scholarly journals Virtual Reality for Stroke Rehabilitation: assessment, training and the effect of virtual therapy

2011 ◽  
Vol 14 (2) ◽  
pp. 23-32 ◽  
Author(s):  
Paweł Kiper ◽  
Andrea Turolla ◽  
Lamberto Piron ◽  
Michela Agostini ◽  
Alfonc Baba ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Function ◽  
Negative Impact ◽  
Innovative Technology ◽  
Rehabilitation Outcomes ◽  
Function Impairment ◽  
Sensory Modalities ◽  
Task Practice ◽  
Adaptive Nature ◽  
Virtual Therapy

The motor function impairment deriving from stroke injury has a negative impact on autonomy and on the activities of daily living. Several studies have demonstrated that learning new motor skills is important to induce neuroplasticity and functional recovery. To facilitate the activation of brain areas and consequently neuroplasticity, it may be advantageous to combine traditional motor rehabilitation with innovative technology, in order to promote motor re-learning and skill re-acquisition by means of an enhanced training. Following these principles, exercises should involve multiple sensory modalities exploiting the adaptive nature of the nervous system, in order to promote active patient participation. Movement re-learning could be improved by means of training in an enriched environment focused on optimizing the affordances between the motor system and the physical environment: virtual reality technologies allow for the possibility to create specific settings where the affordances are optimized. Several autors report that patients treated in virtual representation could, in both acute and chronic stroke, improve their arm motor function. Reinforced Feedback in a Virtual Environment (RFVE), can incorporate the elements necessary to maximize motor learning, such as repetitive and differentiated task practice, feedback of performance and results, and reinforcement of the motivation. The RFVE approach may lead to better rehabilitation outcomes in the treatment of the upper limb in stroke patients.

scholarly journals The application of virtual reality in neuro-rehabilitation: motor re-learning supported by innovative technologies

2014 ◽  
Vol 17 (4) ◽  
pp. 29-36 ◽  
Author(s):  
Paweł Kiper ◽  
Andrzej Szczudlik ◽  
Elżbieta Mirek ◽  
Roman Nowobilski ◽  
Józef Opara ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Learning ◽  
Virtual Environment ◽  
Motor Function ◽  
Negative Impact ◽  
Sensory Information ◽  
Specific Treatment ◽  
Innovative Technology ◽  
Innovative Technologies ◽  
Task Practice

The motor function impairment resulting from a stroke injury has a negative impact on autonomy, the activities of daily living thus the individuals affected by a stroke need long-term rehabilitation. Several studies have demonstrated that learning new motor skills is important to induce neuroplasticity and functional recovery. Innovative technologies used in rehabilitation allow one the possibility to enhance training throughout generated feedback. It seems advantageous to combine traditional motor rehabilitation with innovative technology in order to promote motor re-learning and skill re-acquisition by means of enhanced training. An environment enriched by feedback involves multiple sensory modalities and could promote active patient participation. Exercises in a virtual environment contain elements necessary to maximize motor learning, such as repetitive and diffe-rentiated task practice and feedback on the performance and results. The recovery of the limbs motor function in post-stroke subjects is one of the main therapeutic aims for patients and physiotherapist alike. Virtual reality as well as robotic devices allow one to provide specific treatment based on the reinforced feedback in a virtual environment (RFVE), artificially augmenting the sensory information coherent with the real-world objects and events. Motor training based on RFVE is emerging as an effective motor learning based techniques for the treatment of the extremities.

scholarly journals Combining tDCS With a Motor-Cognitive Task to Reduce the Negative Impact of Dual-Tasking on the Gait of Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 287-288
Author(s):  
Jeffrey Hausdorff ◽  
Nofar Schneider ◽  
Marina Brozgol ◽  
Pablo Cornejo Thumm ◽  
Nir Giladi ◽  
...  
Keyword(s):  
Older Adults ◽  
Virtual Reality ◽  
Executive Function ◽  
Dual Task ◽  
Gait Speed ◽  
Negative Impact ◽  
Virtual Reality Environment ◽  
Dual Tasking ◽  
Concurrent Performance ◽  
Dual Task Cost

