Design of adaptive control and virtual reality-based fine hand motion rehabilitation system and its effects in subacute stroke patients

This chapter focuses on a patient self-controlled rehabilitation system using our developed exoskeleton-type hand-motion-assist robot and tele-rehabilitation. The virtual reality-enhanced new hand rehabilitation support system, which we have developed for stroke patients in the acute stage, is aiming to allow such patients to conduct every day exercises by themselves without supervisors. This system features a multi-DOF motion assistance device, a virtual reality interface for patients, and a symmetrical master-slave motion assistance training strategy called ”self-motion control”, in which the stroke patients' healthy hand on the master side creates the assistance motion for the impaired hand on the slave side. Moreover, a tele-rehabilitation system consisting of a hand rehabilitation support system for the patients, an anthropomorphic robot hand for the therapist, and a remote monitoring system for diagnosing the degree of recovery is explained.

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Design and Control of a Hand-Assist Robot with Multiple Degrees of Freedom for Rehabilitation Therapy

Robotic Systems ◽

10.4018/978-1-7998-1754-3.ch043 ◽

2020 ◽

pp. 838-873

Author(s):

Haruhisa Kawasaki ◽

Satoshi Ueki ◽

Satoshi Ito ◽

Tetsuya Mouri

Keyword(s):

Virtual Reality ◽

Support System ◽

Degrees Of Freedom ◽

Acute Stage ◽

Hand Rehabilitation ◽

Stroke Patients ◽

Hand Motion ◽

Training Strategy ◽

Rehabilitation System ◽

And Control

This chapter focuses on a patient self-controlled rehabilitation system using our developed exoskeleton-type hand-motion-assist robot and tele-rehabilitation. The virtual reality-enhanced new hand rehabilitation support system, which we have developed for stroke patients in the acute stage, is aiming to allow such patients to conduct every day exercises by themselves without supervisors. This system features a multi-DOF motion assistance device, a virtual reality interface for patients, and a symmetrical master-slave motion assistance training strategy called ”self-motion control”, in which the stroke patients' healthy hand on the master side creates the assistance motion for the impaired hand on the slave side. Moreover, a tele-rehabilitation system consisting of a hand rehabilitation support system for the patients, an anthropomorphic robot hand for the therapist, and a remote monitoring system for diagnosing the degree of recovery is explained.

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Postural Control Disturbances Induced by Virtual Reality in Stroke Patients

Applied Sciences ◽

10.3390/app11041510 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1510

Author(s):

Charles Morizio ◽

Maxime Billot ◽

Jean-Christophe Daviet ◽

Stéphane Baudry ◽

Christophe Barbanchon ◽

...

Keyword(s):

Virtual Reality ◽

Postural Control ◽

Virtual Environments ◽

Center Of Pressure ◽

Dynamic Condition ◽

Static Condition ◽

Stroke Patients ◽

Post Stroke ◽

Subacute Stroke

People who survive a stroke are often left with long-term neurologic deficits that induce, among other impairments, balance disorders. While virtual reality (VR) is growing in popularity for postural control rehabilitation in post-stroke patients, studies on the effect of challenging virtual environments, simulating common daily situations on postural control in post-stroke patients, are scarce. This study is a first step to document the postural response of stroke patients to different challenging virtual environments. Five subacute stroke patients and fifteen age-matched healthy adults were included. All participants underwent posturographic tests in control conditions (open and closed eyes) and virtual environment without (one static condition) and with avatars (four dynamic conditions) using a head-mounted device for VR. In dynamic environments, we modulated the density of the virtual crowd (dense and light crowd) and the avoidance space with the avatars (near or far). Center of pressure velocity was collected by trial throughout randomized 30-s periods. Results showed that more challenging conditions (dynamic condition) induced greater postural disturbances in stroke patients than in healthy counterparts. Our study suggests that virtual reality environments should be adjusted in light of obtaining more or less challenging conditions.

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Stroke Telerehabilitation in Calabria: A Health Technology Assessment

Frontiers in Neurology ◽

10.3389/fneur.2021.777608 ◽

2022 ◽

Vol 12 ◽

Author(s):

Contrada Marianna ◽

Arcuri Francesco ◽

Tonin Paolo ◽

Pignolo Loris ◽

Mazza Tiziana ◽

...

