Head-mounted display-based therapies for adults post-stroke: A systematic review and meta-analysis

Immersive virtual reality techniques have been applied to the rehabilitation of patients after stroke, but evidence of its clinical effectiveness is scarce. The present review aims to find studies that evaluate the effects of immersive virtual reality (VR) therapies intended for motor function rehabilitation compared to conventional rehabilitation in people after stroke and make recommendations for future studies. Data from different databases were searched from inception until October 2020. Studies that investigated the effects of immersive VR interventions on poststroke adult subjects via a head-mounted display (HMD) were included. These studies included a control group that received conventional therapy or another non-immersive VR intervention. The studies reported statistical data for the groups involved in at least the posttest as well as relevant outcomes measuring functional or motor recovery of either lower or upper limbs. Most of the studies found significant improvements in some outcomes after the intervention in favor of the virtual rehabilitation group. Although evidence is limited, immersive VR therapies constitute an interesting tool to improve motor learning when used in conjunction with traditional rehabilitation therapies, providing a non-pharmacological therapeutic pathway for people after stroke

A model-driven approach for constructing ambient assisted-living multi-agent systems customized for Parkinson patients

The Parkinson disease affects some people, especially in the last years of their lives. Ambient assisted living systems can support them, especially in the middle stages of the disease. However, these systems usually need to be customized for each Parkinson patient. In this context, the current work follows the model-driven engineering principles to achieve this customized development. It represents each patient with a model. This is transformed into an agent-based model, from which a skeleton of programming code is generated. A case study illustrates this approach. Moreover, 24 engineers expert in model-driven engineering, multi-agent systems and/or health experienced the current approach alongside the three most similar works, by implementing actual systems. Some of these systems were tested by Parkinson patients. The results showed that (1) the current approach reduced the development time, (2) the developed system satisfied a higher percentage of the requirements established for certain Parkinson patients, (3) the usability increased, (4) the performance of the systems improved taking response time into account, and (5) the developers considered that the underlying metamodel is more appropriate for the current goal

Effects of sensory cueing in virtual motor rehabilitation. A review.

Objectives To critically identify studies that evaluate the effects of cueing in virtual motor rehabilitation in patients having different neurological disorders and to make recommendations for future studies. Methods Data from MEDLINE®, IEEExplore, Science Direct, Cochrane library and Web of Science was searched until February 2015. We included studies that investigate the effects of cueing in virtual motor rehabilitation related to interventions for upper or lower extremities using auditory, visual, and tactile cues on motor performance in non-immersive, semi-immersive, or fully immersive virtual environments. These studies compared virtual cueing with an alternative or no intervention. Results Ten studies with a total number of 153 patients were included in the review. All of them refer to the impact of cueing in virtual motor rehabilitation, regardless of the pathological condition. After selecting the articles, the following variables were extracted: year of publication, sample size, study design, type of cueing, intervention procedures, outcome measures, and main findings. The outcome evaluation was done at baseline and end of the treatment in most of the studies. All of studies except one showed improvements in some or all outcomes after intervention, or, in some cases, in favor of the virtual rehabilitation group compared to the control group. Conclusions Virtual cueing seems to be a promising approach to improve motor learning, providing a channel for non-pharmacological therapeutic intervention in different neurological disorders. However, further studies using larger and more homogeneous groups of patients are required to confirm these findings

Head-mounted display-based application for cognitive training

Virtual Reality (VR) has had significant advances in rehabilitation, due to the gamification of cognitive activities that facilitate treatment. On the other hand, Immersive Virtual Reality (IVR) produces outstanding results due to the interactive features with the user. This work introduces a VR application for memory rehabilitation by walking through a maze and using the Oculus Go head-mounted display (HMD) technology. The mechanics of the game require memorizing geometric shapes while the player progresses in two modes, autonomous or manual, with two levels of difficulty depending on the number of elements to remember. The application is developed in the Unity 3D video game engine considering the optimization of computational resources to improve the performance in the processing and maintaining adequate benefits for the user, while the generated data is stored and sent to a remote server. The maze task was assessed with 29 subjects in a controlled environment. The obtained results show a significant correlation between participants’ response accuracy in both the maze task and a face–pair test. Thus, the proposed task is able to perform memory assessments

Medical Image Segmentation to Estimate HER2 Gene Status in Breast Cancer

This work deals with the estimation of HER2 Gene status in breast tumour images treated with in situ hybridization techniques (ISH). We propose a simple algorithm to obtain the amplification factor of HER2 gene. The obtained results are very close to those obtained by specialists in a manual way. The developed algorithm is based on colour image segmentation and has been included in a software application tool for breast tumour analysis. The developed tool focus on the estimation of the seriousness of tumours, facilitating the work of pathologists and contributing to a better diagnosis

