Rehabilitation Environment Research Articles

Individualized management of chronic periodontitis in patients with orthodontic abnormalities: a clinical case report

Relevance. Chronic periodontitis is a multifactorial disease influenced by a variety of factors. Beyond periodontal pathogens and systemic conditions, important contributing factors include malocclusion, dental misalignment, and tooth loss. These conditions can compromise the tissue blood flow hemodynamics and precipitate occlusal trauma with signs of functional overload. Subsequently, this may intensify the inflammation and degradation of the alveolar bone, often leading to premature tooth loss.Correction of malocclusion is paramount in the effective management of periodontal diseases, requiring orthodontic treatment to resolve malocclusion and mitigate signs of functional overload. This treatment aims to redistribute occlusal forces uniformly, thus creating a conducive environment for successful prosthodontic rehabilitation and promoting optimal personal oral hygiene.Clinical case description. This article outlines a personalized approach to managing periodontal inflammation in individuals with orthodontic anomalies. Patient Z., born in 2002, was diagnosed with moderate severity chronic periodontitis (K05.31), presenting with a Class I molar and canine relationship on both sides, constricted dental arches, individual tooth macrodontia, and retrusion and torsiversion of the incisors. The assessment of the patient's periodontal status and overall health was conducted using standard clinical, radiographic, and laboratory diagnostics, whereas the orthodontic assessment involved anthropometric analysis of dental casts and lateral cephalometric radiographs. The periodontal intervention included foundational non-surgical treatments such as ultrasonic scaling both supra- and subgingivally, biofilm disruption using the Vector Paro system, and specific pharmacotherapy. The orthodontic treatment aimed to widen both dental arches and correct the inclination of the upper and lower incisors, achieving a normal occlusion with fixed orthodontic appliances (Damon Q brackets) in accordance with the treatment plan. The effectiveness of the treatment was measured by examining the improvement in gingival conditions, periodontal parameters, and radiographic evidence before and after the intervention.Conclusion. The research demonstrated that an individualized treatment protocol integrating periodontal and orthodontic care can substantially improve the overall health of the dentofacial complex, masticatory efficiency, and aesthetic aspects.

Implementation in the Motek Caren system with virtual reality of an existing motor rehabilitation programme for people with Down’s syndrome in order to increase its effectiveness

IntroductionDown’s syndrome often requires specialized rehabilitation methods in order to effectively improve cognitive and motor functioning. The growing interest in technologies to support rehabilitation is opening up new and promising perspectives for improving the quality of life of people diagnosed with this syndrome. One of these technologies is the Computer Assisted Rehabilitation Environment (CAREN) system from Motek.ObjectivesThe aim of the planned research project is to explore the potential of using the CAREN system in the rehabilitation of people with Down’s syndrome.MethodsThe study included 10 participants with Down’s syndrome (men and women aged 18 to 50 years) without the presence of organic musculoskeletal disease or other somatic causes impairing motor performance. Before the training test, the participants were assessed by two psychological tests: 1) ACE III - Addenbrooke’s Cognitive Examination III Scale (ACE-III), which assesses attention and orientation, memory, verbal fluency, language and visuospatial functions and 2) the TONI 4 Non-Verbal Intelligence Test, which is a test used to measure general intelligence. The tests were carried out using the MOTEK CAREN device, which consists of a treadmill for motor training and a virtual reality screen on which different scenes are displayed for the participant to see during the test. Integrated motion capture technology was used to assess movement capabilities of the patients.. The screen displayed different types of applications in the form of virtual reality, in which the participant had to cope with various tasks accommodating different psychomotor skills, for example:crossing a virtual bridge, walking through a forest. The test took about 45 minutes per person. Two training sessions were conducted for each of the 10 patients with a one-month interval between them.ResultsThe Motek Caren System has proven to be a promising rehabilitation method for people with Down’s syndrome, compared to previous experience with different rehabilitation methods and existing research in the field.ConclusionsResults emphasize the necessity for further investigations and future research should involve more participants. The project has the potential to integrate modern technology with traditional forms of therapy to improve the quality of life and functioning of people affected by this syndrome.Disclosure of InterestNone Declared

Is there a relationship between patient perception of rehabilitation environment and patient outcome?

Is there a relationship between patient perception of rehabilitation environment and patient outcome?

