Virtual Reality-based Rehabilitation Research Articles

The efficacy of virtual reality-based rehabilitation in improving motor function in patients with stroke: a systematic review and meta-analysis.

Stroke is a major cause of adult disability, prompting the exploration of innovative rehabilitation methods. Virtual rehabilitation (VR), leveraging technological advances, has gained popularity as a treatment for stroke recovery. The authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published in English within the last decade, adhering to the PRISMA guidelines. The authors searched databases such as Medline/PubMed, and the Cochrane Library using specific search keywords and Medical Subject Headings (MeSH). The methodological quality was assessed using the PEDro scale, focusing on RCTs involving adult stroke patients undergoing VR rehabilitation, with outcomes related to motor function and quality of life. The authors included 15 studies in our meta-analysis. VR rehabilitation offers several advantages over traditional therapy, such as enhanced feedback and increased patient motivation. Engaging VR environments helps improve focus during treatment, potentially boosting recovery from post-stroke impairments. VR therapies significantly benefit motor function, which can improve activities of daily living and overall quality of life. VR has demonstrated efficacy in improving motor function and quality of life for stroke survivors. Future research should explore patient variability and refine intervention methods. Incorporating VR into rehabilitation programs could optimize stroke recovery outcomes.

Full-body pose reconstruction and correction in virtual reality for rehabilitation training.

Existing statistical data indicates that an increasing number of people now require rehabilitation to restore compromised physical mobility. During the rehabilitation process, physical therapists evaluate and guide the movements of patients, aiding them in a more effective recovery of rehabilitation and preventing secondary injuries. However, the immutability of mobility and the expensive price of rehabilitation training hinder some patients from timely access to rehabilitation. Utilizing virtual reality for rehabilitation training might offer a potential alleviation to these issues. However, prevalent pose reconstruction algorithms in rehabilitation primarily rely on images, limiting their applicability to virtual reality. Furthermore, existing pose evaluation and correction methods in the field of rehabilitation focus on providing clinical metrics for doctors, and failed to offer patients efficient movement guidance. In this paper, a virtual reality-based rehabilitation training method is proposed. The sparse motion signals from virtual reality devices, specifically head-mounted displays hand controllers, is used to reconstruct full body poses. Subsequently, the reconstructed poses and the standard poses are fed into a natural language processing model, which contrasts the difference between the two poses and provides effective pose correction guidance in the form of natural language. Quantitative and qualitative results indicate that the proposed method can accurately reconstruct full body poses from sparse motion signals in real-time. By referencing standard poses, the model generates professional motion correction guidance text. This approach facilitates virtual reality-based rehabilitation training, reducing the cost of rehabilitation training and enhancing the efficiency of self-rehabilitation training.

Virtual reality based rehabilitation in adults with chronic neck pain: a systematic review and meta-analysis of randomized clinical trials

Chronic neck pain is one of the most frequent musculoskeletal disorders, with high prevalence worldwide. Rehabilitation is an essential component of therapeutic strategy. Virtual reality based rehabilitation (VRBR) is a powerful distraction technique that could be beneficial for chronic neck pain patients. The objective of this systematic review was to analyse the effectiveness of VRBR in chronic neck pain treatment. We followed the PRISMA guidelines and used four databases (CINAHL, Medline (Via PubMed), Scopus and Web of Science) from their inception to August 2023. Eligibility criteria were established using PICOS. Methodological quality was evaluated with the Downs and Black scale and the risk of bias with the Revised Cochrane risk-of-bias tool. The meta-analysis was performed using the RevMan software. Six studies were included in the systematic review and the meta-analysis. We observed significant differences in favour of VRBR for pain intensity (SMD = − 0.46; 95% CI = − 0.74, − 0.19; p = 0.001), disability (MD = − 2.84; 95% CI = − 4.23, − 1.45; p < 0.0001), global perceived effect (MD = 0.49; 95% CI = 0.25, 0.72; p < 0.0001) and patient satisfaction (MD = 0.62; 95% CI = 0.38, 0.86; p < 0.00001). However, at short-term follow-up significant differences were only obtained for disability (MD = − 3.52; 95% CI = − 5.85, − 1.20; p = 0.003). VRBR can significantly improve pain intensity, disability, global perceived effect and patient satisfaction. The small number of articles included in the analysis is a limitation, even considering the good methodological quality of these studies. Investigating the effects of VRBR on mid and long-term follow-up and exploring different types of VR are needed.PROSPERO database, registration number ID: CRD42020222129.

