933 research outputs found

    Diseño de entornos de realidad virtual aplicables a sistemas de robótica asistencial: un análisis literario

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    Virtual Reality (VR) environments can be applied to assistive robotics to improve the effectiveness and the user experience perception in the rehabilitation process due to its innovative nature, getting to entertain patients while they recover their motor functions. This literature review pretends to analyze some design principles of VR environments developed for upper limb rehabilitation processes. The idea is to identify features related to peripheral and central nervous systems, types of information included as feedback to increase the user's levels of immersion having a positive impact on the user's performance and experience during the treatment. A total of 32 articles published in Scopus, IEEE, PubMed, and Web of Science in the last four years were reviewed. We present the article selection process, the division by concepts presented previously, and the guidelines that can be considered for the design of VR environments applicable to assistive robots for upper limbs rehabilitation processes.Los entornos de Realidad Virtual (RV) aplicables a sistemas de robótica asistencial pueden ser diseñados de manera que mejoren la efectividad y la experiencia de usuario de los procesos de rehabilitación debido a su naturaleza novedosa, logrando entretener a los pacientes mientras recuperan sus funciones motoras. Esta revisión literaria pretende analizar los criterios de diseño de entornos de RV utilizados en procesos de rehabilitación de miembro superior, identificando las características de entornos para rehabilitación de problemas asociados el sistema nervioso central y periféricos, los tipos de información que se realimenta al usuario para beneficiar los niveles de inmersión y su impacto en términos del desempeño y la experiencia del usuario en tratamiento. Un total de 32 artículos publicados en revistas indexadas de Scopus, IEEE, PubMed y Web of Science en los últimos cuatro años fueron revisados. Se presenta el proceso de selección de artículos, la división por las temáticas presentadas anteriormente y los lineamientos generales que pueden ser considerados para el diseño de entornos de RV aplicables a robots asistenciales en procesos de rehabilitación de miembro superior

    Hand rehabilitation with sonification techniques in the subacute stage of stroke

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    After a stroke event, most survivors suffer from arm paresis, poor motor control and other disabilities that make activities of daily living difficult, severely affecting quality of life and personal independence. This randomized controlled trial aimed at evaluating the efficacy of a music-based sonification approach on upper limbs motor functions, quality of life and pain perceived during rehabilitation. The study involved 65 subacute stroke individuals during inpatient rehabilitation allocated into 2 groups which underwent usual care dayweek) respectively of standard upper extremity motor rehabilitation or upper extremity treatment with sonification techniques. The Fugl-Meyer Upper Extremity Scale, Box and Block Test and the Modified Ashworth Scale were used to perform motor assessment and the McGill Quality of Life-it and the Numerical Pain Rating Scale to assess quality of life and pain. The assessment was performed at baseline, after 2weeks, at the end of treatment and at follow-up (1month after the end of treatment). Total scores of the Fugl-Meyer Upper Extremity Scale (primary outcome measure) and hand and wrist sub scores, manual dexterity scores of the affected and unaffected limb in the Box and Block Test, pain scores of the Numerical Pain Rating Scale (secondary outcomes measures) significantly improved in the sonification group compared to the standard of care group (time*group interaction<0.05). Our findings suggest that music-based sonification sessions can be considered an effective standardized intervention for the upper limb in subacute stroke rehabilitation

    Immersive Virtual Reality Training Improved Upper Extremity Function in Patients with Spinal Cord Injuries: A Case Series

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    Virtual reality (VR) is an emerging treatment tool to engage people in environments that appear and feel similar to real-world objects and events.1 There are various levels of evidence that VR can potentially promote functional activity and neuroplasticity in patients with neurological disorders like spinal cord injury (SCI).2,3 In this case series, we explored the feasibility of using commercially available immersive VR technology as an augmented treatment in the SCI population and compare participant’s suitability for this intervention. Three male SCI participants were recruited in a subacute inpatient rehabilitation facility and participated in VR intervention twice a week in addition to their conventional therapies. Manual strength and functional testing were recorded biweekly until participants discharged. Training includes reaching activities, wrist rotation, gripping, and thumb movement to simulate real-life activities. A questionnaire regarding their experience with VR training was administered at the end. All participants had improvement in strength and functional tests. 9-hole peg test demonstrated clinically meaningful change in two of three participants. Manual muscle test changes were 2, 4.5 and 13.5 points individually. Participants with lower manual muscle test scores at baseline showed more potential to change compared to those who had high scores, which would possibly due to plateau effect. Pinch and grip strength demonstrated small changes which were not clinically important. Participants also rated VR technology of high reality level and great enjoyment in the questionnaire. This case series suggests that immersive VR with head mount display may be viable to provide safe and effective treatment for patients with SCI. VR training appears to be a possible adjunct to physical and occupational therapy as a method of muscle strengthening, improving upper extremity function and improving motivation during subacute rehabilitation