Verbal and Nonverbal Communication in the Rehabilitation Process for Drug Addicts at Rancamaya Singaparna Mental Hospital: An Interactional Analysis

This research investigates communication behavior, both verbal and nonverbal, that occurs in the rehabilitation process for drug addicts at the Rancamaya Mental Hospital. These data are presented in the context of communication between medical staff and residents, and include various aspects of communication such as facial expressions, hand gestures, spatial arrangement (proxemics), use of time (chronemics), clothing, as well as voice characteristics and sound intensity (paralinguistics). The research results show that nonverbal communication plays an important role in building empathy, conveying messages, and creating an effective rehabilitation environment. This research provides in-depth insight into how nonverbal communication influences the rehabilitation process of drug addicts.

Demystifying the Digital Divide: Disparities in Telerehabilitation Readiness Among Older Adults in the United States

ObjectiveTo estimate readiness of older rehabilitation users in the United States to participate in video-based telerehabilitation and assess disparities in readiness among racial and ethnic minoritized populations, socioeconomically disadvantaged populations, and rural-dwelling older adults. DesignRetrospective cohort study using nationally representative survey data from the National Health and Aging Trends Study from 2015 and 2020. Survey-weighted regression models, accounting for complex survey design, were used to generate estimates of readiness and evaluate disparities across racial and ethnic, socioeconomic, and geographic subgroups. Odds ratios (OR) and 95% confidence intervals (CIs) were estimated for each comparison. SettingHome or community rehabilitation environments. ParticipantsA cohort of 5274 home or community-based rehabilitation users aged 70 years or older (N=5274), representing a weighted 33,576,313 older adults in the United States. InterventionsNot applicable. Main Outcome Measure(s)Video-based telerehabilitation readiness was defined consistent with prior work; unreadiness was defined as lacking ownership of internet-enabled devices, limited proficiency of use, or living with severe cognitive, visual, or hearing impairment. Telerehabilitation readiness was categorized as “Ready” or “Unready”. ResultsApproximately 2 in 3 older rehabilitation users were categorized as ready to participate in video-based rehabilitation. Significantly lower rates of readiness were observed among those living in rural areas (OR=0.75, 95% CI: 0.60-0.94), financially strained individuals (OR=0.37, 95% CI: 0.26-0.53), and among individuals identifying as Black or Hispanic (as compared with non-Hispanic White older adults: Non-Hispanic Black [OR=0.23, 95% CI: 0.18-0.30]; Hispanic [OR=0.17, 95% CI: 0.11, 0.27]). ConclusionsOur findings highlight significant disparities in the readiness to uptake video-based telerehabilitation. Policy and practice interventions to address telerehabilitation readiness should focus not only on improving broadband access but also on technology ownership and training to ensure equitable adoption in populations with lower baseline readiness.

Effectiveness of reinforced feedback in virtual environment for upper limb rehabilitation in acute stroke

Background. Motor impairments following stroke result in loss of upper extremity function which is often persistent and disabling. Reinforced feedback in the virtual environment (RFVE) could activate mirror neuron systems which are stimulated during action observation and action execution. This study aims to evaluate the activation of proximal muscles in paretic upper limb following RFVE training. Methodology. Twenty-four stroke patients were included in the study, 12 in control group received impairment specific training and 12 in experimental group received RFVE training using Oculus quest 2 in addition to impairment specific exercise training. Surface electromyography (SEMG) of shoulder muscles of affected upper limb were recorded in both groups. Arm motor recovery was recorded using Chedoke - McMaster stroke assessment scale (CMSA). Results. Paired t-test was used to analyze the results within the group which showed improvement in the both groups and unpaired t-test was used to test the outcomes between the groups where RFVE group showed significant improvement in average muscle activity in anterior deltoid, middle deltoid and CMSA scores than control group (p < 0.005*). Conclusion. The results of this study demonstrated the beneficial effects of RFVE in upper limb training which showed improvements in muscle activation in SEMG and arm recovery in CMSA scores. RFVE training is a safe and well-accepted effective intervention in acute stroke rehabilitation that could become a successful intervention for early functional recovery.

The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients.

Virtual reality (VR) has advanced inmedical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used topractice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitatevarious disorders. VRhas transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapyand demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiencyand encouraging innovative approaches in treatment procedures.

Development of a multidimensional military readiness assessment.

