BackgroundDespite the functional impact of upper limb dysfunction in multiple sclerosis (MS), effects of intensive exercise programs and specifically robot-supported training have been rarely investigated in persons with advanced MS.AimTo investigate the effects of additional robot-supported upper limb training in persons with MS compared to conventional treatment only.MethodsSeventeen persons with MS (pwMS) (median Expanded Disability Status Scale of 8, range 3.5–8.5) were included in a pilot RCT comparing the effects of additional robot-supported training to conventional treatment only. Additional training consisted of 3 weekly sessions of 30 min interacting with the HapticMaster robot within an individualised virtual learning environment (I-TRAVLE). Clinical measures at body function (Hand grip strength, Motricity Index, Fugl-Meyer) and activity (Action Research Arm test, Motor Activity Log) level were administered before and after an intervention period of 8 weeks. The intervention group were also evaluated on robot-mediated movement tasks in three dimensions, providing active range of motion, movement duration and speed and hand-path ratio as indication of movement efficiency in the spatial domain. Non-parametric statistics were applied.ResultsPwMS commented favourably on the robot-supported virtual learning environment and reported functional training effects in daily life. Movement tasks in three dimensions, measured with the robot, were performed in less time and for the transporting and reaching movement tasks more efficiently. There were however no significant changes for any clinical measure in neither intervention nor control group although observational analyses of the included cases indicated large improvements on the Fugl-Meyer in persons with more marked upper limb dysfunction.ConclusionRobot-supported training lead to more efficient movement execution which was however, on group level, not reflected by significant changes on standard clinical tests. Persons with more marked upper limb dysfunction may benefit most from additional robot-supported training, but larger studies are needed.Trial registrationThis trial is registered within the registry Clinical Trials GOV (NCT02257606).
Robot-mediated training resulted in improved movement coordination in both groups, as well as clinical improvement in pwMS. Absence of functional improvements in stroke patients may relate to severe upper limb dysfunction at baseline. Implications for Rehabilitation Robot-mediated training improved strength, active range of motion and upper limb capacity in pwMS. Robot-mediated therapy allows for adapted training difficulty.
For several years, virtual environments (VEs) are promising applications to explore and manipulate 3D data and 3D worlds. Those environments are designed to be intuitive and easy to use, however, in practice no ideal solution has been proposed yet. Designers and researchers always have to make compromises due to the complexity of the human senses and technical and financial restrictions. It is widely accepted that multisensory metaphors dramatically can improve the user's performance when interaction in a VE. In this paper, we present a modelling application, for research purposes, called nVRment, which uses and combines several interaction metaphors. The aim of this application is to test in practice our newly proposed metaphors: the "Object In Hand" metaphor, which uses proprioception together with force feedback for manipulations and the "Small Scene Manipulation" which is suitable for manipulation of an object in its local context.
Rehabilitation games form a promising type of serious games. The goal is to provide the patients with a personalized training. In order to realize this, much information must be handled. This includes general information about the games and parameters regarding modalities, and specific information about the patients and their therapy sessions. Therapists must be able to specify the values for all parameters involved. However, different levels of these parameters should be grouped in a sensible manner in order not to overwhelm the therapists with too much and too detailed information. This paper discusses a system for the rehabilitation of Multiple Sclerosis patients and explains how the information can be managed by the therapists.
Wayfinding inside a virtual environment is a cognitive process during navigation. Normally the user inside the virtual environment has to rely on himself and different cues such as waypoints to improve his knowledge with regard to his surroundings. In this paper we will present our solution for the 3DUI Contest 2012: HeatMeUP, a 3DUI serious game to explore collaborative alternatives, in which a partner is responsible for providing wayfinding cues. The game is set in a multi-storey building where several fires and gas leaks occur and a firefighter has to overcome several challenges, guided by a fire chief.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.