Effect of immersive virtual reality training on hand-to-mouth task performance in people with Multiple Sclerosis: A quantitative kinematic study

Pau, Massimiliano; Porta, Micaela; Bertoni, Rita; Mattos, Fabiola Giovanna Mestanza; Cocco, Eleonora; Cattaneo, Davide

doi:10.1016/j.msard.2022.104455

Cited by 8 publications

(6 citation statements)

References 37 publications

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“…Furthermore, through the use of serious games (games devised for non-leisure applications too, from education to therapy) and the approach of gamification (adding game features to non-leisure systems), the patient is led to perform repetitive training activities with higher motivation and, consequently, clinical adherence ( Godfrey and Barresi, 2022 ). VR-based exergames have garnered attention within MS rehabilitation, particularly for targeting upper limb movements ( Webster et al, 2021 ; Pau et al, 2023b ; Chadali et al, 2023 ). These games combine task-oriented exercises with elements of gamification to create engaging rehabilitation experiences ( Jonsdottir et al, 2019 ).…”

Section: Virtual and Extended Reality In Rehabilitation For Pwmsmentioning

confidence: 99%

Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments

Albanese,

Bucchieri,

Podda

et al. 2024

Front. Robot. AI

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The robotics discipline is exploring precise and versatile solutions for upper-limb rehabilitation in Multiple Sclerosis (MS). People with MS can greatly benefit from robotic systems to help combat the complexities of this disease, which can impair the ability to perform activities of daily living (ADLs). In order to present the potential and the limitations of smart mechatronic devices in the mentioned clinical domain, this review is structured to propose a concise SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of robotic rehabilitation in MS. Through the SWOT Analysis, a method mostly adopted in business management, this paper addresses both internal and external factors that can promote or hinder the adoption of upper-limb rehabilitation robots in MS. Subsequently, it discusses how the synergy with another category of interaction technologies - the systems underlying virtual and augmented environments - may empower Strengths, overcome Weaknesses, expand Opportunities, and handle Threats in rehabilitation robotics for MS. The impactful adaptability of these digital settings (extensively used in rehabilitation for MS, even to approach ADL-like tasks in safe simulated contexts) is the main reason for presenting this approach to face the critical issues of the aforementioned SWOT Analysis. This methodological proposal aims at paving the way for devising further synergistic strategies based on the integration of medical robotic devices with other promising technologies to help upper-limb functional recovery in MS.

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Section: Virtual and Extended Reality In Rehabilitation For Pwmsmentioning

confidence: 99%

Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments

Albanese,

Bucchieri,

Podda

et al. 2024

Front. Robot. AI

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“…Moreover, although gait and balance seem to be the most targeted functions for this kind of approach, there is preliminary evidence about the effectiveness of VR-based treatments in terms of upper limb (UL) motor function, dexterity, and hand grip strength [6]. In this context, recent studies have demonstrated that VR-only training is able to improve clinical measures of UL function [7] as well as performance of tasks associated with activities of daily living [8], and specific software tailored on the needs of pwMS starts to show up [9,10].…”

Section: Introductionmentioning

confidence: 99%

Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality

Pau,

Arippa,

Leban

et al. 2024

Bioengineering

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Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired postural control (i.e., cybersickness). Since these symptoms can significantly impact the safety and tolerability of the treatment, it appears important to correctly estimate their presence and magnitude. Given the existing data scarcity, this study aims to assess the existence and severity of possible adverse effects associated with exposure to immersive VR in a cohort of pwMS using both objective measurements of postural control effectiveness and subjective evaluations of perceived symptoms. To this aim, postural sway under upright quiet posture (in the presence and absence of visual input) of 56 pwMS with an Expanded Disability Status Scale score (EDSS) in the range of 0–6.5 (mean EDSS 2.3) and 33 unaffected individuals was measured before and after a 10-min immersive VR session and at 10 min follow-up on the basis of center of pressure (COP) trajectories. The severity of cybersickness symptoms associated with VR exposure was also self-rated by the participants using the Italian version of the Simulator Sickness Questionnaire (SSQ). Temporary impairments of postural control in terms of significantly increased sway area were observed after the VR session only in pwMS with mild–moderate disability (i.e., EDSS in the range of 2.5–6.5) in the presence of visual input. No changes were observed in pwMS with low disability (EDSS 0–2) and unaffected individuals. In contrast, when the visual input was removed, there was a decrease in sway area (pwMS with mild–moderate disability) and COP path length relating to the use of VR (pwMS with mild–moderate disability and unaffected individuals), thus suggesting a sort of “balance training effect”. Even in this case, the baseline values were restored at follow-up. All participants, regardless of their status, experienced significant post-VR side effects, especially in terms of blurred vision and nausea. Taken together, the findings of the present study suggest that a short immersive VR session negatively (eyes open) and positively (eyes closed) impacts the postural control of pwMS and causes significant disorientation. However, such effects are of limited duration. While it is reasonable to state that immersive VR is sufficiently safe and tolerable to not be contraindicated in the rehabilitation/training of pwMS, in order to reduce possible negative effects and maximize the efficacy, safety and comfort of the treatment, it appears necessary to develop specific guidelines that consider important factors like individual susceptibility, maximum exposure time according to the specific features of the simulation, posture to adopt and protocols to assess objective and perceived effects on participants.

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“…They, thus, represent a promising solution for combining a highly stimulating intervention in an enriched environment with a portable and flexible motion capture system. Given the characteristics of modern HMDs, there are presently several ongoing studies to use them in the rehabilitation of neurological disorders such as multiple sclerosis [ 31 ] and stroke [ 32 ]. However, while the clinical outcomes of immersive VR-based rehabilitation interventions have been thoroughly investigated [ 32 , 33 , 34 ], their potential use as kinematic measurement devices has receive significant less attention.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Comparison of Hand Kinematics Measured with a Markerless Commercial Head-Mounted Display and a Marker-Based Motion Capture System in Stroke Survivors

Casile,

Fregna,

Boarini

et al. 2023

Sensors

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Upper-limb paresis is common after stroke. An important tool to assess motor recovery is to use marker-based motion capture systems to measure the kinematic characteristics of patients’ movements in ecological scenarios. These systems are, however, very expensive and not readily available for many rehabilitation units. Here, we explored whether the markerless hand motion capabilities of the cost-effective Oculus Quest head-mounted display could be used to provide clinically meaningful measures. A total of 14 stroke patients executed ecologically relevant upper-limb tasks in an immersive virtual environment. During task execution, we recorded their hand movements simultaneously by means of the Oculus Quest’s and a marker-based motion capture system. Our results showed that the markerless estimates of the hand position and peak velocity provided by the Oculus Quest were in very close agreement with those provided by a marker-based commercial system with their regression line having a slope close to 1 (maximum distance: mean slope = 0.94 ± 0.1; peak velocity: mean slope = 1.06 ± 0.12). Furthermore, the Oculus Quest had virtually the same sensitivity as that of a commercial system in distinguishing healthy from pathological kinematic measures. The Oculus Quest was as accurate as a commercial marker-based system in measuring clinically meaningful upper-limb kinematic parameters in stroke patients.

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Effect of immersive virtual reality training on hand-to-mouth task performance in people with Multiple Sclerosis: A quantitative kinematic study

Cited by 8 publications

References 37 publications

Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments

Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments

Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality

Quantitative Comparison of Hand Kinematics Measured with a Markerless Commercial Head-Mounted Display and a Marker-Based Motion Capture System in Stroke Survivors

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