Virtual Rehabilitation System Research Articles

In-Home Virtual Reality Videogame Telerehabilitation in Adolescents With Hemiplegic Cerebral Palsy

Golomb MR, McDonald BC, Warden SJ, Yonkman J, Saykin AJ, Shirley B, Huber M, Rabin B, AbdelBaky M, Nwosu ME, Barkat-Masih M, Burdea GC. In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic cerebral palsy. Objective To investigate whether in-home remotely monitored virtual reality videogame-based telerehabilitation in adolescents with hemiplegic cerebral palsy can improve hand function and forearm bone health, and demonstrate alterations in motor circuitry activation. Design A 3-month proof-of-concept pilot study. Setting Virtual reality videogame-based rehabilitation systems were installed in the homes of 3 participants and networked via secure Internet connections to the collaborating engineering school and children's hospital. Participants Adolescents (N=3) with severe hemiplegic cerebral palsy. Intervention Participants were asked to exercise the plegic hand 30 minutes a day, 5 days a week using a sensor glove fitted to the plegic hand and attached to a remotely monitored videogame console installed in their home. Games were custom developed, focused on finger movement, and included a screen avatar of the hand. Main Outcome Measures Standardized occupational therapy assessments, remote assessment of finger range of motion (ROM) based on sensor glove readings, assessment of plegic forearm bone health with dual-energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), and functional magnetic resonance imaging (fMRI) of hand grip task. Results All 3 adolescents showed improved function of the plegic hand on occupational therapy testing, including increased ability to lift objects, and improved finger ROM based on remote measurements. The 2 adolescents who were most compliant showed improvements in radial bone mineral content and area in the plegic arm. For all 3 adolescents, fMRI during grip task contrasting the plegic and nonplegic hand showed expanded spatial extent of activation at posttreatment relative to baseline in brain motor circuitry (eg, primary motor cortex and cerebellum). Conclusions Use of remotely monitored virtual reality videogame telerehabilitation appears to produce improved hand function and forearm bone health (as measured by DXA and pQCT) in adolescents with chronic disability who practice regularly. Improved hand function appears to be reflected in functional brain changes.

A benchmarked automated progress measurement system for haptic motor rehabilitation

As Haptic devices become more affordable and economical, research in Haptic-based virtual rehabilitation systems is gaining more interest. In addition to the benefits provided by virtual rehabilitation, Haptics offer force and tactile feedback which can be crucial for much upper and lower extremity rehabilitation. In this paper, we present such a system that provides a rich media environment for motor rehabilitation of stroke patients. The system can be used by Occupational Therapists (OTs) to measure and monitor the progress of rehab patients. This is an expanded version of a paper presented at the 3rd IEEE International Workshop on Medical Measurements and Applications, 9 10 May 2008, Ottawa, ON, Canada.

TheraGame: A home based virtual reality rehabilitation system

The limitations of existing virtual reality (VR) systems in terms of their use for home-based VR therapy led us to develop “TheraGame”, a novel video capture VR system. TheraGame operates on a standard PC with a simple webcam. The software is programmed using a Javabased visual interaction system. This system enables a quick and easy definition of virtual objects and their behavior. The user sits in front of the monitor, sees himself and uses his movements to interact with the virtual objects. The objective of this presentation is to present the system, a number of the current applications, and some initial pilot usage results. Results from a study of 12 healthy elderly subjects showed moderate to high levels of enjoyment and usability. These scores were also high as reported by 4 participants with neurological deficits. Some limitations in system functionality were reported by one person with stroke who used TheraGame at home for a period of 2.5 weeks. Overall, TheraGame appears to have considerable potential for home based rehabilitation.

Poster 31: Examining Usability of a Virtual Reality Driving Simulator

Objective: To examine aspects of usability, user feedback, and user comfort of a newly developed Virtual Reality Driver Rehabilitation (VR-DR) system. Design: Between-group comparison. All participants drove through a virtual environment using the VR-DR and completed the VR-DR User Feedback Questionnaire. Setting: Medical rehabilitation research facility. Participants: 54 participants in total. 33 subjects with acquired brain injury (20 with traumatic brain injury [TBI], 13 with cerebrovascular accident [CVA]) and 21 healthy controls (HC).

Assessment of various display devices on a virtual reality-based hand rehabilitation system

The purpose of the present study is to assess the effect of an auxiliary lateral image and display devices on manipulation performance in a virtual reality-based hand rehabilitation system. The system consists of a personal computer, a tracker, a data glove, and a display device. For this study, a projector, a monitor, and a head-mounted display were respectively used as the display devices to present three-dimensional virtual environments. Twelve volunteers were recruited to take a pick-and-place procedure at different levels of difficulty. Task time and collision frequency were the parameters used to evaluate the manipulation performance. It was found that the presence of an auxiliary lateral image was a significant factor only for the performance of the projector group and the monitor group. In addition, no statistically significant difference was found in the comparison between the projector group and the monitor group.

The study of auditory and haptic signals in a virtual reality-based hand rehabilitation system

The purpose of the present study is to assess the influence of auditory and haptic signals on the manipulation performance in a virtual reality-based hand rehabilitation system. A personal computer, a tracker, and a data glove were included in this system. Three-dimensional virtual environments were developed. Forty volunteers were recruited to participate in a pick-and-place procedure, with three levels of difficulty and four feedback modes. Task time and collision frequency were the parameters used to evaluate their manipulation performance. It can be concluded that the haptics is a significant signal for improving a subject's performance at the high difficulty level.