Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 15771 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke.DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER, BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Deans' stroke musings
Changing stroke rehab and research worldwide now.Time is Brain!Just think of all thetrillions and trillions of neuronsthateach daybecause there areeffective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.
What this blog is for:
Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group. My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html
Tuesday, September 13, 2016
A Comparative Analysis of 2D and 3D Tasks for Virtual Reality Therapies Based on Robotic-Assisted Neurorehabilitation for Post-stroke Patients
You'll have to see what this means to your doctor and your stroke rehab. No knowledge of this by your doctor means they should be fired. They should have already known about this research in its starting stages, not just waiting for you to ask about it. Lots of research being referred to which your doctor should be up-to-date on. http://journal.frontiersin.org/article/10.3389/fnagi.2016.00205/full?
Biomedical Neuroengineering Group, Miguel Hernández University of Elche, Elche, Spain
Post-stroke neurorehabilitation based on virtual therapies are
performed completing repetitive exercises shown in visual electronic
devices, whose content represents imaginary or daily life tasks.
Currently, there are two ways of visualization of these task. 3D virtual
environments are used to get a three dimensional space that represents
the real world with a high level of detail, whose realism is
determinated by the resolucion and fidelity of the objects of the task.
Furthermore, 2D virtual environments are used to represent the tasks
with a low degree of realism using techniques of bidimensional graphics.
However, the type of visualization can influence the quality of
perception of the task, affecting the patient's sensorimotor
performance. The purpose of this paper was to evaluate if there were
differences in patterns of kinematic movements when post-stroke patients
performed a reach task viewing a virtual therapeutic game with two
different type of visualization of virtual environment: 2D and 3D. Nine
post-stroke patients have participated in the study receiving a virtual
therapy assisted by PUPArm rehabilitation robot. Horizontal movements of
the upper limb were performed to complete the aim of the tasks, which
consist in reaching peripheral or perspective targets depending on the
virtual environment shown. Various parameter types such as the maximum
speed, reaction time, path length, or initial movement are analyzed from
the data acquired objectively by the robotic device to evaluate the
influence of the task visualization. At the end of the study, a
usability survey was provided to each patient to analysis his/her
satisfaction level. For all patients, the movement trajectories were
enhanced when they completed the therapy. This fact suggests that
patient's motor recovery was increased. Despite of the similarity in
majority of the kinematic parameters, differences in reaction time and
path length were higher using the 3D task. Regarding the success rates
were very similar. In conclusion, the using of 2D environments in
virtual therapy may be a more appropriate and comfortable way to perform
tasks for upper limb rehabilitation of post-stroke patients, in terms
of accuracy in order to effectuate optimal kinematic trajectories.
Virtual Reality (VR) is a technology platform that
allows developing computer generated environments which the subjects can
explore and interact with any type of object or events to perform
perspectives and motor tasks. VR gives an accurate way to control all
the elements of a scene and the objectives, adjusting each task to a
specific user. The main feature that the VR provides is the possibility
of repeating the same task in any moment, modifying factors such as
level of complexity, time and intensity of the practice. In this way,
the virtual therapy may be used to promote motor learning and
rehabilitation due to the VR can be adjusted to generate environment,
scenario, or activity that allows for the user practice motor skills to
improve the experience-dependent neural plasticity (Doyon and Benali, 2005).
The possibility of modifying factors such as the repetition, intensity,
time, and specificity of the activities of the virtual therapies is
beneficial for this type of neural recovery (Kleim and Jones, 2008).
In recent years, some scientific and clinical trials have demonstrated
the effectiveness of VR as an intervention tool for the rehabilitation
of different injuries with specific neurological conditions (Burdea, 2002; Crosbie et al., 2007).
However, a control device to interact with virtual activities is
required, depending of the limb affected by the disease. There is a wide
panorama on rehabilitation systems for upper limb that use robotic
technology including virtual reality visualization (Maciejasz et al., 2014).
In some studies, repetitive movements guiaded by robotic devices and
directed by virtual reality improve the motor control in patients with
upper limb injuries (Merians et al., 2006).
Beside this, there are some clinical studies about the development of
VR systems to deliver rehabilitation therapies for motor recovery of
hand function (Jack et al., 2001) or to improve the performance of activities of daily living in post-stroke patients (Laver et al., 2012; Turolla et al., 2013).
Furthermore, a navigation environment in three dimensions (3D) has been
implemented to explore the influence on aging in the episodic memory (Jebara et al., 2014). In Fluet and Deutsch (2013),
an overview of virtual reality studies for sensorimotor rehabilitation
post-stroke has been performed to evaluate a comparative efficacy
between VR and standard of care and/or differences in VR delivery
methods, using different categories.
