scholarly journals Playing your pain away: designing a virtual reality physical therapy for children with upper limb motor impairment

2021 ◽  
Author(s):  
Ivan Phelan ◽  
Penny Jayne Furness ◽  
Maria Matsangidou ◽  
Alicia Carrion-Plaza ◽  
Heather Dunn ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Functional Outcomes ◽  
Positive Emotions ◽  
Therapeutic Process ◽  
Motor Impairment ◽  
Exercise Duration ◽  
Hospital Environment ◽  
Physical Therapies ◽  
Functional Disabilities

AbstractChildren with upper limb motor impairment often undergo repetitive therapeutic physiotherapy sessions to minimize functional disabilities of the affected area. Even though therapeutic processes can improve functional outcomes and minimize persistent disabilities, patients often neglect to participate fully in physical therapies due to the associated procedural pain. Over recent decades, there has been a growing interest in designing non-pharmacological interventions which aim to minimize pain during physical therapies and improve functional outcomes. Via two interrelated studies, we explored the use of virtual reality (VR) as a tool to provide therapeutic physiotherapy for child patients in an out-patient hospital department. We found that VR is an effective solution for children with upper limb motor impairment undergoing painful therapeutic process within a hospital environment. VR can improve functional disabilities, alleviate perceived pain, reduce the perceived difficulty of rehabilitation exercises, increase exercise duration and produce positive emotions towards the therapy.Trial registration number and date of registration Protocol ID NCT03998995. Release Date: June 25, 2019.

Virtual Reality System Toyra: A New Tool to Assess and Treatment for Upper Limb Motor Impairment in Patients with Spinal Cord Injury

2013 ◽  
pp. 853-858 ◽  
Author(s):  
Iris Dimbwadyo-Terrer ◽  
Ana de los Reyes-Guzmán ◽  
Alberto Bernal-Sahún ◽  
Patricia López-Monteagudo ◽  
Fernando Trincado-Alonso ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Upper Limb ◽  
Motor Impairment ◽  
Virtual Reality System ◽  
Cord Injury

scholarly journals Enhancing Upper Limb Rehabilitation of Stroke Patients With Virtual Reality: A Mini Review

2021 ◽  
Vol 2 ◽  
Author(s):  
Julie Bui ◽  
Jacques Luauté ◽  
Alessandro Farnè
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
New Technologies ◽  
Technological Development ◽  
Cochrane Review ◽  
Motor Impairment ◽  
Added Value ◽  
Initial Assessment ◽  
Upper Limb Rehabilitation ◽  
Upper Limb Function

Upper limb motor impairment following stroke is a common condition that impacts significantly the independence and quality of life of stroke survivors. In recent years, scholars have massively turned to virtual reality (VR) to develop more effective rehabilitation approaches. VR systems are promising tools that can help patients engage in intensive, repetitive and task-oriented practice using new technologies to promote neuroplasticity and recovery. Multiple studies have found significant improvements in upper limb function for patients using VR in therapy, but the heterogeneity of methods and tools employed make the assessment of VR efficacy difficult. Here we aimed to assess the potential of VR as a therapy tool for upper limb motor impairment and to provide initial assessment of what is the added value of using VR to both patients and clinicians. Our mini-review focuses the work published since the Cochrane review (2017) and suggests that VR may be particularly effective when used in combination to conventional rehabilitation approaches. We also highlight key features integrated in VR systems that appear to influence rehabilitation and can help maximizing therapy outcomes, if exploited properly. We conclude that although promising results have already been gathered, more focused research is needed to determine the optimal conditions to implement VR in clinical settings in order to enhance therapy and to better define and leverage the true potential of VR. The rapid pace of technological development and increasing research interest toward VR-based therapy will help providing extensive knowledge and lead to rapid advancements in the near future.

scholarly journals Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses

2021 ◽  
Vol 10 (7) ◽  
pp. 1478
Author(s):  
Alexandra Voinescu ◽  
Jie Sui ◽  
Danaë Stanton Fraser
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Brain Injury ◽  
Upper Limb ◽  
Umbrella Review ◽  
High Quality ◽  
Quality Of Evidence ◽  
Upper Limb Function ◽  
Meta Analyses

