Yu-Ping Chen

Effect of virtual reality on upper extremity function in children with cerebral palsy: a meta-analysis.

Purpose: To systematically examine the effect of virtual reality (VR) on upper extremity (UE) function in children with cerebral palsy (CP) and assess the association among VR effects and childrens characteristics and an intervention protocol. Method: A systematic literature search was conducted in PubMed, CINAHL, Cochrane, and PsycINFO up to June 2013. Research studies involving children with CP that used VR as the intervention method and UE outcome measures were included. Results: The search yielded 14 research articles, including 3 randomized controlled trials and 11 case series. Overall, VR provided a strong effect size (d = 1.00) when comparing pre- and postintervention. In subgroup analyses, younger children receiving home-based or laboratory-based VR and using an engineer-built VR system showed better improvement. Conclusions and Implications: Virtual reality is a viable tool to improve UE function in children with CP. However, a more vigorous research design is needed to make a conclusive recommendation.

Effects of robotic therapy on upper-extremity function in children with cerebral palsy: A systematic review.

Abstract Objective: To systematically examine the effects of robotic therapy on upper extremity (UE) function in children with cerebral palsy (CP). Methods: A systematic literature search was conducted in Pubmed, CINAHL, Cochrane, PsychInfo, TRIP, and Web of Science up to July 2013. Studies of children with CP, using robotic therapy and measures of UE were included. Results: Nine articles using three different robotic systems were included. Of these, seven were case studies. Overall, robotic therapy showed the potential effects as all studies reported at least one positive outcome: a moderate effect in improving reaching duration, smoothness, or decreased muscle tone, and a small to large effect in standardized clinical assessment (e.g. Fugl-Meyer). Conclusion: This review confirms the potential for robotic therapy to improve UE function in children with CP. However, the paucity of group design studies summons the need for more rigorous research before conclusive recommendations can be made.

The Effects of Vibration on the Gait Pattern and Vibration Perception Threshold of Children With Idiopathic Toe Walking

The effectiveness of idiopathic toe walking treatments is not conclusive. The study investigated the use of vibration as a therapeutic/treatment method for children with idiopathic toe walking. Fifteen children with idiopathic toe walking and 15 typically developing children, aged 4 to 10 years, completed the study. The study included a barefoot gait examination and a vibration perception threshold test before and after standing on a whole body vibration machine for 60 seconds. Temporal-spatial parameters were recorded along with HR32, a calculation designed to distinguish on aspects of the toe-walking pattern. No significant gait pattern differences were found between children with idiopathic toe walking and typically developing children after one bout of vibration intervention. HR32 was found to be a means to identify the toe-walking pattern (P < .001). Hypersensitivity to vibration of children with idiopathic toe walking was not found in the current study (P = .921).

Super Pop VRTM: An Adaptable Virtual Reality Game for Upper-Body Rehabilitation

Therapists and researchers have studied the importance of virtual reality (VR) environments in physical therapy interventions for people with different conditions such as stroke, Parkinson’s disease, and cerebral palsy. Most of these VR systems do not integrate clinical assessment of outcome measures as an automated objective of the system. Moreover, these systems do not allow real-time adjustment of the system characteristics that is necessary to individualize the intervention. We discuss a new VR game designed to improve upper-arm motor function through repetitive arm exercises. An automated method is used to extract outcome measures of upper extremity movements using the Fugl-Meyer assessment methodology. The accuracy of the system was validated based on trials with eighteen adult subjects. With a corresponding average assessment error of less than 5%, the developed system shows to be a promising tool for therapists to use in individualizing the intervention for individuals with upper-body motor impairments.

Effects of wheelchair Tai Chi on physical and mental health among elderly with disability

ABSTRACT A 12-week Wheelchair Tai Chi 10 Form (WTC10) intervention was conducted among elderly with disability to examine the effect of this WTC10 intervention on selected physical and mental health variables. Thirteen (age 87.23 ± 6.71) in the WTC10 intervention group and 15 (age 89.73 ± 6.31) in the control group completed the study. Independent t-tests and paired t-tests were employed to examine the differences between groups and within groups, respectively, at pretest and post-test. The WTC10 intervention group showed significant improvements in systolic and diastolic blood pressure, shoulder external rotation, left trunk rotation and total trunk rotation after the intervention. A 12-week WTC10 intervention had positive effects on blood pressure, range of motion at the shoulder and trunk, physical activity, and mental health among the elderly with disability. WTC10 is a feasible and safe exercise for the elderly with disability.

Effect of a Home-Based Virtual Reality Intervention for Children with Cerebral Palsy Using Super Pop VR Evaluation Metrics: A Feasibility Study

Objective. The purpose of this pilot study was to determine whether Super Pop VR, a low-cost virtual reality (VR) system, was a feasible system for documenting improvement in children with cerebral palsy (CP) and whether a home-based VR intervention was effective. Methods. Three children with CP participated in this study and received an 8-week VR intervention (30 minutes × 5 sessions/week) using the commercial EyeToy Play VR system. Reaching kinematics measured by Super Pop VR and two fine motor tools (Bruininks-Oseretsky Test of Motor Proficiency second edition, BOT-2, and Pediatric Motor Activity Log, PMAL) were tested before, mid, and after intervention. Results. All children successfully completed the evaluations using the Super Pop VR system at home where 85% of the reaches collected were used to compute reaching kinematics, which is compatible with literature using expensive motion analysis systems. Only the child with hemiplegic CP and more impaired arm function improved the reaching kinematics and functional use of the affected hand after intervention. Conclusion. Super Pop VR proved to be a feasible evaluation tool in children with CP.