    Wrist and hand rehabilitation software platform based on leap motion controller

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    A software platform based on Leap Motion Controller (LMC) movements’ detection was developed. It allows measurements of clinically proved effective hand and finger exercises. The developed software allows representation of amplitude of each different movement, time interval for each movement, frequency of different movements, asymmetry of bilateral movements, standard deviation of signal amplitude, Poincaré plots. A serious game Collect Color Cube, was developed using Unity, C# scrips, and signals from LMC related to movements of the user’s hands and fingers.info:eu-repo/semantics/publishedVersio

    Feasibility and efficacy of a virtual reality game-based upper extremity motor function rehabilitation therapy in patients with chronic stroke: a pilot study

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    This article belongs to the Special Issue New Technologies in the Evaluation and Treatment of Patients with Neurological Pathologies.Background: The objective of the present study was to develop a virtual reality protocol based on activities of daily living and conventional rehabilitation, using Leap Motion Controller to improve motor function in upper extremity rehabilitation in stroke patients. At the same time, the purpose was to explore its efficacy in the recovery of upper extremity motor function in chronic stroke survivors, and to determine feasibility, satisfaction and attendance rate; Methods: A prospective pilot experimental clinical trial was conducted. The outcome measures used were the grip strength, the Action Research Arm Test (ARAT), the Block and Box Test (BBT), the Short Form Health Survey-36 Questionnaire, a satisfaction questionnaire and attendance rate; Results: Our results showed statistically significant changes in the variables grip strength, BBT and ARAT as well as high levels of satisfaction and attendance; Conclusions: This virtual reality platform represents an effective tool in aspects of upper extremity functionality rehabilitation in patients with chronic stroke, demonstrating feasibility and high levels of attendance and satisfaction

    Combining Repetitive Transcranial Magnetic Stimulation and Video Game-Based Training to Improve Dexterity in Parkinson's Disease: Study Protocol of a Randomized Controlled Trial

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    Introduction: Patients with Parkinson’s disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL) due to dysfunctional supplementary motor area (SMA). The aim of this clinical trial protocol work is to describe how the effectiveness of a combined repetitive transcranial magnetic stimulation (rTMS) over SMA and video-game-based skill training (VBT) in PD will be evaluated. The short and long-term benefits are assessed. Methods and analysis: A single-blind (patients) stratified (based on Hoehn & Yahr) parallel randomized sham-controlled rTMS-VBT study with a baseline and two follow-up measurements (3 and 12 weeks) is being conducted. These measurements include the dexterity questionnaire 24 (DextQ-24) as a primary outcome, and nine hole peg test and coin rotation task as main secondary dexterity outcomes. Further secondary outcomes will be the subscale II of the movement disorders society unified PD rating scale (MDS-UPDRS) to assess improvements on overall ADL and the Parkinson’s Disease Questionnaire-39 to assess quality of life. Thirty-six outpatients (from one neurorehabilitation center) with PD (diagnosis based on brain bank criteria) will be recruited who report difficulties with dexterity in performing ADL. All PD patients will receive a 45-min VBT three times a week for 3 weeks. The PD patients randomized in the experimental group will receive VBT preceded by real rTMS, being intermittent theta burst (iTBS) stimulation sessions. The PD patients randomized to the control group receive a VBT with sham rTMS. Discussion: The study will provide evidence to determine whether a combined iTBS and VBT skill intervention is more effective than a VBT intervention alone to improve dexterity in PD. Ethics and dissemination: The study was approved by the Ethics Committee for Northwest and Central Switzerland (EKNZ), Switzerland 2019–00433. The study will be conducted in accordance with the Helsinki Declaration and the Guidelines of Good Clinical Practice. Informed consent will be signed prior to subject enrolment. Dissemination will include submission to international peer-reviewed professional journals and presentation at international congresses. The study protocol has been registered in the clinicaltrials.gov registry with the identification code: NCT04699149

