Posts Tagged VR
Virtual Reality has been a staple of science fiction for some time, Though, in terms of real-life application, the world is still coming to grips with what the tool can offer us.
In recent years, tech experts, doctors, medical students and videographers have used the tool as a way of exploring worlds not normally accessed in everyday life, and as a medium to advance our knowledge.
To fully grasp the potential of this tool, Facebook head of tech, entertainment and connectivity, Jason Juma-Ross, sat down with industry experts at Advertising Week to discuss how VR has moved beyond far entertainment and is now facilitating positive change globally.
Speaking with Facebook global head of consumer research, Helen Crossley, and Sydney University professor of biomedical sciences, Philip Poronnik, Juma-Ross and the panellists discussed how VR is being harnessed by medical students and marketers in entirely different ways.
For Poronnik, VR is a fundamental piece of learning equipment for his students – a tool he called a “total game changer”. He added, “People have been excited about VR since it came out, however we’ve been limited by cost, but now we have Oculus Go and our abilities are unlimited.”
According to professor Poronnik, the Oculus Go has enabled students to help prep patients for operations, offer better stroke rehabilitation to sufferers and even create bespoke situations where students can train in rare medical emergencies that were previously too costly or niche to study.
“The technology has an immense capacity for training,” said Poronnik. “From the Ebola virus to virtually stepping into Hazmat suits which are incredibly expensive, it allows us to teach students to prep without the cost,” he added.
“We can work on quick drug simulations and stressful situations. Teaching knowledge about these situations is critical but given their low probability, the ability to simulate them with GO has been hugely helpful to students in training.”
Poronnik also touched on how VR sets being used in ER rooms are enabling patients to temporarily disappear, creating virtual environments which distract them from the chaos surrounding them. As well as this, VR has proved very effective in helping and curing phobias.
For Crossley, the tool will be massively important to consumers and retailers. Speaking on the impact of VR, Crossley said, “Consumers want to experience a lot of different things. Immersion will soon be the norm, and it’s interesting to realise most consumers’ first experiences with VR will not be in the home.”
Crossley added, “Physical retailers are successful when they offer a completely immersive experience. Where we see VR with commerce in the future is consumers being able to experience products in a visceral way, be that in travel, auto, retail and beyond.”
Looking to the future, both Poronnik and Crossley agreed we are only at the beginning of finding out what VR can do for humans, though neither could predict what the tech would look like in 10 or even five years. Both, however, are extremely excited about it.
Poronnik, for one, questioned how the tool will physically be used by humans in the coming years given its very nature as a “body experience”. He rhetorically asked, “In the future, will it still be glasses or will it be projected onto our eyes? We’re really just scratching the surface.”
Meanwhile, Crossley likened the technological progress of the tool in marketing to the ‘chicken or the egg’ debate. At the moment both marketers and consumers are waiting to see what the other will do with tool, she said.
Crossley also asked, “How will consumers continue using the tool despite the fact there’s not a tonne of content? How will developers and marketers continue building VR considering the base is still growing? We’re not sure.
“We can only imagine what it’ll be like in 10 years,” Crossley added.
The virtual reality (VR) system Serious Game may help children with cerebral palsy and other neurological impairments rehabilitate their upper limbs, suggests a study conducted by a team of Italian researchers who developed the system.
The study, published recently in IEEE Transactions on Neural Systems and Rehabilitation Engineering, examined Serious Game, which is composed of a virtual reality camera mounted to the head and two wearable haptic devices placed on two fingers.
In their study, the team investigated the usability of this rehabilitation system in three patients with cerebral palsy and five patients with developmental dyspraxia—a disorder characterized by the impairment of the ability to plan and carry out sensory and motor tasks. The mean age of participants in this group was 10.13 years, according to a news story from Cerebral Palsy News Today.
Typically developing children, with a mean age of 13.38 years, and adults, with a mean age of 26.75 years, also were included in the study.
The participants were divided into two groups: one assisted by the Serious Game technology and another undergoing conventional neurocognitive rehabilitation therapy. Both conditions required movements involving similar motor functions, such as reaching, grasping, and rotating both forearms and hands, but with different tasks and goals in various contexts.
The children attended 16 training sessions of two sessions per week for 4 weeks, over two separate periods. Between the two interventions, a washout period of 4 weeks was added in which children followed only cognitive therapy with no physical sessions.
