Common Issues of Virtual Reality in Neuro-Rehabilitation

2010-2011 > Academic research: not refereed > Chapter in an edited book (author)201803 bcwhVersion of RecordPublishe

Use of Incremental Adaptation and Habituation Regimens for Mitigating Optokinetic Side-effects

The use of incremental and repeated exposures regimens have been put forth as effective means to mitigate visually induced motion sickness based on the Dual Process Theory (DPT) (Groves & Thompson, 1970) of neural plasticity. In essence, DPT suggests that by incrementing stimulus intensity the depression opponent process should be allowed to exert greater control over the net outcome than the sensitization opponent process, thereby minimizing side-effects. This conceptual model was tested by empirically validating the effectiveness of adaptation, incremental adaptation, habituation, and incremental habituation regimens to mitigate side-effects arising from exposure to an optokinetic drum. Forty college students from the University of Central Florida participated in the experimentation and were randomly assigned to a regimen. Efforts were taken to balance distribution of participants in the treatments for gender and motion sickness susceptibility. Results indicated that overall, the application of an incremental regimen is effective in reducing side-effects (e.g. malaise, dropout rates, postural instabilities, etc.) when compared to a non-incremented regimen, whether it be a one-time or repeated exposure. Furthermore, the application of the Motion History Questionnaire (MHQ) (Graybiel & Kennedy, 1965) for identifying high and low motion sickness susceptible individuals proved effective. Finally, gender differences in motion sickness were not found in this experiment as a result of balancing susceptibility with the gender subject variable. Findings from this study can be used to aid effective design of virtual environment (VE) usage regimens in an effort to manage cybersickness. Through pre-exposure identification of susceptible individuals via the MHQ, exposure protocols can be devised that may extend limits on exposure durations, mitigate side-effects, reduce dropout rates, and possibly increase training effectiveness. This document contains a fledgling set of guidelines form VE usage that append those under development by Stanney, Kennedy, & Kingdon (In press) and other previously established guidelines form simulator use (Kennedy et al., 1987). It is believed that through proper allocation of effective VE usage regimens cybersickness can be managed, if susceptible individuals are identified prior to exposure

Study Habits Of College Students And Their Perceptions Of The Impact Of Brain-Based Attention Strategies On Their Independent Study Time

The purpose of this research was twofold. The first part explored the study habits of lower-division undergraduate college students during independent study time, with special inquiry into sustained attention and mental effort. A questionnaire and focus groups answered research questions that explored students\u27 general study practices, their study habits, factors influencing study, the length of sustained attention and mental effort, the strategies used to maintain attention, perceptions about productivity, and the metacognitive strategies used (i.e., self-monitoring, self-regulating, planning, and self-evaluating). The study showed that 1) students do not spend enough time studying, 2) the more time students spent on the job, the less they studied; 3) different factors impeding study were identified by the different age groups; 4) only 67% of study time was characterized by productive, sustained mental effort; 5) of the variability on productivity, 15.5 % could be accounted for by the use of metacognitive strategies; and 6) students reported using strategies most related to knowledge and comprehension goals rather than higher order thinking goals. The purpose of the second part was to investigate the perceived impact of the use of a brain-based study strategy. Participants used a 20 to 25 minute study segment, followed by a two to five minute break, in which cross-midline body movement was employed. The research focused on questions about the benefits of the study strategy, its effectives in increasing sustained attention, its effect on the length of time studied, its influence on better learning and productivity, and its continued use. After a two-week trial, 15 students completed an individual interview about their results using the strategy. Students reported increasing their attention and productivity and positively impacting their grades and learning. They attributed their successes to use of the strategy and indicated that they would continue its use. Three major conclusions emerged: 1) students need to study more and more productively, 2) professors need to teach study strategies, structuring their courses to include study strategies as an integral part of the course content, and 3) metacognitive study strategies (both cognitive and effort management) and higher order thinking strategies should be taught and supported

Computer-Supported Rehabilitation Management A Case Study of Using Virtual Reality Technology in Ambulatory Training for Post-Acute Stroke Patients

This study investigated the use of virtual reality (VR) technology in ambulatory training for post-acute stroke patients, and sought to determine whether skills gained in virtual environments transfer to real-world conditions. Patients with stroke typically suffer dysfunctions that impair the complex set of motions involved in walking. The limited amount of therapy and resources offered by the current health care system does not provide the frequency and intensity of training needed for functional recovery of the walking skills in patients following stroke assaults. This study, therefore, developed and investigated an alternative intervention technique capable of providing the frequency and intensity needed for improving the walking skills in post-acute stroke patients. The study also helped clarify the controversies surrounding the issue of whether skills gained in the virtual environment transfer to the real world. The research study employed the single case design method to report the results observed from four post-acute stroke patients who trained on a computer-based therapy program for about half an hour per day, five days a week, for a period of four consecutive weeks. The patients performed a VR exercise using a head-mounted display, and their gait variables were analyzed to determine the usefulness of virtual reality technology in ambulatory training for post-acute stroke patients. A follow up examination conducted one week after the intervention sought to determine whether the patients could perform the skills learned on the VR-based intervention program in the real world. The results of the research showed that all the patients improved on their gait parameters and could walk better after the computer-based intervention program. An observational gait analysis carried out showed that the skills gained in the virtual environment transferred to real-world conditions. The study contributes to the current effort to provide wider access to therapeutic intervention techniques using computer technology, and helps to further resolve the disputed issue of whether skills gained in the virtual environment transfer to real-world conditions. Researchers and professionals in the fields of rehabilitation engineering, physical therapy, physiology, and other fields concerned with the study of human movement, could find the outcome of this work useful in improving their professional practice. Other clinicians could also use the results of this work in formulating realistic treatment goals in problem areas involving physical therapy