Keyword(s):

Virtual Reality ◽

Low Income ◽

Cognitive Rehabilitation ◽

Low Income Countries ◽

Rehabilitation Services ◽

Stroke Patients ◽

Post Stroke ◽

Home Service ◽

Rehabilitation System ◽

Specialist Rehabilitation

Introduction: Telerehabilitation (TR) is defined as a model of home service for motor and cognitive rehabilitation, ensuring continuity of care over time. TR can replace the traditional face-to-face approach as an alternative method of delivering conventional rehabilitation and applies to situations where the patient is unable to reach rehabilitation facilities or for low-income countries where outcomes are particularly poor. For this reason, in this study, we sought to demonstrate the feasibility and utility of a well-known TR intervention on post-stroke patients living in one of the poorest indebted regions of Italy, where the delivery of rehabilitation services is inconsistent and not uniform.Materials and Methods: Nineteen patients (13 male/6 female; mean age: 61.1 ± 8.3 years) with a diagnosis of first-ever ischemic (n = 14) or hemorrhagic stroke (n = 5), who had been admitted to the intensive rehabilitation unit (IRU) of the Institute S. Anna (Crotone, Italy), were consecutively enrolled to participate in this study. After the discharge, they continued the motor treatment remotely by means of a home-rehabilitation system. The entire TR intervention was performed (online and offline) using the Virtual Reality Rehabilitation System (VRRS) (Khymeia, Italy). All patients received intensive TR five times a week for 12 consecutive weeks (60 sessions, each session lasting about 1h).Results: We found a significant motor recovery after TR protocol as measured by the Barthel Index (BI); Fugl-Meyer motor score (FM) and Motricity Index (MI) of the hemiplegic upper limbs.Conclusions: This was the first demonstration that a well-defined virtual reality TR tool promotes motor and functional recovery in post-stroke patients living in a low-income Italian region, such as Calabria, characterized by a paucity of specialist rehabilitation services.

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Requirements Elicitation and Prototyping of a Fully Immersive Virtual Reality Gaming System for Upper Limb Stroke Rehabilitation in Saudi Arabia

Mobile Information Systems ◽

10.1155/2017/7507940 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 5

Author(s):

Maram AlMousa ◽

Hend S. Al-Khalifa ◽

Hana AlSobayel

Keyword(s):

Virtual Reality ◽

Saudi Arabia ◽

Upper Limb ◽

Stroke Rehabilitation ◽

Requirements Elicitation ◽

Stroke Survivors ◽

Immersive Virtual Reality ◽

Stroke Patients ◽

Rehabilitation System

Stroke rehabilitation plays an important role in recovering the lifestyle of stroke survivors. Although existing research proved the effectiveness and engagement of nonimmersive virtual reality- (VR-) based rehabilitation systems, limited research is available on the applicability of fully immersive VR-based rehabilitation systems. In this paper, we present the elicited requirements of a fully immersive VR-based rehabilitation system that will be designed for domestic upper limb stroke patients; we will also provide an initial conceptual prototype of the proposed system.

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Effects of virtual reality-based treadmill training on the balance and gait ability in patients after stroke

Hrvatska revija za rehabilitacijska istraživanja ◽

10.31299/hrri.57.2.6 ◽

2021 ◽

Vol 57 (2) ◽

pp. 92-102

Author(s):

Maruša Kržišnik ◽

Barbara Horvat Rauter ◽

Nataša Bizovčar

Keyword(s):

Virtual Reality ◽

Treadmill Training ◽

Step Test ◽

Control Group ◽

Walk Test ◽

Stroke Patients ◽

Lateral Asymmetry ◽

Subacute Stroke ◽

Significant Difference ◽

Experimental Group

Gait and balance impairments contribute significantly to long-term disability after stroke. Modern concepts of stroke rehabilitation recommend a task-specific repetitive approach, such as using treadmill training. The purpose of this study was to investigate the effectiveness of using virtual reality-based treadmill training to improve balance and gait in subacute stroke patients. Twenty-two stroke patients were randomly stratified into two groups: the experimental (n = 11) and the control group (n = 11). Parameters associated with balance and gait were measured using the 6-minute walk test, the 10-meter walk test, the timed “up and go” test, the functional gait assessment, and the four square step test. Gait analysis using the zebris Rehawalk® treadmill system was also performed. Patients in the experimental group received virtual reality-based treadmill training five times a week for a period of four weeks, while those in the control group received treadmill training at the same frequency, duration, intensity, and structure, along with a progressively more difficult task demands. Significant improvements were observed in selected outcome measures in both groups after training. Patients in the experimental group experienced improvements in all of the spatiotemporal gait parameters, but there was a significant difference before and after training in duration of double support and lateral asymmetry. The findings of this pilot randomized controlled trial support the benefits of using a virtual reality-based treadmill training program to improve gait and balance in subacute stroke patients.

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