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Virtual reality and stroke

Gianluca U Sorrento, Philippe S Archambault, Joyce Fung
BACKGROUND: Developing rehabilitation strategies to improve functional walking and postural control in patients is a priority for rehabilitation clinicians and researchers alike. One possible strategy is the use of sensory modalities to elicit adaptive locomotor gait patterns. This study aimed to explore to what extent haptic inputs, in the form of forward-leading tensile forces delivered to the hand, compared to no force, may lead to adaptation and post-adaptation effects on gait parameters, during and after the haptic exposure, respectively...
March 13, 2018: Journal of Neuroengineering and Rehabilitation
Giuseppe Placidi, Luigi Cinque, Matteo Polsinelli, Matteo Spezialetti
Hand rehabilitation is fundamental after stroke or surgery. Traditional rehabilitation requires a therapist and implies high costs, stress for the patient, and subjective evaluation of the therapy effectiveness. Alternative approaches, based on mechanical and tracking-based gloves, can be really effective when used in virtual reality (VR) environments. Mechanical devices are often expensive, cumbersome, patient specific and hand specific, while tracking-based devices are not affected by these limitations but, especially if based on a single tracking sensor, could suffer from occlusions...
March 10, 2018: Sensors
Ayhan Aşkın, Emel Atar, Hikmet Koçyiğit, Aliye Tosun
BACKGROUND: Therapeutic benefits of Kinect-based virtual reality (VR) game training in rehabilitation encourage its use to improve motor function. OBJECTIVE: To assess the effects of Kinect-based VR training on motor recovery of the upper extremity and functional outcomes in patients with chronic stroke. METHODS: In this randomized controlled trial, group A received 20 sessions of physical therapy (PT) + 20 sessions of Kinect-based VR training and group B received only 20 sessions of PT...
March 13, 2018: Somatosensory & Motor Research
Ai-Vi Nguyen, Yau-Lok Austin Ong, Cindy Xin Luo, Thiviya Thuraisingam, Michael Rubino, Mindy F Levin, Franceen Kaizer, Philippe S Archambault
PURPOSE: To identify the facilitators and barriers perceived by clinicians to using an Exergaming Room as adjunct to conventional therapy. DESIGN: Phenomenological qualitative study using an interpretive description methodology. SUBJECTS: Ten clinicians (four physical therapists, six occupational therapists) from the Stroke Program at the Jewish Rehabilitation Hospital (nine female, one male, age range 25-50 years old) who referred clients to the Exergaming Room...
March 12, 2018: Disability and Rehabilitation. Assistive Technology
Marika Demers, Daniel Chan Chun Kong, Mindy F Levin
PURPOSE: To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. METHODS: A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke...
March 11, 2018: Disability and Rehabilitation. Assistive Technology
Kazuhiro Yasuda, Daisuke Muroi, Mizuki Hirano, Kenta Saichi, Hiroyasu Iwata
In clinical practice, therapists often encounter cases of unilateral spatial neglect (USN) observed in far and near space. In this case report, immersive virtual reality (VR) technology was adopted as a therapy tool in a patient with stroke with severe near and far space neglect. Neuropsychological tests in near and far space as well as the Catherine Bergego Scale (CBS), as an index of neglect in daily living, were measured preintervention and postintervention. Improvement of neuropsychological tests, particularly in far space, was clearly demonstrated postintervention...
March 9, 2018: BMJ Case Reports
Stephanie Hyeyoung Lee, Ji-Yeong Lee, Mi-Young Kim, Yu-Jin Jeon, Suyoung Kim, Joon-Ho Shin
OBJECTIVE: To compare virtual reality (VR) combined with functional electrical stimulation (FES) to cyclic FES for improving upper extremity function and health-related quality of life in patients with a chronic stroke. DESIGN: A pilot, randomized, single blinded, controlled trial. SETTING: Stroke rehabilitation inpatient unit PARTICIPANTS: Forty-eight participants with a hemiplegia secondary to a unilateral stroke for >3 months, with a hemiplegic wrist extensor Medical Research Council (MRC) scale score of 1-3...
