Rehabilitación Virtual Motora: una Evaluación al tratamiento de pacientes con Daño Cerebral Adquirido

El uso de la Realidad Virtual dentro del campo de la Rehabilitaci on Motora en pacientes con Da~no Cerebral Adquirido (DCA) es un hecho cient camente contrastado en los ultimos a~nos. Los prometedores y satisfactorios resultados que se est an obteniendo en esta l nea de investigaci on (tanto a nivel cognitivo, como a nivel motor), en conjunci on con los procesos terap euticos tradicionales, proporcionan el auge de un nuevo hito dentro de la rehabilitaci on tradicional conocido como Virtual Motor Rehabilitation cuyo acr onimo es (VMR), describi endolo como Rehabilitaci on Virtual Motora (RVM). Hoy en d a, el Da~no Cerebral Adquirido es uno de los principales problemas de discapacidad y muerte en el mundo, donde las metodolog as propuestas dentro del campo de la rehabilitaci on tradicional, proporcionan resultados prometedores y esperanzadores. No obstante, este tipo de terapias presentan inconvenientes como son la falta de motivaci on del paciente, que lleva a una limitada adherencia al tratamiento, o las limitaciones de tiempo, espacio o coste que surgen en el proceso rehabilitador. Tradicionalmente, los principales experimentos realizados dentro del campo de la Rehabilitaci on Motora, se han realizado en pacientes DCA post-agudos y agudos, con escasas publicaciones basadas en el proceso rehabilitador motor de pacientes DCA cr onicos. En la presente tesis se han desarrollado sistemas de Rehabilitaci on Virtual para que, gracias al uso de dispositivos de bajo coste y las aportaciones obtenidas por los especialistas cl nicos, se haya validado la hip otesis: Mediante t ecnicas de rehabilitaci on virtual es posible obtener en pacientes cr onicos una recuperaci on del equilibrio estad sticamente signi- cativa, y similar a la que es posible obtener en pacientes agudos. Los experimentos realizados en el proceso rehabilitador, junto con las validaciones cl nicas realizadas en el Hospital Valencia al Mar, y el Instituto Valenciano de la Discapacidad, han servido para obtener unos resultados contrastables y satisfactorios, que corroboran la hip otesis de trabajo planteada.Albiol Pérez, S. (2014). Rehabilitación Virtual Motora: una Evaluación al tratamiento de pacientes con Daño Cerebral Adquirido [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/38450TESI

VRChild - Virtual Rehabilitation Child

Los pacientes que sufren una Parálisis Cerebral (PC) padecen de espasticidad en sus extremidades e incluso parálisis parcial o total de algunas de sus extremidades (superiores o inferiores). Es de gran importancia recuperar la fuerza y movilidad en mayor o menor medida que estas disponían previo a la alteración neurológica para poder mejorar su calidad de vida y reducir su dependencia sobre terceras personas. Las técnicas de Rehabilitación Motora Tradicional (RMT) consisten en la realización de ejercicios enfocados en la recuperación de la movilidad. El problema que puede surgir con estos ejercicios es que al paciente le pueden resultar repetitivos y aburridos, siendo uno de los principales métodos utilizado la repetición constante. Esto puede suponer la pérdida progresiva del interés del paciente en dichos ejercicios y por lo consiguiente el beneficio conseguido disminuye si el paciente no se implica al 100%. Uno de los métodos que se utiliza para lidiar con este problema es la utilización de pequeños juegos durante la ejecución de los ejercicios, concentrando la mente del paciente dentro de la tarea que está realizando. Esto es beneficioso sobre todo para niños que necesiten realizar los ejercicios, ya que en edades tempranas es más probable que se distraigan con mayor facilidad. La Rehabilitación Virtual Motora (RVM) sigue la misma finalidad, proporcionar un entorno de juego que permita ejercitar las extremidades de los pacientes con PC mientras estos están entretenidos y proporcionarles un desafío razonable para que así quieran esforzarse cada vez más y fomenten su trabajo diario. El objetivo de este proyecto es el de realizar una aplicación de RVM que ayude en las terapias de rehabilitación de niños con PC utilizando un dispositivo de bajo coste para poder hacerlo más accesible. El dispositivo seleccionado es un sistema de tracking de esqueleto (Kinect v2), ya que dispone de una gran calidad a la hora de capturar movimientos realizados por el cuerpo humano. La aplicación tratará de un juego en el que se pide ordenar una serie de peluches virtuales dentro de una estantería utilizando para esto movimientos con el brazo y la mano. El juego se compone de diez niveles de dificultad para hacerlo más desafiante. Este aplicativo no sustituirá a ningún ejercicio de RM, sino más bien servirá como complemento a los ejercicios realizados durante las sesiones. Su finalidad es la de ayudar al paciente a nivel cognitivo mientras sigue trabajando sus extremidades sin estar tan concentrado en dicha tarea, sino concentrado en terminar el nivel del juego

