1
|
Recent Considerations on Gaming Console Based Training for Multiple Sclerosis Rehabilitation. Med Sci (Basel) 2022; 10:medsci10010013. [PMID: 35225946 PMCID: PMC8884021 DOI: 10.3390/medsci10010013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
Multiple Sclerosis (MS) is a well-known, chronic demyelinating disease of the Central Nervous System (CNS) and one of the most common causes of disability in young adults. In this context, one of the major challenges in patients’ rehabilitation is to maintain the gained motor abilities in terms of functional independence. This could be partially obtained by applying new emerging and cutting-edge virtual/augmented reality and serious game technologies for a playful, noninvasive treatment that was demonstrated to be quite efficient and effective in enhancing the clinical status of patients and their (re)integration into society. Recently, Cloud computing and Internet of Things (IoT) emerged as technologies that can potentially revolutionize patients’ care. To achieve such a goal, a system that on one hand gathers patients’ clinical parameters through a network of medical IoT devices equipped with sensors and that, on the other hand, sends the collected data to a hospital Cloud for processing and analytics is required. In this paper, we assess the effectiveness of a Nintendo Wii Fit® Plus Balance Board (WFBB) used as an IoT medical device adopted in a rehabilitation training program aimed at improving the physical abilities of MS patients (pwMS). In particular, the main scientific contribution of this paper is twofold: (i) to present a preliminary new pilot study investigating whether exercises based on the Nintendo Wii Fit® balance board included in a rehabilitation training program could improve physical abilities and Quality of Life (QoL) of patients compared to that of a conventional four-week rehabilitation training program; (ii) to discuss how such a rehabilitation training program could be adopted in the perspective of near future networks of medical IoT-based rehabilitation devices, interconnected with a hospital Cloud system for big data processing to improve patients’ therapies and support the scientific research about motor rehabilitation. Results demonstrate the advantages of our approach from both health and technological points of view.
Collapse
|
2
|
Objective evaluation of Nintendo Wii Fit Plus balance program training on postural stability in Multiple Sclerosis patients: a pilot study. Int J Rehabil Res 2020; 43:199-205. [DOI: 10.1097/mrr.0000000000000408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
3
|
Ferreira dos Santos L, Christ O, Mate K, Schmidt H, Krüger J, Dohle C. Movement visualisation in virtual reality rehabilitation of the lower limb: a systematic review. Biomed Eng Online 2016; 15:144. [PMID: 28105952 PMCID: PMC5249036 DOI: 10.1186/s12938-016-0289-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Virtual reality (VR) based applications play an increasing role in motor rehabilitation. They provide an interactive and individualized environment in addition to increased motivation during motor tasks as well as facilitating motor learning through multimodal sensory information. Several previous studies have shown positive effect of VR-based treatments for lower extremity motor rehabilitation in neurological conditions, but the characteristics of these VR applications have not been systematically investigated. The visual information on the user's movement in the virtual environment, also called movement visualisation (MV), is a key element of VR-based rehabilitation interventions. The present review proposes categorization of Movement Visualisations of VR-based rehabilitation therapy for neurological conditions and also summarises current research in lower limb application. METHODS A systematic search of literature on VR-based intervention for gait and balance rehabilitation in neurological conditions was performed in the databases namely; MEDLINE (Ovid), AMED, EMBASE, CINAHL, and PsycInfo. Studies using non-virtual environments or applications to improve cognitive function, activities of daily living, or psychotherapy were excluded. The VR interventions of the included studies were analysed on their MV. RESULTS In total 43 publications were selected based on the inclusion criteria. Seven distinct MV groups could be differentiated: indirect MV (N = 13), abstract MV (N = 11), augmented reality MV (N = 9), avatar MV (N = 5), tracking MV (N = 4), combined MV (N = 1), and no MV (N = 2). In two included articles the visualisation conditions included different MV groups within the same study. Additionally, differences in motor performance could not be analysed because of the differences in the study design. Three studies investigated different visualisations within the same MV group and hence limited information can be extracted from one study. CONCLUSIONS The review demonstrates that individuals' movements during VR-based motor training can be displayed in different ways. Future studies are necessary to fundamentally explore the nature of this VR information and its effect on motor outcome.
