Virtual Rehabilitation Research Articles

Abstract 189: Why Digital Health Trials Can Fail: Lessons Learned from the SmartGUIDE Randomized Trial of Virtual Cardiac Rehabilitation

Background: We performed a trial to evaluate the efficacy of a blended intervention with a custom-designed smartphone app combined with health coaching to improve medication adherence and cardiovascular risk factors. The trial failed to achieve objectives due to a number of factors. Here, we describe findings from a root cause analysis and lessons learned. Methods: SmartGUIDE was an open-label, single center trial of patients with coronary artery disease who were prescribed a statin and/or P 2 Y 12 antagonist that randomized 1:1 to either usual care or the use of a mobile app paired with personal virtual coaching. The primary outcome for medication adherence was the proportion of days covered (PDC). The planned sample size was 132 for 80% power. However, the study was terminated early with only 63 patients randomized and data of 26 patients ultimately available for analysis. We performed a root cause analysis using the 5-Whys technique to evaluate processes from study development to closure. Results: Figure 1 shows an Ishikawa cause-and-effect diagram for root cause analysis of trial failure. Root causes included aspects of intervention design, study design, enrollment, and retention. Many factors were related to the startup partner’s product design, inexperience in health care, and insufficient funding. Conclusion: We identified important and preventable factors leading to failure to achieve the trial objectives. These factors may be common across digital health trials and may explain prior observations that many such trials are never completed. Careful vetting of technology partners and more pragmatic study designs may be important lessons.

3086 Virtual World-based Cardiac Rehabilitation to Promote Healthy Lifestyle Among Cardiac Patients

OBJECTIVES/SPECIFIC AIMS: Our aim was to assess the feasibility and acceptability of a VW-based cardiac rehabilitation (CR) program (Destination Rehab) as an extension of a face-to-face conventional CR program. We hypothesized that a VW-based CR program could be successfully implemented as an extension of conventional CR and would have high acceptability among cardiac patients. METHODS/STUDY POPULATION: We recruited 30 adult cardiac patients (10/site) hospitalized at Mayo Clinic Hospitals in Rochester, MN, Jacksonville, FL or Scottsdale, AZ with a diagnosis for CR (eg, acute coronary syndrome (ACS), heart failure, elective percutaneous coronary intervention (PCI)). Other inclusion criteria included at least 1 modifiable, lifestyle risk factor target: sedentary lifestyle (< 3 hours physical activity (PA)/week), unhealthy diet (< 5 servings fruits and vegetables/day) or current smoking (>1 year). Patients participated in an 8-week, health education program using a VW platform from a prior proof-of-concept study and provided intervention usability, usefulness and satisfaction feedback. We assessed cardiovascular (CV) health behaviors (diet, PA) and risk factors (eg, blood pressure (BP), lipids) at baseline and immediate post-intervention. RESULTS/ANTICIPATED RESULTS: Among 30 patients enrolled (mean age; 59 years; 50% women; 65% <college graduate; 32% annual household income <$50,000), 28 (98%) completed the study. The majority (64%) were enrolled in conventional CR with a high session completion rate (median 36 sessions, interquartile range 8-36). The most common CR indication was PCI (68%). There were statistically significant improvements in PA from baseline to post-intervention: vigorous PA, +10.7 (SD 11.7) minutes/day (p = 0.05) and flexibility exercises +0.9 (SD 0.9) days/week for men (p=0.05). There were favorable trends in risk factors: systolic BP (−6.8 mmHg, SD 29.8), total cholesterol (−31.6 mg/dL, SD 46.2) and LDL (−26 mg/dL, SD 44.8) from baseline to post-intervention, although not statistically significant. The majority reported that they would continue to use VW as a resource (76%) and agreed/strongly agreed that the program improved their heart health knowledge (86%) and assisted with adapting healthier lifestyle (100%). Overall, the VW CR program received a rating of 8 (scale 0-10). DISCUSSION/SIGNIFICANCE OF IMPACT: VW-based CR program is a feasible, highly acceptable and innovative platform to influence health behaviors and CV risk and can increase accessibility to disadvantaged populations with higher CVD burdens.