Designing internet of tangible things for children with hearing impairment

Tangible User Interfaces (TUIs) are a new, non-traditional way to interact with digital information using a physical environment. Therefore, TUIs connect a physical set of objects that can be explored and manipulated. TUI can be interconnected over the Internet, using Internet of Things (IoT) technology to monitor a child''s activities in real-time. Internet of Tangible Things (IoTT) is defined as a tangible interaction applied to IoT. This article describes four case studies that apply IoTT to children with cochlear implants and children whose communication is sign language. For each case study, a discussion is presented, discussing how IoTT can help the child development in skills such as: social, emotional, psychomotor, cognitive, and visual. It was found that IoTT works best when it includes the social component in children with hearing impairment, because it helps them to communicate with each other and build social-emotional skills

Affective Communication for Socially Assistive Robots (SARs) for Children with Autism Spectrum Disorder: A Systematic Review

Research on affective communication for socially assistive robots has been conducted to enable physical robots to perceive, express, and respond emotionally. However, the use of affective computing in social robots has been limited, especially when social robots are designed for children, and especially those with autism spectrum disorder (ASD). Social robots are based on cognitiveaffective models, which allow them to communicate with people following social behaviors and rules. However, interactions between a child and a robot may change or be different compared to those with an adult or when the child has an emotional deficit. In this study, we systematically reviewed studies related to computational models of emotions for children with ASD. We used the Scopus, WoS, Springer, and IEEE-Xplore databases to answer different research questions related to the definition, interaction, and design of computational models supported by theoretical psychology approaches from 1997 to 2021. Our review found 46 articles; not all the studies considered children or those with ASD.This research was funded by VRIEA-PUCV, grant number 039.358/202

Análisis de la integración del uso de aplicaciones de apoyo a la docencia universitaria en Internet

La implantación de las nuevas tecnologías de la información en el mundo universitario, aparte de tener unas evidentes ventajas, trae consigo una serie de problemas asociados que es necesario solventar. El presente documento analiza dicha problemática, y propone una serie de alternativas para la puesta en marcha de un sistema de información en el ámbito docente, trasladando las características de calidad tradicionales al nuevo entorno. Una de las alternativas, consiste en el uso de herramientas expertas (Dreamweaver, Funnel Web) como apoyo al desarrollo del sistema de información por parte del personal docente. La otra posibilidad consiste en la adquisición e implantación de sistemas propietarios integrales (WebCT, Blackboard). Finalmente se estudia cada una de las posibilidades, en base a la experiencia adquirida por nuestro grupo, al estar inmersos actualmente en la puesta en marcha del anillo digital docente de la Universidad de Zaragoza

The role of virtual motor rehabilitation: a quantitative analysis between acute and chronic patients with acquired brain injury

