Effect Of Visual Feedback Training Research Articles

Efficacy of Visual Feedback Training for Motor Recovery in Post-Operative Subjects with Knee Replacement: A Randomized Controlled Trial.

To evaluate the effects of visual feedback training on motor recovery in postoperative patients with a total knee replacement (TKR). The performance of 40 first-ever TKR patients (27 females; mean age: 70.5 (67.2-74.0) years) was evaluated in a single center, single-blind, randomized controlled study. The patients were randomly and equally distributed into two demographically/clinically matched groups undergoing experimental or traditional treatments. All patients have been treated in a 1 h session, 2/day for 5 days a week, for six consecutive weeks. The first group ("control") underwent conventional physical therapy, whereas the experimental group received advanced knee training with visual feedback using the TecnoBody® device (Walker View 3.0 SCX, Dalmine (BG), Italy). The clinical scales and kinematic parameters coming from the gait analysis were evaluated to demonstrate the dynamic balance function in a standing position before and after each treatment. After the treatment, both experimental and control groups improved significantly and similarly, as measured by the clinical scales (Numeric Rating Scale for Pain and Barthel index). A significant boosting of the motor performance was detected in the experimental group with respect to the control group in the terms of symmetry index 84 (80.8-85.4) vs. 87.15 (84-92.8) p = 0.001 *; single stance support 34.9 (34.1-36.5) vs. 37.8 (36.6-38.9); p < 0.001; and obliquity parameters 58.65 (51.3-70.3) vs. 73 (62.3-82.1); p < 0.001. Applying visual feedback training in addition to traditional rehabilitation strategies improves the knee function and motor control in postoperative TKR patients.

Effects of Visual Feedback During Balance Training on Knee Function and Balance Ability in Postoperative Patients After Knee Fracture: A Randomized Controlled Trial.

ObjectiveTo investigate the effects of visual feedback training on knee function and balance ability in postoperative patients with knee fracture.MethodsA clinical randomized controlled trial with 104 participants, randomly assigned (1:1) to a visual feedback training group or a control group. Eligible participants were evaluated using Lysholm scores, the Tinetti scale, and the evaluation module of TecnoBody® to demonstrate dynamic balance function in a standing position before treatment and after 4 and 8 weeks of treatment.ResultsBoth visual feedback training and control groups improved significantly in the Lysholm and Tinetti scores after 8 weeks. Compared with the control group, the TecnoBody® tests included centre of pressure path length, and the area over centre of pressure movement, both of which significantly improved in the visual feedback training group at 8 weeks after treatment. There was no difference between the 2 groups in terms of their Lysholm scores and Tinetti gait before the intervention and 4 weeks after treatment.ConclusionApplying visual feedback training in conjunction with traditional rehabilitation strategies may improve knee function and motor control in postoperative patients with knee fracture. Although visual feedback training does not have a short-term effect on knee function and gait, this method could be a useful addition for rehabilitation of knee fracture patients.LAY ABSTRACTThis study used the TecnoBody® (PK-254P, Bergamo, Italy) to evaluate balance in the standing position of all participants. This equipment provides data on the centre of pressure path length and the area over which the centre of pressure moves. The Lysholm score was used to assess knee function, and the Tinetti scale to assess motor control. Applying visual feedback training in conjunction with traditional rehabilitation strategies could decrease postural sway and increase motor control in postoperative patients with knee fracture, as well as subsequently improve knee function and balance ability. There were no adverse effects due to the combined rehabilitation programme.

The Effects of Visual feedback training with Jaw Opening Against Resistance Exercise on swallowing Function in Chronic Stroke Patients

