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

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.

[1]  Ian H. Robertson,et al.  Does computerized cognitive rehabilitation work? A review , 1990 .

[2]  W. Greenough,et al.  Differential rearing effects on rat visual cortex synapses. III. Neuronal and glial nuclei, boutons, dendrites, and capillaries , 1987, Brain Research.

[3]  Peter A. Hancock,et al.  Transfer of training from virtual reality , 1993 .

[4]  M R Rosenzweig,et al.  Effects of differential experience on dendritic spine counts in rat cerebral cortex. , 1973, Journal of comparative and physiological psychology.

[5]  Simon K. Rushton,et al.  Binocular vision in a bi-ocular world: new-generation head-mounted displays avoid causing visual deficit , 1994 .

[6]  B. Will,et al.  Environmental approaches to recovery of function from brain damage: a review of animal studies (1981 to 1991). , 1992, Advances in experimental medicine and biology.

[7]  Mark R. Rosenzweig,et al.  Enriched and impoverished environments : effects on brain and behavior , 1987 .

[8]  F. Volkmar,et al.  Rearing Complexity Affects Branching of Dendrites in the Visual Cortex of the Rat , 1972, Science.

[9]  B Allen An integrated approach to Smart House technology for people with disabilities. , 1996, Medical engineering & physics.

[10]  P J Dyck,et al.  Intravenous immunoglobulin in chronic inflammatory demyelinating polyradiculoneuropathy and in neuropathy associated with IgM monoclonal gammopathy of unknown significance , 1990, Neurology.

[11]  M. Hallett,et al.  Modulation of motor cortical outputs to the reading hand of braille readers , 1993, Annals of neurology.

[12]  Gerald E. Schneider,et al.  Is it really better to have your brain lesion early? a revision of the “Kennard Principle” , 1979, Neuropsychologia.

[13]  W. Greenough,et al.  Subsynaptic plate perforations: changes with age and experience in the rat. , 1978, Science.

[14]  M. Diamond,et al.  Extensive cortical depth measurements and neuron size increases in the cortex of environmentally enriched rats , 1967 .

[15]  J. Mazziotta,et al.  Mapping motor representations with positron emission tomography , 1994, Nature.

[16]  L Pugnetti,et al.  Evaluation and retraining of adults' cognitive impairment: which role for virtual reality technology? , 1995, Computers in biology and medicine.

[17]  W. Greenough,et al.  Effect of environmental complexity on cortical synapses of rats: preliminary results. , 1972, Behavioral biology.

[18]  F. D. Rose,et al.  Virtual reality in rehabilitation following traumatic brain injury , 1996 .

[19]  David J. Brown,et al.  LIVE: learning in virtual environments , 1995 .

[20]  R. Benjamin Knapp,et al.  Controlling computers with neural signals. , 1996 .

[21]  S. Finger,et al.  Margaret Kennard and Her “Principle” in Historical Perspective , 1988 .

[22]  E. Bennett,et al.  Maze training alters brain weights and cortical RDA/DNA ratios. , 1979, Behavioral and neural biology.

[23]  E. A. Attree,et al.  Virtual reality: an assistive technology in neurological rehabilitation , 1996, Current opinion in neurology.

[24]  Francis Rose,et al.  Virtual reality in neurological rehabilitation , 1996 .

[25]  Eugenia M. Kolasinski,et al.  Simulator Sickness in Virtual Environments. , 1995 .

[26]  Dorothy Strickland,et al.  A Virtual Reality Application with Autistic Children , 1996, Presence: Teleoperators & Virtual Environments.

[27]  J. Larson,et al.  Effects of unilateral and bilateral training in a reaching task on dendritic branching of neurons in the rat motor-sensory forelimb cortex. , 1985, Behavioral and neural biology.