Immersive VR for upper-extremity rehabilitation in patients with neurological disorders: a scoping review

 Didn't your competent? doctor create a protocol on this years ago? NO? So you DON'T have a functioning stroke doctor? Why are you seeing them?

• immersive virtual reality (12 posts to January21)

Why the fuck was this review needed? If we had a great stroke association  instead of our  fucking failures of stroke associations, then we would have a publicly available protocol on this in our complete database of stroke research and protocols. But with NO leadership, nothing is ever done to solve stroke. You're screwed, don't have a stroke because of the complete incompetence of your stroke medical 'professionals' using the failed status quo instead of solving stroke.

Immersive VR for upper-extremity rehabilitation in patients with neurological disorders: a scoping review

• Matteo Ceradini,
• Elena Losanno,021
• Silvestro Micera,
• Andrea Bandini &
• Silvia Orlandi 

Journal of NeuroEngineering and Rehabilitation volume 21, Article number: 75 (2024) Cite this article

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Abstract

Background

Neurological disorders, such as stroke and chronic pain syndromes, profoundly impact independence and quality of life, especially when affecting upper extremity (UE) function. While conventional physical therapy has shown effectiveness in providing some neural recovery in affected individuals, there remains a need for improved interventions. Virtual reality (VR) has emerged as a promising technology-based approach for neurorehabilitation to make the patient’s experience more enjoyable. Among VR-based rehabilitation paradigms, those based on fully immersive systems with headsets have gained significant attention due to their potential to enhance patient’s engagement.

Methods

This scoping review aims to investigate the current state of research on the use of immersive VR for UE rehabilitation in individuals with neurological diseases, highlighting benefits and limitations. We identified thirteen relevant studies through comprehensive searches in Scopus, PubMed, and IEEE Xplore databases. Eligible studies incorporated immersive VR for UE rehabilitation in patients with neurological disorders and evaluated participants’ neurological and motor functions before and after the intervention using clinical assessments.

Results

Most of the included studies reported improvements in the participants rehabilitation outcomes, suggesting that immersive VR represents a valuable tool for UE rehabilitation in individuals with neurological disorders. In addition, immersive VR-based interventions hold the potential for personalized and intensive training within a telerehabilitation framework. However, further studies with better design are needed for true comparison with traditional therapy. Also, the potential side effects associated with VR head-mounted displays, such as dizziness and nausea, warrant careful consideration in the development and implementation of VR-based rehabilitation programs.

Conclusion

This review provides valuable insights into the application of immersive VR in UE rehabilitation, offering the foundation for future research and clinical practice. By leveraging immersive VR’s potential, researchers and rehabilitation specialists can design more tailored and patient-centric rehabilitation strategies, ultimately improving the functional outcome and enhancing the quality of life of individuals with neurological diseases.

Background

Neurological disorders affect millions of people around the world. Stroke alone accounts for over 110 million cases, as reported by the World Health Organization [1]. Spinal cord injury, pain syndromes, multiple sclerosis, and many other diseases also affect a substantial number of people. These diseases not only have a physical impact, but also affect people's independence, well-being, and overall quality of life [2,3,4]. The global prevalence of neurological disorders and their profound impact underscore the urgent need for effective rehabilitation strategies to promote neurological recovery and improve the lives of those affected.

Neurological disorders often lead to impairments of the upper limbs, which are essential for performing everyday activities. To recover the use of their arms, patients often undergo conventional interventions, such as physical or occupational therapy [5,6,7]. Conventional physiotherapy for stroke survivors is often paired with technology-based interventions such as electromyographic biofeedback, electrostimulation, repetitive task training, and robotics [8]. Pain-related syndromes typically involve common interventions like mirror therapy, motor imagery, cognitive-behavioral therapies, and pharmacological treatments [9]. In the case of multiple sclerosis, commonly adopted interventions include robot-based training, home-based motor training, and electrical nerve stimulations [10]. Although these methods are effective in improving the outcomes with respect to conventional therapies alone [5, 8, 11], they also have limitations, such as low repeatability, high cost, and low engagement [12, 13]. Therefore, it is crucial to explore innovative technology-based approaches that can mitigate these limitations while improving rehabilitation outcomes [14].

Virtual reality (VR) is an end user human–computer interface technology that involves real-time simulation and interaction [15]. VR offers the possibility of engaging participants in multiple and personalized activities in which they can interact with virtual objects in real-time through multiple sensory modalities [16]. Immersive VR is an advanced form of VR that involves the use of head-mounted displays (HMDs) with high-resolution displays and spatial tracking systems to immerse users in a 3D virtual world that can be visually and audibly realistic. This combination of hardware and software allows users to engage with virtual objects and environments as though they were tangible realities [17]. The HMD includes a stereoscopic display that presents a different image to each eye, creating a sense of depth and immersion. Motion-tracking sensors detect the users' movements, allowing them to look around and interact naturally with the virtual environment.

In the context of rehabilitation, immersive VR is used as a tool to engage patients in virtual activities and therapeutic exercises specifically designed to promote their neurological recovery [18].

Currently, there is a limited understanding of the effectiveness, potential challenges, and facilitators associated with the use of immersive VR for upper limb rehabilitation across diverse neurological conditions. This scoping review aims to address this research gap by examining the characteristics and clinical outcomes of studies focusing on rehabilitation through immersive VR. Our analysis encompasses a comprehensive review of existing studies that utilize immersive VR for upper-limb rehabilitation in individuals with neurological disorders. Various aspects, including study type and design, population characteristics, neurological conditions, types of tasks employed, and rehabilitation outcomes, were thoroughly explored. The scope of our analysis extended beyond the intervention itself, encompassing specific details about the VR setup to provide a detailed account of the technical aspects. Additionally, we assessed potential side effects associated with the use of HMDs, an integral component of the immersive VR experience that requires careful consideration.

 

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