연구목적 : 본 연구의 목적은 삼킴 장애가 있는 만성 뇌졸중 환자에게 시각적 피드백 훈련을 병행한 저항성 턱 벌리기 운동이 삼킴 기능에 어떠한 영향을 미치는지 알아보는 것이다. 연구방법 : 울산광역시에 위치한 S 병원에 입원한 환자 30명을 무작위로 나누어 8주간 시각적 피드백 훈련의 효과를 알아보기 위하여 실험군은 시각적 피드백을 이용하여 저항성 턱 벌리기 운동을 하는 그룹과 대조군으로 아무런 단서 없이 저항성 턱 벌리기 운동을 하는 그룹으로 나누었다. 중재 전과 중재 후에 침습-흡인 척도(Penetration-Aspiration Scale, PAS), 기능적 삼킴 장애 척도 (Functional Dysphagia Scale, FDS)를 사용하여 평가하였다. 삼킴 기능에 미치는 영향을 확인하기 위하여 SPSS 22.0 version 프로그램을 이용하여 분석하였다. 연구결과 : 시각적 피드백을 병행하여 저항성 턱 벌리기 운동을 한 실험군과 아무런 단서 없이 저항성 턱 벌리기 운동을 한 대조군 모두 삼킴 기능이 유의하게 향상되었다. 그룹 간 결과 비교에서는 시각적 피드백을 병행한 실험군의 삼킴 기능이 유의하게 향상되었다. 결론 : 저항성 턱 벌리기 운동은 삼킴 장애가 있는 만성 뇌졸중 환자의 삼킴 기능 증진에 효과적이었으며 시각적 피드백을 병행하였을 때 더 효과적이라는 것을 알 수 있었다. 향후 시각적 피드백을 동반하는 다양한 연구가 필요하다.

Comparative Effect of Visual Feedback Training versus Sensory Integration on Risk of Falling in Parkinson’s Disease Patients: Randomized Controlled Trial

Background. Falling is a major problem for people with Parkinson’s disease (PD), as they are twice as likely to fall compared to other neurological conditions. The consequences of these falls are significant and often result in injuries that contribute to poor quality of life, and care giver stress. Aim. To compare the efficacy of visual feedback versus sensory integration training on risk of falling in idiopathic Parkinson’s disease patients. Materials and Methods. Thirty patients (13 females and 17 males) with idiopathic PD, aged from 60 to 75 years participated in this study. They were randomly assigned to two equal groups. Group (A) received visual feedback training on the Biodex Balance System and group (B) received sensory integration training. Twelve training sessions were given, three times per week, for four weeks. Assessment of overall stability index (fall risk index) and sway index using the modified Clinical Test of Sensory Integration of Balance (m-CTSIB) was done pre-and post-treatment. Results. Both groups (A and B) showed significant decrease in the overall stability index post treatment (p < 0.05). In addition, there was significant difference between both groups in the overall stability index post-treatment (p < 0.05), being lower in group A compared to B. Finally, a significant decrease in sway index was also reported post treatment in both groups (p < 0.05), being significantly lower in group A compared to group B (p < 0.05). Conclusion. Visual feedback training yields improvement in decreasing risk of falling in PD patients compared to sensory integration training.

Effect of Visual Feedback Training of Core Strength on Coordination, Balance and Walking Ability of Stroke Patients

Effect of Visual Feedback Training of Core Strength on Coordination, Balance and Walking Ability of Stroke Patients

Effects of visual feedback training and visual targets on muscle activation, balancing, and walking ability in adults after hemiplegic stroke: a preliminary, randomized, controlled study.

The aim of this randomized, controlled study was to investigate the effect of visual feedback through visual targets on muscle activity, balance, and gait in stroke patients. Patients were recruited from the inpatient unit of a rehabilitation hospital. Twenty-one patients who had experienced hemiplegic stroke were randomly assigned to two groups: an experimental group (visual feedback training with visual targets on gradual weight shifting), and a control group (visual feedback training on gradual weight shifting). All patients performed 30 minutes of comprehensive rehabilitation therapy followed by an additional 20 minutes of gradual weight shifting using visual feedback training with or without visual targets: three sets per day, five times a week, for 4 weeks. Significantly larger gains were identified in the experimental group compared to the control group due to gluteus medius muscle activation and the weight-bearing ability of the paretic side. Visual feedback training with visual targets during gradual weight bearing on the paretic side appears to improve the muscle activation and balancing abilities of hemiplegic stroke patients compared to visual feedback training alone.

