Abstract
Gait training in a virtual reality (VR) environment is promising for children affected by different disorders. However, the efficacy of VR therapy is still under debate, and more research is needed to clarify its effects on clinical conditions. The combination of VR with neuroimaging methods, such as the electroencephalography (EEG), might help in answering this need. The aim of the present work was to set up and test a system for the multimodal analysis of the gait pattern during VR gait training of pediatric populations by analyzing the EEG correlates as well as the kinematic and kinetic parameters of the gait. An EEG system was integrated with the Gait Real-time Analysis Interactive Lab (GRAIL). We developed and validated, with healthy adults (n = 5) and children (n = 4, healthy or affected by cerebral palsy (CP)), the hardware and software integration of the two systems, which allowed the synchronization of the acquired signals and a reliable identification of the initial contact (IC) of each gait cycle, showing good sensitivity and critical success index values. Moreover, we tested the multimodal acquisition by successfully analyzing EEG data and kinematic and kinetic parameters of one healthy child and one child with CP. This system gives the possibility of monitoring the effect of the VR therapy and studying the neural correlates of gait.
Highlights
Virtual reality (VR) training is becoming increasingly popular in its applications for motor and cognitive rehabilitation of heterogeneous clinical populations
The child was walking on the treadmill in the wooden environment wearing the EEG cap for the EEG signal recording, the EMG electrodes for environment wearing the cap for the signal recording, the electrodes formodel for the EMG signals acquisition, and the passive marker according to the Human Body Model 2 (HBM2) the EMG signals acquisition, and the passive marker according to the HBM2 model for the kinematic parameters recording
Expected that fronto-central electrodes, placed on the scalp in correspondence to the motor and pre-motor cortex, would be the most sensitive to show a correct match between the triggering system and the cerebral rhythms variations locked to the gait cycle
Summary
Virtual reality (VR) training is becoming increasingly popular in its applications for motor and cognitive rehabilitation of heterogeneous clinical populations. The spreading of this technique is mainly due to the possibility of combining controlled laboratory environment with a more ecological and interactive training that increases patient motivation and improves the rehabilitation outcome [1]. VR motor and cognitive training have been administered to children with attention-deficit/hyperactivity disorder (ADHD) [9] and developmental delay [10] with positive effects on their gait parameters. More research is needed to better understand the effects of VR-based rehabilitation on different clinical conditions
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