Lower limb pose estimation for monitoring the kicking patterns of infants

Monitoring the spontaneous kicking patterns of infants can give insight into their development. A computer vision based method for estimating the pose of an infants leg from range images is presented in this paper. After some manual inputs for initialization, the range data associated with the infant is extracted. The method uses Robust Point Set Registration (RPSR) to fit an articulated model to the subject in every frame in the sequence, thus it provides the joint trajectories over time of the kicking kinematics. For validation, the method is used to track the articulation of a robotic humanoid that was programmed to kick in a fashion similar to an infant. Furthermore, the method is applied to a sequence collected from an actual infant and the resultant signal estimates are presented.Monitoring the spontaneous kicking patterns of infants can give insight into their development. A computer vision based method for estimating the pose of an infants leg from range images is presented in this paper. After some manual inputs for initialization, the range data associated with the infant is extracted. The method uses Robust Point Set Registration (RPSR) to fit an articulated model to the subject in every frame in the sequence, thus it provides the joint trajectories over time of the kicking kinematics. For validation, the method is used to track the articulation of a robotic humanoid that was programmed to kick in a fashion similar to an infant. Furthermore, the method is applied to a sequence collected from an actual infant and the resultant signal estimates are presented.

Non-contact versus contact-based sensing methodologies for in-home upper arm robotic rehabilitation

In recent years, robot-assisted rehabilitation has gained momentum as a viable means for improving outcomes for therapeutic interventions. Such therapy experiences allow controlled and repeatable trials and quantitative evaluation of mobility metrics. Typically though these robotic devices have been focused on rehabilitation within a clinical setting. In these traditional robot-assisted rehabilitation studies, participants are required to perform goal-directed movements with the robot during a therapy session. This requires physical contact between the participant and the robot to enable precise control of the task, as well as a means to collect relevant performance data. On the other hand, non-contact means of robot interaction can provide a safe methodology for extracting the control data needed for in-home rehabilitation. As such, in this paper we discuss a contact and non-contact based method for upper-arm rehabilitation exercises that enables quantification of upper-arm movements. We evaluate our methodology on upper-arm abduction/adduction movements and discuss the advantages and limitations of each approach as applied to an in-home rehabilitation scenario.

Effectiveness of Virtual Reality in Children With Cerebral Palsy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background Researchers recently investigated the effectiveness of virtual reality (VR) in helping children with cerebral palsy (CP) to improve motor function. A systematic review of randomized controlled trials (RCTs) using a meta‐analytic method to examine the effectiveness of VR in children with CP was thus needed. Purpose The purpose of this study was to update the current evidence about VR by systematically examining the research literature. Data Sources A systematic literature search of PubMed, CINAHL, Cochrane Central Register of Controlled Trials, ERIC, PsycINFO, and Web of Science up to December 2016 was conducted. Study Selection Studies with an RCT design, children with CP, comparisons of VR with other interventions, and movement‐related outcomes were included. Data Extraction A template was created to systematically code the demographic, methodological, and miscellaneous variables of each RCT. The Physiotherapy Evidence Database (PEDro) scale was used to evaluate the study quality. Effect size was computed and combined using meta‐analysis software. Moderator analyses were also used to explain the heterogeneity of the effect sizes in all RCTs. Data Synthesis . The literature search yielded 19 RCT studies with fair to good methodological quality. Overall, VR provided a large effect size (d = 0.861) when compared with other interventions. A large effect of VR on arm function (d = 0.835) and postural control (d = 1.003) and a medium effect on ambulation (d = 0.755) were also found. Only the VR type affected the overall VR effect: an engineer‐built system was more effective than a commercial system. Limitations The RCTs included in this study were of fair to good quality, had a high level of heterogeneity and small sample sizes, and used various intervention protocols. Conclusions Then compared with other interventions, VR seems to be an effective intervention for improving motor function in children with CP.

The Effects of Walking Surface on the Gait Pattern of Children With Idiopathic Toe Walking

Idiopathic toe walking treatments are not conclusively effective. This study investigated the effects of walking surface on gait parameters in children with idiopathic toe walking. Fifteen children with idiopathic toe walking and 15 typically developing children aged 4 to 10 years completed the study, which included a barefoot gait exam over three 4-m walkways. Each of the walkways was covered with a different surface: vinyl tile, carpet, and pea gravel. Temporal-spatial parameters were recorded along with a measure of early heel rise (HR32). Children with idiopathic toe walking and typically developing children shared similarly changed gait patterns on each surfaces. Only HR32 was significantly different between the groups (P < .001). Children with idiopathic toe walking showed significantly less toe-walking on the gravel walkway (P < .001). Walking surface plays a significant role in altering gait patterns in both children with idiopathic toe walking and typically developing children. Walking on a gravel surface should be further explored for idiopathic toe walking.