Maureen K. Holden

Virtual Environment Training: A New Tool for Neurorehabilitation

&NA; This paper is designed to introduce the reader to the use of virtual environments (VE) in rehabilitation by describing the theoretical and practical basis for the technique. Clinically relevant aspects of visual display devices which are available for use in VE are discussed. Next, key features of a VE system developed by the authors and colleagues are presented. The system is designed to enhance motor learning through the use of augmented feedback provided by a virtual teacher. Finally, preliminary clinical findings from a study in which the system was utilized to retrain UE motor control in subjects with chronic stroke are reported. Following treatment, subjects were found to have significant (p<0.05) improvements in the Fugl‐Meyer Test of Motor Recovery, the Wolf Motor Test, and selected strength tests.

Virtual-environment-based telerehabilitation in patients with stroke

We describe a telerehabilitation system that has been developed in our laboratory, and initial results following use of the system on 2 patients with stroke. The system allows a therapist in a remote location to conduct treatment sessions, using a virtual-environment-based motor-training system, with a patient who is located at home. The system consists of a patient computer with motion-capture equipment and video camera, a therapist computer with video camera, and virtual-environment software that is synchronized over a high-speed Internet connection. The patients movements are animated within the context of a virtual scene as she attempts to imitate a prerecorded movement, while the therapist can direct and monitor the activity in real time, as displayed in the animated virtual scene and via videoconference. The design, technical testing, and clinical feasibility testing of the system are reported. Results from the first 2 stroke patients to use the system indicate that patients made significant gains in upper-extremity function as measured by standard clinical tests and by their subjective report. As well, both patients demonstrated gains on quantitative kinematic measures of upper-extremity trajectories performed in the real world, indicating transfer of training from VE to real-world performance.