Virtual Reality Program Research Articles

Efficacy and safety of transcranial direct current stimulation associated to Virtual Reality and toAerobic Exercises program on the treatment of patients with fibromyalgia

Efficacy and safety of transcranial direct current stimulation associated to Virtual Reality and toAerobic Exercises program on the treatment of patients with fibromyalgia

The effect of virtual reality program on the cognitive function and balance of the people with mild cognitive impairment

[Purpose] The purpose of this study was to investigate the effects of a virtual reality (VR) program on cognitive function and balance in the elderly with mild cognitive impairment (MCI) attending G welfare center in Gurye. [Subjects and Methods] Twenty-four patients with MCI were studied. The patients were exposed to the VR program for 30 min per experiment, which was conducted 20 times for four weeks. [Results] The cognitive function and balancing ability of the experimental group, when compared to the control group, showed a statistically significant increase in Visual Span Test (VST), Word Color Test (WCT), and Limit of Stability (LOS), which are the sub-categories of CNT 4.0, after the exposure to the program. In all test categories, the experimental group exhibited statistically significant differences compared to the control group. [Conclusion] Thus, the VR program is an effective intervention for the elderly with MCI.

Effects of Aerobic Exercise using Virtual Reality Program on Vital Capacity of Male Smokers

본 연구는 20대의 흡연 남성을 대상으로 가상현실 게임을 이용한 운동 프로그램이 호흡능력에 미치는 영향을 알아보고자 연구하였다. 대상자는 건강한 대학교 재학생을 대상으로 하였으며, 흡연자를 대상으로 무작위로 가상현실 그룹과 트래드밀 그룹으로 나누었다. 두 그룹은 각각 운동프로그램을 4주 동안, 주 3회, 30분 동안 실시하였으며, 측정방법은 피크플로우를 사용하여 대상자들의 최대 호기량을 측정하였다. 결과에서 가상현실 군과 트레드밀 군에서 운동 후에 유의한 차이를 나타내었으며, 군 간 비교에서는 4주 후에 유의한 차이를 나타내었다. 본 연구 결과 가상현실프로그램이 20대 흡연 남성에의 호흡에 유의한 차이를 나타낸 것을 알 수 있었으며, 본 연구를 기초로 하여 호흡기 문제에 대한 연구가 활발히 진행될 것이라고 생각된다.

The Effect of Virtual Reality Balance Training Program on Balance Ability and Fall Efficacy of Stroke Patients

This purpose of this study was examined the effects of training using virtual reality program therapy on balance ability and fall efficacy for stroke patients. 20 patients with hemiplegia were divided into two groups, Experiment Group (EG) of 10 people, Control Group (CG) of 10 people were conducted. The two groups received conventional occupational therapy for 30-minutes, once a day, 5 times a week for 6 weeks. The EG was additionally conducted which was performed virtual reality balance training and CG was conducted compensatory balance training for 30-minutes, once a day, 3 times a week for 6 weeks. The evaluation of this study was Berg Balance Scale (BBS), Limit Of Stability (LOS) and Fall Efficacy Scale (FES) after 6 weeks of training. We found significant differences for the BBS, LOS between pretest and post-test in the 2 groups. Also, BBS, LOS and FES were significant different between the groups at groups at post-test. The findings of this study suggest that virtual reality training can improve balance function and falls efficacy in stroke patients.

Utility of a Virtual Trier Social Stress Test: Initial Findings and Benchmarking Comparisons.

The Trier Social Stress Test (TSST) is one of the most widely used laboratory-based acute psychosocial stressors. However, there may be advantages to conducting the TSST through the virtual world, including reducing the cost and burden (i.e., no need for colocation between the evaluators and participants). The virtual TSST might also increase the standardization between studies and provide the capacity to bring psychology experiments to more settings (e.g., the home, the magnetic resonance imaging scanner). Fifty undergraduate students participated in the TSST conducted through an online virtual reality program, using a computer screen and microphone/earphone headset. The present study found that the virtual TSST produced a significant acute stress response, measured both through cortisol (F(1,128) = 31.91, p < .001) and subjective report (F(1,148) = 72.86, p < .001). In addition, this method differentially produced a dampened cortisol response (F(1,126) = 4.41, p < .04) in those who had experienced recent loss (e.g., bereavement, romantic breakup, homesickness), similar to prior research. Virtual reality-based administration of the TSST and other mental challenge protocols increases the possibilities of many standard psychological experiments relevant to biobehavioral research.

Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke.

Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients' motivation and enjoyment. The objective of the present study was to develop a mobile game-based upper extremity VR program for patients who have experienced stroke, and to evaluate the feasibility and effectiveness of the program. This randomized, double-blind, controlled trial included 24 patients with ischemic stroke. The intervention group (n = 12) received 30 min of conventional occupational therapy (OT) and 30 min of the mobile upper extremity rehabilitation program using a smartphone and a tablet PC (MoU-Rehab). The controls (n = 12) received conventional OT alone for 1 h per day. Rehabilitation consisted of 10 sessions of therapy, 5 days per week, for 2 weeks. The outcome measures (Fugl-Meyer Assessment of the upper extremity [FMA-UE], Brunnström stage [B-stage] for the arm and the hand, manual muscle testing [MMT], modified Barthel index [MBI], EuroQol-5 Dimension [EQ-5D], and Beck Depression Inventory [BDI]) were assessed at the beginning and end of treatment, and at 1 month. User satisfaction was evaluated by a questionnaire. A greater improvement in the FMA-UE, B-stage, and MMT was found after treatment with the MoU-Rehab than with conventional therapy. The extent of improvements in the MBI, EQ-5D, and BDI was not significantly different between the two groups. Patients in the experimental group completed the 2-weeks treatment without adverse effects, and they were generally satisfied with MoU-Rehab. This mobile game-based VR rehabilitation program appears to be feasible and effective for promoting upper limb recovery after ischemic stroke.

Feasibility of an individually tailored virtual reality program for improving upper motor functions and activities of daily living in chronic stroke survivors: A case series

IntroductionChronic stroke survivors are a clinically diverse group which can make home management difficult. The development of individually tailor made virtual reality programs (ITVRPs) for home management could aid the maintenance or recovery of the physical function of stroke survivors. This study aimed to investigate the feasibility and effectiveness of introducing a newly developed ITVRP on chronic stroke survivors with upper motor problems. MethodFifteen stroke survivors living in the community participated in the ITVRP for 40–50min/day, 3days/week for 8 weeks. Outcome measures included the Fugl-Meyer Assessment, Manual Function Test, Box and Block Test, and Modified Barthel Index. A custom made questionnaire was used to investigate satisfaction and safety of the ITVRP. ResultsAfter participating the program, the stroke survivors showed significant improvements in the Fugl–Meyer assessment (p<0.001), manual function test (p=0.009), and modified Barthel index (p=0.021). Furthermore, 73% of participants were satisfied with the ITVRP in terms of improving their upper motor functions. No adverse events were reported. ConclusionsThe results of this case series indicate the feasibility and accessibility of ITVRP for rehabilitation of chronic stroke survivors.

Technology and Weight Loss: A Systematic Revew

ObjectiveTo evaluate the effects of technology on a weight‐loss program.DesignSystematic review of randomized and non‐randomized controlled trials and cohort studies.Data sourcesPubMedStudy selection20 studies: fourteen randomized controlled trials, one retrospective cohort, one experimental control trial, one cohort study, and one semi‐randomized control trial. Two studies looked at video technology, one through video conferencing, and one through video telehealth, and one through home‐based DVDs. Five of the studies included a text messaging component as part of the intervention. Three studies used a Personal Digital Assistant (PDA) as the technological intervention. Three studies used a website as part of the intervention. Two studies used social media outlets, such as Twitter or Facebook. One study used a virtual reality program for weight loss. Two studies used unique smart phone applications. One study utilized Integrated Voice Recognition software in conjunction with a weight loss program. Two studies used podcasts centered on weight loss strategies. Three studies used two types of technology components in the weight loss intervention.Main outcome measuresweight loss, dietary behaviors, physical activity and quality of lifeResultsInclusion of a technology component to complement a traditional classroom weight loss program increased weight loss and physical activity and improved dietary behaviors.ConclusionTechnology as a supplement to a face‐to‐face weight loss program is an effective and innovative strategy for maintenance of weight loss.

