A Review of Virtual Reality Based Training Simulators for Orthopaedic Surgery

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 total hip replacement pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator

A review of virtual reality based training simulators for orthopaedic surgery

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordThis review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator.Wessex Academic Health Science Network (Wessex AHSN) Innovation and Wealth Creation Accelerator Fund 2014/15Bournemouth Universit

An evaluation framework for virtual reality safety training systems in the South African Mining Industry

The mining industry in South Africa contributes significantly to the national economy. Despite stringent safety legislation, mining accidents cause numerous fatalities and injuries. Inadequate or insufficient training is often cited as a root cause of accidents. Conventional class-based safety training has not reduced the incidence of accidents significantly. By contrast, virtual reality training tools can provide simulated exposure to real-world working conditions without the associated risks. This study describes the application of design-based research (DBR) in the design and development of two desktop virtual reality (VR) systems for safety training in the South African mining industry. The results of a usability context analysis were applied in the design of a VR prototype on generic hazards recognition and rectification, which was used and evaluated at South Africa‘s largest platinum mine site. A case study was conducted to investigate the causes and occurrences of falls of ground, which resulted in the design and development of a second VR prototype focusing on identifying and addressing underground geological conditions. DBR was also used in the generation of an evaluation framework for evaluating VR training systems, namely the Desktop VR Evaluation Framework (DEVREF), which is the major deliverable of the research. DEVREF can make a major contribution to the domain of e-training in mines and is transferable and customisable beyond its initial application. The process flow of the research thus moved beyond merely providing a solution to a complex real-world problem and became a classic DBR study with dual outcomes, namely a practical real-world solution in the form of two VR training systems and a theoretical contribution in the form of the DEVREF evaluation framework. DEVREF evaluates the design of desktop VR training systems in the categories of instructional design, usability, VR systems design, and context-specific criteria for mining. The use of DEVREF is demonstrated by reporting the application of its criteria in evaluating the two VR training systems. Heuristic evaluation, end-user surveys, and interviews were used as evaluation methods. A third contribution is methodological, in that this work proposes a new DBR process model and an interaction design lifecycle model suitable for VR training systems.ComputingD. Phil. (Information Systems

Recent Advances in Minimally Invasive Surgery

Minimally invasive surgery has become a common term in visceral as well as gynecologic surgery. It has almost evolved into its own surgical speciality over the past 20 years. Today, being firmly established in every subspeciality of visceral surgery, it is now no longer a distinct skillset, but a fixed part of the armamentarium of surgical options available. In every indication, the advantages of a minimally invasive approach include reduced intraoperative blood loss, less postoperative pain, and shorter rehabilitation times, as well as a marked reduction of overall and surgical postoperative morbidity. In the advent of modern oncologic treatment algorithms, these effects not only lower the immediate impact that an operation has on the patient, but also become important key steps in reducing the side-effects of surgery. Thus, they enable surgery to become a module in modern multi-disciplinary cancer treatment, which blends into multimodular treatment options at different times and prolongs and widens the possibilities available to cancer patients. In this quickly changing environment, the requirement to learn and refine not only open surgical but also different minimally invasive techniques on high levels deeply impact modern surgical training pathways. The use of modern elearning tools and new and praxis-based surgical training possibilities have been readily integrated into modern surgical education,which persists throughout the whole surgical career of modern gynecologic and visceral surgery specialists