There is a need to be able to accurately evaluate whether an injured service member is able to return to duty. An effective assessment would challenge and measures physical and cognitive performance in a military-relevant context. Current assessments are lacking in one or more of these aspects. The simulation and data capture abilities of virtual reality systems are promising for use as the basis of multidimensional assessments. The team has previously developed a military-specific assessment in the Computer Assisted Rehabilitation Environment (CAREN) called the Readiness Evaluation During simulated Dismounted Operations (REDOp). Due to notable limitations in the original assessment, we have developed the next iteration, REDOp2. The assessment is able to challenge and measure a broader range of physical and cognitive performance domains in a more streamlined fashion. While limited to facilities with a CAREN, REDOp2 has the potential to provide an effective tool for highly trained and experienced wounded service members that require thorough assessment prior to returning to duty to ensure the safety of the team and mission. This methods paper describes the specific limitations in REDOp, how they were addressed in REDOp2, and suggested next steps to prepare the assessment for implementation.

Perceptions of Therapeutic Climbing for Patients with Multiple Sclerosis in Neurorehabilitation: A Qualitative Study.

Therapeutic climbing (TC) has emerged as a prospective rehabilitation approach for individuals with multiple sclerosis (MS). The existing literature primarily focuses on the physical and psychological benefits of TC across diverse populations but is limited concerning its application and efficacy for patients with MS. This study aimed to delineate the experiences, subjective effects, and perceptions of both individuals with MS and therapists regarding TC, highlighting the potential benefits and challenges of this therapeutic approach. Using a qualitative design, semi-structured interviews were conducted with patients living with MS (N = 5) and therapists (N = 7) involved in TC sessions at a rehabilitation facility. The interviews were recorded, transcribed verbatim, and subjected to thematic qualitative text analysis. Our analysis resulted in the identification of five main categories: (1) motivational factors, (2) training conditions, (3) training content, (4) observed effects, and (5) safety protocol. Our findings primarily centred around the motivational aspects of TC. Participants consistently reported experiencing feelings of accomplishment, success, enjoyment, and increased self-confidence. Furthermore, TC was often perceived as a comprehensive intervention, addressing endurance, strength, flexibility, neuromotor functions, cognition, and mental health while having a low-risk profile. However, due to the demanding nature of TC, careful fatigue management is crucial. This entails personalised intensity adjustments during sessions and coordinating TC with other physically demanding therapies when implementing TC within a rehabilitation environment. TC shows promise within MS rehabilitation and can be considered safe under certain framework conditions. This research sheds light on its potential benefits, facilitators, and barriers and provides insights for practical integration into rehabilitation programs.

An NLP-based system for modulating virtual experiences using speech instructions

The application of virtual reality (VR) technology in rehabilitation is a research area that has been attracting remarkable attention recently, especially as an intervention with learning and developmental disorders such as dyslexia and autism. Multi-modal VR-based rehabilitative systems can provide a rich experience to patients by responding to various types of bio-signals. This paper proposes a framework for incorporating voice input in rehabilitative games. The proposed framework equips collaborative learning environments with voice based interaction which allows for a more dynamic flow of therapy sessions between physically impaired patients and specialists in a rehabilitative VR environment. The proposed framework’s pipeline begins with a speech recognition module to parse utterances into sentences. Next, comes the feature extraction module to identify the intent of the user and entities as well. Finally, we modulate the 3D environment in Unity. The framework was designed in a way that guarantees smooth integration with any game or 3D environment. Several technologies were tested in terms of accuracy and speed to increase the overall performance of the pipeline. To the best of our knowledge, this research is the first to do the following: 1) build a dataset of instructions, inspired by a product already used in the healthcare market, 2) based on which we could realize a multi-modal system, with voice as one of the modalities, for the context of VR-based rehabilitation. We evaluate every stage in the system pipeline, and we show that we can achieve considerable results on each of these stages including the speech recognition module, with a 5.64% word error rate, and on intent classification where the BiLSTM model outperforms BERT in the Named Entity Recognition by 11% in terms of the F1-score. We envisage the proposed system to lend itself well to emerging healthcare frameworks in the Metaverse.

