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What is your take on " Virtual Reality " in rehabilitation Engineering?
What is your take on " Virtual Reality " in rehabilitation Engineering?
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Virtual reality (VR) technologies use multimedia devices and computer simulation to allow users to interact with a simulated environment, creating life-like experience. Display devices present sensory information, such as vision, auditory, and touch, sense, to the user. Rehabilitation in healthcare refers to the treatment and process to restore good health and regain impaired functions and abilities. Virtual Reality (VR) has recently emerged as a valid addition to conventional therapy by incorporating rehabilitation strategies in a novel and low-cost approach. Virtual environments can be customized by designing tasks that fit the individual’s cognitive and physical impairments, which is critical in maximizing brain reorganization and reactivating those brain areas involved in motor planning, learning, and execution.Many studies have examined VR as a tool to assess the level and type of cognitive impairment. In contrast to the high number of rehabilitation assessment studies, there are very few studies that have investigated VR applications in rehabilitation training and exercise. In a case report in 2001, a 65-year old woman with impaired memory functions received a 24-week rehabilitation exercise with both music-story therapy and HMD-VR experiences (Pentium III) that visualized the scenes told in the stories. The results showed improved clinical conditions, and the authors suggested that the interactive and immersive features of VR could benefit music-enhanced therapy and better involve the patient during the training. VR can be really effective rehabilitation tool.
VR applications in rehabilitation
Sensory impairments
Physical impairments
Cognitive and behavioral impairments
Orthopedic and mobility impairments.
Physical interactions with environments that are
partially or wholly computer-generated allow a
person to focus on a particular aspect of
functional recovery without exposure to
potentially dangerous situations.For example, practicing stepping over virtual
obstacles during harnessed treadmill walking is
safer than stepping over blocks in the clinic
while aided by a therapist. As proficiency,
coordination, and strength improve, the more
complex realities of real-world situations can be
attempted with increased confidence.
Virtual Reality (VR) has recently emerged as a valid addition to conventional therapy by incorporating rehabilitation strategies in a novel and low-cost approach .VR-based
therapy can provide a positive learning experience, and be engaging and motivating.
With VR-based therapy, tasks can be tailored to the patients’ needs, with imitation or video-game like activities. Virtual environments can be customized by designing tasks that fit the individual’s cognitive and physical impairments, which is critical in maximizing brain reorganization and reactivating those brain areas involved in motor planning, learning, and execution, as well as in maintaining engagement.
VR mediated therapy has also yielded significant improvements in gait rehabilitation following a stroke. Additional biosensors such as Inertial Measurement Units (IMUs), force sensors, and EMG sensors are also used to track progress in the patients’ kinematics, movement dynamics, and muscle activation. Real-time visualization of these parameters allows therapists to provide patients with timely feedback on the progress and quality of tasks they perform, giving them the opportunity to understand and correct possible mistakes.
Furthermore, the adjustable practice and customizable environments enable therapists to design dual tasks and unexpected situations, so that patients can relearn to adapt to environmental changes while walking. Results have shown that VR-trained patients can more effectively increase their gait speed as demanded by the task when compared to patients that underwent traditional rehabilitation. With practice, they can better adapt their gait with respect to the change in the surrounding environment.
Advantage
The advantage of virtual reality is that the possibilities are essentially endless.
Virtual Reality in education field makes education more easily and comfort.
Virtual Reality user can experiment with an artificial environment.
Disadvantage
Virtual Reality user can experiment with an artificial environment.
Escapism is common place among those that use VR environments and people often live in the virtual world instead of dealing with the real one.
: Think about reaching for an object. It feels like a simple process, yet in reality it’s a complex act. This action relies on a combination of motor acts that are processed at many different levels in the brain and body. For people with motor impairments following neurological injury, what looks to be an everyday task like eating, typing an email, reading a book, can become a challenge.
: When thinking about traditional rehabilitation, what does it come to mind? It’s boring! It is repetitive by nature, and these repetitions reduce patients’ motivation over time. Additionally, it requires (at least!) one therapist to work 1:1 with the patient, increasing the need for resources and therefore, the costs for the healthcare system. Moreover, it doesn’t provide objective data and the ability to monitor the portion of therapy patients complete at home.