The children’s exercise capacity was measured using validated clinical scales and motion analysis, the news story continues.
Typically developing children were eager to complete the assigned task even though they were instructed to execute the session with attention and without rushing, while the adults, cerebral palsy, and developmental dyspraxia groups seemed to pay greater attention to precisely performing motor tasks.
The accuracy and velocity of movement were only different between typically developing children and neuromotor patients in the reach-to-grasp exercise, in which children were asked to flip a card protruding from a horizontal support. No significant differences were observed in the path-tracking task, in which children were seated in front of a desk and asked to reach a target by moving the hand along a straight path, the story explains.
Children with neurological disorders completed the game without exceeding the maximum time threshold imposed. Also, these children reported positive feedback after participating in the Serious Game.
The results of virtual reality were consistent with the participants’ motor skills. Overall, the cerebral palsy and developmental dyspraxia group had lower performance than typically developing children and adults, while in turn, the typically developing children had lower performance than adults.
“Results show the system was compliant with different levels of motor skills and allowed patients to complete the experimental rehabilitation session, with performance varying according to the expected motor abilities of the different groups,” researchers wrote, in the study.
“The ability both to customize the modalities of interaction with the virtual environment and, in the same time, to arise motivation in young participants have revealed virtual reality as a potentially important rehabilitation tool in these children,” they add, per the news story.
In the future, the team plans to study this approach in a larger population.
[Source: Cerebral Palsy News Today]
Δημοσιεύτηκε στις 20 Ιουν 2018
A therapist will always be present to monitor these sessions of patients.
Games developed specially for rehabilitation in physiotherapy for patients of stroke, cerebral palsy and similar conditions, will be used by the Ministry of Health and Prevention (Mohap) as it rolls out use of artificial intelligence (AI) and virtual reality (VR) in hospitals.
The AI system is already in use in Ras Al Khaimah Physiotherapy and Sports Centre and will be rolled out soon in all other ministry hospitals. “Games are developed for rehab of such patients, for both children and adults, especially those suffering from cerebral palsy and motor delay conditions,” Dr Yousif Mohammed Al Serkal, assistant undersecretary for the hospital sector, told Khaleej Times.
“The AI system is composed of three parts – a TV set, a sensory kinetic bar and an X-Box linked with these. Specific games are used to assess how cognitive a patient is,” he said.
A therapist will always be present to monitor these sessions of patients and will assess their conditions accordingly, he added.
He also explained the advantages of VR using AI in physiotherapy to provide treatment. “This will allow the patient to complete the treatment at his/her home with the possibility of remote rehabilitation,” he said.
“In the treatment of stroke, the virtual reality system evaluates and enhances the recovery of the affected upper parts, in addition to the training for the walking device used for rehabilitation.
“The patient moves at a speed on the motion platform with changing virtual environments being displayed on the front screen to simulate daily activities. In the treatment of the balance disorder, virtual reality is a safe and effective alternative to conventional therapy to improve the balance in patients,” he said. “Patients have reported that they enjoyed VR therapy without suffering from side effects, and with increased motivation.
“This technique is also used to treat children with developmental disorders, including positive developments in both perceived and performance capabilities in areas of daily activities including social activities that they have not been able to do before.”
The virtual therapy also assists cerebral palsy patients in the reorganisation of the brain and movement ability and visual cognitive skills, in addition to social participation and personal factors.
More about VR with AI
The UAE Strategy for Artificial Intelligence (AI) is a project within the Centennial Plan 2071. The plan will also include virtual reality (VR) rehabilitation in physiotherapy for stroke patients, patients suffering from balance disorder and children with development disorders, cerebral palsy and Parkinson’s syndrome.
VR rehabilitation technology makes use of virtual world simulation to meet various requirements for effective medical intervention to achieve the best results using the video game controller and the moving sensor. Scientific studies have proven the effectiveness of this innovative technique in the rehabilitation and treatment of many such cases.
KT NANO EDIT
AI boost to healthcare
Healthcare industry stands to gain significantly by inducting artificial intelligence into various processes. The technology can take the fear out of procedures and make treatments more effective. The UAE has been experimenting on this front and results are encouraging so far. Innovation through AI is becoming more meaningful with its human-centric approach, and the medical experts are now looking at expanding its scope.
