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The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) - a cross-sectional randomized study.

ABSTRACT: BACKGROUND:Cerebral Palsy (CP) is characterised by variable difficulties in muscular action, resulting in inability of the individual to perform functional movement. An option to provide functionality to the individual with CP is the use of computer innovation. The aim of this paper was to verify if there was any performance improvement in a task performed in a virtual environment and if there was transfer to the task performed in the real environment and vice versa in this population. METHODS:A computer program was developed comprising a motor task, but with two possibilities of user interaction: a) concrete interface (with physical contact): in which the individual touches the computer screen to finish the task and b) abstract interface (no physical contact): in which the individual performs a hand movement in front of the Kinect device. Participants were split into two groups. The experimental group consisted of 28 individuals with CP within the ages of 6 and 15?years old. The control group included 28 typically developing individuals mirroring the age and sex of the experimental group. RESULTS:Individuals from both groups were able to improve task performance and retain acquired information. The CP group presented worse performance than the control group in all phases of the study. Further findings showed that the CP group presented better performance in the abstract interface than in the concrete interface, whereas, in the control group, the opposite occurred: their best performance was in the concrete. CONCLUSIONS:Motor tasks performed by individuals with CP through an interface with a more virtual environment feature (abstract interface: Kinect) provided better performance when compared to an interface with a more real characteristic (concrete interface: Touchscreen). TRIAL REGISTRATION:ClinicalTrials.gov Identifier - NCT03352440; Date of registration - November 17, 2017.

SUBMITTER: Leal AF

PROVIDER: S-EPMC7191706 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) - a cross-sectional randomized study.

Leal Andréa Fernanda AF da Silva Talita Dias TD Lopes Priscila Bianchi PB Bahadori Shayan S de Araújo Luciano Vieira LV da Costa Murillo Vinicius Brandão MVB de Moraes Íbis Ariana Peña ÍAP Marques Ricardo Henrique RH Crocetta Tania Brusque TB de Abreu Luiz Carlos LC Monteiro Carlos Bandeira de Mello CBM

Journal of neuroengineering and rehabilitation 20200429 1

<h4>Background</h4>Cerebral Palsy (CP) is characterised by variable difficulties in muscular action, resulting in inability of the individual to perform functional movement. An option to provide functionality to the individual with CP is the use of computer innovation. The aim of this paper was to verify if there was any performance improvement in a task performed in a virtual environment and if there was transfer to the task performed in the real environment and vice versa in this population.<h ...[more]

PMID: 32349752

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Project description:BackgroundIncreasing evidence supports the use of virtual reality systems to improve upper limb motor functions in individuals with cerebral palsy. While virtual reality offers the possibility to include key components to promote motor learning, it remains unclear if and how motor learning principles are incorporated into the development of rehabilitation interventions using virtual reality.ObjectiveThe objective of this study was to determine the extent to which motor learning principles are integrated into virtual reality interventions targeting upper limb function in individuals with cerebral palsy.MethodsA systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search was performed in 10 databases using a combination of keywords related to cerebral palsy, virtual reality, video games, and rehabilitation. Studies were divided into 2 categories: commercial video game platforms and devices and custom virtual reality systems. Study quality was assessed using the modified Downs and Black checklist.ResultsThe initial search yielded 1497 publications. A total of 26 studies from 30 publications were included, with most studies classified as "fair" according to the modified Downs and Black checklist. The majority of studies provided enhanced feedback and variable practice and used functionally relevant and motivating virtual tasks. The dosage varied greatly (total training time ranged from 300 to 3360 minutes), with only 6 studies reporting the number of movement repetitions per session. The difficulty progression and the assessment of skills retention and transfer were poorly incorporated, especially for the commercial video games.ConclusionsMotor learning principles should be better integrated into the development of future virtual reality systems for optimal upper limb motor recovery in individuals with cerebral palsy.Trial registrationPROSPERO International Prospective Register of Systematic Reviews CRD42020151982; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020151982.