"(c) 2014 IEEE. Personal use of this material is permitted. Permission from IEEE must be obtained for all other users, including reprinting/ republishing this material for advertising or promotional purposes, creating new collective works for resale or redistribution to servers or lists, or reuse of any copyrighted components of this work in other works."Acquired brain injury (ABI) is one of the main problems of disability and death in the world. Its incidence and survival rate are increasing annually. Thus, the number of chronic ABI patients is gradually growing. Traditionally, rehabilitation programs are applied to postacute and acute patients, but recent publications determine that chronic patients may benefit from rehabilitation. Also, in the last few years, the potential of virtual rehabilitation (VR) systems has been demonstrated. However, until now, no previous studies have been carried out to compare the evolution of chronic patients with acute patients in a VR program. To perform this study, we developed a VR system for ABI patients. The system, vestibular virtual rehabilitation (V2R), was designed with clinical specialists. V2R has been tested with 21 people ranging in age from 18 to 80 years old that were classified in two groups: chronic patients and acute patients. The results demonstrate a similar recovery for chronic and acute patients during the intervention period. Also, the results showed that chronic patients stop their improvement when they finish their training. This conclusion encourages us to direct our developments toward VR systems that can be easily integrated at home, allowing chronic patients to have a permanent VR training program.This work was supported by the Ministerio de Educacion y Ciencia Spain: Projects Consolider-C (SEJ2006-14301/PSIC), "CIBER of Physiopathology of Obesity and Nutrition, an initiative of ISCIII," and the Excellence Research Program PROMETEO (Generalitat Valenciana. Conselleria de Educacion, 2008-157).Albiol Pérez, S.; Gil-Gómez, J.; Llorens Rodríguez, R.; Alcañiz Raya, ML.; Colomer Font, C. (2014). The role of virtual motor rehabilitation: a quantitative analysis between acute and chronic patients with acquired brain injury. IEEE Journal of Biomedical and Health Informatics. 18(1):391-398. https://doi.org/10.1109/JBHI.2013.2272101S39139818

USEQ: A Short Questionnaire for Satisfaction Evaluation of Virtual Rehabilitation Systems