Effects of virtual reality on balance in people with diabetes: a systematic review and meta-analysis.

This systematic review aims to identify, critically appraise, and synthesize the effects of virtual reality on balance in people with diabetes. Five biomedical databases were searched from inception to December 15, 2023. Clinical trials investigating the effects of virtual reality on performance-based or patient-reported outcome measures related to balance function among people with diabetes were included. Two independent reviewers conducted study selection, data extraction, and quality assessment. Cochrane risk-of-bias tool-2 were used to assess included studies. Meta-analysis was performed to examine the effects of the intervention. Six studies with a total of 257 participants were identified. Two studies had high risk of bias, and four studies had some concerns regarding risk of bias. No adverse events related to virtual reality were reported. Meta-analysis revealed significant improvements in the Berg Balance Scale (SMD = 1.56, 95% CI 0.71 to 2.40, p < 0.001), Timed Up and Go test (SMD = -0.74, 95% CI -1.21 to -0.28, p = 0.002), and falls efficacy (SMD = 0.99, 95% CI 0.43 to 1.54, p < 0.001) following virtual reality intervention. No significant differences were found for postural sway and single leg stance measures. Virtual reality-based rehabilitation demonstrates promising effects for improving balance in people with diabetes. Further studies with high methodological quality and large sample sizes are warranted. The online version contains supplementary material available at 10.1007/s40200-024-01413-7.

Effectiveness of Virtual Reality-based Rehabilitation and High-intensity Exercise Program for Total Knee Arthroplasty Patients: A Randomised Controlled Trial

Effectiveness of Virtual Reality-based Rehabilitation and High-intensity Exercise Program for Total Knee Arthroplasty Patients: A Randomised Controlled Trial

Effectiveness of virtual reality-based rehabilitation on the upper extremity motor function of stroke patients: A protocol for systematic review and meta-analysis.

Upper extremity deficits (UED) is a common and impactful complication among stroke survivors. Virtual reality (VR)-based rehabilitation holds potential for enhancing rehabilitation intensity and engagement by stimulating tasks. While several clinical studies have examined the effectiveness and safety of VR-based rehabilitation, there is a need for further research to improve consistency in outcomes. The study will incorporate randomized controlled trials (RCTs) concerning the effects of VR-based rehabilitation on upper extremity (UE) function in stroke survivors. A comprehensive search of databases including PubMed, Embase, Cochrane Library, Web of Science, Scopus, Cinahl, China National Knowledge Infrastructure (CNKI), Wan-fang, and Chinese Biology Medicine Database will be performed from inception to the start of the study. Primary outcomes will focus on upper limb motor function assessments such as the Fugl-Meyer Upper Extremity (FMUE), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), and Action Research Arm Test (ARAT). Secondary outcomes related to activities of daily living will include the Barthel Index (BI) and Functional Independence Measure (FIM). Research selection, data extraction, and quality assessment will be independently conducted by two researchers. The recently revised Cochrane risk of bias tool will be employed to evaluate study quality. Meta-regression and subgroup analyses will be utilized to identify effective therapy delivery modes and patterns. The assessment, development, and evaluation of recommendations approach will be applied to achieve a robust conclusion. This study provides a rigorous synthesis to evaluate optimal parameters-specifically intensity and duration-for VR-based rehabilitation interventions aimed at enhancing UE function in stroke survivors. Our secondary objective is to assess the impact of these parameters on rehabilitation outcomes. We anticipate an accurate, transparent, and standardized review process that will yield evidence-based recommendations for integrating VR technology into treating upper extremity dysfunction in stroke patients, offering clinicians effective strategies to enhance upper limb function.

Effectiveness of a Virtual Reality-Based Rehabilitation Program versus Conventional Physical Therapy in Improving Motor Function and Balance in Stroke Survivors: A Randomized Controlled Trial.