Application of visual feedback training based on mirror neuron theory in upper limb function reconstruction in stroke patients

Objective To explore the effects of visual feedback training based on the mirror neuron theory in upper limb function reconstruction in stroke patients. Methods From June 2017 to June 2018, totally 61 stroke patients hospitalized in the Rehabilitation Medical Center of the Second Hospital of Jiaxing were selected by convenient sampling and divided into the observation group (n=31) and the control group (n=30) according to the random number table. Patients in both groups received routine rehabilitation therapy, while patients in the observation group underwent visual feedback training on this basis. They were evaluated using Barthel Index , Fugl-Meyer Assessment (FMA) (upper limb) , and the latency and amplitude of N9 and N20 were detected using somatosensory evoked potentials (SEP) before and 8 weeks after rehabilitation intervention. Results After the intervention, the FMA score of the upper limbs in the observation group was (47.91±6.92) , higher than (40.31±7.87) in the control group, the Barthel Index of the observation group was (77.33±11.82) , higher than (66.79±12.31) in the control group, and the differences between the two groups were statistically significant (P<0.01) . The SEP values of the upper limbs of the hemiplegia side in the observation group were better than those in the control group, and the differences between the two groups were statistically significant (P<0.05) . Conclusions The visual feedback training based on the mirror neuron theory can improve the upper limb motor function in stroke patients with early hemiplegia, improve their daily living activities, increase the N9 and N20 amplitudes of SEP, shorten their latency, and enhance the excitement of the upper limb movement related brain area in the mirror neuron system. Key words: Stroke; Upper limb function; Visual feedback training; Mirror neuron; Somatosensory evoked potentials

Effects of visual feedback training using transient Fresnel prism glasses on balance ability in stroke patients without hemispatial neglect.

The center of mass of the body in patients with stroke was oriented toward the nonparetic side. Abnormal weight shift increases the risk of falls. Therefore, many therapists make an effort to help their functional recovery through balance training. Our aim was to investigate the effect of visual feedback intervention using a Fresnel prism on static and dynamic balance in stroke patients without hemispatial neglect. Participants were assigned to control group (n=10) and experimental group (n=9). In the control group, neurodevelopmental therapy was performance for 30 min. In the experimental group, Fresnel prism glasses were applied with neurodevelopmental therapy for 30 min. We executed motor-free visual perception test for visual perception, balancia for static balance ability, and functional reach test and Berg balance test for dynamic balance ability, respectively. All tests were measured immediately after intervention. The visual perception function showed significant difference between unaffected side performance behaviors and visual perceptual processing time (P<0.05). In the static balance, there was a significant difference in sway velocity and sway distances (P<0.05). Dynamic balance was also significant different between groups (P<0.05). Visual feedback using Fresnel prism helps to control the static and dynamic balance ability by inducing weight shift toward the affected side in stroke patients. Therefore, a Fresnel prism may be suggested as an intervention tool to assist weight training for patients with stroke.

Effects of training with a custom-made visual feedback device on balance and functional lower-extremity strength in older adults: A randomized controlled trial

IntroductionTraining with a slow and sustained mechanical load, such as standing on one leg, is an effective method for improving balance and increasing lower-extremity strength. Also, visual feedback during motor learning is important in facilitating efficient postural responses and balance skills. In this study, a custom-made visual feedback device was invented to provide the training modality and program based on single-leg standing combined with augmented visual feedback training. This study aimed to investigate the effects of visual feedback training using the custom-made visual feedback device on balance and functional lower-extremity strength in older adults. MethodsThirty-four independent older adults were randomly allocated to a training group (TG) and a control group (CG). The participants in the TG received training with the custom-made visual feedback device. The training duration was three sessions per week, for four weeks. The participants in the CG continued their routine activities. Balance (static and dynamic balances, and balance confidence) and functional lower-extremity strength were assessed pre- and post-training. ResultsImprovements in static balance (sway velocity and limit of balance during one-leg standing with eyes open) and dynamic balance (directional control of limits of stability in the backward direction) were found after training in the TG compared with the CG. No significant differences in balance confidence or functional lower-extremity strength were found between groups after training. ConclusionIn older adults, training with a custom-made visual feedback device could be used to improve both static and dynamic balances, but not balance confidence and functional lower-extremity strength.