[EN] New emerging technologies have proven their efficacy in aiding people in their rehabilitation. The tests that are usually used to evaluate usability (in general) or user satisfaction (in particular) of this technology are not specifically focused on virtual rehabilitation and patients. The objective of this contribution is to present and evaluate the USEQ (User Satisfaction Evaluation Questionnaire). The USEQ is a questionnaire that is designed to properly evaluate the satisfaction of the user (which constitutes part of usability) in virtual rehabilitation systems. Forty patients with balance disorders completed the USEQ after their first session with ABAR (Active Balance Rehabilitation), which is a virtual rehabilitation system that is designed for the rehabilitation of balance disorders. Internal consistency analysis and exploratory factor analysis were carried out to identify the factor structure of the USEQ. The six items of USEQ were significantly associated with each other, and the Cronbach alpha coefficient for the questionnaire was 0.716. In an analysis of the principal components, a one-factor solution was considered to be appropriate. The findings of the study suggest that the USEQ is a reliable questionnaire with adequate internal consistency. With regard to patient perception, the patients found the USEQ to be an easy-to-understand questionnaire with a convenient number of questions.Gil-Gómez, J.; Manzano-Hernández, P.; Albiol-Perez, S.; Aula-Valero, C.; Gil Gómez, H.; Lozano Quilis, JA. (2017). USEQ: A Short Questionnaire for Satisfaction Evaluation of Virtual Rehabilitation Systems. Sensors. 17(7):1-12. https://doi.org/10.3390/s17071589S112177BEVAN, N. (2001). International standards for HCI and usability. International Journal of Human-Computer Studies, 55(4), 533-552. doi:10.1006/ijhc.2001.0483Abran, A., Khelifi, A., Suryn, W., & Seffah, A. (2003). Software Quality Journal, 11(4), 325-338. doi:10.1023/a:1025869312943Ergonomic Requirements for Office Work with Visual Display Terminals (VDTs) Part 11: Guidance on Usabilityhttp://www.iso.org/iso/catalogue_detail.htm?csnumber=16883Holden, M. K. (2005). Virtual Environments for Motor Rehabilitation: Review. CyberPsychology & Behavior, 8(3), 187-211. doi:10.1089/cpb.2005.8.187Sveistrup, H. (2004). Journal of NeuroEngineering and Rehabilitation, 1(1), 10. doi:10.1186/1743-0003-1-10Lange, B., Koenig, S., Chang, C.-Y., McConnell, E., Suma, E., Bolas, M., & Rizzo, A. (2012). Designing informed game-based rehabilitation tasks leveraging advances in virtual reality. Disability and Rehabilitation, 34(22), 1863-1870. doi:10.3109/09638288.2012.670029Lewis, G. N., & Rosie, J. A. (2012). Virtual reality games for movement rehabilitation in neurological conditions: how do we meet the needs and expectations of the users? Disability and Rehabilitation, 34(22), 1880-1886. doi:10.3109/09638288.2012.670036Singh, D. K. A., Mohd Nordin, N. A., Aziz, N. A. A., Lim, B. K., & Soh, L. C. (2013). Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. BMC Neurology, 13(1). doi:10.1186/1471-2377-13-199Green, D., & Wilson, P. H. (2011). Use of virtual reality in rehabilitation of movement in children with hemiplegia − A multiple case study evaluation. Disability and Rehabilitation, 34(7), 593-604. doi:10.3109/09638288.2011.613520Meldrum, D., Herdman, S., Moloney, R., Murray, D., Duffy, D., Malone, K., … McConn-Walsh, R. (2012). Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial. BMC Ear, Nose and Throat Disorders, 12(1). doi:10.1186/1472-6815-12-3Gil-Gómez, J.-A., Lloréns, R., Alcañiz, M., & Colomer, C. (2011). Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. Journal of NeuroEngineering and Rehabilitation, 8(1), 30. doi:10.1186/1743-0003-8-30Albiol-Perez, S., Gil-Gomez, J.-A., Llorens, R., Alcaniz, M., & Font, C. C. (2014). The Role of Virtual Motor Rehabilitation: A Quantitative Analysis Between Acute and Chronic Patients With Acquired Brain Injury. IEEE Journal of Biomedical and Health Informatics, 18(1), 391-398. doi:10.1109/jbhi.2013.2272101Jokela, T., Koivumaa, J., Pirkola, J., Salminen, P., & Kantola, N. (2005). Methods for quantitative usability requirements: a case study on the development of the user interface of a mobile phone. Personal and Ubiquitous Computing, 10(6), 345-355. doi:10.1007/s00779-005-0050-7Vermeulen, J., Neyens, J., Spreeuwenberg, van Rossum, E., Sipers, Habets, … de Witte. (2013). User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people. Patient Preference and Adherence, 843. doi:10.2147/ppa.s45897Duffy, S. A., Fowler, K. E., Flanagan, P. S., Ronis, D. L., Ewing, L. A., & Waltje, A. H. (2013). The Development of the Tobacco Tactics Website. JMIR Research Protocols, 2(2), e22. doi:10.2196/resprot.2445Mathew, D., McKibbon, K. A., Lokker, C., & Colquhoun, H. (2014). Engaging With a Wiki Related to Knowledge Translation: A Survey of WhatisKT Wiki Users. Journal of Medical Internet Research, 16(1), e21. doi:10.2196/jmir.3001Mattos, L. S., Deshpande, N., Barresi, G., Guastini, L., & Peretti, G. (2014). A novel computerized surgeon-machine interface for robot-assisted laser phonomicrosurgery. The Laryngoscope, 124(8), 1887-1894. doi:10.1002/lary.24566Meldrum, D., Glennon, A., Herdman, S., Murray, D., & McConn-Walsh, R. (2011). Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii®Fit Plus. Disability and Rehabilitation: Assistive Technology, 7(3), 205-210. doi:10.3109/17483107.2011.616922Kalawsky, R. S. (1999). VRUSE—a computerised diagnostic tool: for usability evaluation of virtual/synthetic environment systems. Applied Ergonomics, 30(1), 11-25. doi:10.1016/s0003-6870(98)00047-7Cameirao, M. S., Bermudez i Badia, S., Duarte Oller, E., & Verschure, P. F. (2010). Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation. Journal of NeuroEngineering and Rehabilitation, 7(1), 48. doi:10.1186/1743-0003-7-48Regenbrecht, H., Hoermann, S., McGregor, G., Dixon, B., Franz, E., Ott, C., … Hoermann, J. (2012). Visual manipulations for motor rehabilitation. Computers & Graphics, 36(7), 819-834. doi:10.1016/j.cag.2012.04.012Shin, J.-H., Ryu, H., & Jang, S. (2014). A task-specific interactive game-based virtual reality rehabilitation system for patients with stroke: a usability test and two clinical experiments. Journal of NeuroEngineering and Rehabilitation, 11(1), 32. doi:10.1186/1743-0003-11-32Kizony, R., Katz, N., & (Tamar) Weiss, P. L. (2003). Adapting an immersive virtual reality system for rehabilitation. The Journal of Visualization and Computer Animation, 14(5), 261-268. doi:10.1002/vis.323Witmer, B. G., & Singer, M. J. (1998). Measuring Presence in Virtual Environments: A Presence Questionnaire. Presence: Teleoperators and Virtual Environments, 7(3), 225-240. doi:10.1162/105474698565686Kizony, R., Raz, L., Katz, N., Weingarden, H., & Weiss, P. L. T. (2005). Video-capture virtual reality system for patients with paraplegic spinal cord injury. The Journal of Rehabilitation Research and Development, 42(5), 595. doi:10.1682/jrrd.2005.01.0023Muñoz Tomás, M. T., Gil Gómez, J. A., Gil Gómez, H., Lozano Quillis, J. A., Albiol-Pérez, S., & Forcano García, M. (2013). Suitability of virtual rehabilitation for elderly: A study of a virtual rehabilitation system using the SEQ. European Geriatric Medicine, 4, S109. doi:10.1016/j.eurger.2013.07.358Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). «Mini-mental state». Journal of Psychiatric Research, 12(3), 189-198. doi:10.1016/0022-3956(75)90026-6Forcano García, M., Albiol-Perez, S., Aula Valero, M. C., Gil Gómez, J. A., Solsona Hernández, S., & Manzano Hernández, P. (2013). Balance virtual rehabilitation in the elderly: The use of the «ABAR» system. European Geriatric Medicine, 4, S109. doi:10.1016/j.eurger.2013.07.356Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16(3), 297-334. doi:10.1007/bf02310555Babikian, T., & Asarnow, R. (2009). Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature. Neuropsychology, 23(3), 283-296. doi:10.1037/a0015268Streiner, D. L. (2003). Starting at the Beginning: An Introduction to Coefficient Alpha and Internal Consistency. Journal of Personality Assessment, 80(1), 99-103. doi:10.1207/s15327752jpa8001_18Fackrell, K., Fearnley, C., Hoare, D. J., & Sereda, M. (2015). Hyperacusis Questionnaire as a Tool for Measuring Hypersensitivity to Sound in a Tinnitus Research Population. BioMed Research International, 2015, 1-12. doi:10.1155/2015/29042