Researchers are seeking novel methodologies to improve and make motor rehabilitation more engaging and effective. Virtual Reality (VR) has recently emerged as a valid addition to conventional therapy by incorporating rehabilitation strategies in a novel and low-cost approach . VR-based therapy can provide a positive learning experience, and be engaging and motivating.
: Real-time visualization of these parameters allows therapists to provide patients with timely feedback on the progress and quality of tasks they perform, giving them the opportunity to understand and correct possible mistakes.
: VR provides a more advanced digital rehabilitation methods as an alternative to traditional therapy, thus maximizing the effect of rehabilitation measures.
It allows patients with different neurological disorders to execute actions they are not able to perform in real life due to their disabilities.
Virtual Reality (VR) is the use of computer technology to create a simulated environment. Unlike traditional user interfaces, VR places the user inside an experience. Instead of viewing a screen in front of them, users are immersed and able to interact with 3D worlds. By simulating as many senses as possible, such as vision, hearing, touch, even smell, the computer is transformed into a gatekeeper to this artificial world. The only limits to near-real VR experiences are the availability of content and cheap computing power.Virtual Reality’s most immediately-recognizable component is the head-mounted display (HMD). Human beings are visual creatures, and display technology is often the single biggest difference between immersive Virtual Reality systems and traditional user interfaces. For instance, CAVE automatic virtual environments actively display virtual content onto room-sized screens. While they are fun for people in universities and big labs, consumer and industrial wearables are the wild west.
Rehabilitation engineering refers to the development and application of techniques, devices, and protocols for restoring function following disability. Although in most cases the concept relates to motor functions (e.g., training after a stroke or the use of limb prosthetics ) , mental rehabilitation engineering is also an emerging area. When thinking about traditional rehabilitation, what does it come to mind? It’s boring! It is repetitive by nature, and these repetitions reduce patients’ motivation over time. Additionally, it requires (at least!) one therapist to work 1:1 with the patient, increasing the need for resources and therefore, the costs for the healthcare system. Moreover, it doesn’t provide objective data and the ability to monitor the portion of therapy patients complete at home. the advantage of virtual reality is that the possibilities are essentially endless. Virtual environments can be customized by designing tasks that fit the individual’s cognitive and physical impairments, which is critical in maximizing brain reorganization and reactivating those brain areas involved in motor planning, learning, and execution [5, 6], as well as in maintaining engagement. VR mediated therapy has also yielded significant improvements in gait rehabilitation following a stroke.
VR interventions to retrain gait frequently comprise treadmill training systems in combination with a screen or a head-mounted device to create an immersive environment. Additional biosensors such as Inertial Measurement Units (IMUs), force sensors, and EMG sensors are also used to track progress in the patients’ kinematics, movement dynamics, and muscle activation. Real-time visualization of these parameters allows therapists to provide patients with timely feedback on the progress and quality of tasks they perform, giving them the opportunity to understand and correct possible mistakes.
Virtual reality (VR) has emerged as a therapeutic tool facilitating motor learning for balance and gait rehabilitation. The evidence, however, has not yet resulted in standardized guidelines. The aim of this study was to systematically review the application of VR-based rehabilitation of balance and gait in 6 neurologic cohorts, describing methodologic quality, intervention programs, and reported efficacy.
This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. VR-based treatments of Parkinson disease, multiple sclerosis, acute and chronic poststroke, traumatic brain injury, and cerebral palsy were researched in PubMed and Scopus, including earliest available records. Therapeutic validity (CONTENT scale) and risk of bias in randomized controlled trials (RCT) (Cochrane Collaboration tool) and non-RCT (Newcastle-Ottawa scale) were assessed.
Ninety-seven articles were included, 68 published in 2013 or later. VR improved balance and gait in all cohorts, especially when combined with conventional rehabilitation. Most studies presented poor methodologic quality, lacked a clear rationale for intervention programs, and did not utilize motor learning principles meticulously. RCTs with more robust methodologic designs were widely recommended.