Reference values for isometric strength tests

In the environment of orthopaedic rehabilitation, isometric strength testing is part of the monitoring in order to document the success of the therapy. For clinical applications, reference values, or at least orientation benchmarks, are needed for every single device, because of serious concerns for direct inter-device comparisons. According to functional ratios, there is only little literature covering comparability concerns. This study aimed to demonstrate reference values for two strength diagnosis systems for trunk and knee-joint flexion and extension as well as resulting functional ratios along with analyses of reproducibility and vice-versa comparisons. In a cross-sectional design, reference values (M, SD, Median, IQR, 5 and 95% percentiles) of 98 healthy adults (47 females, age 25.7±8.2 years, BMI 23.3±2.6 kg/m2) were assessed for trunk and knee flexion and extension and the according functional ratios using either the Myoline or the Frei medical system. For a sub-sample of 20 persons (50% females), the mutual explained total variance (r2) and reliability (ICC3.1, SEM, VK%) were analyzed. Both systems were shown to be reliable (ICC3.1 0.76-0.95), while functional ratios demonstrated a lower reliability (ICC3.1 0.62-0.92). For peak forces, the mutual total explained variance (r2) ranged between 19-68%, for functional ratios on an even lower level (5-21%). The resulting strength test values, and especially the related functional ratios, obtained with the two strength test devices are not comparable at all, but each device was shown to be a reliable tool. Distributions of body weight adjusted peak forces and functional ratios may serve as device specific benchmark values for strength testing in clinical environments.

Machine Learning-Based Approach to Identifying Fall Risk in Seafarers Using Wearable Sensors

Falls on a ship cause severe injuries, and an accident falling off board, referred to as “man overboard” (MOB), can lead to death. Thus, it is crucial to accurately and timely detect the risk of falling. Wearable sensors, unlike camera and radar sensors, are affordable and easily accessible regardless of the weather conditions. This study aimed to identify the fall risk level (i.e., high and low risk) among individuals on board using wearable sensors. We collected walking data from accelerometers during the experiment by simulating the ship’s rolling motions using a computer-assisted rehabilitation environment (CAREN). With the best features selected by LASSO, eight machine learning (ML) models were implemented with a synthetic minority oversampling technique (SMOTE) and the best-tuned hyperparameters. In all ML models, the performance in classifying fall risk showed overall a good accuracy (0.7778 to 0.8519), sensitivity (0.7556 to 0.8667), specificity (0.7778 to 0.8889), and AUC (0.7673 to 0.9204). Logistic regression showed the best performance in terms of the AUC for both training (0.9483) and testing (0.9204). We anticipate that this study will effectively help identify the risk of falls on ships and aid in developing a monitoring system capable of averting falls and detecting MOB situations.

Interactions with virtual therapists during motor rehabilitation in immersive virtual environments: a systematic review

Introduction: Virtual Reality applications for rehabilitation are increasing in popularity. In traditional as well as virtual rehabilitation, the guidance of an occupational therapist through physical and verbal interaction is often required. Several studies have attempted to implement a virtual therapist or assistant in immersive virtual environments for rehabilitation.Objective: This research aims to systematically review these studies, understanding the therapist’s role and how they are represented in the virtual environment, how the virtual therapist and patient interact and the experience of users. Our goal is to provide guidance for virtual therapist implementations into fully immersive virtual reality environments.Method: The researchers systematically reviewed the literature on virtual therapists in immersive virtual environments for motor rehabilitation (protocol prospectively registered with PROSPERO ID: CRD42022357369).Results and Conclusion: Seven studies were identified, with findings showing that virtual therapists are often human-like avatars that guide patients, requiring them to mimic the therapist’s movements. Visual, haptic, or one-direction audio feedback from the therapist to the patient was provided in five studies. The selected studies were all newly developed custom-made systems, with five systems developed using the same game engine. Studies carrying out user testing utilised several methods to understand user experience, evidencing a positive attitude from therapists and motivated and satisfied patients.Future Research: The roles of virtual therapists for motor rehabilitation needs to be explored further in rigorous empirical studies to gather data on patient and therapist user experience. Considerable potential was identified in the development of virtual therapists and therapeutic alliance in the virtual environment. Future systems should reduce manual input from therapists and include personalisation and individualised patient feedback.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=357369], PROSPERO ID [CRD42022357369].

Curved non-motorized treadmills do not biomechanically replicate overground running better than motorized treadmills

ABSTRACT The purpose of this study was to determine if curved non-motorized treadmills can reproduce overground running better than motorized treadmills by analysing the differences in joint kinematics (hip, knee, and ankle) using SPM. Nineteen recreational runners completed three randomized running tests on these surfaces. Kinematic data from the hip, knee, and ankle joints were collected. Two-tailed SPM t-tests were performed to analyse time-continuous gait cycles in three anatomical planes of each joint. Higher within-subject variability was observed in the frontal and transverse planes during curved non-motorized treadmill running. SPM analysis showed more significant differences (p < 0.05) between curved non-motorized treadmill and overground than between motorized treadmill and overground, mainly in knee (from 12% to 30% and 93% to 99% of the gait cycle) and ankle (from 19% to 23% of the gait cycle) in the sagittal plane. Therefore, running on curved non-motorized treadmills is more biomechanically different compared to overground than motorized treadmills, and might not be the best strategy to replicate overground running in terms of joint kinematics during highly controlled research studies. However, they could be an interesting tool in rehabilitation or training environments since the changes observed in joint kinematics were likely not functionally relevant.