델파이 조사 및 환자설문을 반영한 뇌성마비아동을 위한 VR기반 집중유도 재활훈련 시스템 개발과 Pilot Test

델파이 조사 및 환자설문을 반영한 뇌성마비아동을 위한 VR기반 집중유도 재활훈련 시스템 개발과 Pilot Test

Electrotactile Feedback in a Virtual Hand Rehabilitation Platform: Evaluation and Implementation

Tactile feedback plays an important role in hand manipulation, especially in the grasping process which is one of the major functions of the hand. However, few commercially available prosthetic hands or hand motor function rehabilitation systems are equipped with tactile feedback. The absence of suitable tactile feedback modules leads to an inferior rehabilitation performance with a large burden on user training and compromised usability. Thus, it is challenging and essential to integrate a proper tactile feedback module with the existing hand rehabilitation systems to achieve a better control performance and accelerate the rehabilitation process. This paper focuses on the implementation and evaluation of the electrotactile feedback (EF) enhanced rehabilitation system. A virtual hand rehabilitation platform is proposed comprising an surface electromyography (sEMG) acquisition module, an electrotactile stimulation module, a virtual environment with sEMG-driven humanlike hand and numerical feedbacks of grasping force and fingertip deformation, where a closed-loop control is formed. Three different feedback conditions including visual feedback (VF), EF, and no feedback (NF) are compared based on the proposed platform. Experiments were conducted on 10 able-bodied subjects, and multiple quantitative metrics for the rehabilitation performance evaluation including training burden estimation and success rate (SR) of tasks were adopted. Results indicate that the integration of EF is helpful to both reduce the rehabilitation duration and improve the virtual grasping SR in comparison with the NF condition while possessing a better practicality over VF. Note to Practitioners —This paper is motivated by the problem of hand grasp control for rehabilitation purposes, but it also applies to other hand motor function rehabilitation process. Existing hand motor function rehabilitation approaches generally lack a proper feedback and rely on the heavy burden during user training and the users experience. This paper suggests incorporating EF to improve the efficiency and efficacy of the rehabilitation process. The electrical stimulation is driven by the myoelectric-sensing-based force estimation and encoded in a manual scheme to fit each individual involved. In our work, a virtual hand rehabilitation platform is implemented to verify the feasibility of EF in reducing the burden of user training and improving the rehabilitation performance, which allows the expanding of the current system into a broader spectrum of motor function rehabilitation applications. Experiments on able-bodied subjects suggest that the EF in the proposed virtual hand rehabilitation platform is feasible, but it has not been tested on the limb-impaired subjects and confined to a manual encoding of electrical stimulation. In the future research, the design of a general EF enhanced hand rehabilitation platform with a standardized stimulation parameter optimization will be addressed and further validated on the subjects with limb impairments and amputation.

Virtual Rehabilitation Training System Based on Surface EMG Feature Extraction and Analysis.

Aiming at the characteristics that electromyography (EMG) signals can reflect the human body's motive intention and the information of muscle's motive state, this paper makes a thorough study on the evaluation of surface electromyography signals' motive state. At the same time, EMG signals can reflect the characteristics of limb movement and its changing rules, and can acquire the functional characteristics of limb movement so as to accurately evaluate the rehabilitation status of patients. In this paper, EMG signal analysis and feedback control are introduced into the virtual rehabilitation system to study the methods of EMG parameter identification and dynamic feature extraction, and obtain the EMG characteristics and variation rules related to human motion patterns. In this paper, a rehabilitation training system based on EMG feedback and virtual reality is built, and the validity of the system is verified by patient experiment. The feasibility of the system is verified by the methods of validity of the algorithm, recognition rate of the system action pattern and fatigue evaluation.

Impact of virtual reality-based rehabilitation on functional outcomes in patients with acute stroke: a retrospective case-matched study.

To date, the efficacy of the virtual reality (VR) application for acute stroke compared with conventional therapy (CT) remains unclear. This retrospective study aims to assess the impact of adjuvant VR technology on multidimensional therapy for patients with acute-stage stroke. 100 acute ischemic stroke patients with onset within 7 days who underwent combined adjuvant VR-based rehabilitation program and CT (intervention group-VR + CT) were compared to an equal number of cross-matched patients who received CT alone. While the intervention group received 40-min CT plus 20-min VR program (seven times for 1 week), the comparison group received time-matched CT alone. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), medical cost-effectiveness, and shortening of hospital stay were used as outcome measures. Posttreatment, the VR + CT group revealed significantly improved NIHSS and mRS (P < 0.001), whereas only the mRS improvement was remarkable in the CT group. In between-group comparisons, the intervention group had better improvements of symptom severity (NIHSS percentage improvement from the baseline; 20.18% vs. 4.59%, P < 0.005), functional outcomes (mRS improvement from the baseline; - 0.58 vs. - 0.23, P < 0.001), and reduced medical cost (Taiwan dollar; 49474 vs. 66306, P < 0.005). Furthermore, the VR + CT group reached markedly higher proportion of functional independence in activities of daily living (mRS, 0-2) at discharge compared with the CT group (68% vs. 60%, P < 0.001). This study suggests that the combination of VR-based rehabilitation and traditional therapy could be more effective for neurorehabilitation than CT alone in the early improvement of symptom severity, functional outcomes, and lower medical expenditure in acute stroke patients.

