling of full immersion that you are somewhere else; completely detached from the real world yet fully engaged with the virtual world. The high immersion display might trick you into thinking you are on a tennis court playing a game at Wimbledon for example. The low immersion VR environments comprise computer displays – usually tablets or regular screens. In this case you can still enjoy a game or follow on-screen instructions, but your brain keeps check of its whereabouts.
So, the main concept behind VR-based rehabilitation games is twofold. Firstly, they provide a clear, visual means of prompting users’ movements (i.e. in the example of picking up an apple, the user might be guided toward it). Secondly, they increase the personal motivation of the user. The higher the engagement with the environment and varied scenarios, the higher the enjoyment and willingness to repeat the same exercise all over again (Lewis & Rosie, 2012). A Cochrane review (French et al. 2016) reported that repetitive training may improve walking distance and is probably effective for improving upper limb rehabilitation. For a fantastic example of how this field is moving forward see the KATA project based at John Hopkins University which uses a combination of VR (Pixar like!) display with robotic-assisted therapy for stroke.
The reality of stroke and Parkinson’s disease
Stroke and Parkinson’s disease are two different neurological conditions. The first one happens suddenly and changes mobility overnight, which may mean changing from being a fully active person to being limited in one’s independence. The second is characterised by gradual and sneaky progression of compromised mobility. Either condition may make everyday life increasingly a real struggle. When it is not easy to get dressed, the idea of doing physical exercise seems totally unattainable. People find themselves not being able to do the tasks they previously took for granted – preparing a sandwich, driving a car, or simply going out of the house, and now add to it catching up with the modern technology.
Exercise may help
If you are a sufferer, these two aspects might discourage you from reading on – exercise and VR sounds too hard to even bother! But here is the thing. While guidelines on how to improve mobility in neurological conditions are scarce, the ones that are there (Keus et al., 2014)suggest that the power of exercise might help. Studies suggests that intense exercise in Parkinson’s may slow down the progression of the disease due to neuroprotective benefits (Alberts et al., 2016, Corcos et al., 2013) and help maintain independence (van Nimwegen, 2011). After stroke, physiotherapy is usually started straight away or during the hospitalisation period. In fact, many research teams are convinced that the time window for the real functional recovery of lost limb power (i.e. regaining the previous dexterity) is quite short and is limited to 6 months post accident or shorter (Cortes et al., 2017). This is the window of opportunity for brain reorganisation, after which improvement is maybe not impossible, but certainly more challenging.
Depending on patients’ needs, exercise should target general mobility, dexterity, walking, or specific daily activities. There are exercise-based interventions in particular that were reported to show improvement in people with Parkinson’s Disease: such as tandem or automated stationary cycling (Ridgiel et al., 2015) and pole-striding (Bombieri et al., 2017; Krishnamurthi et al., 2017), and for stroke: physical rehabilitation (Pollock et al., 2014) or robot-assisted interventions (Mehrholz et al., 2015, 2017). In both conditions, it is thought to be important to start as soon as possible and introduce exercise regime as a regular part of daily life.
For people with PD or after stroke who are keen to become more fit and actively steer their rehabilitation, VR could be their new best friend.
Does virtual reality offer real life benefits?
The Cochrane review of VR (Dockx et al., 2016) and gaming for Parkinson’s, with a focus on walking and balance, provides us with evidence that VR based training may lead to better improvements for stride length, but overall may have similar effects on walking parameters and balance as conventional therapy, while the effect on quality of life is uncertain. The upper limb interventions were not included.
On the contrary, the Cochrane review of VR in stroke focused interventions (Laver et al., 2015) was primarily focused on upper limb function and found that VR based interventions may lead to greater improvements in both function and daily task performance compared to conventional therapy. Global mobility and grip strength remained on level par. It is not clear how long-lasting those effects are, nor which characteristics are the most meaningful for patients’ recovery. The number of studies examined was small and information insufficient to look into other dimensions such as quality of life or cognitive functions.
So what does this all mean? The interventions using VR were overall found to be probably similar to the conventional therapies, with the potential added value in the form of accurate feedback and the ability to stimulate users by creating personalised, motivational and fun interventions (Dockx et al., 2016, Laver et al., 2015). If more evidence is found to confirm those findings, it would mean VR can be potentially be as good as a supervised therapy, which is great news. Why? Because it means you can bring it home.
