Rachel Kizony

Video capture virtual reality as a flexible and effective rehabilitation tool

Video capture virtual reality (VR) uses a video camera and software to track movement in a single plane without the need to place markers on specific bodily locations. The users image is thereby embedded within a simulated environment such that it is possible to interact with animated graphics in a completely natural manner. Although this technology first became available more than 25 years ago, it is only within the past five years that it has been applied in rehabilitation. The objective of this article is to describe the way this technology works, to review its assets relative to other VR platforms, and to provide an overview of some of the major studies that have evaluated the use of video capture technologies for rehabilitation.

The Sony PlayStation II EyeToy: low-cost virtual reality for use in rehabilitation.

The objective of this study was to investigate the potential of using a low-cost video-capture virtual reality (VR) platform, the Sony PlayStation II EyeToy, for the rehabilitation of older adults with disabilities. This article presents three studies that were carried out to provide information about the EyeToys potential for use in rehabilitation. The first study included the testing of healthy young adults (N = 34) and compared their experiences using the EyeToy with those using GestureTeks IREX VR system in terms of a sense of presence, level of enjoyment, control, success, and perceived exertion. The second study aimed to characterize the VR experience of healthy older adults (N = 10) and to determine the suitability and usability of the EyeToy for this population and the third study aimed to determine the feasibility of the EyeToy for use by individuals (N = 12) with stroke at different stages. The implications of these three studies for applying the system to rehabilitation are discussed.

Interactive virtual environment training for safe street crossing of right hemisphere stroke patients with unilateral spatial neglect

Purpose. The goal of this study was to determine whether non immersive interactive virtual environments are an effective medium for training individuals who suffer from Unilateral Spatial Neglect (USN) as a result of a right hemisphere stroke, and to compare it to a standard computer visual scanning training. Method. Participants included 19 patients with right hemisphere stroke in two groups, 11 in an experimental group were given computer desktop-based Virtual Reality (VR) street crossing training and 8 in a control group who were given computer based visual scanning tasks, both for a total of twelve sessions, 9 hours total, over four weeks. Measures included: 1. Standard USN assessments, paper and pencil and ADL checklist; 2. Test on the VR street program; and 3. Actual street crossing videotaped. Testing was performed pre and post intervention. Results. The VR group achieved on the USN measures results that equaled those achieved by the control group treated with conventional visual scanning tasks. They improved more on the VR test and they did better on some measures of the real street crossing. Conclusions. Despite several limitations in this study the present results support the effectiveness of the VR street program in the treatment of participants with USN, and further development of the program.

Adapting an immersive virtual reality system for rehabilitation

The purpose of this paper is to present an overview of the adaptations that have been done to VividGroups Gesture Xtreme projected VR scenarios in order to facilitate their use in neurological rehabilitation. First, the scenarios and the adaptation (control of the type, speed, location and direction of all stimuli) are briefly described. The advantages and limitations of the adapted VR system as a rehabilitation tool are presented. Next, initial results and two examples of case studies, one a patient following stroke and one who requires balance training as a result of complete spinal cord injury, are used to illustrate applications of this VR system to rehabilitation. Copyright

Textbook of Neural Repair and Rehabilitation: Virtual reality in neurorehabilitation

This chapter provides an overview of applications of virtual reality (VR) to rehabilitation. A key concept related to VR is immersion. Immersion relates to the extent to which the VR system succeeds in delivering an environment which refocuses a users sensations from the real world to a virtual world. Virtual environments are usually experienced with the aid of special hardware and software for input and output. Visual information is commonly displayed by head mounted displays (HMDs), projection systems or flat screens of varying size. VR applications in rehabilitation are expanding at a rapid pace and a large variety of platforms and programs are currently being used and developed. It has been used as a medium for the assessment and rehabilitation of cognitive processes. The ultimate goal of VR-based intervention is to enable clients to become more able to participate in their own real environments in an independent manner.

Video-capture virtual reality system for patients with paraplegic spinal cord injury.

This article presents results from a feasibility study of a video-capture virtual reality (VR) system used with patients who have paraplegic spinal cord injury (SCI) and who need balance training. The advantages of the VR system include providing the user with natural control of movements, the ability to use as many parts of the body as are deemed suitable within the context of therapeutic goals, and flexibility in the way the system can be adapted to suit specific therapeutic objectives. Thirteen participants with SCI experienced three virtual environments (VEs). Their responses to a Short Feedback Questionnaire showed high levels of presence. We compared performance in the environments with a group of 12 nondisabled participants. Response times for the patient group were significantly higher and percentage of success was significantly lower than that for the nondisabled group. In addition, significant moderate correlations were found between performance within a VE and static balance ability as measured by the Functional Reach Test. This study is a first step toward future studies aimed at determining the potential of using this VR system during the rehabilitation of patients with SCI.