The Effect of Virtual Reality Balance Training Program on Balance Ability and Fall Efficacy of Stroke Patients

This purpose of this study was examined the effects of training using virtual reality program therapy on balance ability and fall efficacy for stroke patients. 20 patients with hemiplegia were divided into two groups, Experiment Group (EG) of 10 people, Control Group (CG) of 10 people were conducted. The two groups received conventional occupational therapy for 30-minutes, once a day, 5 times a week for 6 weeks. The EG was additionally conducted which was performed virtual reality balance training and CG was conducted compensatory balance training for 30-minutes, once a day, 3 times a week for 6 weeks. The evaluation of this study was Berg Balance Scale (BBS), Limit Of Stability (LOS) and Fall Efficacy Scale (FES) after 6 weeks of training. We found significant differences for the BBS, LOS between pretest and post-test in the 2 groups. Also, BBS, LOS and FES were significant different between the groups at groups at post-test. The findings of this study suggest that virtual reality training can improve balance function and falls efficacy in stroke patients.

Survivors of chronic stroke – participant evaluations of commercial gaming for rehabilitation

Purpose: There has been an increase in research on the effect that virtual reality (VR) can have on physical rehabilitation following stroke. However, research exploring participant perceptions of VR for post-stroke rehabilitation has been limited.Method: Semi-structured interviews were conducted with 10 chronic stroke participants (10 males, mean age = 72.1, mean time since injury = 38.6 mos.) who had recently completed an upper extremity VR stroke rehabilitation programme.Results: Four main themes emerged: ‘the VR experience,’ ‘functional outcomes,’ ‘instruction,’ and the ‘future of VR in stroke rehabilitation,’ along with nine sub-themes. Participants illustrated the positive impact that VR training had on their functional abilities as well as their confidence towards completing activities of daily living (ADL). Participants also expressed the need for increased rehabilitation opportunities within the community.Conclusion: Overall, participants were optimistic about their experience with VR training and all reported that they had perceived functional gain. VR is an enjoyable rehabilitation tool that can increase a stroke survivor’s confidence towards completing ADL.Implications for RehabilitationAlthough there is an increase in rehabilitation programmes geared towards those with chronic stroke, we must also consider the participants’ perception of those programmes.Incorporating participant feedback may increase enjoyment and adherence to the rehabilitation programmes.The VR experience, as well as provision of feedback and instruction, are important aspects to consider when developing a VR programme for stroke survivors.VR for rehabilitation may be a feasible tool for increasing the survivors’ confidence in completing ADL post-stroke.

Virtual Reality-Guided Motor Imagery Increases Corticomotor Excitability in Healthy Volunteers and Stroke Patients.

ObjectiveTo investigate the effects of using motor imagery (MI) in combination with a virtual reality (VR) program on healthy volunteers and stroke patients. In addition, this study investigated whether task variability within the VR-guided MI programs would influence corticomotor excitability.MethodsThe present study included 15 stroke patients and 15 healthy right-handed volunteers who were presented with four different conditions in a random order: rest, MI alone, VR-guided MI, and VR-guided MI with task variability. The corticomotor excitability of each participant was assessed before, during, and after each condition by measuring changes in the various parameters of motor-evoked potentials (MEPs) of the extensor carpi radials (ECR). Changes in intracortical inhibition (ICI) and intracortical facilitation (ICF) were calculated after each condition as percentages of inhibition (%INH) and facilitation (%FAC) at rest.ResultsIn both groups, the increases in MEP amplitudes were greater during the two VR-guided MI conditions than during MI alone. Additionally, the reductions in ECR %INH in both groups were greater under the condition involving VR-guided MI with task variability than under that involving VR-guided MI with regular interval.ConclusionThe corticomotor excitability elicited by MI using a VR avatar representation was greater than that elicited by MI with real body observations. Furthermore, the use of task variability in a VR program may enhance neural regeneration after stroke by reducing ICI. The present findings support the use of various VR programs as well as the concept of combining MI with VR programs for neurorehabilitation.

Efficacy of virtual reality-based balance training versus the Biodex balance system training on the body balance of adults.

[Purpose] This study investigated efficacy of virtual reality (VR)-based balance training on enhancing balance and postural reactions of adults as a low-cost new modality compared to the established Biodex Balance System (BBS). [Subjects] Thirty normal adults of both genders were divided randomly into two equal-sized experimental groups of 15: BBS balance training and VR balance training. [Methods] The training programmes were conducted in 12 sessions, three 15-min sessions per week. The Nintendo® Wii Fit Plus (NWFP) and its balance board were used to train of the VR group. Each participant answered a questionnaire concerning usability, enjoyment, balance improvement, and fatigue at the end of the training programs. [Results] The study found a significant increase the measure of mean overall balance (OLB) in both groups. No significant difference was found between the groups, but a significant decrease in the mean balance-test time was found for both groups, with no significant difference between the two training methods. The VR programme was rated highly enjoyable by 81.8% of the group. [Conclusion] The Wii Fit Plus system with the balance board as a new VR balance-training technique, can be considered an effective and enjoyable tool for the training of adults’ body balance.