Background: Stroke is a leading cause of mortality and functional impairment worldwide, often resulting in balance and motor function deficits. Conventional stroke therapy, primarily consisting of aerobic exercise and physical training, does not fully address neuroplasticity-related motor improvements in stroke survivors. Recent advancements in technology have enabled the development of virtual reality-based rehabilitation (VRBR), which offers immersive, intensive therapy that may be more effective than traditional methods. Objective: This study aims to evaluate the efficacy of VRBR compared to conventional physical therapy (CPT) in enhancing motor function and balance in individuals who have experienced a stroke. Methods: A randomized controlled trial was conducted at Johar Poly Clinic, Lahore, over a 9-month period, with 56 participants who had recent stroke diagnoses. Participants were randomly assigned to either the VRBR or CPT group. Balance was measured using the Berg Balance Scale, and functional abilities were assessed with the Barthel Index Scale. Statistical analysis included descriptive and inferential methods to identify within-group and between-group differences. Results: In the study, both the Virtual Reality-Based Rehabilitation (VRBR) and Conventional Physical Therapy (CPT) groups showed improvements, but the VRBR group exhibited statistically significant increases in both balance and functional abilities. Specifically, Berg Balance Scale scores improved more in the VRBR group (from 20 ± 3.5 at baseline to 30 ± 6 at 9 months) compared to the CPT group (from 19 ± 4 to 25 ± 5). Similarly, Barthel Index Scale scores, which measure functional abilities, increased substantially in the VRBR group (from 40 ± 6 to 55 ± 9), outperforming the CPT group (from 39 ± 5.5 to 48 ± 8) over the 9-month study period. These results indicate a potential advantage of VRBR in enhancing balance and functional independence among stroke survivors. Conclusion: Virtual Reality-Based Rehabilitation demonstrates significant potential in improving balance and functional abilities among stroke survivors compared to conventional physical therapy. The immersive nature and intensity of VRBR may contribute to its effectiveness, suggesting its incorporation into stroke rehabilitation protocols.

Effectiveness of Virtual Reality-Based Rehabilitation Interventions in Improving Postoperative Outcomes for Orthopedic Surgery Patients.

The surge in orthopedic surgeries strains the US healthcare system, necessitating innovative rehabilitation solutions. This review examines the potential of virtual reality (VR)-based interventions for orthopedic rehabilitation. The effectiveness of VR-based interventions in orthopedic surgery patients is scrutinized. While some studies suggest better patient-reported outcomes and satisfaction, mixed results emerge from others, demonstrating comparable or varied results compared to traditional rehabilitation. The underlying mechanisms of VR-based rehabilitation are elucidated, showing its positive impact on proprioception, pain management, agency, and balance. Challenges of unfamiliarity, patient engagement, and drop-out rates are identified, emphasizing the need for tailored approaches. VR technology's immersive environments and multisensory experiences offer a novel approach to addressing functional deficits and pain post-surgery. The conclusion drawn is that VR-based rehabilitation complements rather than replaces conventional methods, potentially aiding in pain reduction and functional improvement. VR-based rehabilitation holds promise for enhancing orthopedic surgery outcomes, presenting a dynamic approach to recovery. Its potential to reshape healthcare delivery and reimbursement structures underscores its significance in modern healthcare. Overall, VR-based rehabilitation offers a promising avenue for optimizing postoperative recovery in orthopedic surgery patients.

Effects of immersive and non-immersive virtual reality-based rehabilitation training on cognition, motor function, and daily functioning in patients with mild cognitive impairment or dementia: A systematic review and meta-analysis