Study on Brain Electromyography Rehabilitation System Based on Data Fusion and Virtual Rehabilitation Simulation.

In this paper, a virtual rehabilitation training system based on electroencephalogram (EMG) feedback is proposed to solve the problem that the existing virtual rehabilitation training methods can not reflect the initiative of patients and lack of individual adaptability. Aiming at the EEG data fusion rehabilitation system based on Virtual Prototyping technology, a motion pattern recognition method based on the feature fusion of EEG and EMG signals is studied to improve the accuracy and flexibility of the rehabilitation training system. The corresponding virtual rehabilitation training scene is designed, and the control and feedback adjustment of the virtual scene are realized by using the above EEG feature analysis method. Finally, the virtual rehabilitation training is realized. The multi-level coupling relationship between EEG and EMG signals under different grip forces was explored by using the synchronous coupling characteristics between EEG and EMG signals, which provided a theoretical basis for further application in clinical rehabilitation evaluation.

Feature Evaluation of Upper Limb Exercise Rehabilitation Interactive System Based on Kinect

The virtual rehabilitation system combining virtual rehabilitation environment and upper limb rehabilitation technology is interactive and interesting, which can improve the enthusiasm and initiative of patients for rehabilitation training, improve the efficiency of rehabilitation training and improve the effect of rehabilitation treatment. This paper firstly conducts in-depth research and analysis on the research progress of the upper limb rehabilitation robot system, and deeply studies the principle and rehabilitation principle of the stroke caused by hemiplegic dyskinesia, and summarizes the goals and methods of the upper limb rehabilitation system design. Secondly, the hand motion tracking is realized by Kinect’s bone tracking, and the optimal tracking distance is determined experimentally, which verifies the stability and robustness of the tracking. Static gesture recognition adopts two gesture recognition schemes based on Kinect depth image and color space model respectively. Finally, using the rehabilitation robot and Kinect sensor as the hardware platform, the virtual rehabilitation training system experimental platform is constructed, and the horizontal rehabilitation exercise and the three-dimensional space rehabilitation exercise are respectively studied experimentally, and the exercise data obtained by using healthy subjects as the experimental object is analyzed. Based on this, the validity and feasibility of the Kinect-based upper limb exercise rehabilitation interactive system were verified.

New perspectives of motor rehabilitation of patients after focal brain lesions

Rehabilitation of patients after focal brain lesions is one of the topical issues of modern medicine. Motor disorders are known to develop in more than 80% of survivors of stroke and traumatic brain injury and be one of the main causes of disability, which necessitates an active search for new effective techniques for correction of motor disorders. Modern rehabilitation includes both traditional techniques for recovery of patients with motor deficit (exercise therapy and physiotherapy) and botulinum therapy, kinesiotherapy, mechanotherapy, etc., which have been developed in recent years. Robotic technologies have been developed, improved, and implemented. Currently, due to progress in computerization, virtual reality-based rehabilitation of patients is of particular interest. The article reviews the key studies in this field. We describe various visualization methods and means of immersion in a virtual environment for recovery of upper and lower extremity function in patients with focal brain lesions. The study provides an assessment of the effectiveness and safety of various virtual reality-based rehabilitation programs in patients with motor disorders after stroke and traumatic brain injury.