Manual de simulación clínica en especialidades médicas

Manual sobre técnicas y modos de simulación clínica en diversas especialidades médicas.La enseñanza y formación en medicina necesita el uso de la simulación. Existen evidencias de su uso desde hace cientos de años, pero, en los últimos años se ha incrementado y diseminado. La simulación clínica está validada científicamente en múltiples contextos médicos y de otras áreas profesionales de la salud. Y es considerada de gran importancia como proceso de entrenamiento y de mejora de las competencias y adquisición de habilidades médicas en campos que incluye desde la historia clínica, comunicación con el paciente, exploración, diagnóstico terapéutica médica-farmacológica y quirúrgica y seguridad al tratar al paciente. Hoy en día, para muchas técnicas y situaciones clínicas es inaceptable llegar junto a los pacientes sin un dominio adquirido en simulación. La simulación puede ocurrir sin el uso de recursos adicionales, solo las personas, o utilizando pocos o muchos recursos de baja hasta alta tecnología y se puede adaptar a los recursos disponibles, abarcando todas las áreas de conocimiento, y dentro de ellas competencias técnicas o actitudes, solas o en conjunto. El uso racional y basado en evidencia de la simulación es de la mayor importancia por la necesidad de una mayor efectividad y eficiencia en la transformación de los profesionales de la salud para que puedan mejorar su capacidad de atender a los pacientes. La simulación es también una buena herramienta de evaluación de competencias y habilidades en Medicina y otras disciplinas de las Ciencias de la Salud Este manual incluye técnicas y modos de simulación clínica en diversas especialidades médicas, útiles, para quien busque un manual práctico y actualizado.Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Terapias Avanzadas en Patología Cardiovascular Cátedra de Mecenazgo de la Universidad de Málaga. Cátedra de Investigación Biomédica Quirón Salu