March 2, 2018: Archives of Physical Medicine and Rehabilitation
Pawel Kiper, Andrzej Szczudlik, Michela Agostini, Jozef Opara, Roman Nowobilski, Laura Ventura, Paolo Tonin, Andrea Turolla
OBJECTIVE: To evaluate the effectiveness of reinforced feedback in virtual environment (RFVE) treatment combined with conventional rehabilitation (CR) in comparison with CR alone, and to study whether changes are related to stroke aetiology (i.e. ischemic or hemorrhagic). DESIGN: Randomized controlled trial. SETTING: Inpatients in a hospital facility for intensive rehabilitation. PARTICIPANTS: 136 patients within one year from onset of a single stroke...
February 14, 2018: Archives of Physical Medicine and Rehabilitation
Julio Cesar Silva de Sousa, Camila Torriani-Pasin, Amanda Barboza Tosi, Rafael Yokoyama Fecchio, Luiz Augusto Riani da Costa, Cláudia Lúcia de Moraes Forjaz
OBJECTIVE: To evaluate whether virtual reality games (VRG) in stroke survivors produce significant and reproducible heart rate (HR) and oxygen consumption (VO2) responses during their execution, corresponding to an intensity between the anaerobic threshold (AT) and the respiratory compensation point (RCP). DESIGN: Single subjects repeated measure design SETTING: Stroke survivors registered from a rehabilitation program PARTICIPANTS: Twelve chronic hemiparetic stroke survivors (10 men, 58 ± 12 years) rated at 3 or 4 in the Functional Ambulation Categories (FAC)...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
Melanie Cogne, Marie-Helene Violleau, Evelyne Klinger, Pierre-Alain Joseph
BACKGROUND: Topographical disorientation is frequent among patients after a stroke and can be well explored with virtual environments (VEs). VEs also allow for the addition of stimuli. A previous study did not find any effect of non-contextual auditory stimuli on navigational performance in the Virtual Action Planning-Supermarket (VAP-S) simulating a medium-sized 3D supermarket. However, the perceptual or cognitive load of the sounds used was not high. OBJECTIVE: We investigated how non-contextual auditory stimuli with high load affect navigational performance in the VAP-S for patients who have had a stroke and any correlation between this performance and dysexecutive disorders...
January 30, 2018: Annals of Physical and Rehabilitation Medicine
Suzanne Perea Burns, Noralyn Davel Pickens, Deirdre R Dawson, Jaimee D Perea, Asha K Vas, Carlos Marquez de la Plata, Marsha Neville
Adults with stroke frequently experience executive dysfunction. Despite the range of assessments that examine the effects of executive dysfunction on daily tasks, there remains a paucity of literature that examines the influence of the environment on performance in the community. The MET-Home is an ecologically valid assessment for examining post-stroke executive dysfunction in the home environment. This qualitative study explores the relationship between the environment and MET-Home performance among home-dwelling adults with stroke and matched controls...
February 6, 2018: Neuropsychological Rehabilitation
Tatiana Ogourtsova, Philippe Archambault, Samir Sangani, Anouk Lamontagne
BACKGROUND: Unilateral spatial neglect (USN) is a highly prevalent and disabling poststroke impairment. USN is traditionally assessed with paper-and-pencil tests that lack ecological validity, generalization to real-life situations and are easily compensated for in chronic stages. Virtual reality (VR) can, however, counteract these limitations. OBJECTIVE: We aimed to examine the feasibility of a novel assessment of USN symptoms in a functional shopping activity, the Ecological VR-based Evaluation of Neglect Symptoms (EVENS)...
January 1, 2018: Neurorehabilitation and Neural Repair
Mindy F Levin, Melanie C Baniña, Silvi Frenkel-Toledo, Sigal Berman, Nachum Soroker, John M Solomon, Dario G Liebermann
BACKGROUND: Recovery of voluntary movement is a main rehabilitation goal. Efforts to identify effective upper limb (UL) interventions after stroke have been unsatisfactory. This study includes personalized impairment-based UL reaching training in virtual reality (VR) combined with non-invasive brain stimulation to enhance motor learning. The approach is guided by limiting reaching training to the angular zone in which active control is preserved ("active control zone") after identification of a "spasticity zone"...
