Biofeedback as a form of neurorehabilitation in Parkinson's disease

Parkinson's disease is a degenerative disease of the nervous system. An important element in the treatment of the disease is neurorehabilitation. One of the forms of neurorehabilitation may be biofeedback. The above technique uses electronic devices that allows an individual to learn how to change the body's function in order to reduce the clinical symptoms of the disease and improve health. Previous studies have confirmed that biofeedback has a beneficial effect on the health of patients with Parkinson's disease. The aim of the work was a review of the literature on biofeedback as a form of neurorehabilitation in this disease

Effects of augmented visual feedback during balance training in Parkinson's disease: A pilot randomized clinical trial

AbstractBackgroundBalance training has been demonstrated to improve postural control in patients with Parkinson's disease (PD). The objective of this pilot randomized clinical trial was to investigate whether a balance training program using augmented visual feedback is feasible, safe, and more effective than conventional balance training in improving postural control in patients with PD.MethodsThirty-three patients with idiopathic PD participated in a five-week training program consisting of ten group treatment sessions of 60 min. Participants were randomly allocated to (1) an experimental group who trained on workstations consisting of interactive balance games with explicit augmented visual feedback (VFT), or (2) a control group receiving conventional training. Standing balance, gait, and health status were assessed at entry, at six weeks, and at twelve weeks follow-up.ResultsSixteen patients were allocated to the control group and seventeen to the experimental group. The program was feasible to apply and took place without adverse events. Change scores for all balance measures favored VFT, but the change in the primary outcome measure, i.e. the Functional Reach test, did not differ between groups (t(28) = -0.116, p = .908). No other differences between groups were statistically significant.ConclusionsVFT proved to be a feasible and safe approach to balance therapy for patients with PD. In this proof-of-concept study VFT was not superior over conventional balance training although observed trends mostly favored VFT. These trends approached clinical relevance only in few cases: increasing the training load and further optimization of VFT may strengthen this effect.Trial registrationControlled Trials, ISRCTN47046299

The VESPA Project: Virtual Reality Interventions for Neurocognitive and Developmental Disorders

VESPA is a financed project supported by the Sicilian Regional Research and Development funds, and it is structured by the development, research and validation of Virtual Reality (VR) based application for the diagnosis and treatment of neurocognitive conditions. In particular, this article presents its characteristics, referred to as the first (2013-2015) and second (2021-ongoing) generations of VESPA, with particular reference to literature regarding the VR technology application and development, the VR treatment of neurocognitive conditions and prior versions of this intervention. Through a comprehensive review of the research conducted over the last 5 years, evidence has emerged supporting VESPA’s aim and scopes, highlighting how the application of VR can be considered to add value to typical rehabilitation/therapeutic paths. VESPA project generations are then presented in detail, including specific session/task battery characteristics, 2.5D, 3D and 5D typologies, system usability and architecture and pathological domain-based dynamics and features. The discussion about VESPA will highlight the current advantages along with limitations and future directions

Augmented Reality in Physical Therapy: Systematic Review and Meta-analysis

Background: Augmented reality (AR) is a rapidly expanding technology; it comprises the generation of new images from digital information in the real physical environment of a person, which simulates an environment where the artificial and real are mixed. The use of AR in physiotherapy has shown benefits in certain areas of patient health. However, these benefits have not been studied as a whole. Objective: This study aims to ascertain the current scientific evidence on AR therapy as a complement to physiotherapy and to determine the areas in which it has been used the most and which variables and methods have been most effective. Methods: A systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews) was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta - Analyses) recommendations. The search was conducted from July to August 2021 in the PubMed, PEDro, Web of Science, Scopus, and Cochrane Library scientific databases using the keywords augmented reality, physiotherapy, physical therapy, exercise therapy, rehabilitation, physical medicine, fitness, and occupational therapy. The methodological quality was evaluated using the PEDro scale and the Scottish Intercollegiate Guidelines Network scale to determine the degree of recommendation The Cochrane Collaboration tool was used to evaluate the risk of bias. Results: In total, 11 articles were included in the systematic review. Of the 11 articles, 4 (36%) contributed information to the meta-analysis. Overall, 64% (7/11) obtained a good level of evidence, and most had a B degree of recommendation of evidence. A total of 308 participants were analyzed. Favorable results were found for the Berg Balance Scale (standardized mean change 0.473, 95% CI -0.0877 to 1.0338; z=1.65; P=.10) and the Timed Up and Go test (standardized mean change -1.211, 95% CI -3.2005 to 0.7768; z=1.194; P=.23). Conclusions: AR, in combination with conventional therapy, has been used for the treatment of balance and fall prevention in geriatrics, lower and upper limb functionality in stroke, pain in phantom pain syndrome, and turning in place in patients with Parkinson disease with freezing of gait. AR is effective for the improvement of balance; however, given the small size of the samples and the high heterogeneity of the studies, the results were not conclusive. Future studies using larger sample sizes and with greater homogeneity in terms of the devices used and the frequency and intensity of the interventions are needed

Virtual Reality: An Evidence-Based Guide for Occupational Therapy

Problem: Virtual reality (VR) is an emerging technology that serves to position the user in control of a virtual environment to maximize interest and function. VR is a context for intervention included in the Occupational Therapy Practice Framework: Domain and Process 3rd edition (OTPF-3; AOTA, 2014). It is crucial that occupational therapy (OT) practitioners enhance their knowledge about VR technology used by their clients to provide effective client-centered practice (AOTA, 2010). There is a lack of organization of the literature and research evidence regarding the use of VR as an intervention modality. While there has been a significant increase in recent literature supporting the use of VR in OT, there is a need for manuals and resources to guide clinicians in using VR as a therapeutic modality (Levac & Miller, 2013; Proffitt & Lange, 2015). Methods: An extensive literature review for articles regarding the use of the Xbox Kinect and Nintendo Wii within OT was conducted using five databases. Relevant data was extracted from each article related to the use of the Xbox Kinect or Nintendo Wii in intervention to synthesize the findings into charts. The construction of the charts followed the organization of the OTPF-3 (AOTA, 2014). Product: The authors of this product created an evidence-based resource to guide OT practitioners\u27 use of VR. The intended purpose of this product, Virtual Reality: An Evidence-Based Guide, is to assist OT practitioners\u27 adaptation and/or modification of VR activities to address individual client needs. Using this product as a guide to current knowledge and evidence regarding intervention in the context of VR, OT practitioners will be better equipped to make safe and effective choices. To further support development of literature regarding VR, the authors of this product recommended areas for future research

Investigating Immersive Augmented Reality as a Rehabilitation Tool for Parkinson disease

Physical rehabilitation programs are often prescribed in an effort to maintain range of motion, and to adapt strategies for managing the debilitating symptoms of Parkinson disease (PD) in everyday life. An emerging trend to overcome the limitations of traditional rehabilitation is the use of virtual reality technologies. IThe goal of the present study was to determine the feasibility of augmented reality technology (IAR) in a rehabilitative setting. Three IAR environments were designed and a corresponding task was completed in each one. Not surprisingly, the control group generally performed better than the PD group on the tasks. All participants typically performed better in the real-world than the IAR environment. Additionally both the PD and control groups’ performances improved with repeated visits. The system was well-tolerated and important lessons are highlighted about future implementation of this rehabilitation approach (e.g., the need for a familiarization period to the system)