Differing effects of an immersive virtual reality programme on unilateral spatial neglect on activities of daily living

Background: Robot-assisted arm training (RAT) is an innovative exercise-based therapy that provides highly intensive, adaptive, and task-specific training, yet its effects for stroke individuals with unilateral spatial neglect remain to be explored. The study was aimed to investigate the effects of RAT on unilateral spatial neglect, arm motor function, activities of daily living, and social participation after stroke.Methods: In a pilot randomized controlled trial, individuals with unilateral spatial neglect after right hemisphere stroke were equally allocated to intervention group and control group, 45-min training daily, 5 days/week, for 4 weeks. Outcome measures included the Behavioral Inattention Test-conventional section (BIT-C), Catherine Bergego Scale (CBS), Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Modified Barthel Index (MBI), and World Health Organization Disability Assessment Schedule Version 2.0 (WHODAS 2.0).Results: From November 2018 to February 2021, 20 stroke patients (mean age 47.40 ± 8.47) were enrolled in the study. Robot-assisted arm training was feasible and safe for individuals with unilateral spatial neglect. Both groups had significant improvements in all outcome measures. Participants assigned to RAT therapy had significantly greater improvements in BIT-C (difference, 7.70; 95% CI, 0.55–14.85, P = 0.04), FMA-UE (difference, 5.10; 95% CI, 1.52–8.68, P = 0.01), and WHODAS 2.0 (difference, −7.30; 95% CI, −12.50 to −2.10, P = 0.01). However, the change scores on CBS and MBI demonstrated no significance between the groups.Conclusion: Our findings provide preliminary support for introducing robot-assisted arm training to remediate unilateral spatial neglect after stroke. The training program focusing on neglect of contralateral space and affected upper extremity may be effective in neglect symptoms, motor function recovery, and social participation, while not generalizing into improvements in activities of daily living.Clinical Trial Registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn/) on 17 October 2019, identifier: ChiCTR1900026656.

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Rehabilitation training based on virtual reality for patients with Parkinson’s disease in improving balance, quality of life, activities of daily living, and depressive symptoms: A systematic review and meta-regression analysis

Clinical Rehabilitation ◽

10.1177/0269215521995179 ◽

2021 ◽

pp. 026921552199517

Author(s):

Runze Li ◽

Yanran Zhang ◽

Yunxia Jiang ◽

Mengyao Wang ◽

Wei How Darryl Ang ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Virtual Reality ◽

Depressive Symptoms ◽

Activities Of Daily Living ◽

Daily Living ◽

Meta Analysis ◽

Rehabilitation Training

Objective: To examine the effectiveness of rehabilitation training based on virtual reality in improving balance, quality of life, activities of daily living, and depressive symptoms of patients with Parkinson’s disease. Data sources: PubMed, EMBASE, CINAHL, Scopus, Cochrane Library, PsycINFO, ProQuest, Physiotherapy Evidence Database, IEEE Xplore, China National Knowledge Infrastructure, Wanfang, and VIP Information databases were searched from their inception to October 15, 2020. Trial registries, gray literature, and target journals were also searched. Methods: Eligible randomized controlled trials included studies with patients with Parkinson’s disease in rehabilitation training based on virtual reality. Comprehensive Meta-Analysis 3.0 software was used. Physiotherapy Evidence Database Scale and the Grading of Recommendation, Assessment, Development, and Evaluation system were used to assess the methodological quality of individual trials and the overall quality of the evidence, respectively. Results: A total of 22 randomized controlled trials with 836 patients were included. Meta-analysis revealed that training significantly improved balance ( g = 0.66, P < 0.001), quality of life ( g = 0.28, P = 0.015), activities of daily living ( g = 0.62, P < 0.001), and depressive symptoms ( g = 0.67, P = 0.021) compared to the control group. Subgroup analysis indicated that training should utilize video game consoles. Meta-regression analyses showed that age, sessions, and frequency of training had statistically significant impacts on balance scores. Quality of individual trials was high and overall evidence ranged from very low to low. Conclusion: Virtual rehabilitation training could be adopted in healthcare institutions as supplementary training for patients with Parkinson’s disease.

