Head-Mounted Display-Based Virtual Reality and Physiological Computing for Stroke Rehabilitation: A Systematic Review

Abstract

Virtual reality (VR)-mediated rehabilitation is emerging as a useful tool for stroke survivors to recover motor function. Recent studies are showing that VR coupled with physiological computing (i.e., real-time measurement and analysis of different behavioral and psychophysiological signals) and feedback can lead to 1) more engaged and motivated patients, 2) reproducible treatments that can be performed at the comfort of the patient’s home, and 3) development of new proxies of intervention outcomes and success. While such systems have shown great potential for stroke rehabilitation, an extensive review of the literature is still lacking. Here, we aim to fill this gap and conduct a systematic review of the twelve studies that passed the inclusion criteria. A detailed analysis of the papers was conducted along with a quality assessment/risk of bias evaluation of each study. It was found that the quality of the majority of the studies ranked as either good or fair. Study outcomes also showed that VR-based rehabilitation protocols coupled with physiological computing can enhance patient adherence, improve motivation, overall experience, and ultimately, rehabilitation effectiveness and faster recovery times. Limitations of the examined studies are discussed, such as small sample sizes and unbalanced male/female participant ratios, which could limit the generalizability of the obtained findings. Finally, some recommendations for future studies are given.

VR for Vocational and Ecological Rehabilitation of Patients With Cognitive Impairment: A Survey

“…Motor rehabilitation is a domain in which VR is actively used, as VE are under full control and allow to monitor the user precisely [39]. Additionally, cognitive-motor interference allow to use motor tasks to target cognitive rehabilitation or as a mean to create a more challenging exercise, or vice versa [40].…”

“…Combined with a high sense of presence and realism, all these elements may help patients with their rehabilitation. VR applications for motor deficit combines different technological assets like exoskeletons, HMD, hand or motion tracking and haptic feedback to provide a multi-modal rehabilitation [39].…”

“…Upper limb rehabilitation usually requires hand tracking to give an insight of the finger or arms position. Some approaches increase the precision of the tracking using complementary devices [39]. For lower limb rehabilitation, various devices can be used to monitor the balance and posture of the user such as motion tracking suits, infrared cameras or platforms.…”

Enhancing motor imagery detection efficacy using multisensory virtual reality priming

“…Virtual reality (VR) has emerged as one particular presentation modality that has shown to positively impact BCI performance (Vourvopoulos et al, 2016 ; Amini Gougeh and Falk, 2022a ; Arpaia et al, 2022 ; Choy et al, 2022 ). VR-based presentation can increase the sense of embodiment, improve immersion, and foster greater engagement levels, which, in turn, could lead to the generation of neural signals with increased discriminability (Škola and Liarokapis, 2018 ; Vourvopoulos et al, 2019 ).…”

“…VR-based presentation can increase the sense of embodiment, improve immersion, and foster greater engagement levels, which, in turn, could lead to the generation of neural signals with increased discriminability (Škola and Liarokapis, 2018 ; Vourvopoulos et al, 2019 ). In fact, Amini Gougeh and Falk ( 2022a ) surveyed the literature and showed that VR coupled with MI-BCIs could lead to improved neurorehabilitation outcomes.…”