Abstract
In this paper, we advocate the combination of four key ingredients that we believe are necessary to design long-lasting effective treatments for neurorehabilitation: (i) motor-cognitive training, (ii) evidence-based neuroscience principles, in particular those related to body perception, (iii) motivational games, and (iv) empowerment techniques. Then, we propose virtual reality (VR) as the appropriate medium to encompass all the requirements mentioned above. VR is arguably one of the most suitable technologies for neurorehabilitation able to integrate evidence-based neurorehabilitation techniques and neuroscience principles into motivating training approaches that promote self-management by empowering patients to own their recovery process. We discuss the advantages and challenges of such an approach on several exemplary applications and outline directions for future developments. We strongly believe that the combination of positive psychology and positive technology mediated by VR-based interventions can heavily impact the rehabilitation outcomes of motor-cognitive functions along all the stages of the rehabilitation path.
Highlights
Stroke remains a leading cause of long-term disability worldwide, making the improvement of post stroke outcomes a major healthcare objective
There is a close relationship between motor and cognitive deficits post stroke
In a prospective study contrasting functional independence and cognitive assessments at two time-points, Jokinen et al (2015) showed that, even with a good recovery 3 months post-stroke, 69% of first-ever-stroke patients suffered from cognitive impairment affecting one (25%), two (15%) or multiple (32%) domains
Summary
Stroke remains a leading cause of long-term disability worldwide, making the improvement of post stroke outcomes a major healthcare objective. When integrated into effective training programs, they can boost the rehabilitation outcome and significantly increase the quality of life of stroke survivors (Fryer et al, 2016) In this position paper, we advocate the combination of four key ingredients that we believe are necessary to design longlasting effective treatments for neurorehabilitation: (i) motorcognitive training, (ii) evidence-based neuroscience principles, in particular those related to body perception, (iii) motivational games, and (iv) empowerment techniques. There is increasing evidence that physical exercise contributes to improving cognitive functions post stroke (Cumming et al, 2012; Oberlin et al, 2017) Training both motor and cognitive functions simultaneously (instead of in separate sessions) would increase therapy efficiency, maximizing the amount of therapy (dose) delivered for both modalities while reducing risk of fatigue. Basing neurorehabilitation programs on current neuroscientific understanding and transferring them into clinical practice via personalized treatments (e.g., enabled by technology-mediated interventions), could help boost recovery
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