Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: study protocol of a randomized clinical trial

Kairy, Dahlia; Veras, Mirella; Archambault, P.; Hernández, A.; Higgins, Johanne; Levin, Mindy F.; Poissant, Lise; Raz, Amir; Kaizer, Franceen

doi:10.1016/j.cct.2015.12.006

Cited by 50 publications

(39 citation statements)

References 35 publications

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“…We did not discard these articles because pilot studies are also a valuable source of information, but we considered them as an experience in relation to the patients involved. Finally, we chose only a few of articles (n=27) to assess applications of telerehabilitation to meet patients’ needs in everyday life [ 18 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

Telerehabilitation: Review of the State-of-the-Art and Areas of Application

Peretti

Amenta

Tayebati

et al. 2017

JMIR Rehabil Assist Technol

380

293

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BackgroundTelemedicine applications have been increasing due to the development of new computer science technologies and of more advanced telemedical devices. Various types of telerehabilitation treatments and their relative intensities and duration have been reported.ObjectiveThe objective of this review is to provide a detailed overview of the rehabilitation techniques for remote sites (telerehabilitation) and their fields of application, with analysis of the benefits and the drawbacks related to use. We discuss future applications of telerehabilitation techniques with an emphasis on the development of high-tech devices, and on which new tools and applications can be used in the future.MethodsWe retrieved relevant information and data on telerehabilitation from books, articles and online materials using the Medical Subject Headings (MeSH) “telerehabilitation,” “telemedicine,” and “rehabilitation,” as well as “disabling pathologies.”ResultsTelerehabilitation can be considered as a branch of telemedicine. Although this field is considerably new, its use has rapidly grown in developed countries. In general, telerehabilitation reduces the costs of both health care providers and patients compared with traditional inpatient or person-to-person rehabilitation. Furthermore, patients who live in remote places, where traditional rehabilitation services may not be easily accessible, can benefit from this technology. However, certain disadvantages of telerehabilitation, including skepticism on the part of patients due to remote interaction with their physicians or rehabilitators, should not be underestimated.ConclusionsThis review evaluated different application fields of telerehabilitation, highlighting its benefits and drawbacks. This study may be a starting point for improving approaches and devices for telerehabilitation. In this context, patients’ feedback may be important to adapt rehabilitation techniques and approaches to their needs, which would subsequently help to improve the quality of rehabilitation in the future. The need for proper training and education of people involved in this new and emerging form of intervention for more effective treatment can’t be overstated.

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Section: Resultsmentioning

confidence: 99%

Telerehabilitation: Review of the State-of-the-Art and Areas of Application

Peretti

Amenta

Tayebati

et al. 2017

JMIR Rehabil Assist Technol

380

293

View full text Add to dashboard Cite

show abstract

“…In addition, interacting with a VR environment of the patient's choosing activates reward mechanisms and is likely to encourage more of the activity. Finally, the overall simplicity of the apparatus and near ubiquitous availability of its components opens the door to using VR at home [115][116][117][118], increasing the likelihood that they will get more exposure to the therapy. However, it is likely that some stroke patients with USN will be more responsive to VR based VMA, due to multiple factors including overall stroke severity, lesion location, and level of attention impairment.…”

Section: Application To Patients With Usnmentioning

confidence: 99%

Inducing Visuomotor Adaptation Using Virtual Reality Gaming with a Virtual Shift as a Treatment for Unilateral Spatial Neglect

