A Paediatric Interactive Therapy System for arm and hand rehabilitation

Paediatric rehabilitation using virtual reality systems pose unique usability challenges distinct from those in adult rehabilitation. These challenges relate to the different epidemiology and aetiology of childrenpsilas disorders requiring rehabilitation and the physical design of interactive virtual reality hardware for children of varying sizes. Just as importantly, children need highly entertaining interactive scenarios that suit their differing levels of cognitive development and thus their differing abilities to comprehend gaming scenarios. In this paper we present our virtual reality-based Paediatric Interactive Therapy System (PITS) designed specifically for upper arm rehabilitation in children aged from five years of age upwards. It incorporates a range of interchangeable position sensing devices (compass, bend sensor, pressure sensor and camera tracking) that can be adjusted to a large range of different hand sizes, and interactive gaming scenarios specifically designed for maximum entertainment value for children. We describe the neuroscientific principles behind our system, the technical details of the hardware components and the design of the interactive scenarios. An initial usability and patient acceptance pilot study has been conducted at the Rehabilitation Centre Affoltern of the University Childrenpsilas Hospital Zurich. To date all patients have accepted the system, and trained in reaching and grasping tasks at a far higher rate than in conventional occupational therapy. The system thus promises to be a valuable complement to conventional therapeutic programs offered in rehabilitation clinics.

[1]  J. McComas,et al.  Current uses of virtual reality for children with disabilities. , 1998, Studies in health technology and informatics.

[2]  V. Mathiowetz,et al.  Adult norms for the Box and Block Test of manual dexterity. , 1985, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[3]  G. Rizzolatti,et al.  The mirror neuron system. , 2009, Archives of neurology.

[4]  Clark C. Presson,et al.  Normative and Validation Studies of the Nine-Hole Peg Test with Children , 2000, Perceptual and motor skills.

[5]  Dong Pyo Jang,et al.  The Effect of Virtual Reality Cognitive Training for Attention Enhancement , 2002, Cyberpsychology Behav. Soc. Netw..

[6]  M. Grealy,et al.  The rehabilitation of brain injured children: the case for including physical exercise and virtual reality. , 2000, Pediatric rehabilitation.

[7]  Paul F. M. J. Verschure,et al.  Interactive visuo-motor therapy system for stroke rehabilitation , 2007, Medical & Biological Engineering & Computing.

[8]  G. Rizzolatti,et al.  Motor facilitation during action observation: a magnetic stimulation study. , 1995, Journal of neurophysiology.

[9]  B. Johansson.  Functional and cellular effects of environmental enrichment after experimental brain infarcts. , 2004, Restorative neurology and neuroscience.

[10]  Bernadett Kiss,et al.  Developing multimedia software and virtual reality worlds and their use in rehabilitation and psychology. , 2004, Studies in health technology and informatics.

[11]  Mark Hallett,et al.  Cortical reorganization induced by virtual reality therapy in a child with hemiparetic cerebral palsy , 2005, Developmental medicine and child neurology.

[12]  W J van der Eerden,et al.  CAREN--Computer Assisted Rehabilitation Environment. , 1999, Studies in health technology and informatics.

[13]  H. Théoret,et al.  The mirror neuron system: grasping others' actions from birth? , 2007, Developmental science.

[14]  D. Reid.  Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study , 2002, Pediatric rehabilitation.

[15]  S. Fecteau,et al.  A motor resonance mechanism in children? Evidence from subdural electrodes in a 36-month-old child , 2004, Neuroreport.

[16]  Joseph P. McCleery,et al.  EEG evidence for mirror neuron dysfunction in autism spectrum disorders. , 2005, Brain research. Cognitive brain research.

[17]  J B Carlin,et al.  Reliability of the Melbourne assessment of unilateral upper limb function. , 2001, Developmental medicine and child neurology.

[18]  Tien-Yow Chuang,et al.  Use of Virtual Reality to Improve Upper-Extremity Control in Children With Cerebral Palsy: A Single-Subject Design , 2007, Physical Therapy.

[19]  Kimatha Oxford Grice,et al.  Adult norms for a commercially available Nine Hole Peg Test for finger dexterity. , 2003, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[20]  Maggie Campbell.  The rehabilitation of brain injured children: the case for including physical exercise and virtual reality: a clinical perspective , 2002, Pediatric rehabilitation.

[21]  Denise Reid,et al.  The influence of virtual reality on playfulness in children with cerebral palsy: a pilot study. , 2004, Occupational therapy international.

[22]  E. Bisson,et al.  Outcomes of intervention programs using flatscreen virtual reality , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[23]  Heidi Sveistrup,et al.  Feasibility, Motivation, and Selective Motor Control: Virtual Reality Compared to Conventional Home Exercise in Children with Cerebral Palsy , 2006, Cyberpsychology Behav. Soc. Netw..

[24]  John C. Mazziotta,et al.  Mirroring others' emotions relates to empathy and interpersonal competence in children , 2008, NeuroImage.

[25]  H. Bourke-Taylor.  Melbourne Assessment of Unilateral Upper Limb Function: construct validity and correlation with the Pediatric Evaluation of Disability Inventory , 2003, Developmental medicine and child neurology.

[26]  S. Small,et al.  Action observation has a positive impact on rehabilitation of motor deficits after stroke , 2007, NeuroImage.

[27]  G. Rizzolatti,et al.  Hearing Sounds, Understanding Actions: Action Representation in Mirror Neurons , 2002, Science.

[28]  D. Reid,et al.  The Influence of Virtual Reality Play on Children'S Motivation , 2005, Canadian journal of occupational therapy. Revue canadienne d'ergotherapie.

[29]  E. A. Attree,et al.  Rehabilitation of the head-injured child: basic research and new technology. , 1997, Pediatric rehabilitation.

[30]  G. Rizzolatti,et al.  Premotor cortex and the recognition of motor actions. , 1996, Brain research. Cognitive brain research.