Neurological disorders are a leading cause of death and disability worldwide. Can virtual reality (VR) based intervention, a novel technology-driven change of paradigm in rehabilitation, reduce impairments, activity limitations, and participation restrictions? This question is directly addressed here for the first time using an umbrella review that assessed the effectiveness and quality of evidence of VR interventions in the physical and cognitive rehabilitation of patients with stroke, traumatic brain injury and cerebral palsy, identified factors that can enhance rehabilitation outcomes and addressed safety concerns. Forty-one meta-analyses were included. The data synthesis found mostly low- or very low-quality evidence that supports the effectiveness of VR interventions. Only a limited number of comparisons were rated as having moderate and high quality of evidence, but overall, results highlight potential benefits of VR for improving the ambulation function of children with cerebral palsy, mobility, balance, upper limb function, and body structure/function and activity of people with stroke, and upper limb function of people with acquired brain injury. Customization of VR systems is one important factor linked with improved outcomes. Most studies do not address safety concerns, as only nine reviews reported adverse effects. The results provide critical recommendations for the design and implementation of future VR programs, trials and systematic reviews, including the need for high quality randomized controlled trials to test principles and mechanisms, in primary studies and in meta-analyses, in order to formulate evidence-based guidelines for designing VR-based rehabilitation interventions.

scholarly journals Kinematic of the Position and Orientation Synchronization of the Posture of a n DoF Upper-Limb Exoskeleton with a Virtual Object in an Immersive Virtual Reality Environment

Electronics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1069
Author(s):  
Deyby Huamanchahua ◽  
Adriana Vargas-Martinez ◽  
Ricardo Ramirez-Mendoza
Keyword(s):  
Virtual Reality ◽  
Upper Limb ◽  
Human Performance ◽  
Early Stage ◽  
Inverse Kinematic ◽  
Virtual Object ◽  
Immersive Virtual Reality ◽  
Virtual Reality Environment ◽  
Upper Limb Exoskeleton ◽  
Position And Orientation

Exoskeletons are an external structural mechanism with joints and links that work in tandem with the user, which increases, reinforces, or restores human performance. Virtual Reality can be used to produce environments, in which the intensity of practice and feedback on performance can be manipulated to provide tailored motor training. Will it be possible to combine both technologies and have them synchronized to reach better performance? This paper consists of the kinematics analysis for the position and orientation synchronization between an n DoF upper-limb exoskeleton pose and a projected object in an immersive virtual reality environment using a VR headset. To achieve this goal, the exoskeletal mechanism is analyzed using Euler angles and the Pieper technique to obtain the equations that lead to its orientation, forward, and inverse kinematic models. This paper extends the author’s previous work by using an early stage upper-limb exoskeleton prototype for the synchronization process.

scholarly journals Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review

2021 ◽  
pp. 153944922110326
Author(s):  
Mary E. Stoykov ◽  
Courtney Heidle ◽  
Shamshir Kang ◽  
Lisa Lodesky ◽  
Lindsay E. Maccary ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Motor Skills ◽  
Upper Limb ◽  
Scoping Review ◽  
Web Of Science ◽  
Motor Impairment ◽  
Cochrane Collaboration ◽  
Prisma Statement ◽  
Meta Analyses ◽  
The Cochrane Collaboration

Sensory priming is a technique to facilitate neuroplasticity and improve motor skills after injury. Common sensory priming modalities include peripheral nerve stimulation/somatosensory electrical stimulation (PNS/SES), transient functional deafferentation (TFD), and vibration. The aim of this study was to determine whether sensory priming with a motor intervention results in improved upper limb motor impairment or function after stroke. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and EMBASE were the databases used to search the literature in July 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and recommendations for the Cochrane collaboration. In total, 30 studies were included in the analysis: three studies examined TFD, 16 examined PNS/SES, 10 studied vibration, and one combined the three stimulation techniques. Most studies reported significant improvements for participants receiving sensory priming. Given the low risk, it may be advantageous to use sensory-based priming prior to or concurrent with upper limb training after stroke.

