Nu!RehaVR: virtual reality in neuro tele-rehabilitation of patients with traumatic brain injury and stroke

The availability of virtual environments on the Web is fostering new applications of virtual reality in several fields, including some therapeutical applications. We present an application of virtual reality applied to the tele-rehabilitation of patients with traumatic brain injury and stroke. Our system, based on X3D and Ajax3D technologies, enhances the possibility of making tele-rehabilitation exercises aimed at the recovery of the neurological disease. The system, called Nu!RehaVR, has been designed to integrate the activity carried out on a tele-rehabilitation system, Nu!Reha (Nu!Reha is a trademark of Pragma Engineering srl. See http://www.nureha.eu) desk, with the activities performed in the virtual worlds, through some rehabilitation exercises in contexts incompatible with the patients’ impairments (not able to move or forced in static positions because of therapies, etc.). The architecture of Nu!RehaVR and the environments associated to two exercises, “Utilising an elevator to reach a given floor” and “Crossing a road using a traffic light”, are illustrated. These exercises can be considered as prototypes of a series of tele-rehabilitation exercises which help to stimulate the patients performing actions in relatively dangerous scenarios. The system is designed to allow the remote monitoring and assessment of the patient’s activities by the medical staff at the hospital using the communication facilities of the tele-rehabilitation system.

[1]  Kathleen Torsney.  Advantages and disadvantages of telerehabilitation for persons with neurological disabilities. , 2003, NeuroRehabilitation.

[2]  Michael L. Jones,et al.  Using Telerehabilitation to Identify Home Modification Needs , 2004, Assistive technology : the official journal of RESNA.

[3]  Scott M Lewis,et al.  Comparison of Finger Tracking Versus Simple Movement Training via Telerehabilitation to Alter Hand Function and Cortical Reorganization After Stroke , 2007, Neurorehabilitation and neural repair.

[4]  D. Fensterheim,et al.  Tele-Rehabilitation using the Rutgers Master II glove following Carpal Tunnel Release surgery , 2006, 2006 International Workshop on Virtual Rehabilitation.

[5]  Andrea Gaggioli,et al.  An Open-Source Virtual Reality Platform for Clinical and Research Applications , 2007, HCI.

[6]  Peter Levine,et al.  Modified constraint-induced therapy extension: using remote technologies to improve function. , 2007, Archives of physical medicine and rehabilitation.

[7]  Giuseppe Riva,et al.  Virtual Reality in Psychotherapy: Review , 2005, Cyberpsychology Behav. Soc. Netw..

[8]  D.J. Reinkensmeyer,et al.  Web-based telerehabilitation for the upper extremity after stroke , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[9]  M. Holden,et al.  Telerehabilitation Using a Virtual Environment Improves Upper Extremity Function in Patients With Stroke , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[10]  Jonathan J. Evans,et al.  Error-free Learning in the Rehabilitation of People with Memory Impairments , 1996 .

[11]  Maureen K. Holden,et al.  Virtual Environments for Motor Rehabilitation: Review , 2005, Cyberpsychology Behav. Soc. Netw..

[12]  Helen Hoenig,et al.  The Effects of In‐Home Rehabilitation on Task Self‐Efficacy in Mobility‐Impaired Adults: A Randomized Clinical Trial , 2006, Journal of the American Geriatrics Society.

[13]  P. Tonin,et al.  Virtual Reality as an assessment tool for arm motor deficits after brain lesions. , 2001, Studies in health technology and informatics.

[14]  Giuseppe Placidi,et al.  A smart virtual glove for the hand telerehabilitation , 2007, Comput. Biol. Medicine.

[15]  Klaus Abraham-Fuchs,et al.  Telerehabilitation Needs: A Survey of Persons with Acquired Brain Injury , 2002, The Journal of head trauma rehabilitation.

[16]  G. Burdea,et al.  Telerehabilitation Using the Rutgers Master II Glove Following Carpal Tunnel Release Surgery: Proof-of-Concept , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[17]  Roxanne Pickett Hauber,et al.  Telerehabilitation Support for Families at Home Caring for Individuals in Prolonged States of Reduced Consciousness , 2002, The Journal of head trauma rehabilitation.

[18]  Osvaldo Gervasi,et al.  An X3D Approach to Neuro-Rehabilitation , 2008, ICCSA.

[19]  William C Mann,et al.  The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in frail elderly men. , 2004, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[20]  V Popescu,et al.  Virtual reality-based orthopedic telerehabilitation. , 2000, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[21]  E. Opisso,et al.  Upper limb telerehabilitation with Home Care and Activity Desk (HCAD) system , 2007, 2007 Virtual Rehabilitation.

[22]  Paolo Tonin,et al.  Motor tele-rehabilitation in post-stroke patients , 2004, Medical informatics and the Internet in medicine.

[23]  Jun Nakanishi,et al.  Feedback error learning and nonlinear adaptive control , 2004, Neural Networks.

[24]  Annie J. Hill,et al.  An Internet-based telerehabilitation system for the assessment of motor speech disorders: a pilot study. , 2006, American journal of speech-language pathology.

[25]  Dorothy Strickland,et al.  The challenge of using virtual reality in telerehabilitation. , 2004, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[26]  R. Wootton,et al.  Physical outcome measurements via the Internet: reliability at two Internet speeds. , 2002, Journal of telemedicine and telecare.

[27]  Eloy Opisso,et al.  Feasibility of a home-based telerehabilitation system compared to usual care: arm/hand function in patients with stroke, traumatic brain injury and multiple sclerosis , 2008, Journal of telemedicine and telecare.

[28]  G.C. Burdea,et al.  Virtual reality-enhanced stroke rehabilitation , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[29]  Susan L Garber,et al.  Telerehabilitation for veterans with a lower-limb amputation or ulcer: Technical acceptability of data. , 2004, Journal of rehabilitation research and development.

[30]  Sally Sue Robinson,et al.  Use of telemedicine to follow special needs children. , 2003, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.