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The virtual reality (VR) therapy described below consists of a series of VR exercises, delivered with low-cost equipment. It replicates the conventional exercise and activity sequence recommended for restoring postural and coordination abnormalities after traumatic brain injuries (TBI). Efficacy was tested in a pilot group of 9 participants with TBI. They completed 15 sessions, each approximately...
Patients' willingness to play is essential for rehabilitation games. This study (1) identified patients' general expectations for rehabilitation games; and (2) evaluated two newly developed low-cost rehabilitation games through surveys. Patients were found to expect low-cost systems (< $100), ease of use, interesting game contents, proven clinical efficiency, and access to rehabilitation games...
Therapeutic games motivate patients and intrinsically generate a large number of movement repetitions that is key to inducing brain plasticity and facilitating recovery. While virtual rehabilitation has gained clinical acceptance, bimanual therapy is less developed at this time. The novel RABBIT system combines physical and cognitive training via integrative game-play sessions. Using the Razer Hydra...
Rehabilitation of the weak hand is an important aspect of improving daily activities post-stroke. iPad applications have opened new opportunities for rehabilitation by facilitating goal-oriented, repetitive and motivating hand movements. This pilot study assessed the suitability of the iPad for improving hand function post-stroke. Eleven individuals with and 11 without stroke experienced existing...
This study attempts to identify a difference between a virtually simulated program of repetitive task practice and a similar program of traditionally presented activities. 30 subjects with chronic stroke performed one of the two programs for eight three hour sessions which were performed in a two week period. Both groups demonstrated statistically significant improvements in Upper Extemity Fugyl-Meyer...
Persons with visuospatial neglect are at risk of colliding with objects while walking due to their inattention to the contralesional space. Twelve participants were assessed on their ability to avoid moving obstacles while walking. Collisions were observed for head-on and contralesionally approaching obstacles, but not for ipsilesional ones. Participants showed delayed responses and maintained smaller...
Approximately 70% of individuals with spinal injury eventually develop shoulder pain. A home exercise program can reduce this pain. Virtual reality gaming (VRG) may enhance motivation for exercise. This study aimed to determine if performance of shoulder exercises integrated into VRG results in similar muscle activation as non-VRG exercise. Five volunteers with paraplegia performed shoulder exercises...
The clinical consequences of an acquired brain injury can lead to a lack of insight or self-awareness. These symptoms are associated with a lack of motivation and adherence to the treatment. We have developed a virtual game board on a multi-touch table that promotes the collaboration and competition among patients while developing the role-playing and the self-assessment strategies. This paper presents...
Controlled studies show that motor function can be maintained in the chronic phase post-stroke. Unfortunately, standard of care does not currently include long-term maintenance rehabilitation for these patients. The case study reported here involved 6-weeks booster virtual rehabilitation therapy at 2 years post initial VR training. The booster used the Rutgers Arm II and a novel vibrating brace. It...
We explored the use of the Virtual Integrated Environment (VIE), developed by the Johns Hopkins University Applied Physics Lab (JHU/APL), in treating phantom limb pain in seven upper-extremity amputees. Further, we tested pattern recognition control of a virtual avatar using surface electromyography signals captured from subjects' residual limbs. The majority of patients responded to treatment, reporting...
Aphasia is an acquired communication disorder that affects the ability to speak and understand spoken language. The purpose of this project is to create a virtual clinician to help individuals with aphasia practice self-initiated speech in everyday communication situations. The project will gauge the interaction and quality of this virtual clinician against those of a real clinician. The first of...
Individuals with stroke demonstrate deficits in community ambulation, which may be related to deficits in obstacle avoidance. We have devised a VR paradigm to assess locomotor strategies for obstacle circumvention. Four individuals with chronic stroke and four healthy controls walked towards a target while in the presence of a moving obstacle. Dynamic clearance from the obstacle was smaller among...
We present an auditory feedback system to assist learning the single-legged stance on a slackline, sensing the user's posture with a Microsoft Kinect. Slacklining, or walking on an elevated length of tensioned webbing, has been associated with improved core strength, balance and concentration and may have applications for balance rehabilitation and research. Based on the considerable body of research...
Training in a Virtual Environment simulating a power wheelchair, can enhance safety, cost-effectiveness, training quality, and can also be used for the assessment of potential future users. Power wheelchair simulators often lack correct physics simulation, do not support peripheral vision, or do not provide features required for assessment. Here we address these issues with a novel power wheelchair...
This study evaluated the kinematic validity of Microsoft Kinect skeletal tracking for use with an upper limb virtual reality rehabilitation system. We determined the extent to which Kinect tracking of hand position, elbow angle, and trunk position matched that recorded by a motion tracking system over a range of Kinect camera positions. The optimal Kinect camera position was between 1.45m and 1.75m...
The majority of falls occur during walking. This begs the question, “Why are most balance training exercises performed when standing still?” Visual feedback for balance training is becoming more prevalent in rehabilitation, but is often performed while standing still. Five subjects have completed an eight week intervention study, part of an ongoing randomized controlled clinical trial. All subjects...
Visual field immersion and plantar vibration effects on balance were examined. Healthy adults stood quietly in a 3-wall immersive virtual environment (VE) and with a 3DTV for four trials while: barefoot, barefoot on foam, and wearing shoes on foam with and without sub-threshold plantar vibration. RMS of center of pressure velocity were significantly larger in VE than 3DTV (p<0.0002). Responses...
Despite its significant benefits, clinical adoption of virtual rehabilitation is slow. One reason is that current systems are typically constrained to providing therapy for one specific motor deficit with a limited number of pre-defined therapeutic game exercises. Any adjustments to these exercises require highlevel programming knowledge beyond the therapists' skill level. With our adaptive MATLAB-based...
Stepping games with Dance Mat has been developed to extend Web-based home rehabilitation gaming system for patients with movement disorders. Preliminary assessment of the games was performed on five patients with Cerebral Palsy that conducted daily home training sessions for a period of two weeks. The patients have been assessed by following tests: Timed Up and Go test, Pediatric Balance Scale, Four...
Most virtual rehabilitation environments rely on visual feedback. However, little is known on the optimum characteristics of these feedbacks. Here, we present first results of a systematic literature review to assess and compare visual feedback types in virtual reality (VR) based neurological motor rehabilitation of the upper limb. Overall we identified 104 relevant publications. Within these some...
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