scholarly journals Patient Clothing as a Healing Environment: A Qualitative Interview Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5357
Author(s):  
Seon-Ju Kam ◽  
Young-Sun Yoo
Keyword(s):  
Emotional Response ◽  
Positive Emotions ◽  
Design Method ◽  
Medical Center ◽  
Emotional Responses ◽  
University Hospital ◽  
Hospital Environment ◽  
University Hospitals ◽  
Pattern Design ◽  
Qualitative Interview Study

Patients’ emotional responses to the hospital environment can be considered as important as medical technology and equipment. Therefore, this study investigated their experiences to determine whether the pattern using hospital identity (HI) elements, a widely used design method for patient clothing in university hospitals, can affect their emotional response and contribute to healing. It aimed to identify whether controlling the motif characteristics, arrangement, and spacing in this pattern design, and the direction between motifs, could be a method to design patient clothing for healing. To investigate patients’ emotional response and suggestions for patient clothing design, an interview-based qualitative approach was used. In-depth interviews were conducted with 12 patients discharged from Kyung Hee University Hospital Medical Center (KHUMC), Seoul. The interview questions consisted of two parts. One part featured questions about participants’ emotional responses to the medical environment and their latest patient clothing experience, and the other featured questions about their emotional response to, and suggestions for, the healing expression of pattern design using HI. The results confirmed that the motif characteristics, arrangement, and spacing, and the direction between motifs, influenced patients’ positive emotions and contributed to the healing effect. Therefore, when the HI elements of a medical institution are applied in the design of patient clothing with the characteristics of a healing design, patients perceive this as providing stability and comfort. The design of patient clothing becomes a medium that not only builds the brand image of medical institutions, but also enhances the quality of medical services centered on patient healing.

scholarly journals Effect of post-stroke spasticity on voluntary movement of the upper limb

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hadar Lackritz ◽  
Yisrael Parmet ◽  
Silvi Frenkel-Toledo ◽  
Melanie C. Baniña ◽  
Nachum Soroker ◽  
...  
Keyword(s):  
Upper Limb ◽  
Target Location ◽  
Distance Measure ◽  
Movement Time ◽  
Motor Impairment ◽  
Reach To Grasp ◽  
Motion Patterns ◽  
Post Stroke ◽  
The Impact ◽  
Elbow Motion

Abstract Background Hemiparesis following stroke is often accompanied by spasticity. Spasticity is one factor among the multiple components of the upper motor neuron syndrome that contributes to movement impairment. However, the specific contribution of spasticity is difficult to isolate and quantify. We propose a new method of quantification and evaluation of the impact of spasticity on the quality of movement following stroke. Methods Spasticity was assessed using the Tonic Stretch Reflex Threshold (TSRT). TSRT was analyzed in relation to stochastic models of motion to quantify the deviation of the hemiparetic upper limb motion from the normal motion patterns during a reaching task. Specifically, we assessed the impact of spasticity in the elbow flexors on reaching motion patterns using two distinct measures of the ‘distance’ between pathological and normal movement, (a) the bidirectional Kullback–Liebler divergence (BKLD) and (b) Hellinger’s distance (HD). These measures differ in their sensitivity to different confounding variables. Motor impairment was assessed clinically by the Fugl-Meyer assessment scale for the upper extremity (FMA-UE). Forty-two first-event stroke patients in the subacute phase and 13 healthy controls of similar age participated in the study. Elbow motion was analyzed in the context of repeated reach-to-grasp movements towards four differently located targets. Log-BKLD and HD along with movement time, final elbow extension angle, mean elbow velocity, peak elbow velocity, and the number of velocity peaks of the elbow motion were computed. Results Upper limb kinematics in patients with lower FMA-UE scores (greater impairment) showed greater deviation from normality when the distance between impaired and normal elbow motion was analyzed either with the BKLD or HD measures. The severity of spasticity, reflected by the TSRT, was related to the distance between impaired and normal elbow motion analyzed with either distance measure. Mean elbow velocity differed between targets, however HD was not sensitive to target location. This may point at effects of spasticity on motion quality that go beyond effects on velocity. Conclusions The two methods for analyzing pathological movement post-stroke provide new options for studying the relationship between spasticity and movement quality under different spatiotemporal constraints.

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