R.O.G.E.R Help software for the diagnosis and rehabilitation of cognitive disorders

Event Abstract Back to Event R.O.G.E.R Help software for the diagnosis and rehabilitation of cognitive disorders Sébastien Serlet1* 1 CO3 / Consciousness, Cognition & Computation Group, Belgium R.O.G.E.R (Realistic Observation in Game and Experiences in Rehabilitation) is a virtual reality software. It is developed by a video game company (Fishing Cactus), by neuropsychological researchers (University of Brussels) and clinicians (ERASME Hospital) that allows the creation of cognitive assessment scale and observation and the creation of game scenarios for cognitive rehabilitation purposes. This tool can be found in laboratories or rehabilitation services and can be used by different therapists (neuropsychology, physiotherapy, speech therapy, occupational therapy ...). It also allows adding physiological measurements which can record and analyze data during sessions of reeducation (eye-tracker, electrodermal activity, cardiac ...) We now find a virtual home (https://www.youtube.com/watch?v=7IwtA-YOL2E) on a computer accessible to all, the graphic quality allowing a complete immersion. Virtual reality is accepted as a therapeutic tool and allows a better transfer of rehabilitation in everyday life. The software integrates a scenario editor (simple creation without knowledge of codings beforehand, https://www.youtube.com/watch?v=8pGH_WqyvkY). Subsequently, a platform of buying and selling scenarios will enrich the catalog of this serious game. The possibility of standardization of the data in real time for each scenario with an evaluation aim as well as scales of evaluations for the rehabilitation scenarios will also be found. R.O.G.E.R promises a graphic quality, a grip accessible to all, a constant updating and in real time. It also makes it possible to work on all the cognitive functions and to bring new data for the clinic and the research. References Traité de neuropsychologie clinique de l'adulte: Tome 2-Rééducation. De Boeck Superieur, 2016. Camara Lopez, M. (2018). DÉVELOPPEMENT D’UN OUTIL D’ÉVALUATION NEUROPSYCHOLOGIQUE EN RÉALITÉ VIRTUELLE: CAS SPÉCIFIQUE DE L’ÉVALUATION DE LA MÉMOIRE PROSPECTIVE. Keywords: virtual reality, Rehabilitation, Neuropsychologie, Neurological disorders & brain damage, medical device Conference: 13th National Congress of the Belgian Society for Neuroscience , Brussels, Belgium, 24 May - 24 May, 2019. Presentation Type: Poster presentation Topic: Behavioral/Systems Neuroscience Citation: Serlet S (2019). R.O.G.E.R Help software for the diagnosis and rehabilitation of cognitive disorders. Front. Neurosci. Conference Abstract: 13th National Congress of the Belgian Society for Neuroscience . doi: 10.3389/conf.fnins.2019.96.00033 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 25 Apr 2019; Published Online: 27 Sep 2019. * Correspondence: Mr. Sébastien Serlet, CO3 / Consciousness, Cognition & Computation Group, Brussels, B-1050, Belgium, sebastien.serlet@yahoo.fr Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract Supplemental Data The Authors in Frontiers Sébastien Serlet Google Sébastien Serlet Google Scholar Sébastien Serlet PubMed Sébastien Serlet Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Advanced virtual reality-based rehabilitation of balance and gait in clinical practice.

Background:Extensive research shows that virtual reality (VR) enhances motor learning and has advantages in balance and gait rehabilitation of neurological patients. There is still uncertainty, however, as for the practicality and efficacy of VR in long-term clinical routine. The objective of this study was to report on 3 years of clinical practice conducting VR-based rehabilitation of balance and gait in a large medical center.Methods:This retrospective study systematically analyzed clinical records of patients who received VR-based rehabilitation in a large rehabilitation center during 3 years. We evaluated the effect of VR-based rehabilitation treatments on balance and gait, cognitive dual-task load, patient’s balance confidence (ABC-scale) and perception of suitability. Patients were either neurological patients, allocated to five groups: Parkinson’s disease (PD), poststroke (PS), multiple sclerosis, traumatic brain injury, and ‘other conditions’, or non-neurological patients.Results:Records of 167 patients were analyzed. The availability of multiple VR systems and environments contributed to highly personalized interventions that tailored specific deficits with therapeutic goals. VR-based rehabilitation significantly improved balance and gait (measured by 10-Meter Walk Test, Timed-Up-and-Go, Berg Balance Scale, and Mini BESTest). Patients with PD and PS decreased dual-task cost while walking. Patients increased balance confidence and deemed VR suitable for rehabilitation.Conclusions:Our results suggest that VR-based rehabilitation is practicable and effective in clinical routine. Functional measures of balance and gait show significant improvements following VR-based interventions. Clinical approaches should exploit VR advantages for promoting motor learning and motivation. This study serves to aid transition to long-term clinical implementation of VR.

Evaluating the use of robotic and virtual reality rehabilitation technologies to improve function in stroke survivors: A narrative review.