Burton J. Tabaac, MD
This review examined the efficacy of virtual reality, compared with an alternative intervention or no intervention, on upper limb function and activity. The publication is an update of the authors’ review first published in 2011 and then revised in 2015. The initial review, published in 2011, identified only 19 studies. For this iteration, 11 databases and trial registries were searched, including randomized and quasi-randomized trials of virtual reality in adults after stroke. A total of 72 trials (with 2470 participants) were included in the review.
While most recovery after stroke is thought to be made in the first few weeks, patients may make improvements on functional tasks many months after having a stroke. Prior research has shown that repetitive task training is effective in some aspects of rehabilitation, such as improving walking distance and speed and improving upper limb function. Virtual reality is a relatively recent approach that may enable simulated practice of functional tasks at a higher dosage than traditional therapies. Virtual reality has been defined as the “use of interactive simulations created with computer hardware and software to present users with opportunities to engage in environments that appear and feel similar to real-world objects and events.”
In assessing the primary outcome for this review paper, virtual reality was compared with the same dose of conventional therapy, and the results were not statistically significant for upper limb function. However, when virtual reality was used to supplement usual care (providing participants in the intervention group with a higher dose of therapy), there was a statistically significant difference between groups. There was a trend suggesting that customized virtual reality programs were preferable to commercial game products; however, these findings were not statistically significant.
Evidence of neuroplasticity as a result of training in virtual reality is modest; however, neuroimaging findings are guiding the development of virtual reality. The authors are keen to note that one major advantage of virtual reality programs, which has been underutilized to date, is that they allow clinicians to be able to trial tasks that are unsafe to practice in the real world, such as crossing the street. In addition, some programs are designed to be used without supervision, meaning that increased dosage of therapy can be provided without increased staffing levels. It is important to continually evaluate the efficacy of virtual reality in order to guide future design and use.
Swiss startup MindMaze, which raised $100 million in funding, has launched its MindMaze Pro virtual reality treatment for stroke recovery patients in the U.S.
The launch shows that VR is for more than just games, as it stands at the intersection of neuroscience and entertainment. The launch is the latest example of how VR is spreading far beyond games and entertainment. And that’s important, as consumer VR sales have been slower than expected.
Based on a decade of research and testing for “neuro VR,” the MindMaze Pro is an upper-limb neurorehabilitation platform that uses proprietary 3D motion-tracking cameras to help patients recovering from traumatic injuries and those suffering from acute and chronic strokes.
MindMaze introduced MindMotion Pro to the European market in 2013, and hundreds of patients have used the platform for the rehabilitation therapy.
Lausanne, Switzerland-based MindMaze already delivered a thought-powered virtual reality, augmented reality, and motion capture game system in MindLeap. The company, whose board includes some of the world’s leading doctors and neuroscientists, will be applying its multisensory computing platform to numerous new fields, which include robotics and transportation.
The U.S. Food and Drug Administration has granted MindMaze 510(k) clearance. Mindmaze also said that it has completed 261 patient trials of MindMotion Go, a portable neurotechnology device that uses VR to continue therapy after a patient leaves the hospital. Those trials were conducted in the United Kingdom, Germany, and Switzerland.
Each year in the U.S., about 800,000 people suffer a stroke, resulting in debilitating health effects as well as direct and indirect losses of economic activity of $65 billion according to research published in The American Journal of Managed Care.
MindMotion Pro works by mapping a patient’s movements onto 3D avatars in customized interactive exercises that are based on standardized neurorehabilitation principles of upper limb rehabilitation and cognitive paradigms. By doing so, it reactivates damaged neural pathways and activates new ones.
MindMaze’s technology is specifically designed to help stroke patients and those with traumatic brain injuries start recovery early and continue it for maximum gains.
MindMotion Pro uses VR games to keep patients engaged with therapies for recovery. It has custom tracking technology that gives real-time and accurate patient tracking in both bedside and wheelchair uses. It also helps the therapist in supporting the patient during the activities.
“Our work at the forefront of neuroscience and virtual reality allows patients to recover faster and return more fully to the life they lived before injury,” said Tadi in a statement. “Over the last decade, we’ve honed this therapy to be cost-effective for both patients and healthcare providers.”
Due to the motivating effects of the virtual-reality based games, patients can engage in 10 to 15 times more exercising repetitions than with standard rehabilitation programs, and because the system offers real-time multisensory feedback, therapists can assess progress and tailor therapy to patient performance.
