Did your stroke hospital do ONE DAMN THING with this in the past 9 years?
DO YOUR PREFER YOUR HOSPITAL INCOMPETENCE; NOT KNOWING? OR NOT DOING?
Application of Virtual Reality in Neuro-Rehabilitation: An Overview
December 2010
Lucia F Lucca 1,
Lucia F Lucca 1,
Antonio Candelieri 1,2
and Loris Pignolo 1
1 S. Anna Institute and RAN - Research in Advanced Neuro-rehabilitation, Crotone,
2 Laboratory of Decision Engineering for Health Care Delivery, University of Cosenza, Italy
1 S. Anna Institute and RAN - Research in Advanced Neuro-rehabilitation, Crotone,
2 Laboratory of Decision Engineering for Health Care Delivery, University of Cosenza, Italy
1. Introduction
Virtual reality (VR) collectively refers to the realistic, albeit artificial environments that are simulated by computer and are experienced by end-users via human-machine interfaces involving multiple sensory channels. In this respect, comparable technical solutions are applicable across different domains such as
cyberspace, virtual environments, teleoperation, telerobotics, augmented reality, and synthetic environments.
This makes application possible in a variety of conditions such as (1) design, engineering, manufacturing, and marketing; (2) medicine and healthcare; (3) online monitoring of children and the elderly at home and accident prevention; (4) hazardous operations in extreme or hostile surroundings; and (5) training in military and industrial machine operation, medical teaching and surgery planning/training. An implement of VR with live direct or indirect view of a physical real-world environment whose elements are purportedly enhanced (augmented) by virtual computer-generated imagery to meet the viewer needs, Augmented Reality is extensively used in open surgery, virtual endoscopy, radiosurgery, neuropsychological assessment and medical rehabilitation. Application in psychotherapy ranked 3rd among 38 psychotherapy interventions predicted to increase in use in the next future (Gorini & Riva, 2008a; Gorini & Riva, 2008b). Application in rehabilitation is increasing and expanding; innovative technical solutions in motor and sensory-cognitive rehabilitation result in substantial developments from the available procedures and in prototypes for clinical testing. The clinical results appear promising.
2. Rationale for VR-mediated neuro-rehabilitation
The rationale for application mainly rests on the available evidence that a functional re-arrangement of the injured motor cortex can be induced with the mediation of the mirror neurons system (Eng et al, 2007; Holden, 2005; Rose et al, 2005) or through the subject’s motor imagery and learning (Gaggioli et al, 2006). Intensive training (repetition) facilitating re-arrangement of cortical function and
motivation reinforced by feedback information about the ongoing improvement are necessary for motor learning to be possible after brain damage. These conditions are easily made available in VR-mediated neuro-rehabilitation paradigms. Motor impairment and recovery can be measured in real time (e.g.
at the end of each trial or a series of trials) to give the user the knowledge-of-performance (about his/her movement patterns) and knowledge-of-results (about the outcome predictable at each time point during rehabilitation) that reinforce motivation and the training procedure itself. VR allows online or offline feedback, that has been extensively investigated with a general agreement that it improves learning (Bilodeau & Bilodeau, 1962; Gentile, 1972; Khan & Franks, 2000; Newell & Carlton, 1987; Winstein, 1991; Young & Schmidt, 1992; Woldag & Hummelsheim, 2002). The expectation is, that VR-mediated rehabilitation should improve the approach efficacy and the outcome by making tasks easier, less demanding and less tedious/distractive, and more informative for the subject. Interactive VR environments are flexible and customizable for different therapeutic purposes; individual treatments can be personalized in order to facilitate movement retraining, to force the user to focus on the task key elements, and to facilitate transfer of motor patters learned in VR environments
to the real world.
Virtual reality (VR) collectively refers to the realistic, albeit artificial environments that are simulated by computer and are experienced by end-users via human-machine interfaces involving multiple sensory channels. In this respect, comparable technical solutions are applicable across different domains such as
cyberspace, virtual environments, teleoperation, telerobotics, augmented reality, and synthetic environments.
This makes application possible in a variety of conditions such as (1) design, engineering, manufacturing, and marketing; (2) medicine and healthcare; (3) online monitoring of children and the elderly at home and accident prevention; (4) hazardous operations in extreme or hostile surroundings; and (5) training in military and industrial machine operation, medical teaching and surgery planning/training. An implement of VR with live direct or indirect view of a physical real-world environment whose elements are purportedly enhanced (augmented) by virtual computer-generated imagery to meet the viewer needs, Augmented Reality is extensively used in open surgery, virtual endoscopy, radiosurgery, neuropsychological assessment and medical rehabilitation. Application in psychotherapy ranked 3rd among 38 psychotherapy interventions predicted to increase in use in the next future (Gorini & Riva, 2008a; Gorini & Riva, 2008b). Application in rehabilitation is increasing and expanding; innovative technical solutions in motor and sensory-cognitive rehabilitation result in substantial developments from the available procedures and in prototypes for clinical testing. The clinical results appear promising.
2. Rationale for VR-mediated neuro-rehabilitation
The rationale for application mainly rests on the available evidence that a functional re-arrangement of the injured motor cortex can be induced with the mediation of the mirror neurons system (Eng et al, 2007; Holden, 2005; Rose et al, 2005) or through the subject’s motor imagery and learning (Gaggioli et al, 2006). Intensive training (repetition) facilitating re-arrangement of cortical function and
motivation reinforced by feedback information about the ongoing improvement are necessary for motor learning to be possible after brain damage. These conditions are easily made available in VR-mediated neuro-rehabilitation paradigms. Motor impairment and recovery can be measured in real time (e.g.
at the end of each trial or a series of trials) to give the user the knowledge-of-performance (about his/her movement patterns) and knowledge-of-results (about the outcome predictable at each time point during rehabilitation) that reinforce motivation and the training procedure itself. VR allows online or offline feedback, that has been extensively investigated with a general agreement that it improves learning (Bilodeau & Bilodeau, 1962; Gentile, 1972; Khan & Franks, 2000; Newell & Carlton, 1987; Winstein, 1991; Young & Schmidt, 1992; Woldag & Hummelsheim, 2002). The expectation is, that VR-mediated rehabilitation should improve the approach efficacy and the outcome by making tasks easier, less demanding and less tedious/distractive, and more informative for the subject. Interactive VR environments are flexible and customizable for different therapeutic purposes; individual treatments can be personalized in order to facilitate movement retraining, to force the user to focus on the task key elements, and to facilitate transfer of motor patters learned in VR environments
to the real world.
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