Immersive Virtual Reality in Post-Stroke Rehabilitation: A Systematic Review

Demeco, Andrea; Zola, Laura; Frizziero, Antonio; Martini, Chiara; Palumbo, Arrigo; Foresti, Ruben; Buccino, Giovanni; Cipolla, Costantino

doi:10.3390/s23031712

Cited by 62 publications

(56 citation statements)

References 97 publications

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“…The choice of environment used in this study was made in reference to previous studies. Previous studies have indicated that FIVR environments outperform SIVR and NIVR environments (Choi et al 2020b;Demeco et al 2023). Additionally, scientific publications have demonstrated the positive impact of embodiment (Matamala-Gomez et al 2022;Ventura et al 2023).…”

Section: Discussionmentioning

confidence: 97%

Designing an immersive virtual reality environment for hand rehabilitation purposes: A preliminary study

Tastan,

Başpınar,

Hamurcu

et al. 2024

Preprint

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This study investigates the influence of immersive virtual reality environments and gamification on the classification of imaginary motor (MI) signals and the associated increase in energy in the motor cortex region for neurorehabilitation purposes. Two immersive virtual environments, indoor and outdoor, were selected, each with gamified and non-gamified scenarios. Event-Related Desynchronization (ERD) data underwent analyses to determine if there were significant differences in ERD levels between distinct age groups and whether Fully Immersive Virtual Reality (FIVR) environments induced notable energy increases. The initial analysis found no significant energy changes between age groups under constant environmental conditions. In the second analysis, FIVR environments did not lead to a statistically significant increase in cortical energy for the 21–24 age group (Group I). However, a notable difference in cortical energy increase was identified between gamified and non-gamified environments within the 32–43 age group (Group II). The study also explored the impact of environmental factors on MI signal classification using four deep learning algorithms. The Recurrent Neural Network (RNN) classifier exhibited the highest performance, with an average accuracy of 86.83%. Signals recorded indoors showed higher average classification performance, with a significant difference observed among age groups. Group I participants performed better in non-gamified environments (88.8%), while Group II achieved high performance indoors, especially in the gamified scenario (93.6%). Overall, the research underscores the potential of immersive virtual environments and gamification in enhancing MI signal classification and cortical energy increase, with age and environmental factors influencing the outcomes.

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Section: Discussionmentioning

confidence: 97%

Designing an immersive virtual reality environment for hand rehabilitation purposes: A preliminary study

Tastan,

Başpınar,

Hamurcu

et al. 2024

Preprint

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“…[28][29][30] A scoping review also discovered, in contrast to another one, that many studies included psychological outcomes, including immediate intrinsic motivation, anxiety, depression, and mood. [28,[31][32][33] ADL and balance analysis indicated that improvement in BBS (4.78%) was significantly different between the DRA and CPT groups. This finding was in concordance with a previous study by Sana et al (2023) who reported increased improvement in balance (11.1%) following 8 weeks of virtual reality therapy than vestibular rehabilitation therapy in 34 patients with subacute hemiplegic stroke.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of a novel deep learning-based rehabilitation application on cardiopulmonary function, dynamic and static balance, gait function, and activities of daily living in adolescents with hemiplegic cerebral palsy

An,

Min,

Park

2024

Medicine

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Background: Adolescents with hemiplegic cerebral palsy undergo conventional physical therapy (CPT) to improve static and dynamic balance, activities of daily living and cardiopulmonary function. To overcome this problem, we developed an innovative deep learning-based rehabilitation application (DRA) to provide a motivational and chaffed platform for such individuals. DRA evaluates the patients’ functional abilities and diagnosis an appropriate therapeutic intervention like CPT. Methods: We compared the effects of DRA and CPT on 6-minute walking test (6 MWT), Borg rating of perceived exertion scale, Berg balance scale, functional ambulation category, and modified Barthel index in adolescents with hemiplegic cerebral palsy. A convenience sample of 30 adolescents with hemiplegic cerebral palsy was randomized into either the DRA or CPT group. DRA and CPT were administered to the participants, with each session lasting 30 minutes and apportioned thrice a week for a total of 4 weeks. Results: Analysis of variance was performed and the level of significance was set at P < .05. The analysis indicated that DRA showed therapeutic effects on 6 MWT, Berg balance scale, and modified Barthel index compared to CPT. Conclusion: Our results provide evidence that DRA can improve cardiopulmonary function, balance, and activities of daily living more effectively than CPT in adolescents with hemiplegic cerebral palsy.

