Improving cognitive function after brain injury: the use of exercise and virtual reality.
ABSTRACT To assess the impact of exercise and virtual reality (VR) on the cognitive rehabilitation of persons with traumatic brain injury (TBI).
Before-after trial assessed cognitive function after a 4-week intervention program. A random allocation crossover assessed changes in reaction and movement times after a single bout of VR exercise and a no-exercise control condition.
Brain injury rehabilitation unit in Edinburgh, Scotland.
(1) Four-week intervention: a consecutive sample of 13 suitable TBI adults were compared to control populations (n > 25) of previous TBI patients of similar age, severity, and time postinjury. (2) Single-bout intervention: a consecutive sample of 13 suitable adults with moderate TBI, 6.29 to 202.86 weeks postinjury.
Nonimmersive VR exercise.
(1) Tests of attention, information processing, learning, and memory. (2) Reaction and movement times.
After the 4-week intervention patients performed significantly better than controls on the digit symbol (p < .01). verbal (p < .01), and visual learning tasks (p < .05). Significant improvements in reaction times (p < .01) and movement times (p < .05) were gained following a single bout of VR exercise.
Exercising in a virtual environment offers the potential for significant gains in cognitive function.
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ABSTRACT: Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patient-reported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs. Neurourol. Urodynam. © 2014 Wiley Periodicals, Inc.Neurourology and Urodynamics 01/2014; · 2.67 Impact Factor
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ABSTRACT: Abstract Primary objective: The study objective was to test the efficacy of game-based virtual reality (VR) therapy as a mean of correcting postural and co-ordination abnormalities in individuals with traumatic brain injury (TBI). Therapy was done with interactive customized VR games and scenarios, utilizing an Xbox Kinect sensor. Research design: The study was a pilot project using the structure of a phase II clinical trial. Methods and procedures: Fifteen participants with mild-to-moderate chronic TBI-related balance and motor co-ordination impairments participated in 15 sessions, each lasting ∼50-55 minutes, scheduled 2-3 times a week over 5-6 consecutive weeks. Participants were evaluated at baseline, immediately after the final session and in a 1-month follow-up with a battery of clinical tests (measuring postural stability, gait and co-ordination) and movement performance parameters. Movement parameters included arm-leg co-ordination, dynamic stability and arm precision, calculated from kinematic data recorded with Xbox Kinect sensor. Results: Following therapy, most participants improved their static and dynamic postural stability, gait and arm movements. These effects persisted over the retention interval. Conclusions: Results will be used to improve the VR program, with the goal of producing a cost-effective, accessible and easy to individualize therapeutic approach. The pilot data will be used for designing a larger scale clinical trial.Brain Injury 04/2014; · 1.51 Impact Factor
Conference Paper: Virtual reality game-based therapy for persons with TBI: A pilot study[Show abstract] [Hide abstract]
ABSTRACT: The virtual reality (VR) therapy described below consists of a series of VR exercises, delivered with low-cost equipment. It replicates the conventional exercise and activity sequence recommended for restoring postural and coordination abnormalities after traumatic brain injuries (TBI). Efficacy was tested in a pilot group of 9 participants with TBI. They completed 15 sessions, each approximately 50 minutes duration. Most participants improved their postural stability, gait, and upper extremity movements. Exercise was done in a supervised environment to establish safety criteria. Results will be used to refine the current version of the therapy into a cost-effective, highly-accessible approach which can be delivered remotely via telerehabilitation.Virtual Rehabilitation (ICVR), 2013 International Conference on; 08/2013