Objective To examine the effectiveness of virtual reality (VR)-based rehabilitation training in improving cognition, motor function, and daily functioning in patients with mild cognitive impairment and dementia. Data sources A systematic review of published literature was conducted using PubMed, Web of Science, Elsevier, Embase, Cochrane, CNKI, Networked Digital Library of Theses and Dissertations. Methods The search period was from inception to 7 October 2023. Eligible studies were randomized controlled trials evaluating the efficacy of VR-based rehabilitation training in patients with mild cognitive impairment or dementia versus control subjects. Methodologic quality was assessed with the Cochrane risk of bias tool, and outcomes were calculated as the standard mean difference between participant groups with 95% confidence interval. Results A total of 21 randomized controlled trials with 1138 patients were included. The meta-analysis showed that VR-based rehabilitation training had significant effects on Montreal Cognitive Assessment (SMD: 0.50; 95%CI: 0.05 to 0.95; P = 0.030), Trail-making test A (SMD: −0.38; 95%CI: −0.61 to −0.14; P = 0.002), and Berg Balance Scale scores (SMD: 0.79; 95%CI: 0.13 to 1.45; P = 0.020). A subgroup analysis revealed that the type of VR, and duration and frequency of interventions had statistically significant effects on cognition and motor function. Conclusion VR-based rehabilitation training is a beneficial nonpharmacologic approach for managing mild cognitive impairment or dementia. Immersive VR-based training had greater effects on cognition and motor function than non-immersive VR-based training, but non-immersive VR-based training was more convenient for patients with limitations imposed by their disease. Also, an intervention lasting 5–8 weeks and for >30 min at a frequency of ≥3 times/week achieved the best results. It indicated that a longer intervention cycle may not achieve the best intervention effect and training duration and schedule should be carefully considered when managing patients.

Application of Virtual Reality-Assisted Exergaming on the Rehabilitation of Children with Cerebral Palsy: A Systematic Review and Meta-Analysis.

Rehabilitation programs for children with cerebral palsy (CP) aim to improve their motor and cognitive skills through repeated and progressively challenging exercises. However, these exercises can be tedious and demotivating, which can affect the effectiveness and feasibility of the programs. To overcome this problem, virtual reality VR-assisted exergaming has emerged as a novel modality of physiotherapy that combines fun and motivation with physical activity. VR exergaming allows children with CP to perform complex movements in a secure and immersive environment, where they can interact with virtual objects and scenarios. This enhances their active engagement and learning, as well as their self-confidence and enjoyment. We aim to provide a comprehensive overview of the current state of research on VR exergaming for CP rehabilitation. The specific objectives are: To identify and describe the existing studies that have investigated the effects of VR exergaming on motor function and participation outcomes in children with CP. In addition, we aim to identify and discuss the main gaps, challenges, and limitations in the current research on VR exergaming for CP rehabilitation. Finally, we aim to provide recommendations and suggestions for future research and practice in this field. In June 2023, we conducted a systematic search on Scopus, Web of Science, PubMed, Cochrane, and Embase for randomized trials and cohort studies that applied VR-assisted exergaming to rehabilitating patients with CP. The inclusion criteria encompassed the following: (1) Randomized controlled trials (RCTs) and cohort studies involving the rehabilitation of children with CP; (2) the application of VR-based exergaming on the rehabilitation; (3) in comparison with conventional rehabilitation/usual care. The quality of the selected RCTs was evaluated using Cochrane's tool for risk of bias assessment bias includes. Whereas the quality of cohort studies was assessed using the National Institutes of Health (NIH) tool. The systematic search of databases retrieved a total of 2576 studies. After removing 863 duplicates, 1713 studies underwent title and abstract screening, and 68 studies were then selected as eligible for full-text screening. Finally, 45 studies were involved in this review (n = 1580), and 24 of those were included in the quantitative analysis. The majority of the included RCTs had a low risk of bias regarding study reporting, participants' attrition, and generating a random sequence. Nearly half of the RCTs ensured good blinding of outcomes assessors. However, almost all the RCTs were unclear regarding the blinding of the participants and the study personnel. The 2020 retrospective cohort study conducted at Samsung Changwon Hospital, investigating the effects of virtual reality-based rehabilitation on upper extremity function in children with cerebral palsy, demonstrated fair quality in its methodology and findings. VR-assisted exergaming was more effective than conventional physiotherapy in improving the Gross Motor Function Measurement (GMFM)-88 score (MD = 0.81; 95% CI [0.15, 1.47], p-value = 0.02) and the GMFM walking and standing dimensions (MD = 1.45; 95% CI [0.48, 2.24], p-value = 0.003 and MD = 3.15; 95% CI [0.87, 5.42], p-value = 0.007), respectively. The mobility and cognitive domains of the Pediatric Evaluation of Disability Inventory score (MD = 1.32; 95% CI [1.11, 1.52], p-value < 0.001) and (MD = 0.81; 95% CI [0.50, 1.13], p-value < 0.0001) were also improved. The Canadian Occupational Performance Measure performance domain (MD = 1.30; 95% CI [1.04, 1.56], p-value < 0.001), the WeeFunctional Independence Measure total score (MD = 6.67; 95% CI [6.36, 6.99], p-value < 0.0001), and the Melbourne Assessment of Unilateral Upper Limb Function-2 score (p-value < 0.001) improved as well. This new intervention is similarly beneficial as conventional therapy in improving other efficacy measures. Our findings suggest that VR-assisted exergaming may have some advantages over conventional rehabilitation in improving CP children's functioning and performance in daily life activities, upper and lower limb mobility, and cognition. VR-assisted exergaming seems to be as effective as conventional physiotherapy in the other studied function measures. With its potential efficacy, better feasibility, no reported side effects, and entertaining experience, VR-assisted exergaming may be a viable complementary approach to conventional physiotherapy in rehabilitating children with CP.