A Review of the Evolution and Advancements of Neurological Physical Therapy

Over the years, the discipline of neurological physical therapy has undergone modifications, with a shift in focus from muscular weakness to non-muscular issues. Neurofacilitation and Proprioceptive Neuromuscular Facilitation (PNF) are methods designed to improve both the flexibility and muscular power of people. The rehabilitation environment and the duration of physical activity are also crucial. The advancement of robot-assisted therapy and the implementation of suitable training methodologies have the potential to enhance the functionality of individuals with neurological impairments. This research examines the advancement of neurological physical therapy and the advancements achieved in treatment techniques aimed at enhancing functional mobility. This article explores the influence of early research in neurophysiology and experimental models on therapeutic approaches, highlighting the need of incorporating advancements in neurology into clinical practice. The research emphasizes the importance of motor learning, muscle biology, biomechanics, and exercise science in optimizing motor performance and facilitating functional motor recovery.

Application of A System Dynamics Model in Forecasting the Effect of Self-care Ability on the Quality of Life of Mildly Disabled Elderly in Nursing Homes

Background: The large number of mildly disabled elderly people in China has resulted in the occupation of a large amount of public social resources. They have also imposed a serious social burden on the society. This study predicts that changes in the level coefficients of physical functioning, motor participation, and external environment are associated with quality of life (QoL) among the elderly with mild disabilities in nursing homes. Methods: A simulation model was created using the system dynamics method. Meanwhile, a 50-day simulation was used to predict the subsequent changes in the level of QoL of the elderly. This study was completed in the nursing homes of Chengdu, China, using random sampling and 85 elderly subjects participated to obtain the primary data. The data were analyzed using the Vensim software. Results: The results showed that the level of physical functioning (pain value of 0.241, autonomy of 0.163, and chronic disease of 0.192), the level of motor participation (education value of 0.186, and rehabilitation partner of 0.21), and the level of external environment (medical care value of 0.26, and rehabilitation environment value of 0.184) lead to subsequent changes in the level of QoL of mildly disabled elderly in nursing homes in 30 days. Conclusion: Considering the results of this simulation study, changes in the level of physical functioning, exercise participation, and external environment could forecast the QoL of mildly disabled elderly in the nursing homes of Chania, China. It is necessary to make the required changes in the nursing homes to promote the QoL of these groups.

Condicionadores de solo melhoram o ambiente para o crescimento de gramínea em rejeitos de mineração de ferro

ABSTRACT Areas impacted by the deposition of iron mining tailings present physical and chemical characteristics that can hinder root growth, and applying soil conditioners can help alleviate these limitations. The objective was to evaluate the effect of soil conditioners in improving the environment for the growth of grass in soil affected by iron mining tailing. Four different experiments were conducted testing conditioner proportions (0, 5, 10, 25, and 50% v/v), in a completely randomized design with four replications, using Cynodon spp. The conditioners were sand, vermiculite, sawdust, and organic compost. Bulk density, macro- and microporosity, total pore volume (VTP), pH, organic matter content (OM), cation exchange capacity (CEC), and dry mass of the aboveground, root, and total plant were evaluated. There were improvements in porosity and a reduction in density with the application of vermiculite, sawdust, and organic compost; however, sand decreased the VTP. The pH was reduced with sawdust and increased with compost. Sawdust and compost increased OM. CEC increased with vermiculite and compost. The sand and vermiculite conditioners promoted the greatest growth of Cynodon spp., with emphasis on vermiculite, which provided the greatest increases in plant biomass production. The soil conditioners, overall, proved effective in improving porosity conditions, reducing density, increasing OM, and promoting plant growth, this makes this technology efficient for application in tailings. Due to its notable effect on increasing biomass and improving the environment for grass growth, vermiculite can be recommended for rehabilitation environments impacted by iron mining tailings or for post-mining revegetation.