Brain-Computer Interfaces

Die vorliegende Dissertation beschreibt Ergebnisse der Arbeit, durchgeführt am Fraunhofer Institut für Rechnerarchitektur und Softwaretechnik (FIRST), insbesondere bei der Forschungsgruppe für Intelligente Datenanalyse (IDA), im Rahmen des Projektes "Brain-Computer Interface" (BCI). Das angestrebte Ziel des aktuell laufenden Projektes ist es, ein Hardware- und Software-System zu entwerfen und zu entwickeln, das in der Lage ist elektroencephalographische (EEG)Signale(gewonnen auf eine nicht-invasive Art, mit Hilfe der Oberflächenelektroden, die über dem Kopf des Benutzers angebracht sind), in Echtzeit in spezielle Kommandos umzuwandeln, so dass für den Probanden eine verlässliche Steuerung einer Computeranwendung, bzw. eines Gerätes ermöglicht wird. Die Steuerung einer Computeranwendung soll im Rahmen dieser Arbeit in Form von einfachen Computerspielen (Ping-Pong, Pacman, Tetris) repräsentiert werden, im Weiteren bezeichnet als "Brain-Gaming". Hierzu sind fundierte Überlegungen zum Entwurf und Realisierung einer Kommunikationsschnittstelle und des zugehörigen Protokolls angestellt worden. Ein weiterer wichtiger Bestandteil jeder Steuerung ist deren Strategie und der Befehlssatz der Anwendung. So wurden mehrere Strategien entwickelt, implementiert und in verschiedenen Szenarien experimentell erprobt. Die Flexibilität der Steuerungsschnittstelle stellte sich als einer der wichtigsten Aspekte beim Entwurf und der Entwicklung von Rückkopplungsanwendungen. Bei der Steuerung eines Gerätes kann es sich um das Lenken und Bewegen eines Rollstuhls, z.B. für querschnittsgelehmte Patienten, oder um das Bewegen einer Arm-, bzw. Beinprothese für Patienten mit amputierten Extremitäten handeln. Dies wurde vorerst als Simulation einer Extremität (Arm) auf dem Computer-Bildschirm realisiert, so dass es in zukünftigen Experimenten an bedürftigen Patienten getestet werden kann. Im Gegensatz zu Brain-Gaming Experimenten, bei denen der Spieler mit einem zusätzlichen Kommunikationskanal (der unabhängig von anderen normalen Kanälen des menschlichen neuromuskulären Systems ist) ausgestattet wird, stellen die Experimente an Patienten keine Anforderung an die ultra-schnelle Erkennung der Bewegungsabsicht; So kann das Steuersignal zur Ausführung einer simulierten Bewegung auch nach dem Auslösen der eigentlichen Phantombewegung, sogar nach deren Ausführung, erkannt werden. In Experimenten mit Feedback-Szenarien, die kompetitiven Spielen ähneln, können verschiedene Aspekte der ultraschnellen Erkennung einer Bewegungsintension mit Hilfe von Reaktionstests untersucht werden. Dieses eröffnet neue Perspektiven bei der Ausführung von Präventivmaßnahmen in zeitkritischen Anwendungen. Diese Dissertation, sowie die Entwicklung und Implementierung des Prototyps basiert auf fundierten Erkenntnissen der Neurophysiologie; Ein ausgewähltes Kapitel dieser Dissertation verschafft deshalb tieferen Einblick in die menschliche Neurophysiologie. Ferner, beschreibt ein gesondertes Kapitel dieser Dissertation die Entwicklung und Implementierung eines online Prototyps " des BBCI-Systems (Berliner Brain-Computer Interface) " in dessen Einzelkomponenten und der Gesamtheit aus dem Sichtpunkt der Softwaretechnik. Im Rahmen der Arbeit wurden mehrere Rückkopplungsmodule (Bio-Feedback), sowohl spielerischen Charakters, als auch zu Rehabilitationszwecken entwickelt, die hier im Detail vorgestellt werden. Mit besonderer Aufmerksamkeit wurde der Einfluss des online Bio-Feedbacks auf den Probanden untersucht.This dissertation aims to describe work carried out at the Fraunhofer Institute for Computer Architecture and Software Technology (FhG-FIRST), in particular at the research group for Intelligent Data Analysis (IDA), within the project "Brain-Computer Interface" (BCI). The goal of that project is to design and develop a hardware and software system that is capable of transforming, in real-time, electroencephalographic (EEG) signals (signals retrieved in a non-invasive way from surface electrodes placed over the user's head) into specific commands such that the user gains reliable control over a computer application or a device. In this dissertation, control over a computer application will be represented with "Brain-Gaming", i.e. simple computer games like Ping-Pong, Pacman or Tetris. To this end, substantial considerations were made on the design and realization of a communication interface and its corresponding protocol. A further important component of every control operation is its strategy and the control alphabet, i.e. the command set. For this purpose, several control strategies were developed, implemented and proved experimentally in different scenarios. The most important aspect of the design and development of these interfaces turned out to be their flexibility. Control over a device could include the steering and moving of a wheel-chair for paralyzed patients or the gaining of control over an arm or foot prosthesis for patients with amputated limbs. The latter was realized here as a computer-based simulation of a virtual limb (e.g. arm), such that it can be tested in future experiments on patients with amputated limbs. In contrast to the "Brain-Gaming" experiments, where the player was equipped with an additional communication channel (one that exists independently of normal communication channels of the human neuromuscular system), the experiments with patients did not require an ultra-fast recognition of the intended movement; i.e. the command signal for a simulated movement can be recognized after the phantom movement is initialized and performed. In experiments with feedback scenarios, which can be resembled as competitive games, several aspects of ultra-fast movement detection could be investigated with reaction tests. This opens new perspectives for the execution of preventive actions in time-critical applications. This dissertation, and the development and implementation of the prototype, is based on well-founded insights into human neurophysiology; one chapter will deal exclusively with these insights. Moreover, a special chapter of this dissertation will also describe the development and implementation of an online prototype of the BBCI system (Berlin Brain-Computer Interface) from the software engineering viewpoint. A number of bio-feedback modules, for gaming and for rehabilitation purposes, were developed within this work and will be presented in detail. Special attention was paid to the influence of the online bio-feedback on the user's behavior

Brain Injury

The present two volume book "Brain Injury" is distinctive in its presentation and includes a wealth of updated information on many aspects in the field of brain injury. The Book is devoted to the pathogenesis of brain injury, concepts in cerebral blood flow and metabolism, investigative approaches and monitoring of brain injured, different protective mechanisms and recovery and management approach to these individuals, functional and endocrine aspects of brain injuries, approaches to rehabilitation of brain injured and preventive aspects of traumatic brain injuries. The collective contribution from experts in brain injury research area would be successfully conveyed to the readers and readers will find this book to be a valuable guide to further develop their understanding about brain injury