Virtual environments for stroke rehabilitation: examining a novel technology against end-user, clinical and management demands with reference to UK care provision

In the field of post-stroke rehabilitation, there appears to be growing interest in the use of virtual reality (VR)-based systems as adjunct technologies to standard therapeutic practices. The limitations and the potentials of this technology are not, however, generally well understood. The present study thus seeks to determine the value of the technology with reference to end-user requirements by surveying and evaluating its application against a variety of parameters: user focus, clinical effectiveness, marketability and contextual meaningfulness, etc. A key theme in the research considers how a technology developed internationally might interface with care provision demands and cultures specific to the United Kingdom. The barriers to innovation entry in this context are thus examined. Further practical study has been conducted in the field with a small sample of post-stroke rehabilitation patients. The data garnered from these enquiries have informed a detailed system analysis, a strategy for innovation and a broad theoretical discussion as to the effectiveness of the technology in delivering VR environments by which the patient can undertake ‘meaningful’ therapeutic activities. The data reveal that there does appear to be clinical value in using this technology, yet establishing its maximal value necessitates greater integrity among clinicians and engineers, and the furthering of progressive channels for innovation by public health administrators

Virtual reality and stroke rehabilitation: a mixed reality simulation of an everyday task

This thesis is about the process of designing a computer simulation as a treatment tool for stroke rehabilitation. A stroke is a debilitating disease that is characterised by focal neural damage usually leading to physical and cognitive impairments. These impairments may severely compromise the stroke survivor's ability to perform everyday tasks of self-care such as dressing, washing and preparing meals. Safety issues are also an important consideration for the rehabilitation of the stroke survivor. Some everyday tasks can be hazardous, particularly when electrical equipment or hot liquids are involved. Computer simulations are gaining interest as a tool for stroke rehabilitation because they offer a means to replicate assessments and everyday tasks within ecologically valid environments. Training the motor skills required to perform everyday tasks together with the cognitive component of the activity is desirable however this is not always achieved due to the limitations of the human computer interface. These limitations are addressed by a simulation that is presented in this thesis. Stakeholders in stroke care contributed to the design and development of the simulation in order to ensure that it conformed to their requirements. The development culminated in a mixed reality system with a unique method of interaction in which real household objects were monitored by various electronic sensing technologies. The purpose of controlling the computer simulation using real objects was to encourage users to practice an everyday task (making a hot drink) using naturalistic upper limb movement whilst performing the task in a safe and controlled environment. The role of the computer was to monitor and score user's progress, and to intervene with prompts and demonstrations as required. The system was installed on a hospital stroke unit and tested by patients, something that had previously not been achieved. It was found to be acceptable and usable as a means of practicing making a hot drink. The system design, limitations and recommendations for future developments are discussed

Virtual reality and stroke rehabilitation: a mixed reality simulation of an everyday task

This thesis is about the process of designing a computer simulation as a treatment tool for stroke rehabilitation. A stroke is a debilitating disease that is characterised by focal neural damage usually leading to physical and cognitive impairments. These impairments may severely compromise the stroke survivor's ability to perform everyday tasks of self-care such as dressing, washing and preparing meals. Safety issues are also an important consideration for the rehabilitation of the stroke survivor. Some everyday tasks can be hazardous, particularly when electrical equipment or hot liquids are involved. Computer simulations are gaining interest as a tool for stroke rehabilitation because they offer a means to replicate assessments and everyday tasks within ecologically valid environments. Training the motor skills required to perform everyday tasks together with the cognitive component of the activity is desirable however this is not always achieved due to the limitations of the human computer interface. These limitations are addressed by a simulation that is presented in this thesis. Stakeholders in stroke care contributed to the design and development of the simulation in order to ensure that it conformed to their requirements. The development culminated in a mixed reality system with a unique method of interaction in which real household objects were monitored by various electronic sensing technologies. The purpose of controlling the computer simulation using real objects was to encourage users to practice an everyday task (making a hot drink) using naturalistic upper limb movement whilst performing the task in a safe and controlled environment. The role of the computer was to monitor and score user's progress, and to intervene with prompts and demonstrations as required. The system was installed on a hospital stroke unit and tested by patients, something that had previously not been achieved. It was found to be acceptable and usable as a means of practicing making a hot drink. The system design, limitations and recommendations for future developments are discussed