Project description:BackgroundCerebral palsy (CP) is the most common developmental motor disorder in children. Individuals with CP demonstrate abnormal muscle tone and motor control. Within the population of children with CP, between 4% and 17% present dystonic symptoms that may manifest as large errors in movement tasks, high variability in movement trajectories, and undesired movements at rest. These symptoms of dystonia typically worsen with physical intervention exercises.ObjectiveThe aim of this study is to establish the effect of haptic feedback in a virtual reality (VR) game intervention on movement outcomes of children with dystonic CP.MethodsThe protocol describes a randomized controlled trial that uses a VR game-based intervention incorporating fully automated robotic haptic feedback. The study consists of face-to-face assessments of movement before, after, and 1 month following the completion of the 6-session game-based intervention. Children with dystonic CP, aged between 7 and 17 years, will be recruited for this study through posted fliers and laboratory websites along with a group of typically developing (TD) children in the same age range. We anticipate to recruit a total of 68 participants, 34 each with CP and TD. Both groups of children will be randomly allocated into an intervention or control group using a blocked randomization method. The primary outcome measure will be the smoothness index of the interaction force with the robot and of the accelerometry signals of sensors placed on the upper limb segments. Secondary outcomes include a battery of clinical tests and a quantitative measure of spasticity. Assessors administering clinical measures will be blinded. All sessions will be administered on-site by research personnel.ResultsThe trial has not started and is pending local institutional review board approval.ConclusionsMovement outcomes will be examined for changes in muscle activation and clinical measures in children with dystonic CP and TD children. Paired t tests will be conducted on movement outcomes for both groups of children independently. Positive and negative results will be reported and addressed.Trial registrationClinicalTrials.gov NCT03744884; https://clinicaltrials.gov/ct2/show/NCT03744884 (Archived by WebCite at http://www.webcitation.org/74RSvmbZP).International registered report identifier (irrid)PRR1-10.2196/11470.

Project description:Performance-based functional tests for the evaluation of daily living activities demonstrate strong psychometric properties and solve many of the limitations associated with self- and informant-report questionnaires. Virtual reality (VR) technology, which has gained interest as an effective medium for administering interventions in the context of healthcare, has the potential to minimize the time-demands associated with the administration and scoring of performance-based assessments. To date, efforts to develop VR systems for assessment of everyday function in older adults generally have relied on non-immersive systems. The aim of the present study was to evaluate the feasibility of an immersive VR environment for the assessment of everyday function in older adults. We present a detailed case report of an elderly woman who performed an everyday activity in an immersive VR context (Virtual Reality Action Test) with two different types of interaction devices (controller vs. sensor). VR performance was compared to performance of the same task with real objects outside of the VR system (Real Action Test). Comparisons were made on several dimensions, including (1) quality of task performance (e.g., order of task steps, errors, use and speed of hand movements); (2) subjective impression (e.g., attitudes), and (3) physiological markers of stress. Subjective impressions of performance with the different controllers also were compared for presence, cybersickness, and usability. Results showed that the participant was capable of using controllers and sensors to manipulate objects in a purposeful and goal-directed manner in the immersive VR paradigm. She performed the everyday task similarly across all conditions. She reported no cybersickness and even indicated that interactions in the VR environment were pleasant and relaxing. Thus, immersive VR is a feasible approach for function assessment even with older adults who might have very limited computer experience, no prior VR exposure, average educational experiences, and mild cognitive difficulties. Because of inherent limitations of single case reports (e.g., unknown generalizability, potential practice effects, etc.), group studies are needed to establish the full psychometric properties of the Virtual Reality Action Test.

Dataset Information

The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) - a cross-sectional randomized study.

Publications

The use of a task through virtual reality in cerebral palsy using two different interaction devices (concrete and abstract) - a cross-sectional randomized study.

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