Graph analysis of cortical reorganization after virtual reality-based rehabilitation following stroke: a pilot randomized study.

Stroke is the leading cause of functional disability worldwide. With the increase of the global population, motor rehabilitation of stroke survivors is of ever-increasing importance. In the last decade, virtual reality (VR) technologies for rehabilitation have been extensively studied, to be used instead of or together with conventional treatments such as physiotherapy or occupational therapy. The aim of this work was to evaluate the GestureCollection VR-based rehabilitation tool in terms of the brain changes and clinical outcomes of the patients. Two groups of chronic patients underwent a rehabilitation treatment with (experimental) or without (control) complementation with GestureCollection. Functional magnetic resonance imaging exams and clinical assessments were performed before and after the treatment. A functional connectivity graph-based analysis was used to assess differences between the connections and in the network parameters strength and clustering coefficient. Patients in both groups showed improvement in clinical scales, but there were more increases in functional connectivity in the experimental group than in the control group. The experimental group presented changes in the connections between the frontoparietal and the somatomotor networks, associative cerebellum and basal ganglia, which are regions associated with reward-based motor learning. On the other hand, the control group also had results in the somatomotor network, in its ipsilateral connections with the thalamus and with the motor cerebellum, which are regions more related to a purely mechanical activity. Thus, the use of the GestureCollection system was successfully shown to promote neuroplasticity in several motor-related areas.

Effectiveness of Virtual Reality-based Rehabilitation of Osteoarthritis Undergoing Total Knee Arthroplasty: A Pre–Post Study

Osteoarthritis is a widespread health issue that causes pain, limits physical function, lowers quality of life, and makes individuals disabled. To improve impairments, virtual reality-based rehabilitation treatments are becoming more acceptable because of effectiveness in recent decades. This pre–post study examines rehabilitative training program that trains different motor areas. To check feasibility and benefits of a developed system for postoperative rehabilitation in individuals with osteoarthritis-undergone primary Total knee Arthroplasty to improve their performance. Eleven-individuals suffering from various motor impairments aged 50–85 years with post-operative duration of ≥4weeks. The experimental group followed, virtual reality-based rehabilitation training, whereas control group received standard therapies for 4 weeks, 5 sessions/week of 40–45 min. To evaluate baseline and post-assessment with Visual Analogue scale, Womac Osteoarthritis Index, Activities-specific Balance Confidence Scale, Knee Range of motion, Lower limb muscle strength. Results of system were evaluated using system usability scale for performance and user-friendliness. Statistically significant differences were found between experimental and control group: pain, range of motion, muscle strength, and balance confidence (p < 0.05). No significant improvement in lower limb muscle strength was recorded. Mean SUS score was 72 % (SD = 08.55). The findings suggest that virtual reality-based rehabilitation treatment is an effective therapy, resulting in motivation and functional recovery with lower extremity in these individuals.