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“…In post-stroke rehabilitation, common inclusion criteria may involve factors such as a certain time since the stroke event, specific types of strokes, and a particular level of upper limb motor impairment. On the other hand, exclusion criteria may consider factors such as severe cognitive impairments or co-morbidities that could interfere with the study intervention [26]. By carefully selecting participants based on the following inclusion and exclusion criteria, the study aimed to create a more homogeneous sample.…”

Section: Participantsmentioning

confidence: 99%

Evaluation of custom-made VR exergame for at-home Stroke rehabilitation. A longitudinal single-arm study.

Castillo,

Vega,

Cardona

et al. 2024

Preprint

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Exercise games (Exergames) based on Virtual Reality (VR) have emerged as a promising option for supporting physical rehabilitation in stroke users. As a com- plementary therapy, they offer valuable benefits such as therapy engagement and enjoyment. In this study, we assessed the effectiveness of an immersive, custom- made VR exergame designed for upper limb rehabilitation in stroke participants aged 50 and above. We conducted 14 sessions of 15 minutes involving ten par- ticipants (6 females, ages 58.1 ± 7.5 years old) who volunteered to participate in an assisted at-home rehabilitation process. The study employed a range of evaluation tests to measure physical rehabilitation and game user experience out- comes. The tests included pre- and post-assessments of range of motion (ROM), the Ashworth spasticity test, and the Borg rating of perceived fatigue question- naire. To evaluate the game participant experience, we used the VR Neuroscience Questionnaire (VRNQ), and the Immersive Tendencies Questionnaire (ITQ). Our results revealed significant improvements in the range of motion for elbow and shoulder flexion, extension, adduction, and abduction. Furthermore, we observed a reduction in Ashworth spasticity, and the fatigue scale showed reduced per- ception comparing the last with the first session, although the difference was insignificant. The VRNQ questionnaire indicated significant enhancements in the domains related to ”Game Experience” and ”Game Mechanics” and an overall reduction of the perceived “Motion Sickness”. In the ITQ questionnaire, partic- ipants reported high levels of ”Attention,” and while there were no significant differences in ”Immersion” and ”Enjoyment,” a considerable improvement was observed in ”Excitement”. In summary, our results indicate that the immersive VR exergame improved the range of motion, spasticity, and overall game user experience among participants with stroke in a longitudinal, single-arm inter- vention. We conclude that using custom-made VR exergames is an effective and motivating tool for upper limb rehabilitation, with positive changes in both clin- ical and perception outcomes, and the positive and measurable effects persist after the first sessions. These findings support using VR exergames as a comple- mentary tool for at-home rehabilitation therapy with good ease of use, improved physical rehabilitation outcomes, and high treatment adherence.

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Immersive Virtual Reality in Post-Stroke Rehabilitation: A Systematic Review

Cited by 62 publications

References 97 publications

Designing an immersive virtual reality environment for hand rehabilitation purposes: A preliminary study

Designing an immersive virtual reality environment for hand rehabilitation purposes: A preliminary study

Clinical effects of a novel deep learning-based rehabilitation application on cardiopulmonary function, dynamic and static balance, gait function, and activities of daily living in adolescents with hemiplegic cerebral palsy

Evaluation of custom-made VR exergame for at-home Stroke rehabilitation. A longitudinal single-arm study.

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