Cognitive Load and Dual-Task Performance During Locomotion Poststroke: A Feasibility Study Using a Functional Virtual Environment

Background Gait and cognitive functions can deteriorate during dual tasking, especially in people with neurological deficits. Most studies examining the simultaneous effects of dual tasking on motor and cognitive aspects were not performed in ecological environments. Using virtual reality technology, functional environments can be simulated to study dual tasking. Objectives The aims of this study were to test the feasibility of using a virtual functional environment for the examination of dual tasking and to determine the effects of dual tasking on gait parameters in people with stroke and age-matched controls who were healthy. Design This was a cross-sectional observational study. Methods Twelve community-dwelling older adults with stroke and 10 age-matched older adults who were healthy participated in the study. Participants walked on a self-paced treadmill while viewing a virtual grocery aisle projected onto a screen placed in front of them. They were asked to walk through the aisle (single task) or to walk and select (“shop for”) items according to instructions delivered before or during walking (dual tasking). Results Overall, the stroke group walked slower than the control group in both conditions, whereas both groups walked faster overground than on the treadmill. The stroke group also showed larger variability in gait speed and shorter stride length than the control group. There was a general tendency to increase gait speed and stride length during dual-task conditions; however, a significant effect of dual tasking was found only in one dual-task condition for gait speed and stride duration variability. All participants were able to complete the task with minimal mistakes. Limitations The small size and heterogeneity of the sample were limitations of the study. Conclusions It is feasible to use a functional virtual environment for investigation of dual tasking. Different gait strategies, including an increase or decrease in gait speed, can be used to cope with the increase in cognitive demands required for dual tasking.

Video capture virtual reality: A decade of rehabilitation assessment and intervention

Abstract Background: Video capture virtual reality (VR) systems display the users on a TV or projected screen where they see themselves within a virtual environment (VE) and interact with the virtual stimuli by naturalistic movements without any encumbrance. This is one of the greatest assets of video capture VR systems, making it ideally suited as a tool for rehabilitation. Objective: To provide an overview of how single camera-based markerless video-capture technology has developed and been applied to rehabilitation over the past decade. Method: Short summaries are provided of the numerous studies that use video capture VR for motor and cognitive rehabilitation of clinical populations including stroke, spinal cord injury, traumatic brain injury, cerebral palsy and intellectual disabilities. Results and conclusions: VEs running on video capture VR systems have been shown to be feasible for clinical use for a wide variety of patient populations. The summarised papers include reports of case studies, group comparisons and review articles. Most of the studies using video-capture VR systems were aimed at improving motor aspects of individuals with neurologic conditions but some also address cognitive impairment and motivation in populations with developmental disorders. The majority of the VEs are gaming environments (involving competitive games such as virtual soccer) but functional environments (e.g. street crossing, supermarket shopping) have also been developed. The VEs have been found to be sensitive to differences in motor and cognitive ability and appear to provide an enjoyable and motivating setting for implementing a wide variety of therapeutic goals.

TheraGame - a home based virtual reality rehabilitation system

The limitations of existing virtual reality (VR) systems in terms of their use for home-based VR therapy led us to develop “TheraGame”, a novel video capture VR system. TheraGame operates on a standard PC with a simple webcam. The software is programmed using a Javabased visual interaction system. This system enables a quick and easy definition of virtual objects and their behavior. The user sits in front of the monitor, sees himself and uses his movements to interact with the virtual objects. The objective of this presentation is to present the system, a number of the current applications, and some initial pilot usage results. Results from a study of 12 healthy elderly subjects showed moderate to high levels of enjoyment and usability. These scores were also high as reported by 4 participants with neurological deficits. Some limitations in system functionality were reported by one person with stroke who used TheraGame at home for a period of 2.5 weeks. Overall, TheraGame appears to have considerable potential for home based rehabilitation.

Performance within a virtual supermarket and its relationship to executive functions in post-stroke patients

Executive functions are defined as higher-order functions that are needed for performing complex or non-routine tasks. People who have had a stroke often suffer from impairments in executive functions which have implications for their ability to return to full participation in their everyday activities and occupations. During the rehabilitation process clinicians seek opportunities, which will not be time consuming or expensive, to engage patients in complex functional activities, in order to train and improve deficits in executive functions. One solution for this is using functional virtual environments. The objectives of this study were to examine the feasibility of using a virtual supermarket to assess and treat executive function deficits for people who have had a stroke, and to explore the relationships between performance within the virtual supermarket and executive functions. The virtual supermarket used in this study runs on a desktop computer and is easy to operate in typical clinical settings. Twenty-six people, aged 31 to 65 years, who had a stroke participated in the study. Participants were tested with the virtual supermarket where they were asked to buy seven products from a prepared list. Each participant was also tested with the behavioral assessment of the dysexecutive syndrome. The results showed a large variance of performance within the virtual supermarket. In addition, moderate relationships were found between performance within the virtual supermarket and executive functions. The results point to the potential of the virtual supermarket to be used as an assessment and training tool for executive functions of people who have had a stroke