Whether Visual-related Structural and Functional Changes Occur in Brain of Patients with Acute Incomplete Cervical Cord Injury: A Multimodal Based MRI Study

Visual-related cortex plays an important role in the process of movement. It is of great importance to clarify whether traumatic spinal cord injury (SCI), which is a typical disease that results in sensorimotor dysfunction, leads to the alteration of visual-related brain structure and function area. To address this issue, multimodality MRI was applied on eleven patients with acute incomplete cervical cord injury (ICCI) and eleven healthy controls (HCs) to explore possible structural and functional changes of the brain. Voxel-based morphometry (VBM) analysis was performed to investigate the changes in brain structure of ICCI patients. The fractional amplitude of low-frequency fluctuations (fALFF) was used to characterize changes in regional neural activities, and independent component analysis (ICA) was carried out to explore alterations in the resting-state networks (RSNs) after ICCI. We also investigated correlations among brain imaging metrics and between the metrics and clinical variables. Compared with HCs, ICCI patients exhibited significant gray matter atrophy in the left hippocampus and parahippocampal gyrus, right superior frontal gyrus (SFG), and middle frontal gyrus (MFG) and also a decrease in fALFF in the left orbitofrontal cortex (OFC). Moreover, ICCI patients exhibited decreased intra-network functional connectivity (FC) in the medial vision network (mVN). The mean fALFF value was correlated with clinical motor scores of the left extremities and the total motor scores. Our findings proved that ICCI can not only cause structural changes in visual-related brain regions, but also result in visual-related brain functional alterations, revealing the possible mechanism of the effects of visual feedback training in motor function rehabilitation of SCI patients.

Adaptation effects in static postural control by providing simultaneous visual feedback of center of pressure and center of gravity

BackgroundThe benefit of visual feedback of the center of pressure (COP) on quiet standing is still debatable. This study aimed to investigate the adaptation effects of visual feedback training using both the COP and center of gravity (COG) during quiet standing.MethodsThirty-four healthy young adults were divided into three groups randomly (COP + COG, COP, and control groups). A force plate was used to calculate the coordinates of the COP in the anteroposterior (COPAP) and mediolateral (COPML) directions. A motion analysis system was used to calculate the coordinates of the center of mass (COM) in both directions (COMAP and COMML). The coordinates of the COG in the AP direction (COGAP) were obtained from the force plate signals. Augmented visual feedback was presented on a screen in the form of fluctuation circles in the vertical direction that moved upward as the COPAP and/or COGAP moved forward and vice versa. The COP + COG group received the real-time COPAP and COGAP feedback simultaneously, whereas the COP group received the real-time COPAP feedback only. The control group received no visual feedback. In the training session, the COP + COG group was required to maintain an even distance between the COPAP and COGAP and reduce the COGAP fluctuation, whereas the COP group was required to reduce the COPAP fluctuation while standing on a foam pad. In test sessions, participants were instructed to keep their standing posture as quiet as possible on the foam pad before (pre-session) and after (post-session) the training sessions.ResultsIn the post-session, the velocity and root mean square of COMAP in the COP + COG group were lower than those in the control group. In addition, the absolute value of the sum of the COP − COM distances in the COP + COG group was lower than that in the COP group. Furthermore, positive correlations were found between the COMAP velocity and COP − COM parameters.ConclusionsThe results suggest that the novel visual feedback training that incorporates the COPAP–COGAP interaction reduces postural sway better than the training using the COPAP alone during quiet standing. That is, even COPAP fluctuation around the COGAP would be effective in reducing the COMAP velocity.

Comparison of the effects of visual feedback training and unstable surface training on static and dynamic balance in patients with stroke.

[Purpose] This study compared the effects of visual feedback training and unstable surface training on the static and dynamic balance of stroke patients. [Subjects and Methods] The study enrolled 20 stroke patients and randomly assigned them to visual feedback training and unstable surface training groups. Both groups performed 30 minutes of conventional exercise therapy twice a week for 4 weeks. In addition, the subjects in the visual feedback training group completed a visual feedback training regimen and the subjects in the unstable surface training group completed training on an unstable surface (30-minute session three times a week for 4 weeks in both groups). Static and dynamic balance parameters were recorded immediately before and after the 4 weeks of training. For data analysis, the paired and independent t-test was used to compare the two groups. [Results] In the visual feedback training group, the sway line at the postural sway of the center of pressure and trace length decreased significantly after training. In both groups, the sway range at the limits of stability in the anteroposterior and mediolateral directions increased significantly after training. [Conclusion] Visual feedback training was better at improving static and dynamic balance than unstable surface training in stroke patients.