Carter¹,

Foreman²,

Martin³

et al. 2016

J. Intellect. Disabl. Diagn. Treat.

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Unilateral spatial neglect after stroke is characterized by reduced responses to stimuli on the contralesional side, causing significant impairments in self-care and safety. Conventional visuomotor adaptation (VMA) with prisms that cause a lateral shift of the visual scene can decrease neglect symptoms but is not engaging according to patients. Performing VMA within a virtual reality (VR) environment may be more engaging but has never been tested. To determine if VMA can be elicited in a VR environment, healthy subjects (n=7) underwent VMA that was elicited by either wearing prisms that caused an optical shift, or by application of a virtual shift of the hand cursor within the VR environment. A low cost VR system was developed by coupling the Kinect v2 gaming sensor to online games via the Flexible Action and Articulated Skeleton Toolkit (FAAST) software. The adaptation phase of training consisted of a reaching task in online games or in a custom target pointing program. Following the adaptation phase the optical or virtual shift was removed and participants were assessed during the initial portion of the de-adaptation phase for the presence of an after-effect on their reaching movements, with lateral reaching errors indicating the successful induction of VMA. Results show that practicing reaching in a VR environment with a virtual shift lead to a horizontal after-effect similar to conventional prism adaptation. The results demonstrate that VMA can be elicited in a VR environment and suggest that VR gaming therapy could be used to improve recovery from unilateral spatial neglect.

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“…Akin to the telemedicine efforts, telerehabilitation treatments have been proposed. However, telerehabilitation interactions are typically limited to off-line monitoring by the therapist [ 8 , 9 , 15 ], phone calls between a therapist and client [ 16 , 17 ], or videoconferencing [ 18 – 20 ]. While systems allowing more direct interaction have been proposed, the hardware cost and complexity limit applicability for home-based therapy [ 21 – 23 ].…”

Section: Introductionmentioning

confidence: 99%

Development of a 3D, networked multi-user virtual reality environment for home therapy after stroke

Triandafilou

Tsoupikova

Barry

et al. 2018

J NeuroEngineering Rehabil

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BackgroundImpairment of upper extremity function is a common outcome following stroke, to the detriment of lifestyle and employment opportunities. Yet, access to treatment may be limited due to geographical and transportation constraints, especially for those living in rural areas. While stroke rates are higher in these areas, stroke survivors in these regions of the country have substantially less access to clinical therapy. Home therapy could offer an important alternative to clinical treatment, but the inherent isolation and the monotony of self-directed training can greatly reduce compliance.MethodsWe developed a 3D, networked multi-user Virtual Environment for Rehabilitative Gaming Exercises (VERGE) system for home therapy. Within this environment, stroke survivors can interact with therapists and/or fellow stroke survivors in the same virtual space even though they may be physically remote. Each user’s own movement controls an avatar through kinematic measurements made with a low-cost, Kinect™ device. The system was explicitly designed to train movements important to rehabilitation and to provide real-time feedback of performance to users and clinicians. To obtain user feedback about the system, 15 stroke survivors with chronic upper extremity hemiparesis participated in a multisession pilot evaluation study, consisting of a three-week intervention in a laboratory setting. For each week, the participant performed three one-hour training sessions with one of three modalities: 1) VERGE system, 2) an existing virtual reality environment based on Alice in Wonderland (AWVR), or 3) a home exercise program (HEP).ResultsOver 85% of the subjects found the VERGE system to be an effective means of promoting repetitive practice of arm movement. Arm displacement averaged 350 m for each VERGE training session. Arm displacement was not significantly less when using VERGE than when using AWVR or HEP. Participants were split on preference for VERGE, AWVR or HEP. Importantly, almost all subjects indicated a willingness to perform the training for at least 2–3 days per week at home.ConclusionsMulti-user VR environments hold promise for home therapy, although the importance of reducing complexity of operation for the user in the VR system must be emphasized. A modified version of the VERGE system is currently being used in a home therapy study.Electronic supplementary materialThe online version of this article (10.1186/s12984-018-0429-0) contains supplementary material, which is available to authorized users.

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Maximizing post-stroke upper limb rehabilitation using a novel telerehabilitation interactive virtual reality system in the patient's home: study protocol of a randomized clinical trial

Cited by 50 publications

References 35 publications

Telerehabilitation: Review of the State-of-the-Art and Areas of Application

Telerehabilitation: Review of the State-of-the-Art and Areas of Application

Inducing Visuomotor Adaptation Using Virtual Reality Gaming with a Virtual Shift as a Treatment for Unilateral Spatial Neglect

Development of a 3D, networked multi-user virtual reality environment for home therapy after stroke

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