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Abstract : Personalized Virtual Reality for Upper Extremity Rehabilitation: Moving from the Clinic to a Home Exercise Program
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Abstract: Introduction: Traditional rehabilitation does not provide adequate repetitions for maximal motor recovery in the clinic and home exercise programs (HEPs) have low compliance rates. Personalized virtual reality (PVR) is a promising low-cost therapeutic tool for improving compliance by incorporating the client's interests, abilities, and goals into a motivating and engaging intervention using internet games. Objectives: The current study aimed to develop and refine a clinic-to-home PVR intervention, determine its feasibility and usability in an outpatient rehabilitation clinic and as a HEP, and examine its effects on motivation/engagement, compliance, motor repetitions, and functional motor performance. Methods: The PVR system utilizes a Microsoft Kinect sensor to track the participants’ movements, free software to translate movements to keystrokes, and free internet games. The therapist matched participants’ interests to internet games, customized therapeutic movements for game play, and increased the movement thresholds for game activation as participants improved. Two participants who had strokes resulting in upper extremity (UE) hemiplegia were recruited. The participants attended outpatient occupational therapy (OT) services twice weekly. Following training, the participants used the PVR system at home in place of their UE HEP. They continued to receive traditional OT once a week and clinic-PVR once a week for 5-8 weeks. Results: The PVR intervention was successfully implemented in the clinic and the clients’ homes. PVR increased motivation and treatment compliance. The clients exhibited improvements in UE active range of motion, function, symptoms, and occupational performance. Conclusion: Preliminary evidence suggests PVR can improve motivation, compliance, function, and occupational performance. However, larger scale studies and protocol refinement are necessary. Keywords: Occupational therapy, client-centered, stroke, hemiparesis, motivation, occupational performance, home exercise program, upper extremity rehabilitation.Download Full Article |
Abstract : Inducing Visuomotor Adaptation Using Virtual Reality Gaming with a Virtual Shift as a Treatment for Unilateral Spatial Neglect
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Abstract: Unilateral spatial neglect after stroke is characterized by reduced responses to stimuli on the contralesional side, causing significant impairments in self-care and safety. Conventional visuomotor adaptation (VMA) with prisms that cause a lateral shift of the visual scene can decrease neglect symptoms but is not engaging according to patients. Performing VMA within a virtual reality (VR) environment may be more engaging but has never been tested. To determine if VMA can be elicited in a VR environment, healthy subjects (n=7) underwent VMA that was elicited by either wearing prisms that caused an optical shift, or by application of a virtual shift of the hand cursor within the VR environment. A low cost VR system was developed by coupling the Kinect v2 gaming sensor to online games via the Flexible Action and Articulated Skeleton Toolkit (FAAST) software. The adaptation phase of training consisted of a reaching task in online games or in a custom target pointing program. Following the adaptation phase the optical or virtual shift was removed and participants were assessed during the initial portion of the de-adaptation phase for the presence of an after-effect on their reaching movements, with lateral reaching errors indicating the successful induction of VMA. Results show that practicing reaching in a VR environment with a virtual shift lead to a horizontal after-effect similar to conventional prism adaptation. The results demonstrate that VMA can be elicited in a VR environment and suggest that VR gaming therapy could be used to improve recovery from unilateral spatial neglect. Keywords: Sensorimotor learning, plasticity, stroke, spatial attention, engagement.Download Full Article |
Abstract : Commentary: Zika Virus and Microcephaly: Challenges in Brazil
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Commentary |
Abstract : Feeding/Swallowing Disorders: Maintaining Quality of Life in Persons with Intellectual Disability
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Abstract: Persons with intellectual disability (ID) have received little attention in systematic studies of healthcare and quality of life. Less attention has been provided to specific disorders, such as those impacting the swallowing mechanism. In comparison to the general population, persons with ID experience noticeably greater healthcare inequalities and despite greater life expectancy, it is still lower than the general population. This paper serves as an introduction to healthcare colleagues regarding the risks involved in choking and swallowing disorders in persons with ID, how to evaluate these potential risks and possible treatments. Associated etiologies are presented. A discussion on feeding disorders versus swallowing disorders is also introduced. The inadequacy of swallowing assessment services to persons with ID may be related to the lack of professionals with specialized training in working with this population, reduced funding for research to explore options for improved nutrition and reduced risk of choking and minimal research on changes in feeding skills and/or swallow physiology in this select group of individuals. Keywords: Dysphagia, Feeding disorders, Aspiration, Videofluoroscopy, Endoscopy Download Full Article |
Abstract : Attentional Factors Involved in Learning in the First Grade
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Abstract: In the school population, attentional problems are one of the most frequent causes of failure in learning; sometimes these take the form of a specific deficit and in other cases an attention disorder occurs in comorbidity with a learning disorder. It seems crucial to focus on what peculiar characteristics of attention are involved in basic learning in order to contribute to the diagnostic order and to arrange paths of development. This research aims to verify the weight of the different components of attention involved in the outcomes of the first stages of learning. A total of 69 children (34 males and 35 females, aged 6.4±1.1 years and 7.3±1.2 years respectively) in first grade, participated in the study. The results of the correlational analysis carried out show that there are specific significant relationships between the various components of attention and performance in reading, writing and calculation. In particular, visual attention appears to be the aspect most involved in the initial development of the learning of these three abilities. Factorial analysis shows a single factor involved in the learning of reading, writing and calculation: “Rapid Visual Attention”. The processes identified in the factor are: Selective Attention, Visual Selective Attention, Shifting Focus, Focused Attention, Planning and Inhibition. This factor is characterised by speed in Selective/Sustained Visual Attention and this explains the role of attention in success in reading, writing and calculation in the early stages of school learning. The Rapid Visual Attention Factor contributes to rapidity in reading, speed in writing and numerical knowledge in first grade children, confirming the causal relationship between visual attention and initial learning in this age group. This “Rapid Visual Attention” Factor may be crucial in accounting for the comorbidity between Attention Deficit Hyperactivity Disorder and Learning Disabilities. Keywords: Visual attention, literacy, numeracy, processing speed, attention deficit. |