Virtual Environment Training Therapy for Arm Motor Rehabilitation

Piron, Lamberto; Tonin, Paolo; Piccione, Francesco; Iaia, Vincenzo; Trivello, Elena; Dam, Mauro

doi:10.1162/105474605775196580

Cited by 77 publications

(41 citation statements)

References 27 publications

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“…[15][16][17][18][19][20][21][22][23][24][25][26] Among them, there were 5 RCTs 18,19,22,23,26 and 7 observational studies with a pre-/ postintervention design. [15][16][17]20,21,23,25 Table 2 summarizes the studies' characteristics and outcomes. Studies included VR (nϭ9) and commercial video game (nϭ3) interventions.…”

Section: Resultsmentioning

confidence: 99%

Virtual Reality in Stroke Rehabilitation

Saposnik

Levin

2011

Stroke

515

204

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Background and Purpose-Approximately two thirds of stroke survivors continue to experience motor deficits of the arm resulting in diminished quality of life. Conventional rehabilitation provides modest and sometimes delayed effects. Virtual reality (VR) technology is a novel adjunctive therapy that could be applied in neurorehabilitation. We performed a meta-analysis to determine the added benefit of VR technology on arm motor recovery after stroke. Methods-We searched Medline, EMBASE, and Cochrane literature from 1966 to July 2010 with the terms "stroke,""virtual reality," and "upper arm/extremity." We evaluated the effect of VR on motor function improvement after stroke. Results-From the 35 studies identified, 12 met the inclusion/exclusion criteria totaling 195 participants. Among them, there were 5 randomized clinical trials and 7 observational studies with a pre-/postintervention design. Interventions were delivered within 4 to 6 weeks in 9 of the studies and within 2 to 3 weeks in the remaining 3. Eleven of 12 studies showed a significant benefit toward VR for the selected outcomes. In the pooled analysis of all 5 randomized controlled trials, the effect of VR on motor impairment (Fugl-Meyer) was ORϭ4.

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Section: Resultsmentioning

confidence: 99%

Virtual Reality in Stroke Rehabilitation

Saposnik

Levin

2011

Stroke

515

204

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“…Various methods can be used by a therapist to provide feedback, such as verbal and non-verbal cues. Some research has been conducted investigating alternative feedback mediums including a computer-based display (Jang et al, 2003;Piron et al, 2005) and video recordings (Gilmore & Spaulding, 2007). The timing of feedback may also vary, with feedback being provided during, immediately after or following task performance (Winstein, 1991).…”

Section: Effectiveness Of Feedback For Improving Motor Performance Pomentioning

confidence: 99%

Feasibility of a home-based program to improve handwriting after stroke: a pilot study

Simpson

McCluskey

Lannin

et al. 2015

Disability and Rehabilitation

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facilities, health-related websites and in a seniors' newspaper. Eligibility criteria included having sustained a stroke at least three months previously, having self-reported difficulties with, and goals related to, handwriting, being able to hold a pen, and having sufficient cognitive and communication skills to complete a daily home program.A four-week, home-based handwriting training program was delivered by an occupational therapist. The intervention applied principles of task-specific motor training, involving intensive practice of meaningful handwriting tasks related to participant goals. Whole handwriting tasks were practised, as well as problematic handwriting task components. An occupational therapist provided supervised practice and coaching, giving feedback on task performance and using shaping to achieve the right level of challenge. Two 1-hour therapy sessions were provided per week. Another three hours per week of independent, unsupervised practice was prescribed to increase practice intensity. Participants were taught cognitive strategies to analyse their handwriting performance and problem-solve ways to improve specific handwriting features.Handwriting performance was measured at baseline, after the training program (at four weeks) and four weeks later. The primary outcome measure was the modified Evaluation Tool of Children's Handwriting-Words (mETCH-W), a subtest of the Handwriting Assessment Battery (HAB). Secondary outcome measures included other subtests of the HAB, the modified Four Point Scale, and the modified Disability of the Arm, Shoulder and Hand (DASH) Scale. Legibility was scored by a blinded rater.Feasibility of recruitment, intervention and outcome measures was evaluated using descriptive statistics, including means, standard deviations and proportions. Utility of the outcome measures was also evaluated by comparing participant score at baseline, postintervention and follow-up. Mean or median change scores were then calculated between these three time points and reported with a 95% confidence interval or interquartile range.Results: Seven adults with stroke were recruited over 18 months (eligibility fraction 43% of those screened, and enrolment fraction 78% of those eligible). There were no dropouts. Mean time post stroke was 2.6 years (range: 3 months to 7 years). Mean age was 71 years (range: 50 to 87 years). Mean disability measured using the Modified Rankin Scale was 2.3 (range 1 to 4). Although recruitment was slow, the intervention was feasible. Participants completed a mean of 7.9 hours of occupational therapy supervised handwriting practice (range: 7.6 to 8.3 hours) and 10 hours of independent practice (range: 6 to 14 hours). Participants were able to

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“…It was suggested that VR-mediated rehabilitation is an effective and efficient approach to (re)train a set of basic tasks with upgrading to a wide variety of skilled movements (Holden, 2005). Piron et al (2005) replicated these results in a study on 50 patients with impaired upper limb motion after stroke. The VR-supported rehabilitation system included a virtual environment (a PC workstation with a wall screen), a motion tracking device and the dedicated software for editing 3D-scenarios in a learning-by-imitation rehabilitation process with a virtual teacher.…”

Section: Vr In the Upper Limb Motor Rehabilitationmentioning

confidence: 82%