Immersive virtual reality during gait rehabilitation increases walking speed and motivation: a usability evaluation with healthy participants and patients with multiple sclerosis and stroke

Winter, Carla; Kern, Florian; Gall, Dominik; Latoschik, Marc Erich; Pauli, Paul; Käthner, Ivo

doi:10.1186/s12984-021-00848-w

Cited by 82 publications

(63 citation statements)

References 65 publications

(84 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, VR can be considered semi-immersive when large screens are used [24]. In comparison, immersive VR (iVR) allows a 360 • view of a virtual environment through a head-mounted display, in which patients can interact with virtual objects by using hand-held controllers or their own hands [25]. Some examples of this technology are the Oculus Quest or HTC Vive.…”

Section: Introductionmentioning

confidence: 99%

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Cortés‐Pérez

Sánchez-Alcalá

Nieto-Escámez

et al. 2021

Sensors

View full text Add to dashboard Cite

Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.

show abstract

Section: Introductionmentioning

confidence: 99%

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Cortés‐Pérez

Sánchez-Alcalá

Nieto-Escámez

et al. 2021

Sensors

View full text Add to dashboard Cite

show abstract

“…However, a fully immersive VR treadmill exergame can expose the individual to tasks beyond merely viewing a scene as in the study by Kim et al ( 2017 ). A good example of this is the VR environment used by Winter et al ( 2021 ) where players rebuild their companions world by walking on a treadmill. The technology can easily be used to create a multi-component environment where the player can perform more complicated tasks that focus on training specific functions while walking on a treadmill—although these could turn out to be too demanding and cause frustration or rejection (Laver et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Experiences of Stroke Survivors and Clinicians With a Fully Immersive Virtual Reality Treadmill Exergame for Stroke Rehabilitation: A Qualitative Pilot Study

Moan

Vonstad

et al. 2021

Front. Aging Neurosci.

View full text Add to dashboard Cite

Use of VR-games is considered a promising treatment approach in stroke rehabilitation. However, there is little knowledge on the use and expectations of patients and health professionals regarding the use of treadmill walking in a fully immersive virtual environment as a rehabilitation tool for gait training for stroke survivors. The objectives of the current study were to determine whether stroke survivors can use fully immersive VR utilizing modern HMDs while walking on a treadmill without adverse effects, and to investigate the experiences of stroke survivors and clinicians after testing with focus on acceptability and potential utilization in rehabilitation. A qualitative research design with semi-structured interviews was used to collect data. Five stroke survivors and five clinicians participated in the study and tested a custom-made VR-game on the treadmill before participating in individual semi-structured interview. Data were analyzed through thematic analysis. The analysis of the interview data identified two main categories: (1) experiencing acceptability through safety and motivation, and (2) implementing fully immersive VR in rehabilitation. Both stroke survivors' and clinicians enjoyed the treadmill-based VR-game and felt safe when using it. The stroke survivors experienced motivation for exercising and achievement by fulfilling tasks during the gaming session as the VR-game was engaging. The clinicians found additional motivation by competing in the game. Both groups saw a potential for use in gait rehabilitation after stroke, on the premise of individual adaptation to each patient's needs, and the technology being easy to use. The findings from this qualitative study suggest that a fully immersive treadmill-based VR-game is acceptable and potentially useful as part of gait rehabilitation after stroke, as it was positively received by both stroke survivors and clinicians working within stroke rehabilitation. The participants reported that they experienced motivation in the game through safety, engagement and achievement. They also saw the potential of implementing such a setup in their own rehabilitation setting. Elements that enable safety and engaging experience are important to maintain when using a fully immersive VR-game in stroke rehabilitation.

show abstract

“…The rehabilitation of gait disorders in patients with multiple sclerosis and stroke is often based on conventional treadmill training. VR-based treadmill training can increase motivation and improve therapy outcomes [3]. The same is confirmed for upper limb motor recovery, when combined with arm cycling [4].…”

Section: Introductionmentioning

confidence: 80%

Digital Technologies for Innovative Mental Health Rehabilitation

et al. 2021

View full text Add to dashboard Cite

Schizophrenia is a chronic mental illness, characterized by the loss of the notion of reality, failing to distinguish it from the imaginary. It affects the patient in life’s major areas, such as work, interpersonal relationships, or self-care, and the usual treatment is performed with the help of anti-psychotic medication, which targets primarily the hallucinations, delirium, etc. Other symptoms, such as the decreased emotional expression or avolition, require a multidisciplinary approach, including psychopharmacology, cognitive training, and many forms of therapy. In this context, this paper addresses the use of digital technologies to design and develop innovative rehabilitation techniques, particularly focusing on mental health rehabilitation, and contributing for the promotion of well-being and health from a holistic perspective. In this context, serious games and virtual reality allows for creation of immersive environments that contribute to a more effective and lasting recovery, with improvements in terms of quality of life. The use of machine learning techniques will allow the real-time analysis of the data collected during the execution of the rehabilitation procedures, as well as enable their dynamic and automatic adaptation according to the profile and performance of the patients, by increasing or reducing the exercises’ difficulty. It relies on the acquisition of biometric and physiological signals, such as voice, heart rate, and game performance, to estimate the stress level, thus adapting the difficulty of the experience to the skills of the patient. The system described in this paper is currently in development, in collaboration with a health unit, and is an engineering effort that combines hardware and software to develop a rehabilitation tool for schizophrenic patients. A clinical trial is also planned for assessing the effectiveness of the system among negative symptoms in schizophrenia patients.

show abstract

Immersive virtual reality during gait rehabilitation increases walking speed and motivation: a usability evaluation with healthy participants and patients with multiple sclerosis and stroke

Cited by 82 publications

References 65 publications

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis

Experiences of Stroke Survivors and Clinicians With a Fully Immersive Virtual Reality Treadmill Exergame for Stroke Rehabilitation: A Qualitative Pilot Study

Digital Technologies for Innovative Mental Health Rehabilitation

Contact Info

Product

Resources

About