Coupling neurologic music therapy with immersive virtual reality to improve executive functions in individuals with Parkinson’s disease: A Quasi-Randomized Clinical Trial

IntroductionParkinson’s disease (PD) is one the most common neurodegenerative movement disorder, leading to motor and non-motor symptoms, including deficits in executive functions (EF), memory, visuospatial abilities, and psychomotor speed. Current treatments are primarily symptomatic, involving pharmacological, surgical strategies. Neurologic Music Therapy (NMT) has gained recognition for its effectiveness in neurorehabilitation of PD patients and improving motor and cognitive domains, such as EF. This study combines NMT with the virtual reality (VR) platform Computer-Assisted Rehabilitation Environment (CAREN), offering customizable environments for rhythmic cue practice to provide an innovative approach to Parkinson’s rehabilitation. MethodsIn our single-blind quasi-randomized controlled trial, forty patients were assigned to either an experimental group (EG = 20) or a control group (CG = 20). Both groups underwent two months of training with CAREN scenarios (three times a week for 24 sessions). The experimental group additionally received NMT applied to the selected scenarios. Participants were evaluated by a neuropsychologist at baseline and immediately after training. ResultsIntra-group analysis showed significant improvements in the EG for MOCA (p = 0.007), FAB (p = 0.008), Stroop Error (p = 0.003), Stroop Time (p < 0.001), and Visual Search (p < 0.001). The CG showed a significant difference only in Stroop Error (p = 0.02). ConclusionsThis pilot study is the first to combine NMT with CAREN in PD patients. Our findings suggest that NMT, within an immersive VR environment, effectively improves cognitive and EF in PD. Music structured within NMT techniques, coupled with advanced audio-visual feedback from VR, offers an innovative and potentially more effective approach for managing cognitive and executive deficits associated with PD.

Effects of Immersive Virtual Reality on Upper-Extremity Stroke Rehabilitation: A Systematic Review with Meta-Analysis.

Virtual reality (VR) is an innovative rehabilitation tool increasingly used in stroke rehabilitation. Fully immersive VR is a type of VR that closely simulates real-life scenarios, providing a high level of immersion, and has shown promising results in improving rehabilitation functions. This study aimed to assess the effect of immersive VR-based therapy for stroke patients on the upper extremities, activities of daily living (ADLs), and pain reduction and its acceptability and side effects. For this review, we gathered all suitable randomized controlled trials from PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science. Out of 1532, 10 articles were included, with 324 participants. The results show that immersive VR offers greater benefits in comparison with conventional rehabilitation, with significant improvements observed in ADLs (SMD 0.58, 95% CI 0.25 to 0.91, I2 = 0%, p = 0.0005), overall function as measured by the Fugl-Meyer Assessment (MD 6.33, 95% CI 4.15 to 8.50, I2 = 25%, p = 0.00001), and subscales for the shoulder (MD 4.96, 95% CI-1.90-8.03, I2 = 25%, p = 0.002), wrist (MD 2.41, 95% CI-0.56-4.26, I2 = 0%, p = 0.01), and hand (MD 2.60, 95% CI-0.70-4.5°, I2 = 0%, p = 0.007). These findings highlight the potential of immersive VR as a valuable therapeutic option for stroke survivors, enhancing their ADL performance and upper-limb function. The immersive nature of VR provides an engaging and immersive environment for rehabilitation.

Correlates of Presence in a Virtual Reality Gamification Environment for Rehabilitation after Musculoskeletal Injury

Abstract Virtual reality (VR) has emerged as a powerful option for rehabilitation by providing real-time performance feedback and a safe and customized training environment. This study aimed: (1) to investigate the association between presence in the virtual environment, usability of the system, intrinsic motivation, and immersion in VR gaming designed for rehabilitation after musculoskeletal injury; and (2) to examine the users’ emotional response in terms of pleasure, arousal, and dominance after participating in VR gaming. Thirty-seven individuals aged 23.69 ± 6.98 years participated in five customized VR games designed to provide a complete rehabilitation session after a musculoskeletal injury. Pearson product-moment correlation coefficients and multiple regression analyses were used to investigate the relationship between presence in virtual environments and immersive tendencies, the usability of the system, and intrinsic motivation. The Wilcoxon Signed Rank Test was conducted to evaluate the impact of participation in VR gaming on participants’ presence in virtual environments. Significant correlations were found between presence and immersive tendencies (r = −.40, p = .017), intrinsic motivation (r = .42, p = .013), and usability of the system (r = .64, p &amp;lt; .001). The linear regression model explained 59% of the total variance in the presence of virtual environments. There was a statistically significant increase in the pleasure scores from the beginning to the end of the session. Our results indicate that VR may be useful in increasing adherence to treatment to recover from musculoskeletal injuries.