Effectiveness of Virtual Reality-Based Early Postoperative Rehabilitation after Total Knee Arthroplasty: A Systematic Review with Meta-Analysis of Randomized Controlled Trials

Virtual reality-based rehabilitation (VRBR) is being used in rehabilitation after total knee arthroplasty (TKA). This meta-analysis assesses the effect of immediate and/or maintained effect of VRBR (alone or in combination with conventional therapy (CT) in TKA recovery. To perform this meta-analysis, we searched in PubMed, SCOPUS, WOS, CINAHL, and PEDro until 5 February 2023. We included randomized controlled trials that assessed the effect of VRBR in improving knee pain and function, dynamic balance, range of motion (ROM), and strength, among others, after TKA. The pooled effect was calculated with Cohen’s standardized mean difference (SMD) with a 95% confidence interval (95% CI). Twelve studies, providing data from 997 participants (69.9 ± 8.1 years old), were included. At post-immediate assessment, VRBR is effective in improving knee pain (SMD = −0.36; 95% CI −0.56 to −0.17), knee function (SMD = −0.51; 95% CI −0.75 to −0.27), dynamic balance (SMD = −0.59; 95% CI −1.02 to −0.15), knee flexion ROM (SMD = 0.4; 95% CI 0.17 to 0.62), and extension strength (SMD = 0.43; 95% CI 0.19 to 0.68). Our findings showed that immersive and non-immersive VRBR is effective to be used after TKA, and the effect on knee pain and function may be maintained over 3 or 6 months. A high level of satisfaction and adherence to VRBR was reported.

The Influence of Conventional and Innovative Rehabilitation Methods on Brain Plasticity Induction in Patients with Multiple Sclerosis

Physical rehabilitation and physical activity are known non-pharmacological methods of treating multiple sclerosis. Both lead to an improvement in physical fitness in patients with movement deficits while improving cognitive function and coordination. These changes occur through the induction of brain plasticity. This review presents the basics of the induction of brain plasticity in response to physical rehabilitation. It also analyzes the latest literature evaluating the impact of traditional physical rehabilitation methods, as well as innovative virtual reality-based rehabilitation methods, on the induction of brain plasticity in patients with multiple sclerosis.

A Systematic Review and Meta-Analysis of the Effectiveness of Virtual Reality-Based Rehabilitation Therapy on Reducing the Degree of Pain Experienced by Individuals with Low Back Pain.

The concept of virtual reality (VR)-based rehabilitation therapy for treating people with low back pain is of growing research interest. However, the effectiveness of such therapy for pain reduction in clinical settings remains controversial. The present study was conducted according to the reporting guidelines presented in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. We searched the PubMed, Embase, CENTRAL, and ProQuest databases for both published and unpublished papers. The Cochrane risk of bias tool (version 2) was used to evaluate the quality of the selected studies. GRADEprofiler software (version 3.6.4) was used to evaluate the level of evidence. We analyzed the included research results using RevMan software (version 5.4.1). We included a total of 11 articles in the systematic review and meta-analysis, with a total of 1761 subjects. Having assessed the quality of these studies, the risk of bias was generally low with high heterogeneity. The results revealed a small to medium effect (standardized mean difference = ±0.37, 95% confidence interval: 0.75 to 0) based on evidence of moderate overall quality. There is evidence that treatment using VR improves patients' pain. The effect size was small to medium, with the studies presenting evidence of moderate overall quality. VR-based treatment can reduce pain; therefore, it may help in rehabilitation therapy.

AI-Driven Stroke Rehabilitation Systems and Assessment: A Systematic Review.

Post-stroke therapy restores lost skills. Traditionally, patients are supported by skilled therapists who monitor their progress and evaluate the program's effectiveness. Due to a shortage of qualified therapists, rehabilitation facilities are both expensive and inadequate. Furthermore, evaluations may be subjective and prone to errors. These limitations motivate the researchers to devise automated systems with minimal human intervention, therapist-like assessment, and broader outreach. This article reviews seminal works from 2013 onwards, qualitatively and quantitatively adapting the PRISMA approach to examine the potential of robot-assisted, virtual reality-based rehabilitation and automated assessments through data-driven learning. Extensive experimentation on KIMORE and UI-PRMD datasets reveal high agreement between automated methods and therapists. Our investigation shows that deep learning with spatio-temporal skeleton data and dynamic attention outperforms others, with an RMSE as low as 0.55. Fully automated rehabilitation is still in development, but, being an active research topic, it could hasten objective assessment and improve outreach.

