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Abstract

Virtual reality (VR) is an emerging technology with a variety of potential benefits for many aspects of rehabilitation assessment, treatment, and research. Through its capacity to allow the creation and control of dynamic 3-dimensional, ecologically valid stimulus environments within which behavioral responding can be recorded and measured, VR offers clinical assessment and rehabilitation options that are not available with traditional methods. Initial applications of VR in other aspects of medicine and psychology have yielded encouraging results, but continued research and understanding of this evolving technology will be crucial for its effective integration into rehabilitation. This article provides a brief introduction to VR technology, examines the specific benefits VR offers consumers and providers of rehabilitation services and discusses potential areas of application and important considerations in applying this technology. Finally, 2 examples of current Vr applications are presented. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... A second possible solution to the limitations of the firstperson perspective lies in the provision of a more realistic firstperson perspective through the use of immersive virtual reality (i.e., the participant is wearing a headset that projects them into the virtual environment). Virtual reality (VR) has received much attention for its potential in rehabilitation (for reviews see Schultheis and Rizzo 2001;Rose et al., 2018;Bevilacqua et al., 2019), but there are relatively few studies using VR in stroke populations, and many of those have used desktop-based VR applications rather than immersive VR (e.g., (Buxbaum et al., 2012;Alarcón-Aldana et al., 2020). Immersive VR offers many advantages over other testing and assessment tools. ...
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Imitation is an important daily activity involved in social interactions, motor learning, and is commonly used for rehabilitation after stroke. Moreover, deficits in imitation of novel movements commonly occur after left hemisphere stroke (LCVA) in the syndrome of limb apraxia. In the current study, we used a novel virtual reality (VR) imitation paradigm to assess two factors that have remained underexplored in novel movement imitation: the imitation of complex, dynamic full-arm movements, and the effect of spatial perspective. VR holds promise as a tool for a number of clinical assessments and treatments, but has very rarely been studied in the context of imitation or diagnosis of apraxia. Thirty participants (18 with LCVA and 12 age- and education-matched controls) wore a VR headset and observed and imitated an instructor avatar demonstrating arm movements. Three spatial perspectives were examined within-subjects: first-person, third-person mirror, and third-person anatomical. Movements of the ipsilesional (left) arm were recorded and qualitatively coded for accuracy compared to the instructor avatar. Participants also completed embodiment questionnaires, a measure of limb apraxia (imitation of video-recorded meaningless movements), and three computerized background tasks that were hypothesized to evoke some of the same processing requirements of each of the three perspective conditions: a block-matching task, a block-mirroring task, and a mental rotation task. Imitation accuracy was highest in the first-person perspective, consistent with predictions, but did not differ between third-person mirror and anatomical. Surprisingly, patients and controls performed similarly on the imitation task for all spatial perspectives, with overall modest accuracy in both groups, and both patients and controls felt a moderate level of embodiment of their own avatar. Higher imitation accuracy related to quicker block-matching reaction times and higher mental rotation accuracy, regardless of perspective, but was unrelated to imitation of video-recorded meaningless movements. In sum, virtual reality provides advantages in terms of experimental manipulation and control but may present challenges in detecting clinical imitation deficits (limb apraxia).
... Recent developments in information and communication technologies have led to attempts to implement virtual reality (VR)-or augmented reality (AR)-based healthcare systems in musculoskeletal post-op rehabilitation [13][14][15]. These VR-or AR-based rehabilitation programs have shown advantages in terms of increasing patients' compliance levels and documenting their progress [16,17], essential factors for successful post-op rehabilitation. However, most previous studies have used commercial healthcare applications or devices providing generalized fitness exercise programs rather than rehabilitation-oriented programs. ...