This review evaluates the effectiveness of robotic and virtual reality technologies used for neurological rehabilitation in stroke survivors. It examines each rehabilitation technology in turn before considering combinations of these technologies and the complexities of rehabilitation outcome assessment. There is high-quality evidence that upper-limb robotic rehabilitation technologies improve movement, strength and activities of daily living, whilst the evidence for robotic lower-limb rehabilitation is currently not as convincing. Virtual reality technologies also improve activities of daily living. Whilst the benefit of these technologies over dose-controlled conventional rehabilitation is likely to be small, there is a role for both technologies as part of a broader rehabilitation programme, where they may help to increase the intensity and amount of therapy delivered. Combining robotic and virtual reality technologies in a rehabilitation programme may further improve rehabilitation outcomes and we would advocate randomised controlled trials of these technologies in combination.

Effects of virtual reality based physical therapy interventions on balance and gait performances of chronic hemiparetic stroke patients - a literature review.

Background: Approximately 795.000 strokes occur each year in the United States of America. On average, every 40 seconds, an American suffers a stroke (AHA, 2014). Hemiparesis is a common post-stroke symptomatic condition (about 8/10 stroke survivors), with dramatic impact on balance, gait and activities of daily living. Approximately 2/3 of stroke survivors need an intensive rehabilitation provided by multidisciplinary teams, in which physiotherapy plays a significant role. Method: A systematic review was conducted in the PEDro database. Studies published after 2007 were searched. Results: Clinical trials including virtual rehabilitation interventions for stroke patients started to appear in the early 2000s. Meanwhile, the latest Cochrane systematic review titled “Virtual reality for stroke rehabilitation” includes 72 trials involving 2470 participants, showing an increasing therapeutically interest. The primary objective of this study is to clarify if virtual reality-based therapy can offer a genuine clinical alternative to conventional physical therapy in the treatment of chronic hemiparetic stroke patients, helping physiotherapists and individuals reach higher rehabilitation performance outcomes in terms of balance and ambulation. Conclusion: The three trials presented in this essay show that balance recovery benefits most from a combination of virtual reality-based and conventional physiotherapy. Moreover, virtual task-oriented exercises can be enjoyable and motivating, increasing patient compliance to rehabilitation.

Combining Proprioceptive Neuromuscular Facilitation and Virtual Reality for Improving Sensorimotor Function in Stroke Survivors: A Randomized Clinical Trial.

Aim:To assess a program combining virtual reality (VR) games and proprioceptive neuromuscular facilitation (PNF) and to compare it with the standalone techniques in stroke survivors.Methods:A randomized controlled clinical trial. A total of 48 participants were recruited in the outpatient clinic of a University Hospital in Salvador, Brazil. They were randomly assigned to 3 groups (n = 16 each): PNF, VR, and PNF/VR. Participants attended twice-weekly 50-minute sessions over a 2-month period. The PNF/VR group performed both PNF and VR exercises employing Nintendo Wii electronic games. Motor performance was assessed before and immediately after the treatment using the Fugl-Meyer Assessment scale.Results:An improvement in the mean scores was observed after treatment independent of the allocation group with significant intragroup changes: 14.5, 10.5, and 10.4 for PNF, VR, and PNF/VR, respectively. Score changes were also observed in the analyses of specific sections as follows: (1) a significant improvement in the passive movement and pain score was observed in the PNF and PNF/VR groups; (2) the same was observed for the motor function of the upper limb in all groups, for the motor function of the lower limb in the VR group and for balance in the PNF and PNF/VR groups.Conclusions:The use of a program combining virtual rehabilitation and PNF presented results that were comparable with those obtained with the isolated techniques.

Characteristics of Phantom Limb Pain Alleviated with Virtual Reality Rehabilitation.

Neurorehabilitation techniques using virtual reality (VR) systems have recently become widespread as a rehabilitation method for restoring phantom limb movement and alleviating phantom limb pain (PLP). However, analgesic effects have varied between studies, possibly because of differences in the characteristics of PLP between patients (e.g., cramping, burning, shooting). We aimed to reveal the relationship between VR effects and PLP characteristics using an exploratory factor analysis. PLP characteristics of 19 patients were measured using the Short-Form McGill Pain Questionnaire (SF-MPQ), and all PLP patients performed the VR rehabilitation protocol for 20 minutes. During VR rehabilitation, mirror-reversed computer graphic images of an intact arm (the virtual phantom limb) were presented to patients via a head-mounted display, inducing the perception of voluntary execution of movements of their phantom limb when intending bimanual movements. VR rehabilitation significantly restored movement representation (P < 0.0001) quantified using the bimanual coupling effect and significantly alleviated PLP intensity (P < 0.0001). The factor analysis revealed that PLP characteristics could be divided into two factors: "somatosensory-related pain characteristics" and "kinesthesia-related pain characteristics." PLP alleviation via VR rehabilitation was significantly correlated with "kinesthesia-related pain characteristics" (r = 0.47, P = 0.02) but not "somatosensory-related pain characteristics" (r = 0.22, P = 0.17). The current findings indicate that VR rehabilitation may be particularly effective for PLP associated with distorted phantom limb movement and body representations (e.g., clamping, gnawing), compared with typical neuropathic sensations (e.g., shooting, burning, dysesthesia).