Abstract The simultaneous performance of a secondary task while walking (i.e., dual tasking) increases motor-cognitive interference and fall risk in older adults. Combining transcranial direct current stimulation (tDCS) with the concurrent performance of a task that putatively involves the same brain networks targeted by the tDCS may reduce the negative impact of dual-tasking on walking. We examined whether tDCS applied while walking reduces the dual-task costs to gait and whether this combination is better than tDCS alone or walking alone (with sham stimulation). In 25 healthy older adults (aged 75.7±10.5yrs), a double-blind, within-subject, cross-over pilot study evaluated the acute after-effects of 20 minutes of tDCS targeting the primary motor cortex and the dorsal lateral pre frontal cortex during three separate sessions:1) tDCS while walking on a treadmill in a virtual-reality environment (tDCS+walking), 2) tDCS while seated (tDCS+seated), and 3) walking in the virtual-reality environment with sham tDCS (sham+walking). The complex walking condition taxed motor and cognitive abilities. During each session, single- and dual-task walking and cognitive function were assessed before and immediately after stimulation. Compared to pre-tDCS performance, tDCS+walking reduced the dual-task cost to gait speed (p=0.004) and other gait features (e.g., variability p=0.02), and improved (p<0.001) executive function (Stroop interference score). tDCS+seated and sham+walking did not affect the dual-task cost to gait speed (p>0.17). These initial findings demonstrate that tDCS delivered during challenging walking ameliorates dual-task gait and executive function in older adults, suggesting that the concurrent performance of related tasks enhances the efficacy of the neural stimulation and mobility.

scholarly journals A performance model for mobile robot-based part feeding systems to supermarkets

2021 ◽  
Author(s):  
Emilio Moretti ◽  
Elena Tappia ◽  
Martina Mauri ◽  
Marco Melacini
Keyword(s):  
Negative Impact ◽  
Positive Impact ◽  
Waiting Times ◽  
Performance Model ◽  
Innovative Technology ◽  
Shop Floor ◽  
Storage And Retrieval ◽  
Trade Offs ◽  
Part Feeding ◽  
Feeding Systems

AbstractIn a context where companies are striving to produce highly customised goods in small batches and within short lead times, increasing attention is being put on the design and management of part feeding systems. This research is the first to model automated part feeding to supermarkets in a factory environment, considering an innovative technology called vertical robotic storage and retrieval systems. This technology allows automating the storage, picking, and internal transportation activities in an integrated process, thanks to rack-climbing robots roaming in both the shop floor and the storage racks. We develop an analytical model based on the queuing network approach to analyse the system performance, and we use it to perform numerical experiments and to evaluate the design trade-offs with reference to a real case in the automotive industry. Results show that an increase in the number of robots leads to better performance since the positive impact on the response time is stronger than the negative impact on the waiting times of robots at the supermarkets due to congestion. Furthermore, a configuration with multiple small supermarkets improves the efficiency of the replenishment process, compared to a setting with few big supermarkets.

Who is in the Room? Notification for Intrusions While in Virtual Reality

2020 ◽  
Vol 64 (1) ◽  
pp. 521-525
Author(s):  
Aaron Crowson ◽  
Zachary H. Pugh ◽  
Michael Wilkinson ◽  
Christopher B. Mayhorn
Keyword(s):  
Virtual Reality ◽  
Visual Field ◽  
Physical World ◽  
Visual Modality ◽  
Auditory Modality ◽  
Oculus Rift ◽  
Head Mounted Display ◽  
Sensory Modalities ◽  
Orientation Type

The development of head-mounted display virtual reality systems (e.g., Oculus Rift, HTC Vive) has resulted in an increasing need to represent the physical world while immersed in the virtual. Current research has focused on representing static objects in the physical room, but there has been little research into notifying VR users of changes in the environment. This study investigates how different sensory modalities affect noticeability and comprehension of notifications designed to alert head-mounted display users when a person enters his/her area of use. In addition, this study investigates how the use of an orientation type notification aids in perception of alerts that manifest outside a virtual reality users’ visual field. Results of a survey indicated that participants perceived the auditory modality as more effective regardless of notification type. An experiment corroborated these findings for the person notifications; however, the visual modality was in practice more effective for orientation notifications.

scholarly journals Virtual reality applied to the lower limb motor function in post-stroke individuals

2016 ◽  
Vol 23 (3) ◽  
Author(s):  
Marcos Paulo Braz de Oliveira ◽  
Daiane Marques Ferreira ◽  
Josie Resende Torres da Silva ◽  
Andreia Maria Silva ◽  
Daniel Ferreira Moreira Lobato ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Motor Function ◽  
Lower Limb ◽  
Post Stroke

Abstract 144: Forced Aerobic Exercise Enhances Upper Extremity Task Practice in Patients with Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Susan Linder ◽  
Anson Rosenfeldt ◽  
Jay Alberts
Keyword(s):  
Aerobic Exercise ◽  
Upper Extremity ◽  
Motor Function ◽  
Cardiovascular Health ◽  
Statistical Significance ◽  
Voluntary Exercise ◽  
Depressive Symptomology ◽  
Task Practice ◽  
The Central Nervous System ◽  
Minute Session