    The effect of leap motion controller based exergame therapy on hand function, cognitive function and quality of life in older adults. A randomised trial

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    Objective. To evaluate the effect of leap motion controller based exergame therapy (LMCBET) on hand function, cognitive function and quality of life (QoL) in older adults. Design. A parallel, double-blind trial with participants allocated (1:1) to one of two groups as the structured exercise (SE) and LMCBET. Setting. The study was conducted in “Barınyurt Nursing Home and Elderly Care Center” in Istanbul. Participants. Thirty-two older adults who had adequate hand function, ability to follow commands, 24 points or more in the mini mental state examination (MMSE) were included and 30 were analyzed. Interventions. SE Group performed a Structured Hand Exercise program while LMCBET group performed “ErgoActive’’ and “HandROM” exercise apps focusing on hand exercises and fine motor skills along 30-45 minute sessions, 2 days a week, over 8 weeks. Main outcome measures. Participants were evaluated with box and block test (BBT), Purdue Pegboard test (PPT), hand dynamometer, Duruöz hand index (DHI), stroop test (ST), digit span test (DST), and World Health Organization QoL instrument-older adults module (WHOQOL-OLD) at the beginning (T0), at 8 (T1), and 16 (T2) weeks after the study started. Results. There were significant differences in BBT, PPT, DHI, and WHOQOL-OLD in the SE group (p 0.05). Conclusions. SE and LMCBET were effective on hand function and QoL in healthy older adults.Nursing Home and Elderly Care Cente

    Development and Usability Evaluation of Low-cost Virtual Reality Rehabilitation Games for Patients with Upper Limb Impairment

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    Stroke is one of the primary causes of long-term disability in adults in the United States which leads to mild to severe sensorimotor impairments. Long-term continuous rehabilitation therapies are needed to facilitate sensorimotor recovery and empower patients in performing daily living activities. Currently, the opportunity of receiving post stroke rehabilitation in the chronic stage (\u3e 6 months post stroke) is limited due to a lack of insurance and the high cost of therapy. Low-cost virtual rehabilitation games with motion tracking devices have tremendous potential to assist physical rehabilitation. Motion tracking devices such as Kinect (Microsoft, Redmond, CA; 100)andP5Glove(EssentialReality,LLC,NY;100) and P5 Glove (Essential Reality, LLC, NY; 40) have become available to enable development of low-cost virtual rehabilitation games. Such low-cost games may encourage continuous, repeated, and intensive rehabilitation therapies thereby enhancing recovery post stroke. However, current virtual rehabilitation games emphasize on gross arm movements using Kinect or fine finger movements using P5 Glove, but not both at the same time. Since most daily living activities require coordination of the gross shoulder/elbow movement and fine finger movement such as reaching to grasp and transferring a jar to a shelf, effective upper limb rehabilitation must involve coordination of the arm and finger movements. In addition, many virtual rehabilitation games have been developed without user input and feedback, which may be the primary reason why virtual rehabilitation games are not prominently used at home by patients. This thesis presents the development and usability evaluation of low-cost virtual rehabilitation games. In addition to the archery and puzzle games previously developed in the laboratory, a low-cost rehabilitation kitchen game was developed to encourage patients to practice various functional tasks involving coordinated arm and finger movements that were detected by using Kinect and P5 Glove, respectively. Usability of the three games was assessed with ten chronic stroke survivors using pre-game and post-game surveys. The games met patients\u27 expectations of providing challenging movements. The House of Quality analysis revealed that technical characteristic needing the most improvement was device reliability. The future research should address device reliability by developing a better instruction manual to facilitate device set-up and use. In addition, filtering data can also improve quality of virtual arm movements in future versions of the games. In summary, this thesis presents promising evidence for low-cost rehabilitation games using commercially available motion tracking devices of Kinect and P5 Glove together with free Blender software
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