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

A Velostat-Based Pressure-Sensitive Mat for Center-of-Pressure Measurements: A Preliminary Study

Center-of-pressure (CoP) displacements play a key role in studies assessing postural stability. The accepted instrument to measure CoP trajectories is the force platform, but pressure-sensitive mats (PSMs) are an alternative composed of a matrix of sensitive cells. A typical cell comprises two electrodes with piezoresistive material in between, while a force platform has a force sensor at each of its corners. In this paper, we compare a homemade Velostat-based PSM and an affordable commercial mat with a commercial force platform in a test series with 42 healthy volunteers in single-legged trials (29 males, 13 females; height 1.74 (0.09) m, weight 74.3 (16.34) kg, age 31.21 (12.66) years). The aim of the research was to perform a preliminary study of the performance of our prototype to measure CoP, and more specifically, the standard deviation of the CoP path on both axes, the medial–lateral and anterior–posterior. We could thus discover several improvements for future clinical applications. The intraclass correlation coefficient (ICC) for agreement in the base experiment showed a moderate value for the prototype (0.38 to 0.63) and lower values for the commercial mat (0.11 to 0.12). However, we identified several factors that were relevant to improve ICC and reduce error by considering several processing options: (i) the known crosstalk problem between cells that appears in this kind of mats must be eliminated; (ii) the response time of the sensor has to be taken into account; and (iii) increasing the mat resolution also improves agreement. Therefore, as future work, we plan to test the improved version of the prototype in a clinical environment

SEQ: Suitability Evaluation Questionnaire for Virtual Rehabilitation systems. Application in a Virtual Rehabilitation system for Balance Rehabilitation. 2013 Presented at: SEQ: Suitability Evaluation Questionnaire for Virtual Rehabilitation systems. Appli

Abstract-Usability, acceptance and security of use are key factors in the validation of Virtual Rehabilitation system. Current literature offers different questionnaires for this purpose, but many of them do not consider some important issues and other are inadequate for patients. In this paper, we present SEQ (Suitability Evaluation Questionnaire) a novel questionnaire designed specifically for Virtual Rehabilitation systems. SEQ is based on a questionnaire with proven efficacy (SFQ) but with new questions that cover fundamental items not covered by SFQ. SEQ is an easy to understand questionnaire, with an affordable number of questions (14), which is being currently validated. This contribution presents also the study that is being carried out, and the preliminary results obtained from patients who have already completed the study (N=13). These initial results show an acceptable internal consistency of SEQ. As a secondary result, this contribution also indicates initial suitability evaluation of a Virtual Rehabilitation system designed for balance recovery