Introduction: Aerobic exercise (AE) has been shown to improve cardiovascular health in individuals with stroke; however, the potential role of AE in enhancing neuroplasticity after stroke has not been systematically studied. We have implemented a forced exercise (FE) cycling intervention, initially developed for individuals with Parkinson’s disease, with a cohort of individuals with chronic stroke. We hypothesize that intensive AE training, when paired with repetitive task practice (RTP), will “prime” the central nervous system, to exploit the motor learning effects of task practice. Hypothesis: Individuals who perform FE followed by RTP will demonstrate greater improvements in motor and non-motor function compared to the voluntary rate aerobic exercise (VE) + RTP and RTP only groups. Individuals in both AE groups (FE and VE) will demonstrate greater improvements in VO2peak compared to the RTP only group. Methods: Fifteen individuals 6-12 months post-stroke were enrolled into one of the following groups: 1) Forced Exercise + RTP (FE + RTP); 2) Voluntary Exercise + RTP (VE + RTP); and 3) Time-matched RTP. Participants in the AE groups completed one 45-minute session of stationary cycling followed immediately by one 45-minute session of upper extremity RTP; however, the rate of cycling for the FE group was augmented to approximately 35% faster than their voluntary rate. All participants completed a total of 24 exercise sessions over an 8-week period. Results: While all three groups made significant improvements in motor function as measured by the Fugl-Meyer Assessment (p=.03), the FE+RTP group exceeded the VE+RTP and RTP only groups, approaching statistical significance (p=0.06), despite the two AE groups completing 44% less RTP practice time than the RTP group. Improvements in self-reported quality of life and depressive symptomology also improved across all three groups, with trends favoring the FE group. VO2peak improved by 1.1 and 2.68 mL/kg/min for the FE+RTP and VE+RTP groups, respectively; while VO2peak decreased by 0.85mL/kg/min in the RTP group. Conclusion: FE + RTP is a promising intervention to enhance motor and non-motor function, in addition to aerobic capacity in individuals 6-12 months after stroke.

Focus on Patient in Virtual Reality-Assisted Rehabilitation

2018 ◽  
pp. 1422-1450 ◽  
Author(s):  
Stefano Mottura ◽  
Luca Fontana ◽  
Sara Arlati ◽  
Claudia Redaelli ◽  
Andrea Zangiacomi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Emotional State ◽  
Models Of Care ◽  
Point Of View ◽  
Self Awareness ◽  
Patient Centered ◽  
Natural Interaction ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs

Since several years scientists are carrying on research about innovative systems, based on robotics, mechatronics devices and IT tools – especially the graphical ones – to support patients in rehabilitation programs for rescuing from various brain damages due to adverse events as stroke. Training sessions with a combination of robot and virtual reality (VR) lead to better rehabilitation outcomes than using only a robot and evidence from the field proved the importance of the use of VR interfaces in rehabilitation. The main aim of such a kind of environments is to monitor, motivate and drive the patient during the rehabilitation sessions. These systems mainly provide motor guidance and multimedia communication channels also measuring patients' performance and other observable variables. The approach implemented is usually based on gaming, where the patient has the key role to perform certain tasks or movements for controlling the game in the correct way and exercise the injured part. According to daily experience from physiotherapists, different aspects related to the physical and self-perceived patients' state revealed to have a fundamental role in influencing the rehabilitation session. Indeed, the treatment result depends not only on motor skills but also on patient's personal behavior and feelings that are not directly investigable, observable and measurable from outside. In other words this kind of elements can only be assessed by subjective measurements (as questions, interviews, narratives) revealing the point of view of the patient. Moreover, the emotional state has implications at different levels: on one hand, it is important to evaluate if the single rehabilitation session affects the emotional state of the patient, on the other, if the performance was influenced by this state. Some answers of a questionnaire administrated to post-stroke patients in a previous study underlined also the need for the patient to focus his/her attention on the trained body portion and the relevance of a visual feedback on movements to increase self-awareness on the action performed, avoiding any possible distraction derived from other kind of tasks and related visual/auditory stimuli. Patient-centered models of care are actually becoming increasingly common among rehabilitation clinical settings. They help to focus the therapy on improving the treatment of those deficiencies that most influence the quality of life of the patient. Another important aspect is represented by the relationship with the caregiver that in virtually assisted rehabilitation would not be direct anymore and will need to be mediated without completely loosing natural interaction. According to this patient centered vision, and in order to reduce possible side effects related to semi-automatic rehabilitation systems, it has been studied and developed a system which has not the aim of merely entertain the patient but to focalize the rehabilitation on him/her as a proactive character aware of what is happening and of the quality of the work performed.

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