Patient perspectives on virtual reality-based rehabilitation after knee surgery: Importance of level of difficulty

This article explored the perspectives of 25 patients regarding virtual reality (VR)-based rehabilitation following knee surgery and identified the important factors that allowed patients to immerse themselves in rehabilitation. Qualitative analysis of data collected via open-ended questionnaire and quantitative analysis of data from physical assessments and surveys were conducted. In the open-ended questionnaire, the majority of participants mentioned level of difficulty as the most common reason for selecting both the most and the least immersive exercise programs. Quantitative analysis showed that participants experienced a high level of flow (3.9 +/- 0.3 out of 5.0) and a high rate of expectation of therapeutic effect (96%) and intention of exercise adherence (96%). Further, participants with more severe pain or physical dysfunction tended to have more positive experiences (e.g., Difficulty-Skill Balance, Clear Goals, and Transformation of Time), leading to high levels of flow during VR-based rehabilitation. In conclusion, VR-based games are potentially acceptable as a motivational rehabilitation tool for patients following knee surgery. However, to best meet patients' needs, it might be useful to equip a VR program with varied levels of difficulty, taking into account the severity of the individual's knee injury. Additionally, severe pain or physical dysfunction might act as an indication rather than a contraindication for VR-based rehabilitation.

Effectiveness of the Virtual Reality System Toyra on Upper Limb Function in People with Tetraplegia: A Pilot Randomized Clinical Trial.

The aim of this study was to investigate the effects of a virtual reality program combined with conventional therapy in upper limb function in people with tetraplegia and to provide data about patients' satisfaction with the virtual reality system. Thirty-one people with subacute complete cervical tetraplegia participated in the study. Experimental group received 15 sessions with Toyra® virtual reality system for 5 weeks, 30 minutes/day, 3 days/week in addition to conventional therapy, while control group only received conventional therapy. All patients were assessed at baseline, after intervention, and at three-month follow-up with a battery of clinical, functional, and satisfaction scales. Control group showed significant improvements in the manual muscle test (p = 0,043, partial η 2 = 0,22) in the follow-up evaluation. Both groups demonstrated clinical, but nonsignificant, changes to their arm function in 4 of the 5 scales used. All patients showed a high level of satisfaction with the virtual reality system. This study showed that virtual reality added to conventional therapy produces similar results in upper limb function compared to only conventional therapy. Moreover, the gaming aspects incorporated in conventional rehabilitation appear to produce high motivation during execution of the assigned tasks. This trial is registered with EudraCT number 2015-002157-35.

Effect of Virtual Reality on Postural and Balance Control in Patients with Stroke: A Systematic Literature Review.

Objective. To critically evaluate the studies that were conducted over the past 10 years and to assess the impact of virtual reality on static and dynamic balance control in the stroke population. Method. A systematic review of randomized controlled trials published between January 2006 and December 2015 was conducted. Databases searched were PubMed, Scopus, and Web of Science. Studies must have involved adult patients with stroke during acute, subacute, or chronic phase. All included studies must have assessed the impact of virtual reality programme on either static or dynamic balance ability and compared it with a control group. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. Results. Nine studies were included in this systematic review. The PEDro scores ranged from 4 to 9 points. All studies, except one, showed significant improvement in static or dynamic balance outcomes group. Conclusions. This review provided moderate evidence to support the fact that virtual reality training is an effective adjunct to standard rehabilitation programme to improve balance for patients with chronic stroke. The effect of VR training in balance recovery is less clear in patients with acute or subacute stroke. Further research is required to investigate the optimum training intensity and frequency to achieve the desired outcome.

Effects of Virtual Reality Programs on Proprioception and Instability of Functional Ankle Instability

We investigated the effects of a Virtual reality(VR) program on the proprioception and instability of functional ankle instability(FAI) patients. Among the 20s old individuals who lived in Republic of Korea; 20 people were selected through a public participation process. The 20 participants were then randomly divided into two groups, one of strength exercise(n=10) and one of balance exercise(n=10). Of the patients who had experienced an ankle sprain in the past and currently felt ankle instability, those who recorded 24 points or less on the Cumberland ankle instability tool(CAIT) were determined to have FAI. We selected the strength exercise and balance exercise in the Nintendo Wii Fit Plus as a VR program. The subjects used the program on the Wii Balance Board three times per week for 20 minutes and total 10-minute warm-up and down for four weeks. Proprioception and CAIT of the balance exercise group were improved significantly after the exercise compared to before the exercise(p<.05). Authors recommend that the balance exercise in the VR program be used as an aid for physical therapeutic intervention.