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Background Operative repair of a rotator cuff tear requires up to 12 weeks of post-operative (post-op) home-based rehabilitation. Maintaining patients’ compliance in the post-op rehabilitation program is a pivotal component for generating successful outcomes. By developing a post-op rehabilitation-oriented digital healthcare system and applying it in patients who had undergone rotator cuff repair, we aim to increase the efficacy of the rehabilitation program and raise patients’ compliance levels. Here, we present a protocol developed for comparing the efficacy of rehabilitation using a newly developed augmented reality (AR)-based digital healthcare system with that of conventional rehabilitation for post-op rehabilitation of rotator cuff repair. Methods This study will recruit a total of 115 patients who had undergone rotator cuff repair within 3 days after surgery. Patients will be randomly allocated to rehabilitation using an AR-based digital healthcare system (digital group) or conventional rehabilitation (conventional group). Patients in both groups will perform brochure-based exercises from the immediate post-op period to post-op 6 weeks. From post-op 6 weeks to 12 weeks, patients in the digital group will use the AR-based system for post-op exercises, whereas patients in the conventional group will continue brochure-based rehabilitation exercises. The primary outcome will be scores on the Simple Shoulder Test at post-op 12 weeks. Secondary outcomes include numeric rating scale scores for pain, measures of range of motion and muscle strength of the affected shoulder, grip strength of the affected arm, scores on the Disabilities of the Arm, Shoulder and Hand test, the Shoulder Pain and Disability Index, and the EuroQoL-5D-5L quality-of-life measure. Analyses will be conducted using an intention-to-treat approach. Discussion This study will examine the effectiveness of an AR-based digital healthcare system for post-op rehabilitation in the patients after rotator cuff repair. The study will add evidence for the application of digital healthcare systems in post-op rehabilitation. Trial registration ClinicalTrials.gov NCT04511377. Registered on 10 August 2020.
... Similarly, the Stanmore et al. randomized controlled trial showed that a 12-week exergames program targeting balance and strength in adults aged 55 years and older in the UK, reduced fear of falling, improved balance and was cost-effective in terms of fall prevention (19). Other studies have also reported exergames as effective rehabilitation tools for balance training, especially for the elderly population (20)(21)(22). ...
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Balance disorders and falls are common in the elderly population. Regular balance exercises are an evidence-based physical intervention to prevent falls in older adults, while patient motivation and adherence are important factors for intervention outcome. Exergames are a relatively new, alternative intervention for physical rehabilitation as they improve balance and strength in older adults. The aims of this systematic review and meta-analysis were to assess the (1) effect of motivation factors as per the Capability, Opportunity and Motivation model of Behavior change (COM-B) on the effectiveness of exergame interventions in healthy older adults, (2) effectiveness of exergames to improve balance in older healthy adults and, (3) impact of exergames on cognitive outcomes. Results show that motivation and capability components influence the general outcome of the exergame training. Motivational factors should thus be considered when setting-up an exergame intervention. Furthermore, exergame intervention appears to be a promising training method in comparison to traditional exercise training. However, exergame training in itself might not be sufficient to improve fall risk and cognitive performance.
... Finally, in the studies that indicated the time of VR use, this information was included, offering valuable insights about how and how long to use this technology to treat mental and physical health conditions and in medical education and training. Simulation on a computer of 3D environments, which can be explored in real-time and in which the user can interact with objects contained within it [59]. They are made through specific software such as Unreal or Unity 360° videos and photos Images or videos of real or digital environments presented in a spherical version. ...
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Background: Virtual reality can play an important role during the COVID-19 pandemic in the healthcare sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment and may increase access to training and therapies in various healthcare settings. Objective: This systematic review aimed to describe the literature on healthcare-targeted virtual reality applications during the COVID-19 crisis. Methods: We conducted a systematic search of the literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines on the PsycINFO, Web of Science, and Medline databases. The search string was: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-COV2) OR (healthcare)]”. Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. Results: Thirty-nine studies met inclusion criteria. Seventeen research showed the usefulness of virtual reality during the COVID-19 crisis in reducing stress, anxiety, depression, pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatry. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (i.e., immersive and desktop virtual reality), types of HMDs (i.e., PC-based, mobile, standalone), and content (i.e., 360° videos and photos, virtual environments, virtual reality video games, embodied virtual agents) have been successfully used. Virtual reality resulted helpful in both face-to-face and remote trials. Conclusions: Virtual reality has been applied frequently during the COVID-19 pandemic in medicine with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for a broader adoption of virtual reality in the healthcare panorama. Review Registration: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY)— INPLASY202190108.
... During the last decade VR technologies have been shown to be a relevant tool to prevent falls in the elderly (Cano Porras et al., 2018;Khanuja et al., 2018;Keshner et al., 2019). VR technology, defined as a numerical immersive and interactive environment provided by an interface (Burdea, 2003), has been used exponentially in gait training and motor learning in the elderly (Schultheis & Rizzo, 2001;Levin et al., 2015;Howard, 2017;Cano Porras et al., 2018). VR technology qualifies many devices characterized by different levels of immersion. ...
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