Sleep dysfunctions influence decision making in undemented Parkinson's disease patients: a study in a virtual supermarket

In the early-middle stages of Parkinson's disease (PD), polysomnographic studies show early alterations of the structure of the sleep, which may explain frequent symptoms reported by patients, such as daytime drowsiness, loss of attention and concentration, feeling of tiredness. The aim of this study was to verify if there is a correlation between the sleep dysfunction and decision making ability. We used a Virtual Reality version of the Multiple Errand Test (VMET), developed using the NeuroVR free software (http://www.neurovr2.org), to evaluate decision-making ability in 12 PD not-demented patients and 14 controls. Five of our not-demented 12 PD patients showed abnormalities in the polysomnographic recordings associated to significant differences in the VMET performance

Development and validation of tele-health system for stroke rehabilitation

ABSTRACT Tele-rehabilitation refers to the use of information and communication technologies to provide rehabilitation services to people in their homes or other environments. The objective of this paper is to present the development, validation and usability testing of a low-cost, markerless full body tracking virtual reality system designed to provide remote rehabilitation of the upper extremity in patients who have had a stroke. The Methods and Results sections present the progress of our work on system development, system validations and a feasibility/usability study. We conclude with a brief summary of the initial stages of an intervention study and a discussion of our findings in the context of the next steps. The validation study demonstrated considerable accuracy for some outcomes (i.e., shoulder "pitch" angle, elbow flexion, trunk forward and side-to-side deviation). In addition positive responses were received from the clients who participated in the feasibility study. We are currently at the process of improving the accuracy of the system as well as conducting a randomized clinical trial to assess the effectiveness of the system to improve upper extremity function post-stroke

Constraints on perception of information from obstacles during foot clearance in people with chronic stroke

The aim of this study was to examine effects of different types of task constraints on coupling of perception and action in people with chronic stroke when crossing obstacles during a walking task. Ten participants with hemiplegic chronic stroke volunteered to walk over a static obstacle under two distinct task constraints: simple and dual task. Under simple task constraints, without specific instructions, participants walked at their preferred speed and crossed over an obstacle. Under dual task constraints the same individuals were required to subtract numbers whilst walking. Under both distinct task constraints, we examined emergent values of foot distance when clearing a static obstacle in both affected and unaffected legs, measured by a 3D motion tracking system. Principal Component Analysis was used to quantify task performance and discriminant analysis was used to compare gait performance between task constraints. Results suggested that patients, regardless of affected body side, demonstrated differences in perception of distance information from the obstacle, which constrained gait differences in initial swing, mid-swing and crossing phases. Further, dual task constraints, rather than hemiplegic body side, was a significant discriminator in patients' perceptions of distance and height information to the obstacle. These findings suggested how performance of additional cognitive tasks might constrain perception of information from an obstacle in people with chronic stroke during different phases of obstacle crossing, and thus may impair their adaptive ability to successfully manoeuvre around objects

Cognitive and cognitive-motor interventions affecting physical functioning: A systematic review

Background Several types of cognitive or combined cognitive-motor intervention types that might influence physical functions have been proposed in the past: training of dual-tasking abilities, and improving cognitive function through behavioral interventions or the use of computer games. The objective of this systematic review was to examine the literature regarding the use of cognitive and cognitive-motor interventions to improve physical functioning in older adults or people with neurological impairments that are similar to cognitive impairments seen in aging. The aim was to identify potentially promising methods that might be used in future intervention type studies for older adults. Methods A systematic search was conducted for the Medline/Premedline, PsycINFO, CINAHL and EMBASE databases. The search was focused on older adults over the age of 65. To increase the number of articles for review, we also included those discussing adult patients with neurological impairments due to trauma, as these cognitive impairments are similar to those seen in the aging population. The search was restricted to English, German and French language literature without any limitation of publication date or restriction by study design. Cognitive or cognitive-motor interventions were defined as dual-tasking, virtual reality exercise, cognitive exercise, or a combination of these. Results 28 articles met our inclusion criteria. Three articles used an isolated cognitive rehabilitation intervention, seven articles used a dual-task intervention and 19 applied a computerized intervention. There is evidence to suggest that cognitive or motor-cognitive methods positively affects physical functioning, such as postural control, walking abilities and general functions of the upper and lower extremities, respectively. The majority of the included studies resulted in improvements of the assessed functional outcome measures. Conclusions The current evidence on the effectiveness of cognitive or motor-cognitive interventions to improve physical functioning in older adults or people with neurological impairments is limited. The heterogeneity of the studies published so far does not allow defining the training methodology with the greatest effectiveness. This review nevertheless provides important foundational information in order to encourage further development of novel cognitive or cognitive-motor interventions, preferably with a randomized control design. Future research that aims to examine the relation between improvements in cognitive skills and the translation to better performance on selected physical tasks should explicitly take the relation between the cognitive and physical skills into account.ISSN:1471-231

Virtual reality rehabilitation for all: Vivid GX versus Sony PlayStation II EyeToy

hw.haifa.ac.il/occupa/LIRT The main objective of this paper was to investigate the potential of the Sony PlayStation II EyeToy (www.EyeToy.com) for use in during the rehabilitation of elderly people with disabilities. This system is a projected, video-capture system which was developed as a gaming environment for children. As compared to other virtual reality systems such as VividGroup’s Gesture Xtreme (GX) VR (www.vividgroup.com), the EyeToy is sold commercially at a relatively low cost. This paper presents three pilot studies which were carried out in order to provide essential information of the EyeToy’s potential for use in rehabilitation. The first study included the testing of healthy, young adult participants (N=18) and compared their experiences using the EyeToy system to the GX system in terms of sense of presence, sense of enjoyment, control, success and perceived exertion. The second study assessed the usability of the EyeToy with healthy elderly subjects (N=10) and the third study assessed the use of the EyeToy with stroke patients (N=8). The implications of these three studies are discussed. 1

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A neuroVR based tool for cognitive assessment and rehabilitation of post-stroke patients:two case studies

Neuropsychological disorders are common in stroke patients, ranging from an isolated impairment to impairment in multiple cognitive functions. The cognitive domains affected are in particular executive functions. These comprise planning, organising, conducting, assessing and controlling actions. Dual task abilities, that is the ability to perform successive or simultaneous tasks, are not easy to be evaluated and recovered by traditional paper and pencil methods, due to their ecological and contextual nature. NeuroVR 1.5 is a cost-free virtual reality platform based on open-source software, allowing professionals to easily modify a virtual world, to best suit the needs of the clinical setting.The present study was designed to develop and test a NeuroVR based tool for the rehabilitation of shifting of attention and action planning functions using tasks reminiscent of daily life tasks. We present the virtual environment and the cognitive procedure we developed, discussing two stroke patients case studies, which underwent an integrated neuropsychological and VR assessment