Research from the leading rehabilitation facility Clinique Romande de Réadaptation/EPFL in Sion, Switzerland, found that 90 percent of chronic stroke patients using MindMotion Pro reported heightened motivation to perform rehab, increased the potential for motor function recovery and that their training intensity doubled within the first 10 sessions of using the platform. Additionally, Lausanne University Hospital-CHUV reported 100 percent of patients forgot they were in a hospital.
[ARTICLE] Combining Upper Limb Robotic Rehabilitation with Other Therapeutic Approaches after Stroke: Current Status, Rationale, and Challenges – Full Text
A better understanding of the neural substrates that underlie motor recovery after stroke has led to the development of innovative rehabilitation strategies and tools that incorporate key elements of motor skill relearning, that is, intensive motor training involving goal-oriented repeated movements. Robotic devices for the upper limb are increasingly used in rehabilitation. Studies have demonstrated the effectiveness of these devices in reducing motor impairments, but less so for the improvement of upper limb function. Other studies have begun to investigate the benefits of combined approaches that target muscle function (functional electrical stimulation and botulinum toxin injections), modulate neural activity (noninvasive brain stimulation), and enhance motivation (virtual reality) in an attempt to potentialize the benefits of robot-mediated training. The aim of this paper is to overview the current status of such combined treatments and to analyze the rationale behind them.
Significant advances have been made in the management of stroke (including prevention, acute management, and rehabilitation); however cerebrovascular diseases remain the third most common cause of death and the first cause of disability worldwide [1–6]. Stroke causes brain damage, leading to loss of motor function. Upper limb (UL) function is particularly reduced, resulting in disability. Many rehabilitation techniques have been developed over the last decades to facilitate motor recovery of the UL in order to improve functional ability and quality of life [7–10]. They are commonly based on principles of motor skill learning to promote plasticity of motor neural networks. These principles include intensive, repetitive, task-oriented movement-based training [11–19]. A better understanding of the neural substrates of motor relearning has led to the development of innovative strategies and tools to deliver exercise that meets these requirements. Treatments mostly target the neurological impairment (paresis, spasticity, etc.) through the activation of neural circuits or by acting on peripheral effectors. Robotic devices provide exercises that incorporate key elements of motor learning. Advanced robotic systems can offer highly repetitive, reproducible, interactive forms of training for the paretic limb, which are quantifiable. Robotic devices also enable easy and objective assessment of motor performance in standardized conditions by the recording of biomechanical data (i.e., speed, forces) [20–22]. This data can be used to analyze and assess motor recovery in stroke patients [23–26]. Since the 1990s, many other technology-based approaches and innovative pharmaceutical treatments have also been developed for rehabilitation, including virtual reality- (VR-) based systems, botulinum neurotoxin (BoNT) injections, and noninvasive brain stimulation (NIBS) (Direct Current Stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS)). There is currently no high-quality evidence to support any of these innovative interventions, despite the fact that some are used in routine practice . By their respective mechanisms of action, each of these treatments could potentiate the effects of robotic therapy, leading to greater improvements in motor capacity. The aim of this paper is to review studies of combined treatments based on robotic rehabilitation and to analyze the rationale behind such approaches.[…]
[Abstract] Effects of Kinect-based virtual reality game training on upper extremity motor recovery in chronic stroke.
Therapeutic benefits of Kinect-based virtual reality (VR) game training in rehabilitation encourage its use to improve motor function.
To assess the effects of Kinect-based VR training on motor recovery of the upper extremity and functional outcomes in patients with chronic stroke.
In this randomized controlled trial, group A received 20 sessions of physical therapy (PT) + 20 sessions of Kinect-based VR training and group B received only 20 sessions of PT. Clinical outcome measures were assessed at baseline and at the end of the treatments. Primary outcome measures that assess stroke patients’ motor function included upper extremity (UE) Fugl-Meyer Assessment (FMA). Secondary outcome measures were Brunnstrom Recovery Stages (BRS), Modified Ashworth Scale (MAS), Box and Block test (BBT), Motricity index (MI), and active range of motion (AROM) measurement.
Statistically significant improvements in game scores (p < 0.05) were observed in group A. In within-group analysis, there were statistically significant improvements in all clinical outcome measures except for the BRS-hand, MAS-distal, and MAS-hand in group A; MAS-(proximal, distal, hand) and BRS-(UE, hand) in group B compared with baseline values. Differences from baseline of FMA, MI, and AROM (except adduction of shoulder and extension of elbow) were greater in group A (p < 0.05).
