Pilot study: Computer-based virtual anatomical interactivity for rehabilitation of individuals with chronic acquired brain injury

Abstract

Abstract-Deficiencies in upper-limb motor function and executive functioning can compromise an affected individual's ability to complete everyday activities. Impaired motor and executive functioning therefore pose a risk to increasing numbers of veterans who have been diagnosed with acquired brain injury. This article reports on changes in upper-limb motor function and executive functioning of 12 adult participants with chronic acquired brain injury using a novel, computer-based, motor and cognitive rehabilitation program called PreMotor Exercise Games (PEGs). Manual muscle, goniometric range of motion, and dynamometer assessments were used to determine motor functioning while the Executive Function Performance Test measured cognitive functioning. A three-level repeated measures design was conducted to determine changes pre-and postintervention. Participants demonstrated significant improvement in shoulder (p = 0.01) and wrist (p = 0.01) range of motion and clinically relevant improvement for elbow range of motion. Participants demonstrated clinically relevant improvement in shoulder, elbow, and wrist strength. Finally, participants demonstrated significant improvement in executive functioning (p < 0.05). Using PEGs as a modality for both motor and cognitive intervention is a potentially beneficial adjunct to rehabilitation and warrants further study.

The Effectiveness of Virtual Reality Interventions for Improvement of Neurocognitive Performance After Traumatic Brain Injury: A Systematic Review

“…One comparative study was a cross-over study 17 . Two non-comparative studies evaluated all acquired brain injury patients, meaning that patients that had previously suffered a stroke were also included: one study had one patient with TBI and three stroke patients 18 , and another study had four patients with TBI and eight stroke patients 19 .…”

Computer-Based Cognitive Rehabilitation Interventions for Traumatic Brain Injury: A Critical Review of the Literature

“…Of the studies identified, two evaluated the CogMed QM software; 9,13 two studies evaluated study-specific computer-based cognitive training software; 11,14 and two studies evaluated Parrott software. 15,16 Of the remaining, one study evaluated Rehacom; 12 one study evaluated ProMotor Exercise Games; 17 one study evaluated a virtual reality cognitive rehabilitation program; 18 and one study used both Attention Process Training (APT-3) and Lumosity games. 19 Two studies randomized participants to receive rehabilitation plus the intervention or rehabilitation alone.…”

“…Simmons et al 17 tested a computer-based virtual reality intervention among participants with acquired brain injury recruited from an adult care center on upper extremity motor function and executive function. The intervention study was conducted using a three-level repeated measures design.…”

“…13,14 The Wechsler Adult Intelligence Scale III and Barrow Neurological Institute Screen for Higher Cerebral Functions (BNIS) were used in one study. 9 Also present in one study each were the Trail Making Test (TMT-A and B) 12 , Cognistat Assessment 15 , Montreal Cognitive Assessment (MoCA 7.1) and Medication-box sorting test 16 , Executive Function Performance Test 17 , and Test of Everyday Attention and Adapted version of the Neurological Assessment Battery 19 . Several studies used multiple measures of cognitive performance.…”

“…Specifically, there were no details provided on the type and severity of acquired brain injury in some publications. 9,11,17-20 Other publications provided the number of participants with TBI but not the severity. 12-16 One study included participants with prior TBI of at least one year and with ages ranging from 34-84 years.…”