Several studies suggest that the robotic technology can
be used to improve the quality and the evaluation in the neurological
rehabilitation (Garcia et al., 2011),
enhancing the productivity and reducing costs in that field. Recent
developments in robotic technology can help to perform a most objective
and reliable analysis of the therapies that are applied to the patients
with neurological injuries (Badesa et al., 2012, 2014a,c).
That is because this type of devices are able to record kinematic and
kinetic data. From this data, useful markers can be extracted to
quantify the motor recovery process during the therapy (Volpe et al., 2009; Einav et al., 2011; Bertomeu-Motos et al., 2015; Papaleo et al., 2015). Recently in Norouzi-Gheidari et al. (2012),
it is shown that the rehabilitation sessions performed with the robotic
device get better recovery outcomes than the conventional therapy
during the rehabilitation of the upper limb of stroke patients. For
these reasons, the rehabilitation with robotic devices can provide an
enhancement in the quality of patient's life, giving them most
independence in the daily life activities (Pollock et al., 2014).
The use of more complex and realistic VR systems in the
neurorehabilitation therapies assisted by robotic device is increasing.
The combination of robotic systems for neuromotor rehabilitation and
virtual reality takes advantages of both techniques such as: to increase
the patient's motivation; to enhance the variability and adaptability;
transparent storage of the data provided by the robotic system and the
VR system separately; online recording of the data for remote
verification; possibility to replicate any environment of the daily life
without having the physical. With this methodology, a more effective
therapeutic treatment and a better recovery of the patient is
accomplished (González et al., 2015).
There are a two important issues concerning the virtual
reality: one is related to how the virtual environment may be perceived
by the user using different visualization platforms, and the other one
is related to graphic content. Regarding the first appointment,
different visualization platforms exist such as computer monitors,
head-mounted-displays (HMDs) or large screen-projection-systems (SPS).
Each platform has a particular way to apply the virtual therapies taking
into account therapeutic goals and may provide different benefits that
are suitable for the patient's needs. In Rand et al. (2005),
the effects of viewing the same virtual environment through a HMD (3D
platform) and a computer monitor (2D platform) have been compared in
young and older subjects. Conversely, a 3D virtual enviroment shown
through a HMD and a SPS (2D platform) have been analyzed by Subramanian and Levin (2011),
evaluating the motor performance with respect to the kinematic
movements in healthy and post-stroke subjects. In both studies, better
outcomes have been obtained when the virtual environment was shown in
the 2D platform visualization, in a computer monitor and a SPS
respectively. However, this studies have focused in the visualization
platform and the same environments have been presented respectively in
the experiments without taking account the type of graphic content that
are shown (2D or 3D graphics).
Regarding the second issue appointed above about the
graphic content, there are studies about VR systems with environments
based on 2D graphics and others in 3D graphics. In García-Betances et al. (2015)
an overview of recent VR technology for Alzheimer's disease
applications has performed, and these systems use conventional 2D
graphics display or 3D graphics indistinctly. Similarly occurs with the
brain damage rehabilitation in Rose et al. (2005), post-stroke studies such as Merians et al. (2006), Saposnik (2016), Henderson et al. (2007), Mottura et al. (2015).
Therefore, there is a wide panorama on virtual rehabilitation in the
scientific literature. However, an objective comparison about how
affects the visualization of 2D graphics display and 3D virtual
environment to the motion perception in post-stroke subjects have not
been addressed yet. That means, there is no evidence that shows if it is
better or not to perform virtual rehabilitation tasks produced by 2D or
3D graphics. The visual perception of the virtual objects can be
incremented using 3D graphics, in such a way that tasks based in the
daily life designs are more similar to the reality. While a 2D graphics
allow a more simple representation of the tasks. The two perspectives
must be tested to evaluate what kind of visual representation provides
better quality of motor performance in terms of movement kinematics.
This evaluation can be carried out when the subject performs the same
movement to complete the targets in both types of visualization.
Therefore, the robotic devices can be used to restrict this movement and
extract objectively quantitative data. This way, the
neuro-rehabilitation therapies can be adapted to each patient (Morales et al., 2014; Lledó et al., 2015a).
In this study, the effects of applying therapeutic games
in two or three dimensions in the virtual therapies assisted by a
robotic device are evaluated and their outcomes are compared. In this
way, quantitative data is provided to evaluate the influence of the
virtual therapy and to asses what kind of virtual environment is
adjusted better to each patient in terms of usability, confidence, and
comfort. Therefore, the main objective of this study was to determine if
there are differences in the movement kinematics parameters recorded by
the robotic device that assess the patient's motor performance in 2D
and 3D virtual tasks. To do this, two visual tasks have been designed
modifying the immersion level using graphics in two and three
dimensions, but the kinematic target of the two visual tasks was