January 4, 2018: Trials
Paweł Balsam, Sonia Borodzicz, Karolina Malesa, Dominika Puchta, Agata Tymińska, Krzysztof Ozierański, Łukasz Kołtowski, Michał Peller, Marcin Grabowski, Krzysztof J Filipiak, Grzegorz Opolski
BACKGROUND: Atrial fibrillation (AF) is associated with high risk of stroke and other thromboembolic complications. The OCULUS study aimed to evaluate the effectiveness of the three-dimensional (3D) movie in teaching patients about the consequences of AF and pharmacological stroke prevention. METHODS: The study was based on a questionnaire and included 100 consecutive patients (38% women, 62% with AF history). Using the oculus glasses and a smartphone, a 3D movie describing the risk of stroke in AF was shown...
January 3, 2018: Cardiology Journal
Tim Vanbellingen, Suzanne J Filius, Thomas Nyffeler, Erwin E H van Wegen
Background: Approximately 70-80% of stroke survivors have limited activities of daily living, mainly due to dexterous problems. Videogame-based training (VBT) along with virtual reality seems to be beneficial to train upper limb function. Objective: To evaluate the usability of VBT using the Leap Motion Controller (LMC) to train fine manual dexterity in the early rehabilitation phase of stroke patients as an add-on to conventional therapy. Additionally, this study aimed to estimate the feasibility and potential efficacy of the VBT...
2017: Frontiers in Neurology
Zun-Rong Wang, Ping Wang, Liang Xing, Li-Ping Mei, Jun Zhao, Tong Zhang
Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs (arms) because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers...
November 2017: Neural Regeneration Research
Shih-Ching Yeh, Si-Huei Lee, Rai-Chi Chan, Yi Wu, Li-Rong Zheng, Sheryl Flynn
Stroke is a leading cause of long-term disability, and virtual reality- (VR-) based stroke rehabilitation is effective in increasing motivation and the functional performance. Although much of the functional reach and grasp capabilities of the upper extremities were regained, the pinch movement remains impaired following stroke. In this study, we developed a haptic-enhanced VR system to simulate haptic pinch tasks to assist the recovery of upper-extremity fine motor function. We recruited 16 adults with stroke to verify the efficacy of this new VR system...
2017: Journal of Healthcare Engineering
Mario Widmer, Jeremia P Held, Frieder Wittmann, Olivier Lambercy, Kai Lutz, Andreas R Luft
BACKGROUND: Fifty percent of all stroke survivors remain with functional impairments of their upper limb. While there is a need to improve the effectiveness of rehabilitative training, so far no new training approach has proven to be clearly superior to conventional therapy. As training with rewarding feedback has been shown to improve motor learning in humans, it is hypothesized that rehabilitative arm training could be enhanced by rewarding feedback. In this paper, we propose a trial protocol investigating rewards in the form of performance feedback and monetary gains as ways to improve effectiveness of rehabilitative training...
December 2, 2017: Trials
Jinmin Kim, Jaehoon Yi, Chang-Ho Song
[Purpose] The purpose of this study was to investigate mirror therapy (MT) condition by analyzing kinematic parameters according to mirror size and angle. [Subjects and Methods] Three hemiparesis stroke patients and five healthy adults participated in this cross-sectional study. Kinematic parameters during the MT were collected over a total of 5 trials for each subject (3 mirror angles × 3 mirror sizes). Center of pressure (COP) excursion data was collected by force plate, and other kinematic parameters by infra-red cameras...
October 2017: Journal of Physical Therapy Science
Kate E Laver, Belinda Lange, Stacey George, Judith E Deutsch, Gustavo Saposnik, Maria Crotty
BACKGROUND: Virtual reality and interactive video gaming have emerged as recent treatment approaches in stroke rehabilitation with commercial gaming consoles in particular, being rapidly adopted in clinical settings. This is an update of a Cochrane Review published first in 2011 and then again in 2015. OBJECTIVES: Primary objective: to determine the efficacy of virtual reality compared with an alternative intervention or no intervention on upper limb function and activity...
November 20, 2017: Cochrane Database of Systematic Reviews
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