The future of health in the metaverse

Metaverse references an immersive three-dimensional digital space, conceptions about its specific nature and organization have changed over time, and more strongly emphasize the evolution from considering the metaverse as an extended version of a single virtual world to a wide network of an infinite number of interconnected worlds. The aim of this article is to describe the potential of the metaverse in health care. One potential feature of a doctor's office in the metaverse could be the use of virtual reality technology to create immersive, personalized treatment environments for patients. The doctor may also be able to use virtual reality tools to demonstrate treatment options or procedures, or to provide educational materials to the patient. There are several potential applications of the metaverse in medicine, including the use of virtual reality and other immersive technologies for patient care. Some examples of these applications include: Virtual reality exposure therapy for anxiety disorders; Virtual reality-based cognitive behavioral therapy for depression; Virtual reality-based rehabilitation and physical therapy; Virtual reality pain management; and Virtual reality education and training. There are several potential benefits to delivering clinical care in the metaverse. Metaverse may allow for more efficient and convenient access to care, particularly for patients who live in remote or underserved areas. These platforms will contribute for more personalized and immersive treatment experiences, as virtual reality technology can be used to create tailored environments and experiences for patients. There may also be concerns around patient privacy and security, as well as the potential for cyber-attacks.

Designing Virtual Reality-based Testing and Rehabilitation Software for People with Multiple Sclerosis

Designing Virtual Reality-based Testing and Rehabilitation Software for People with Multiple Sclerosis

Efficacy of Virtual Reality-Based Rehabilitation Interventions to Improve Balance Function in Patients with Cerebral Palsy: A Systematic Review and Meta-analysis of RCTs

Context: Cerebral palsy (CP) results from damage to the central nervous system, leading to disturbances of motor and sensory functions, especially the balance. Virtual reality exercise intervention (VRI) is a promising technique to improve motor function in children with CP by engaging such individuals in real-like world events through simulations. This review study examines the effects of VRI on static and functional balances and summarizes the effective protocols of virtual reality-based rehabilitation interventions for the CP patients. Methods: A comprehensive search was performed using the following databases: Medline/PubMed, Scopus, Cochrane Library, PEDro, EBSCOhost, and the Online Library of the University of London. The PEDro scale was used to assess the methodological quality. The data extracted from the reviewed studies were coded according to Cooper and Hedges’ guidelines considering the following criteria: (I) Patients' characteristics, (II) intervention protocols, (III) outcomes, and (IV) results. To this end, twelve RCTs with 248 patients aged 4 - 20 years old were analyzed and assessed as "fair" to "good" methodological quality according to Pedro’s scale (4 to 8). VRI alone or in combination with a standard physiotherapy program or with other tools such as tDCS was applied. Results: Twelve RCTs met the inclusion criteria. The meta-analysis showed the good effect of VRI on the static and functional balances of patients with CP (Cohen’s d = 0.66). The funnel plot revealed no significant asymmetry or heterogeneity among the studies (P = 0.271, I2 = 19.71%), reflecting the absence of publication biases. Conclusions: This review reports four major perspectives of the VRI applications: (1) VRI settings, (2) selection of exercises, (3) outcome measures, and (4) long-term effects. Moreover, this review summarizes the specific effects of VRI on balance improvement in patients with CP from different perspectives. However, considering the limited number of well-conducted RCTs in this field, a large homogeneous samples size is still needed for future RCTs.

Authoring Tools for Procedural Modeling of Virtual Reality-Based Rehabilitation Exercises

Patient compliance is one of the key factors for rehabilitation programs to be effective. To increase patients’ engagement game technologies and virtual reality can be applied. However, the advantages provided by these techniques are not enough to be applied in real scenarios since experts do not always have the required technological skills. To overcome this limitation, a new virtual reality-based rehabilitation system that combines virtual reality, procedural modelling, and authoring tools, is proposed. The system provides easy-to-use editors for the experts to prepare rehabilitation exercises that will take place in an expanding and varied open virtual world created using procedural generation strategies. Patients using a virtual reality headset explore this immersive virtual scenario and solve challenges by applying actions according to their rehabilitation goals and receiving success/failure feedback. While the patient interacts with the exercises through immersive virtual reality, the expert supervises the patient’s actions via a computer monitor where the exercise is displayed at the same time as in the headset. The paper presents the system and the evaluation that has been carried out to set the system configuration parameters that allow non-experts the easy creation of varied open virtual worlds for rehabilitation purposes. In addition, it collects the first impressions of rehabilitators which have been very satisfactory.