Fog computing for assisting and tracking elder patients with neurodegenerative diseases

U.S. hospitals transmit and manage great amounts of information with the avenue of Internet of things. This work departs from a real need detected by healthcare centers and hospitals in U.S., Spain and Ecuador. This work focuses on the application of fog computing for obtaining an app rich in visual content that will not overload U.S. hospital infrastructures even if it was used massively. The simulation results showed that the proposed fog-based approach could support a regular use (one day out of three on average) by 1% of patients of one of the most common neurodegenerative diseases in 14 states in U.S (i.e. 36, 400 patients in total) with only a traffic of 528 KB per day on average when using one hospital per state

Study on the vibration characteristics of the telescope T80 in the Javalambre astrophysical observatory (JAO) aimed at detecting invalid images

The location of large telescopes, generally far from the data processing centers, represents a logistical problem for the supervision of the capture of images. In this work, we carried out a preliminary study of the vibration signature of the T80 telescope at the Javalambre Astrophysical Observatory (JAO). The study analyzed the process of calculating the displacement that occurs because of the vibration in each of the frequencies in the range of interest. We analyzed the problems associated with very low frequencies by means of simulation, finding the most critical vibrations below 20 Hz, since they are the ones that generate greater displacements. The work also relates previous studies based on simulation with the real measurements of the vibration of the telescope taken remotely when it is subjected to different positioning movements (right ascension and/or declination) or when it performs movement actions such as those related to filter trays or mirror cover. The obtained results allow us to design a remote alarm system to detect invalid images (taken with excess vibration)

Modified filtered-x hierarchical lms algorithm with sequential partial updates for active noise control

In the field of active noise control (ANC), a popular method is the modified filtered-x LMS algorithm. However, it has two drawbacks: Its computational complexity higher than that of the conventional FxLMS, and its convergence rate that could still be improved. Therefore, we propose an adaptive strategy which aims at speeding up the convergence rate of an ANC system dealing with periodic disturbances. This algorithm consists in combining the organization of the filter weights in a hierarchy of subfilters of shorter length and their sequential partial updates (PU). Our contribution is threefold: (1) we provide the theoretical basis of the existence of a frequency-depend-ent parameter, called gain in step-size. (2) The theoretical upper bound of the step-size is compared with the limit obtained from simulations. (3) Additional experiments show that this strategy results in a fast algorithm with a computational complexity close to that of the conventional FxLMS

An Alternative Approach to Obtain a New Gain in Step-Size of LMS Filters Dealing with Periodic Signals

Partial updates (PU) of adaptive filters have been successfully applied in different contexts to lower the computational costs of many control systems. In a PU adaptive algorithm, only a fraction of the coefficients is updated per iteration. Particularly, this idea has been proved as a valid strategy in the active control of periodic noise consisting of a sum of harmonics. The convergence analysis carried out here is based on the periodic nature of the input signal, which makes it possible to formulate the adaptive process with a matrix-based approach, the periodic least-mean-square (P-LMS) algorithm In this paper, we obtain the upper bound that limits the step-size parameter of the sequential PU P-LMS algorithm and compare it to the bound of the full-update P-LMS algorithm. Thus, the limiting value for the step-size parameter is expressed in terms of the step-size gain of the PU algorithm. This gain in step-size is the quotient between the upper bounds ensuring convergence in the following two scenarios: first, when PU are carried out and, second, when every coefficient is updated during every cycle. This step-size gain gives the factor by which the step-size can be multiplied so as to compensate for the convergence speed reduction of the sequential PU algorithm, which is an inherently slower strategy. Results are compared with previous results based on the standard sequential PU LMS formulation. Frequency-dependent notches in the step-size gain are not present with the matrix-based formulation of the P-LMS. Simulated results confirm the expected behavior

A virtual reality-based cognitive telerehabilitation system for use in the covid-19 pandemic

The COVID-19 pandemic has changed people’s lives and the way in which certain services are provided. Such changes are not uncommon in healthcare services and they will have to adapt to the new situation by increasing the number of services remotely offered. Limited mobility has resulted in interruption of treatments that traditionally have been administered through face-to-face modalities, especially those related to cognitive impairments. In this telerehabilitation approach, both the patient and the specialist physician enter a virtual reality (VR) environment where they can interact in real time through avatars. A spaced retrieval (SR) task is implemented in the system to analyze cognitive performance. An experimental group (n = 20) performed the SR task in telerehabilitation mode, whereas a control group (n = 20) performed the SR task through a traditional face-to-face mode. The obtained results showed that it is possible to carry out cognitive rehabilitation processes through a telerehabilitation modality in conjunction with VR. The costeffectiveness of the system will also contribute to making healthcare systems more efficient, overcoming both geographical and temporal limitations