Applicability of the Kinect Sensor in the Rehabilitation of Balance Control in the Elderly: A Pilot Study

Background: Taking into consideration the inversion of the age pyramid in the coming years and the limitations and diseases that predispose the elderly to episodes of falling, it is necessary to develop resources that can address postural balance in this population. The use of virtual rehabilitation, i.e., rehabilitation using electronic platforms, has been increasing due to the increased treatment adherence observed with these methods. Objectives: This study was conducted to evaluate the effectiveness of a rehabilitation program using the Kinect sensor (KS) on the postural balance of the elderly. Methods: This was a non-randomized controlled clinical trial in which 10 elderly subjects and 10 younger adults underwent a 10-session rehabilitation protocol lasting 20 minutes per session. Each session involved muscle stretching and motor coordination exercises, as well as use of the KS. The period between the evaluations was five weeks, and the sessions were held three times per week. The initial and final evaluations included the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test and the tandem Romberg test. Results: After treatment with the KS, the elderly required a longer time to perform the TUG test and had lower static balance results in the tandem Romberg test compared to younger adults; however, there were no significant differences between the pre- and post-treatment values for these two tests within either group (P > 0.05). The elderly scored lower on the BBS than the younger adults both before and after treatment (P = 0.0001 and P = 0.0006, respectively). However, the elderly showed a balance gain according to the BBS scores between the pre- and post-treatment evaluations (P = 0.005), which did not occur in the younger adults (P = 0.31). Conclusions: The KS is able to promote improvements in static and dynamic postural balance in the elderly, who reached a condition close to what was observed in young adults. This improvement is evident when evaluating the changes using the BBS.

A Novel Methodology for Extracting and Evaluating Therapeutic Movements in Game-Based Motion Capture Rehabilitation Systems.

Virtual rehabilitation yields outcomes that are at least as good as traditional care for improving upper limb function and the capacity to carry out activities of daily living. Due to the advent of low-cost gaming systems and patient preference for game-based therapies, video game technology will likely be increasingly utilized in physical therapy practice in the coming years. Gaming systems that incorporate low-cost motion capture technology often generate large datasets of therapeutic movements performed over the course of rehabilitation. An infrastructure has yet to be established, however, to enable efficient processing of large quantities of movement data that are collected outside of a controlled laboratory setting. In this paper, a methodology is presented for extracting and evaluating therapeutic movements from game-based rehabilitation that occurs in uncontrolled and unmonitored settings. By overcoming these challenges, meaningful kinematic analysis of rehabilitation trajectory within an individual becomes feasible. Moreover, this methodological approach provides a vehicle for analyzing large datasets generated in uncontrolled clinical settings to enable better predictions of rehabilitation potential and dose-response relationships for personalized medicine.

Feasibility of Combining Virtual Reality Motor Rehabilitation With Cognitive Strategy Use for People With Stroke

Abstract Date Presented 4/20/2018 MetacogVR is a new intervention blending top-down, cognitive strategy training and bottom-up, virtual reality motor rehabilitation. Feasibility testing yielded a low recruitment rate, high retention rate, and large effects on measures of activity performance and upper extremity motor performance. Primary Author and Speaker: Anna Boone Contributing Authors: Timothy J. Wolf, Jack R. Engsberg

경두개 직류전류자극이 가상현실 재활프로그램을 적용한 뇌졸중 환자의 상지기능과 우울에 미치는 영향

경두개 직류전류자극이 가상현실 재활프로그램을 적용한 뇌졸중 환자의 상지기능과 우울에 미치는 영향

Evaluation of a Novel Virtual Rehabilitation Program for Service Members Post ABI: A Feasibility Study

To assess clinical acceptance of the BrightBrainer virtual rehabilitation program from participant and occupational therapist (OT) self-reports.