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Reabilitação do equilíbrio postural com o uso de jogos de realidade virtual

Revista Científica FAEMA ◽

10.31072/rcf.v8i1.443 ◽

2017 ◽

Vol 8 (1) ◽

pp. 161

Author(s):

Luana Hilario de Meireles Lima ◽

Diego Santos Fagundes ◽

Miguel Furtado Menezes ◽

Maiara Lazaretti Rodrigues Do Prado ◽

Michele Thais Favero

Keyword(s):

Virtual Reality ◽

Activities Of Daily Living ◽

Therapeutic Intervention ◽

Postural Balance ◽

Daily Living ◽

Review Of The Literature ◽

Risk Of Falls ◽

Balance Deficits ◽

Technological Tool ◽

Traditional Therapies

Os déficits de equilíbrio postural podem levar a limitações nas atividades de vida diária, reduzindo a autonomia e aumentando o risco de quedas dos indivíduos. A fisioterapia dispõe de uma variedade de recursos que podem ser utilizados para a reabilitação do equilíbrio postural, e a realidade virtual é um dos recursos que vem sendo utilizado com este objetivo, pois através de repetição, feedback e motivação, pode proporcionar ao usuário maior controle do equilíbrio postural. Objetivo: Revisar a literatura existente sobre os efeitos das intervenções com jogos de realidade virtual na reabilitação de déficits de equilíbrio postural. Método: Foi realizada uma revisão de literatura utilizando Descritores em Ciências da Saúde (DECs), com análise de publicações impressas em livros do acervo da Biblioteca Júlio Bordignon da Faculdade de Educação e Meio Ambiente – FAEMA, e consulta de trabalhos indexados e publicados nas bases de dados LILACS, SCIELO, PubMed e Google Acadêmico. Considerações Finais: Os estudos analisados apontam que a intervenção terapêutica com o uso da realidade virtual como uma ferramenta tecnológica para a reabilitação do equilíbrio postural mostrou ser de grande importância e poderia auxiliar as terapias tradicionais, no entanto, mais estudos serão necessários para entender qual é o mecanismo pelo qual a realidade virtual atua melhorando o equilíbrio postural. ABSTRACT: Postural balance deficits can lead to limitations in activities of daily living, reducing autonomy and increasing the risk of falls of individuals. Physiotherapy has a variety of resources that can be used for the rehabilitation of postural balance, and virtual reality is one of the resources that has been used with this objective, because through repetition, feedback and motivation can provide the user greater control of the postural balance. Aim: To review the existing literature on the effects of interventions with virtual reality games in the rehabilitation of postural balance deficits. Method: A review of the literature was performed with Descritores em Ciências da Saúde (DECs) an analysis of publications printed on books from the Júlio Bordignon Library of the Faculdade de Educação e Meio Ambiente - FAEMA, and confer of papers indexed and published in the databases LILACS, SCIELO, PubMed and Google Scholar. Conclusions: The studies analyzed indicate that therapeutic intervention with the use of virtual reality as a technological tool for the rehabilitation of postural balance has been shown to be of great importance and could help traditional therapies; however, further studies will be necessary to understand the mechanism by which virtual reality works by improving postural balance.

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Effects of Home Environment Modification Service With Virtual Reality-Based Intervention for Activities of Daily Living

The Journal of Korean Society of Occupational Therapy ◽

10.14519/kjot.2021.29.2.03 ◽

2021 ◽

Vol 29 (2) ◽

pp. 31-44

Author(s):

Yumi Ju ◽

◽

Eun-Hwa Jeong ◽

Jeh-Kwang Ryu

Keyword(s):

Virtual Reality ◽

Activities Of Daily Living ◽

Home Environment ◽

Daily Living

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The Use of Virtual Reality Tools for the Assessment of Executive Functions and Unilateral Spatial Neglect

Advances in Medical Technologies and Clinical Practice - Virtual Reality Enhanced Robotic Systems for Disability Rehabilitation ◽

10.4018/978-1-4666-9740-9.ch007 ◽

2016 ◽

pp. 115-140 ◽

Cited By ~ 2

Author(s):

Elisa Pedroli ◽

Silvia Serino ◽

Alice Chicchi Giglioli ◽

Federica Pallavicini ◽

Pietro Cipresso ◽

...

Keyword(s):

Virtual Reality ◽

Executive Functions ◽

Neuropsychological Assessment ◽

Spatial Neglect ◽

Advanced Technology ◽

Daily Activities ◽

Medical Decision ◽

Evidence Based ◽

Unilateral Spatial Neglect ◽

Future Challenges

Virtual Reality is one of the most promising tools in the development of new methods for neuropsychological assessment and rehabilitation. Neuropsychological assessment is typically carried out by administering paper-and-pencil tests to patients. However, these tests have some limitations, due to the fact that they are not effectively able to evaluate the subject's performance of daily activities. To cope with this void, neuropsychologists base their evaluation on their clinical experience, often successfully. Nevertheless, this is not an evidence-based practice, thus it is not considered optimal from a medical decision-making perspective. More recently, however, the increasing accessibility of advanced technology such as virtual reality has opened new possibilities for neuropsychological assessment and rehabilitation. Starting with this frame, the chapter explores the changes that have occurred over time in the neuropsychological assessment and rehabilitation up to the most recent VR-based tools. In particular, we will present a VR-based PC tool for the assessment of executive functions, and a VR-based mobile tool for the assessment and rehabilitation of unilateral spatial neglect. In accordance with the literature, we show the potential for virtual reality, highlighting the advantages, limitations, and the possible future challenges.

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