Our results suggest that VR-based rehabilitation is developing rapidly, has the potential to improve balance and gait in neurologic patients, and brings additional benefits when combined with conventional rehabilitation. This systematic review provides detailed information for developing theory-driven protocols that may assist overcoming the observed lack of argued choices for intervention programs and motor learning implementation and serves as a reference for the design and planning of personalized VR-based treatments.
Virtual Reality (VR) is a recent digital invention that is steadily changing the way we live as well as significantly improving our daily well-being and health.
VR places the user inside the virtual experience, instead of having just to show a screen. Virtual technologies can simulate different senses like vision, hearing, smelling or even touching and other actions.
Physical therapy and rehabilitation with VR
Virtual reality technology allows physical and neurology therapists to make the therapy process engaging and what importantly more effective than usual exercises.
Under medical research, patients do only 30% of the needed exercises during rehabilitation.
Here come VR technologies. They can combine physical exercises into virtual games and customize the program for every patient including neuro impaired people.
As a great example of such a tool is VR physical therapy system developed by HTC Vive.
Virtual reality can be used in fears and phobias treatment and post-traumatic stress disorder recovering. Thorough virtual world patients are faced with their fears slowly and in such a way can compete with such disorders.
Making patients feel like staying at home via VR during long in-hospital treatment
The need to stay at the hospital during long-term treatment is always stressful and hard psychologically for all patients and especially for children missing their parents and friends. Virtual reality glasses can help to get rid of any stress caused by staying at the hospital.
Conclusively, virtual reality is set to revolutionize the outlook of the healthcare industry. It can be used in fields ranging from developing new life-saving techniques, helping in rehabilitation and pain or phobias management to training the doctors for the needs that the future will demand.
VIRTUAL REALITY IN REHABLITATION
Researchers are seeking novel methodologies to improve and make motor rehabilitation more engaging and effective. Virtual Reality (VR) has recently emerged as a valid addition to conventional therapy by incorporating rehabilitation strategies in a novel and low-cost approach . VR-based therapy can provide a positive learning experience, and be engaging and motivating.
With VR-based therapy, tasks can be tailored to the patients’ needs, with imitation or video-game like activities. The advantage of virtual reality is that the possibilities are essentially endless. Virtual environments can be customized by designing tasks that fit the individual’s cognitive and physical impairments, which is critical in maximizing brain reorganization and reactivating those brain areas involved in motor planning, learning, and execution [5, 6], as well as in maintaining engagement.
Researchers at the University of South Carolina combine the principles of VR and Brain Computer Interface (BCI) to treat chronic stroke survivors with different levels of motor impairment [7]. Their multimodal approach uses virtual reality to show patients avatars of their upper limbs; then, combine brain (electroencephalography, or EEG) and muscle (electromyography, or EMG) sensors and signals to visualize their attempted movement to perform the presented task. Over time, this has shown to improve the patients’ motor-imagery (their ability to imagine and plan movements), re-engage the motor circuits, and improve recovery of upper limb motor functions.
VR mediated therapy has also yielded significant improvements in gait rehabilitation following a stroke. VR interventions to retrain gait frequently comprise treadmill training systems in combination with a screen or a head-mounted device to create an immersive environment. Additional biosensors such as Inertial Measurement Units (IMUs), force sensors, and EMG sensors are also used to track progress in the patients’ kinematics, movement dynamics, and muscle activation. Real-time visualization of these parameters allows therapists to provide patients with timely feedback on the progress and quality of tasks they perform, giving them the opportunity to understand and correct possible mistakes.
However, initial results from pilot studies are highly encouraging, especially for post-stroke chronic patients, and provide insights on the effectiveness of VR-based motor rehabilitation, including:
· It provides a more advanced digital rehabilitation methods as an alternative to traditional therapy, thus maximizing the effect of rehabilitation measures.
· It allows patients with different neurological disorders to execute actions they are not able to perform in real life due to their disabilities.
· It can provide individualized treatment plans developed on the basis of careful assessment and following case-by-case treatment goals.
· It enhances patient’s engagement and motivation with 3D virtual environments and video game-like tasks.
· It provides immediate and illustrative feedback.
· It improves outcomes through neurophysiological measurements and analysis.
· It provides a controlled environment for telerehabilitation.
