Rehabilitation of the head-injured child: basic research and new technology

Abstract

The view that brain damage in children is less impairing than equivalent damage in adults is no longer acceptable. However, it is acknowledged that recovery following brain damage, when it does occur, owes much to the plasticity of the brain and that the young brain displays greater plasticity than the mature brain. To maximize brain damage recovery in children we need to focus both on what is known about brain plasticity and how to influence it. Research on environmental enrichment in rats has told us that enforced interaction with a complex environment can both stimulate anatomical and biochemical plasticity and ameliorate some of the behavioural consequences of brain damage. The view that environmental interaction has rehabilitative value also accords with clinical experience. However, the sensory, motor and cognitive consequences of brain damage often conspire to make environmental interaction difficult. One potential solution lies in using computers to generate virtual environments tailored to the precise sensory and motor capacities of the brain-injured child. In this way children may be enabled to benefit from environmental interaction whatever their level of disability. The use of Virtual Reality (VR) in the context of rehabilitation is discussed and relevant work reviewed.

Route Learning in a Case of Amnesia: A Preliminary Investigation into the Efficacy of Training in a Virtual Environment

“…The potential value of virtual environments within neurological rehabilitation has been discussed by several authors in recent years (Rizzo & Buckwalter, 1997;Rose, Attree, & Johnson, 1996;Rose, Johnson, & Attree, 1997). The two most popular ways in which virtual environments are currently being used are described as "immersive" and "non-immersive".…”

A Review of Indoor Localization Technologies: towards Navigational Assistance for Topographical Disorientation

“…Individuals living with post-traumatic effects of brain injury are oftentimes faced with symptoms such as weak visual scanning skills, or deficits in complex attention, prospective memory or sequential processing [47]. These symptoms cause problems of interaction with and perception of the surrounding environment even several years post-injury [16,72]. It has also been argued that deficits in topographical orientation can lead to spatial anxiety or wandering behaviours [11,77,87].…”

A Paediatric Interactive Therapy System for arm and hand rehabilitation

“…It typically works by creating motivating exercise environments with systematic manipulation of intensity of practice and positive feedback. Attractive enriched environments, such as those that can be provided using VR technologies, may ameliorate some consequences of brain damage by stimulating motor learning and neuronal plasticity [1], [2]. It has been postulated that training and treatment of motor functions using VR can improve brain structure and function [3].…”

“…The available results include treatment of upper limbs in children with cerebral palsy [6], [7] and brain injury [2], [8], [9], training of cognitive skills and attention [10] and investigation of neuropsychological disorders [11]. The motor therapy results found improvements in reaching quality, force and muscle activation and understanding of compensation strategies [12].…”