Virtual reality-enhanced stroke rehabilitation

A personal computer (PC)-based desktop virtual reality (VR) system was developed for rehabilitating hand function in stroke patients. The system uses two input devices, a CyberGlove and a Rutgers Master II-ND (RMII) force feedback glove, allowing user interaction with a virtual environment. This consists of four rehabilitation routines, each designed to exercise one specific parameter of hand movement: range, speed, fractionation or strength. The use of performance-based target levels is designed to increase patient motivation and individualize exercise difficulty to a patient's current state. Pilot clinical trials have been performed using the above system combined with noncomputer tasks, such as pegboard insertion or tracing of 2D patterns. Three chronic stroke patients used this rehabilitation protocol daily for two weeks. Objective measurements showed that each patient showed improvement on most of the hand parameters over the course of the training. Subjective evaluation by the patients was also positive. This technical report focuses on this newly developed technology for VR rehabilitation.

[1]  E. Taub,et al.  Constraint-induced movement therapy and massed practice. , 2000, Stroke.

[2]  M Girone,et al.  Orthopedic rehabilitation using the "Rutgers ankle" interface. , 2000, Studies in health technology and informatics.

[3]  T. Olsen,et al.  Outcome and time course of recovery in stroke. Part I: Outcome. The Copenhagen Stroke Study. , 1995, Archives of physical medicine and rehabilitation.

[4]  P N Wilson,et al.  Virtual reality, disability and rehabilitation. , 1997, Disability and rehabilitation.

[5]  S. Wolf,et al.  Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients , 1989, Experimental Neurology.

[6]  J. Liepert,et al.  Treatment-induced cortical reorganization after stroke in humans. , 2000, Stroke.

[7]  Daniel H. Gomez.  A dextrous hand master with force feedback for virtual reality , 1998 .

[8]  E Taub,et al.  New discovery equals change in clinical practice. , 1999, Journal of rehabilitation research and development.

[9]  Grigore C. Burdea,et al.  A virtual-reality-based telerehabilitation system with force feedback , 2000, IEEE Transactions on Information Technology in Biomedicine.

[10]  P. Duncan.  Synthesis of Intervention Trials To Improve Motor Recovery following Stroke. , 1997, Topics in stroke rehabilitation.

[11]  P. Rijken,et al.  Clinical experience of rehabilitation therapists with chronic diseases: a quantitative approach , 1998, Clinical rehabilitation.

[12]  Michael R. Ault.  Oracle8i Administration and Management , 1999 .

[13]  E. Taub,et al.  Constraint Induced Movement Techniques To Facilitate Upper Extremity Use in Stroke Patients. , 1997, Topics in stroke rehabilitation.

[14]  G. Kwakkel,et al.  Effects of intensity of rehabilitation after stroke. A research synthesis. , 1997, Stroke.

[15]  M. Dam,et al.  The Effects of Long‐term Rehabilitation Therapy on Poststroke Hemiplegic Patients , 1993, Stroke.

[16]  N. Hogan,et al.  A novel approach to stroke rehabilitation , 2000, Neurology.

[17]  T. Olsen,et al.  Outcome and time course of recovery in stroke. Part II: Time course of recovery. The Copenhagen Stroke Study. , 1995, Archives of physical medicine and rehabilitation.

[18]  R. Werner,et al.  Effectiveness of an intensive outpatient rehabilitation program for postacute stroke patients. , 1996, American journal of physical medicine & rehabilitation.

[19]  Carl Machover,et al.  Virtual reality , 1994, IEEE Computer Graphics and Applications.

[20]  H. Flor,et al.  Plasticity in the motor system related to therapy-induced improvement of movement after stroke. , 1999, Neuroreport.

[21]  R. H. Jebsen,et al.  An objective and standardized test of hand function. , 1969, Archives of physical medicine and rehabilitation.

[22]  J. Liepert,et al.  Motor cortex plasticity during constraint-induced movement therapy in stroke patients , 1998, Neuroscience Letters.

[23]  Nigel Foreman,et al.  Transfer of spatial information from a virtual to a real environment in physically disabled children , 1996 .

[24]  Nigel Foreman,et al.  VR and spatial awareness in disabled children , 1997, CACM.

[25]  N. Hogan,et al.  Robot-aided neurorehabilitation. , 1998, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

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

[27]  Simon K. Rushton,et al.  Rehabilitative environments for attention and movement disorders , 1997, CACM.

[28]  R. Nudo,et al.  Neural Substrates for the Effects of Rehabilitative Training on Motor Recovery After Ischemic Infarct , 1996, Science.

[29]  E Bizzi,et al.  Augmented Feedback Presented in a Virtual Environment Accelerates Learning of a Difficult Motor Task. , 1997, Journal of motor behavior.

[30]  N. Miller,et al.  An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping. , 1994, Journal of the experimental analysis of behavior.

[31]  M. Merzenich,et al.  Reorganization of neocortical representations after brain injury: a neurophysiological model of the bases of recovery from stroke. , 1987, Progress in brain research.

[32]  Michael Recce,et al.  A virtual reality-based exercise program for stroke rehabilitation , 2000, Assets '00.

[33]  E. Taub,et al.  Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. , 1999, Journal of rehabilitation research and development.

[34]  N. Hogan,et al.  The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke. , 1997, Archives of neurology.

[35]  S. G. Nelson,et al.  Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. , 1983, Physical therapy.

[36]  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.

[37]  Philippe Coiffet,et al.  Virtual Reality Technology , 1992 .

[38]  N. Miller,et al.  Technique to improve chronic motor deficit after stroke. , 1993, Archives of physical medicine and rehabilitation.

[39]  N. Hogan,et al.  Robot training enhanced motor outcome in patients with stroke maintained over 3 years , 1999, Neurology.

[40]  Howard Rheingold,et al.  Virtual Reality , 1991 .

[41]  K. Rim,et al.  Maximum Finger Force Prediction Using a Planar Simulation of the Middle Finger , 1990, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[42]  Judith E. Deutsch,et al.  Rehabilitation of Musculoskeletal Injuries Using the Rutgers Ankle Haptic Interface: Three Case Reports , 2001 .

[43]  Suzanne Weghorst,et al.  Augmented reality and Parkinson's disease , 1997, CACM.

[44]  P. Langhorne,et al.  Physiotherapy after stroke: more is better? , 1996, Physiotherapy research international : the journal for researchers and clinicians in physical therapy.

[45]  A K Williams,et al.  Rehabilitation of chronic stroke patients: changes in functional performance. , 1990, Archives of physical medicine and rehabilitation.