Client perceptions of the mental health engagement network: a qualitative analysis of an electronic personal health record

BackgroundInformation technologies such as websites, mobile phone applications, and virtual reality programs have been shown to deliver innovative and effective treatments for mental illness. Much of the research studying electronic mental health interventions focuses on symptom reduction; however, to facilitate the implementation of electronic interventions in usual mental health care, it is also important to investigate the perceptions of clients who will be using the technologies. To this end, a qualitative analysis of focus group discussions regarding the Mental Health Engagement Network, a web-based personal health record and smartphone intervention, is presented here.MethodsIndividuals living in the community with a mood or psychotic disorder (n = 394) were provided with a smartphone and access to an electronic personal health record, the Lawson SMART Record, for 12 to 18 months to manage their mental health. This study employed a delayed-implementation design and obtained both quantitative and qualitative data through individual interviews and focus group sessions. Participants had the opportunity to participate in voluntary focus group sessions at three points throughout the study to discuss their perceptions of the technologies. Qualitative data from 95 focus group participants were analysed using a thematic analysis.ResultsFour overarching themes emerged from focus group discussions: 1) Versatile functionality of the Lawson SMART Record and smartphone facilitated use; 2) Aspects of the technologies as barriers to use; 3) Use of the Mental health Engagement Network technologies resulted in perceived positive outcomes; 4) Future enhancement of the Lawson SMART Record and intervention is recommended.DiscussionThese qualitative data provide a valuable contribution to the understanding of how smarttechnologies can be integrated into usual mental health care. Smartphones are extremely portable andcommonplace in society. Therefore, clients can use these devices to manage and track mental health issuesin any place at almost any time without feeling stigmatized.ConclusionsAssessing clients’ perspectives regarding the use of smart technologies in mental health care provides an invaluable addition to the current literature. Qualitative findings support the feasibility of implementing a smartphone and electronic personal health record intervention with individuals who are living in the community and experiencing a mental illness, and provide considerations for future development and implementation.

Personalized Internet-based treatment services for posttraumatic stress disorder

Among the most important innovations within the psychotherapeutic care system are the new opportunities in the field of e-mental health. During the past decade, Internet-based and other e-mental health approaches for the treatment of post-traumatic stress disorder and related stress-associated symptoms have been developed in great variety. Solely Internet-based self-help programs are the lowest-threshold approaches in a stepped-care system. By contrast, individualized online psychotherapy and virtual reality programs are at the opposite pole of the spectrum. Approaches in the field of m(obile)-mental health complement these new developments in psychotherapy. The existing evidence supports the clinical efficacy of all the described approaches, although not all have been tested rigorously analog to phase III studies in psychopharmacology. Nonetheless, e-mental health approaches will shape our field more and more in the future.

Study on the Content Development of the Exercise Programs for Rehabilitation using the Motion Recognition Technology

This study was conducted to present the development direction of the contents of rehabilitation exercise program for person with disabilities using motion recognition technology. Through the literature review, we selected for those who needed rehabilitation service focusing on exercise. They have difficulties in an exercise for the upper extremity, learning and mobility within a community due to physical and mental disability, brain injury and autism. To set a goal for rehabilitation exercise program, we analyzed preceding literature related to the needs of the disabled persons and 17 evaluation tools for daily living skills in occupational therapy. Accordingly, the goal was set for improving activities of daily living and the goal activities specifically focused on dressing/taking off clothes, eating and personal hygiene. Then, the functional motion elements consisting of each activity and their levels were defined and analyzed. In the rehabilitation program, the motion elements of the goal activity that could be measured by motion recognition sensor were presented. The motion elements of the goal activity involved muscle strength and range of motion that could be measured, so that the development direction of rehabilitation exercise program contents was specifically presented for improving daily living skills. The study presented the possibility that virtual reality program contents developed for rehabilitation for the disabled could attribute to not only simple physical and/or cognitive improvement but also to the actual daily living skills.

The Effects of Bilateral Training Using Virtual Reality Program on Children With Cerebral Palsy.

The Effects of Bilateral Training Using Virtual Reality Program on Children With Cerebral Palsy.