I hope you’ve enjoyed reading about the use of VR in rehabiliation, if you’d like to learn more about using VR devices with iMotions, download our brochure below.
Recently, VR is used more to specifically referring to systems using head-mounted displays (HMDs), which can create 3D depth perception and change the view as the head moves. rehabilitation in healthcare refers to the treatment and process to restore good health and regain impaired functions and abilities. The impaired functions can be categorized into physical and cognitive groups. Physical functions include movement and control of physical body parts such as limbs, hands, fingers, and head. In contrast, cognitive functions are related to information processing such as vision, hearing, task execution, memory, and decision.
VR in Rehabilitation Assessment:-
A simple driving simulation with PC and a projector, which allows a user to navigate a virtual city or town passively as a passenger or actively as a driver. After the exploration, participants' episodic memory about the virtual place was tested in recall and recognition questions.
VR for Rehabilitation Exercise:-
The VR environment simulates a clothes shop where the patient was trained for a shop clerk job, performing tasks such as sorting clothes and handling customers' requests. The results showed that VR vocational training was more effective than therapist administered vocational training and conventional training without the shop scenario, in terms of better problem solving and executive control abilities measured by Wisconsin Card Sorting Test and better self-efficacy scores. The findings suggest that an immersive environment and real-world purposes are both important in rehabilitation. It would be interesting to compare VR implemented on HMDs and desktop displays. Since 2D displays are less expensive and more available, if VR training using desktop displays can be equally effective for certain types of exercises, there will be no need to use HMDs
Potential Advantages and side-effects of VR in Rehabilitation:-
1. Increase the degrees of immersion and interaction (especially HMD-VR), making the exercise interesting and motivating persistent practice. 2. Allow tests and exercise of activities (such as driving) that would be too dangerous for patients to do in the real world. 3. Allow tests and exercise (such as visual perception and field of view tasks) that are otherwise too difficult, time-consuming, or impossible to do in the real world.VR also offers improved standardization of protocols, better control of stimulus presentation, and easier collection of response measures. Some of the drawbacks include eye strains such as eye dryness etc and VR devices may agitate schizophrenia patients with persecutory delusion and paranoia
"Virtual Reality" in Rehabilitation Engineering:
Virtual reality (VR) technologies use multimedia devices and computer simulation to allow users to interact with a simulated environment, creating life-like experience.
One of the most valuable applications of virtual reality (VR) is in the
domain of rehabilitation. After brain injuries or diseases, many patients suffer
from impaired physical and/or cognitive capabilities, such as difficulties in
moving arms or remembering names. Over the past two decades, VR has been
tested and examined as a technology to assist patients' recovery and rehabilitation, both physical and cognitive.
The increasing prevalence of low-cost VR devices brings new opportunities, allowing VR to be used in practice. Using VR devices such as head-mounted displays (HMDs), special virtual scenes can be
designed to assist patients in the process of re-training their brain and reorganizing their functions and abilities.
However, such VR interfaces and applications must be comprehensively tested and examined for their effectiveness and potential side effects. This paper presents a review of related literature and discussesthe new opportunities and challenges.
Most of existing studies examined VR as an assessment method rather than a training/exercise method. Nevertheless, promising cases and positive preliminary results have been shown. Considering the increasing need for self-administered, home-based, and personalized rehabilitation, VR rehabilitation is potentially an important approach.
VIRTUAL REALITY
Virtual Reality is a trending technology that gives excellent scope to diverse businesses to take a leap and simulate physical presence in the real world as well as the imaginary world.
VR Based Telerehabilitation.
For stroke survivors, maintaining a daily therapy routine increases the probability of positive rehabilitation outcomes. However, millions of patients in the US and Europe live in rural areas and don’t have easy access to therapists, which can force them to choose between costly daily travel to urban areas, or foregoing the beneficial treatments.
In these conditions, maintaining the patients’ motivation becomes a challenge. Additionally, for the portion of therapy that patients complete at home, the inability to monitor their compliance with the prescribed exercise regimen makes traditional rehabilitation outcomes difficult to predict, and potentially less likely to succeed.