To conclude, our results suggest that the adjunct use of Kinect-based VR training may contribute to the improvement of UE motor function and AROM in chronic stroke patients. Further studies with a larger number of subjects with longer follow-up periods are needed to establish its effectiveness in neurorehabilitation.
[ARTICLE] Effectiveness of Wii-based rehabilitation in stroke: A randomized controlled study – Full Text HTML
Objective: To investigate the efficacy of Nintendo Wii Fit®-based balance rehabilitation as an adjunctive therapy to conventional rehabilitation in stroke patients.
Methods: During the study period, 70 stroke patients were evaluated. Of these, 23 who met the study criteria were randomly assigned to either the experimental group (n = 12) or the control group (n = 11) by block randomization. Primary outcome measures were Berg Balance Scale, Functional Reach Test, Postural Assessment Scale for Stroke Patients, Timed Up and Go Test and Static Balance Index. Secondary outcome measures were postural sway, as assessed with Emed-X, Functional Independence Measure Transfer and Ambulation Scores. An evaluator who was blinded to the groups made assessments immediately before (baseline), immediately after (post-treatment), and 4 weeks after completion of the study (follow-up).
Results: Group-time interaction was significant in the Berg Balance Scale, Functional Reach Test, anteroposterior and mediolateral centre of pressure displacement with eyes open, anteroposterior centre of pressure displacement with eyes closed, centre of pressure displacement during weight shifting to affected side, to unaffected side and total centre of pressure displacement during weight shifting. Demonstrating significant group-time interaction in those parameters suggests that, while both groups exhibited significant improvement, the experimental group showed greater improvement than the control group.
Conclusion: Virtual reality exercises with the Nintendo Wii system could represent a useful adjunctive therapy to traditional treatment to improve static and dynamic balance in stroke patients.
Stroke is one of the leading causes of disability (1). In stroke patients, balance can be affected by various factors, such as muscular weakness, abnormal muscle tone, deficits in visual and sensory function or disturbances in vestibular mechanisms (2). Since balance dysfunction is associated with increased risk of falling, balance exercises are a critical component of the rehabilitation of stroke patients.
Recent years have seen growing interest in the use of new technologies, such as virtual reality (VR), in stroke rehabilitation. Clinical results indicate that the use of VR technologies improves motor functioning (3–5). VR can be used to improve upper limb function, gait and balance, global motor function and cognitive function in stroke patients (6). However, VR equipment is usually complex and expensive, and may be available only in specialist centres with the help of experienced therapists. As a consequence, there has been an increase in the number of studies on the efficacy of commercial gaming programs in stroke rehabilitation. PlayStation, Wii, and Xbox, along with Kinect, are the game consoles most commonly used in stroke rehabilitation. Wii (Nintendo, Kyoto, Japan) is a game console used to improve balance, strength, flexibility and fitness. It provides a relatively simple and inexpensive opportunity for VR treatment (7).
Several randomized controlled studies have evaluated the effect of Wii-based balance rehabilitation programmes in stroke patients. Cho et al. (8) investigated the effects of VR balance training using Wii in chronic stroke patients. They reported that Wii-based VR exercises resulted in a significant improvement in dynamic balance (8). In another study, chronic stroke patients were randomly assigned to 2 groups. In the first group patients played console games for 5 weeks, and in the control group patients maintained their usual daily activities. A slight improvement was measured in the first group (9).
There are conflicting results in the literature about the efficacy of Wii-based balance exercises compared with other balance rehabilitation programmes, such as progressive balance training and task-specific programmes.
A number of studies have investigated whether the addition of Wii exercises or other exercise options to balance rehabilitation programmes makes a difference in stroke patients. The results are controversial. Lee et al. (10) reported better results in the Wii group. In contrast, Yatar et al. (11) indicated that there were no differences between Wii Fit balance training and progressive balance exercises.
Adequate postural control and good balance performance are prerequisites for independence in daily activities; therefore, these should be important goals of stroke rehabilitation (8). The aim of this study was to investigate the efficacy of Wii Fit-based balance rehabilitation as an adjunctive therapy to conventional rehabilitation in stroke patients.[…]