The Effects of Visual Feedback Training and Combined Training on Dynamic Balance Ability for Chronic Stroke Patients

본 연구의 목적은 만성 편마비 환자를 대상으로 시각적 되먹임 훈련과 복합훈련이 편마비 환자의 동적균형에 미치는 영향을 알아보고자 하였다. 20명의 환자를 각각 10명씩 시각적 되먹임 훈련군, 복합 훈련군으로 무작위 배정하였다. 두 그룹은 정해진 4가지의 적용 프로그램을 하루에 30분씩 주 3회로 4주 동안 훈련을 받았다. 두 군은 TUG, FRT와 동적 균형 능력(선 자세에서 안정성 한계의 전-후, 좌-우의 이동범위)을 측정하였다. 결과 측정은 4주간의 훈련 전, 후로 측정하였고 통계적 분석은 Wilcoxon 부호순위 검정과 Mann-Whitney 검정을 이용하여 다음과 같은 결과를 얻었다. TUG, FRT는 두 그룹 모두 훈련 전에 비해 유의한 향상을 보였으며 동적 균형 능력에서는 시각적 되먹임 훈련군은 좌-우 이동범위, 복합훈련군은 전-후, 좌-우 이동범위에서 훈련 전에 비해 유의한 향상을 보였다. 이러한 결과를 볼 때 시각적 되먹임 훈련과 체간 안정화 운동을 함께 실시한 복합훈련이 만성 편마비 환자의 동적 균형능력 증진에 더 효과적이라고 생각된다.

The effects of ankle joint strategy exercises with and without visual feedback on the dynamic balance of stroke patients.

[Purpose] The aim of this study was to examine the effects of visual feedback training on the balance of stroke patients performing ankle joint strategy exercises. [Subjects and Methods] In this study, 26 stroke patients were randomly and equally assigned to a visual feedback group (VFG) and a visual disuse group (VDG). They performed ankle joint strategy exercises for 30 minutes, three times per week for six weeks. The patients’ balance ability was measured before and after the exercises to compare the effects of visual feedback. To assess balance ability, the limits of stability (LOS) and the distance the center of pressure (CoP) moved were measured using a BT4 portable force platform. The Berg balance scale (BBS) and the timed up and go (TUG) test were also used to assess balance before and after the exercises. [Results] Changes in LOS were significant in the anterior, posterior, left, and right directions in each group, and the interactions between the two groups were significant in the posterior, left, and right directions. The changes in TUG and BBS results between pre-test and the post-test were statistically significant in the two groups, and also between the groups. [Conclusion] Visual feedback training had a positive effect on balance when ankle joint strategy exercises were performed by stroke patients to improve balance.

The Effects of Visual Feedback Training on Sitting Balance Ability and Visual Perception of Patients with Chronic Stroke

[Purpose] The purpose of this study was to investigate the effects of visual feedback training (VFT) in the sitting position on sitting balance ability and visual perception of chronic stroke patients. [Subjects] Twenty-two hospitalized subjects who had experienced a stroke more than six months earlier were included in this study. [Methods] Subjects in both the experimental group (n=12) and the control group (n=10) participated in a conventional rehabilitation program involving a 60-minute session five days per week for a period of four weeks. Subjects in the experimental group additionally practiced VFT 30-minute sessions, five days per week, for a period of four weeks. [Results] After the intervention, the experimental group showed significantly improved static sitting balance ability (left∙right, anterior∙posterior moment, and velocity moment), and dynamic sitting balance ability (anterior∙lateral moment). In visual perception tests, motor free visual perception test (MVPT) scores showed a significant increase of approximately 17% in the experimental group after the intervention. [Conclusion] The results of this study demonstrate the effectiveness of VFT in enhancing body function, as evidenced by improved sitting balance and visual perception of chronic stroke patients.

運動想起フィードバック訓練による事象関連脱同期（ＥＲＤ）出現の検証

Stroke patients have some motor deficits, but they can regain their motor abilities by rehabilitation. In the aspect of rehabilitation, voluntary movement is very important. We propose a system which can make a closed loop in brain for stroke patients like voluntary movement. Event Related Desynchronization (ERD) is used to extract patients' motor intention, and then Functional Electrical Stimulation (FES) stimuls their paralyzed muscles. In many Brain Computer Interface (BCI) researches, subjects are trained for several months or years to do the task, because of the difficulty to extract clear ERD without training. Thinking about applying for stroke patients, motor imagery training should be shorter, because of the brain plasticity. We did a pilot study about the effect of visual feedback training for three days with healthy subjects. The result indicated that ERD could be clearly extracted in three days, but the training effect differs in each subjects.