Why Occupational Therapists can sleep well at night (for now…)
Let’s make it clear, this is not an overnight take-over of conventional therapy. VR and gaming solutions have the potential to provide a similar level of care to traditional exercise-based therapy, without having to replace it. At least for the next decades, think of it as a potential complementary therapy subsidised by the NHS or private insurance: part of a medical treatment that would encourage patients to do meaningful exercise in between the supervised physiotherapy sessions. Conversely, VR-based exercise units in hospitals could train patients in daily tasks, emulating their home environment. Beyond that, the technology is simply not mature enough to match that of a human eye and brain in terms of assessment and choice of best treatment. However, with Artificial Intelligence looming on the distant horizon, this is not beyond the realms of possibility…some day.
Tread carefully though when it comes to any products or apps that are advertised as a rehabilitation tool on the consumer market. In order for it to be a relevant training tool it needs to be paired with sensors (attached to your body or embedded in a special clothing) in order to provide feedback.
Looking to the future: Extended Reality
The future however, might lie in a newly born sister of VR, namely Extended Reality (ER). This technology is also based on wearable headsets (such as Hololens) but allows the user to be immersed in the virtual reality while seeing the physical environment.
The idea is that the juxtaposed feedback information is relevant and not interruptive for your current activity (e.g. walking a dog). It is also a safer mode of exercise as it does not require being detached from one’s surroundings despite a high level of immersion in the virtual environment/of immersion. At least four labs so far have been investigating this idea for stroke and Parkinson’s (Technical University of Munich, University of Rochester, University of Connecticut and Northeastern University). Along with ER developments, the level of immersion and therefore enjoyment can be increased with the sound spatialisation and touch sensation (i.e. Ultrahaptics). One could easily imagine that ER opens new horizons for combining a very accurate feedback tool with, for example, robotic therapy.
Hopefully the next years will bring answers to questions such as the level of transferability of VR/ER training into real life skills. Further research is necessary to inform tailored technology-based exercise regimes and to clarify whether or not rehabilitation with limited supervision is a feasible model.
The take home message
While certainly the technological development in the current era is both exciting and a little daunting, it brings solutions that were not previously available at such affordable cost. VR essentially offers a therapy that is likely to become almost as good as conventional therapy from within the comforts of your own home. VR and gaming can be fun, can provide excitement of immersion and prevent boredom while also achieving exercise goals for task-specific rehabilitation. While current solutions are not yet up to the ‘buy now’ level, this area should definitely make your watchlist.
References may be found here.
Marta Bieńkiewicz has nothing to disclose.
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.”
[Abstract] Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system.
Background: New technologies, such as telerehabilitation and gaming devices offer the possibility for patients to train at home. This opens the challenge of safety for the patient as he is called to exercise neither with a therapist on the patients’ side nor with a therapist linked remotely to supervise the sessions.
Aim: To study the safety, usability and patient acceptance of an autonomous telerehabilitation system for balance and gait (the REWIRE platform) in the patients home.
Design: Cohort study.
Setting: Community, in the stroke patients’ home.
Population: 15 participants with first-ever stroke, with a mild to moderate residual deficit of the lower extremities.
Method: Autonomous rehabilitation based on virtual rehabilitation was provided at the participants’ home for twelve weeks. The primary outcome was compliance (the ratio between days of actual and scheduled training), analysed with the two-tailed Wilcoxon Mann- Whitney test. Furthermore safety is defined by adverse events. The secondary endpoint was the acceptance of the system measured with the Technology Acceptance Model. Additionally, the cumulative duration of weekly training was analysed.
Results: During the study there were no adverse events related to the therapy. Patients performed on average 71% (range 39 to 92%) of the scheduled sessions. The Technology Acceptance Model Questionnaire showed excellent values for stroke patients after the training. The average training duration per week was 99 ±53min.
Conclusion: Autonomous telerehabilitation for balance and gait training with the REWIRE-system is safe, feasible and can help to intensive rehabilitative therapy at home.
Clinical Rehabilitation Impact: Telerehabilitation enables safe training in home environment and supports of the standard rehabilitation therapy.