Today, telerehabilitation based on virtual reality is an area of active research. Therapists using VR-based telerehabilitation can prescribe exercise routines via the web which are then easily accessed and executed by patients from the comfort of their homes. VR-based tasks provide patients with a controlled environment where they can exercise. Clinical measures are collected in real time and stored in online databases, accessible remotely.
Therapists can thus monitor the patients’ progress via the web and modify the therapy as needed without real-time interaction or training. In this way, therapists are able to monitor several patients exercising simultaneously at home, a big step forward from the 1:1 paradigm of traditional methods and a big cut of costs.
Advantages of Virtual Reality Rehabilitation:
Patient motivation.
Adaptability and variability based on patient baseline.
Online remote data access.
Reduced Medical Costs.
Disadvantages of Virtual Reality Rehabilitation:
Issues generated by the human-computer interfaces that it uses, which may seem unnatural for first time users.
Immersion issues may influence the quality of the rehabilitation process, and also compatibility issues between various devices may arise.
Virtual Reality systems usually process large amounts of data, thus need processing and storage capacity
Virtual reality (VR) technologies use multimedia devices and computer simulation to allow users to interact with a simulated environment, creating life-like experience. Display devices present sensory information, such as vision, auditory, and touch sense, to the user; control devices collect user actions such as motion, gesture, and voices. The term VR is a very broad term, and researchers have used it to refer to a wide range of systems. A system using motion sensing gloves and a desktop display can be called VR, which emphasizes life-like hand control and feedback. In some studies, especially early studies, a system using standard computer input (keyboard and mouse) and output (desktop displays) devices can also be called VR, which em- phasizes the virtual environment generated by the software. In this sense, many first were exploration and navigation using a joystick. The results showed that the VR training was more effective than the music therapy training. The fifteen elderly pa- tients (with memory deficits) in the VR group showed significantly improved memory test scores; in contrast, the sixteen elderly patients in the control group of the face-to- face music therapy showed progressive declined memory. In contrast to the high number of rehabilitation assessment studies, there are very few studies that have investigated VR applications in rehabilitation training and exercise. The results showed improved clinical conditions, and the authors suggested that the inter- active and immersive features of VR could benefit music-enhanced therapy and better involve the patient during the training. A later controlled study by the same research group in compared HMD- VR memory training (Pentium III) and traditional face-to-face music training, where the participants were encouraged to sing and play music instruments, in six months. The VR scenes included home, park, and streets familiar to the participants. The tasks were exploration and navigation using a joystick. The results showed that the VR training was more effective than the music therapy training. The fifteen elderly patients (with memory deficits) in the VR group showed significantly improved memory test scores; in contrast, the sixteen elderly patients in the control group of the face-to-face music therapy showed progressive declined memory
Many studies have examined VR as a tool to assess the level and type of cognitive
impairmen.. The following studies are reviewed as an illustration of typical research in this area. An early study in 1998 used HMD (486 PC platform) to present a household kitchen environment . A meal preparation task was
used to evaluate memory and executive functions of patients with traumatic brain
injury (TBI). Thirty participants were tested twice within 7 to 10 days, and the results
showed good test-retest reliability; however, there was no comparison between VR
and traditional assessment methods.
A study in 1999 [7] reported an HMD-VR system (Pentium 166 MHz) developed
to assess patients' driving abilities. Driving test performance such as lane keeping and
stop sign stopping were compared between 17 brain-injured adults and uninjured
participants matched in age, gender, and education. The results showed some trend of
worse performance by brain-injured patients, but no statistical significance was reported.
A study in 2008 [8] showed that HMD-VR (Onyx2 Reality; 640 x 480) can be used
to differentiate two types of Parkinson's disease. Participants were asked to walk
while wearing the system that showed a virtual corridor with optic flow. Patients with
predominant left-hemisphere dysfunction deviated right of centre, whereas patients
with predominant right-hemisphere dysfunction did not.
In a recent study in 2012 [9], the authors implemented a simple driving simulation
with PC and a projector, which allows a user to navigate a virtual city or town passively as a passenger or actively as a driver. After the exploration, participants' episodic memory about the virtual place was tested in recall and recognition questions.
The results showed that the method was sensitive enough to tell the difference between three groups, healthy older adults, early clinical manifestations of Alzheimer's
disease, and amnesic mild cognitive impairment.