Collapse
Affiliation(s)
- Luara Ferreira dos Santos
- Rehabilitation Robotics Group (TU Berlin/ Fraunhofer IPK), Department of Industrial Automation Technology, Technische Universität Berlin, Pascalstr. 8-9, 10587 Berlin, Germany
- DFG Research Training Group Prometei, Technische Universität Berlin, Marchstr. 23, 10587 Berlin, Germany
| | - Oliver Christ
- Institute Humans in Complex Systems, School of Applied Psychology, University of Applied Sciences and Arts Nortwestern Switzerland, Riggenbachstrasse 16, Olten, Switzerland
| | - Kedar Mate
- School of Physical and Occupational Therapy, McGill University, 3654 Promenade Sir William Osler Montreal, Quebec, H3G 1Y5 Canada
| | - Henning Schmidt
- Rehabilitation Robotics Group (Fraunhofer IPK/ TU Berlin), Department of Automation Technology, Fraunhofer Institute for Production Systems and Design Technology (IPK), Pascalstr. 8-9, 10587 Berlin, Germany
| | - Jörg Krüger
- Rehabilitation Robotics Group (TU Berlin/ Fraunhofer IPK), Department of Industrial Automation Technology, Technische Universität Berlin, Pascalstr. 8-9, 10587 Berlin, Germany
- Rehabilitation Robotics Group (Fraunhofer IPK/ TU Berlin), Department of Automation Technology, Fraunhofer Institute for Production Systems and Design Technology (IPK), Pascalstr. 8-9, 10587 Berlin, Germany
| | - Christian Dohle
- Department of Neurological Rehabilitation, MEDIAN Klinik Berlin-Kladow, Kladower Damm 223, 14089 Berlin, Germany
- Center for Stroke Research Berlin, Charité-University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany
| |
Collapse
|
4
|
Taylor MJD, Griffin M. The use of gaming technology for rehabilitation in people with multiple sclerosis. Mult Scler 2014; 21:355-71. [PMID: 25533296 DOI: 10.1177/1352458514563593] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Gaming technology - exergaming - is a novel tool to facilitate exercise, improve balance, and encourage rehabilitation training. This review will describe some of the key exergame research to promote physical activity and its use in rehabilitation in other diseases or clinical populations. We will then describe the current state of research in exergaming in people with multiple sclerosis and describe the theories for the mechanism behind some of the improvements in outcomes seen after using exergaming. Lastly, we will identify gaps in the literature and provide directions for future work in this growing area. The current work is contradictory and there is no consensus with regards to training duration/intensity and the outcomes used to assess the clinical effectiveness. This in part is due to the off-the-shelf nature of the games used. A more satisfactory approach would be the development of bespoke games which match a clinical need. Exergames are seen as enjoyable and could be effective in enhancing adherence to rehabilitation. However, the definitive RCT has yet to be carried out comparing exergaming to traditional exercise.
Collapse
Affiliation(s)
- M J D Taylor
- School of Biological Sciences, University of Essex Colchester, UK
| | - M Griffin
- School of Biological Sciences, University of Essex Colchester, UK
| |
Collapse
|
5
|
Hung JW, Chou CX, Hsieh YW, Wu WC, Yu MY, Chen PC, Chang HF, Ding SE. Randomized Comparison Trial of Balance Training by Using Exergaming and Conventional Weight-Shift Therapy in Patients With Chronic Stroke. Arch Phys Med Rehabil 2014; 95:1629-37. [DOI: 10.1016/j.apmr.2014.04.029] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/22/2014] [Indexed: 11/29/2022]
|
6
|
Prosperini L, Fortuna D, Giannì C, Leonardi L, Marchetti MR, Pozzilli C. Home-Based Balance Training Using the Wii Balance Board. Neurorehabil Neural Repair 2013; 27:516-25. [DOI: 10.1177/1545968313478484] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective. To evaluate the effectiveness of a home-based rehabilitation of balance using the Nintendo Wii Balance Board System (WBBS) in patients affected by multiple sclerosis (MS). Methods. In this 24-week, randomized, 2-period crossover pilot study, 36 patients having an objective balance disorder were randomly assigned in a 1:1 ratio to 2 counterbalanced arms. Group A started a 12-week period of home-based WBBS training followed by a 12-week period without any intervention; group B received the treatment in reverse order. As endpoints, we considered the mean difference (compared with baseline) in force platform measures (ie, the displacement of body center of pressure in 30 seconds), 4-step square test (FSST), 25-foot timed walking test (25-FWT), and 29-item MS Impact Scale (MSIS-29), as evaluated after 12 weeks and at the end of the 24-week study period. Results. The 2 groups did not differ in baseline characteristics. Repeated-measures analyses of variance showed significant time × treatment effects, indicating that WBBS was effective in ameliorating force platform measures ( F = 4.608, P = .016), FSST ( F = 3.745, P = .034), 25-FWT ( F = 3.339, P = .048), and MSIS-29 ( F = 4.282, P = .023). Five adverse events attributable to the WBSS training (knee or low back pain) were recorded, but only 1 patient had to retire from the study. Conclusion. A home-based WBBS training might potentially provide an effective, engaging, balance rehabilitation solution for people with MS. However, the risk of WBBS training-related injuries should be carefully balanced with benefits. Further studies, including cost-effectiveness analyses, are warranted to establish whether WBBS may be useful in the home setting.
Collapse
|
7
|
Perlman SL. Treatment and management issues in ataxic diseases. HANDBOOK OF CLINICAL NEUROLOGY 2012; 103:635-54. [PMID: 21827924 DOI: 10.1016/b978-0-444-51892-7.00046-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Susan L Perlman
- David Geffen School of Medicine at the University of California at Los Angeles, CA 90095, USA.
| |
Collapse
|
8
|
Screening for balance disorders in mildly affected multiple sclerosis patients. J Neurol 2011; 259:1413-9. [DOI: 10.1007/s00415-011-6366-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 12/08/2011] [Indexed: 12/20/2022]
|
9
|
Bellizzi M, Rizzo G, Bellizzi G, Ranieri M, Fanelli M, Megna G, Procoli U. Electronic Baropodometry in Patients Affected by Ocular Torticollis. Strabismus 2011; 19:21-5. [DOI: 10.3109/09273972.2010.545469] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
10
|
Prosperini L, Leonardi L, De Carli P, Mannocchi ML, Pozzilli C. Visuo-proprioceptive training reduces risk of falls in patients with multiple sclerosis. Mult Scler 2010; 16:491-9. [DOI: 10.1177/1352458509359923] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lack of balance and falls are common and disabling symptoms of multiple sclerosis. The aim of this study was to investigate the effectiveness of a novel visuo-proprioceptive feedback training in ameliorating balance and reducing the risk of falls. Patients with multiple sclerosis with unrestricted walking ability and healthy age/sex-matched controls were recruited. After a baseline clinical evaluation, including a postural assessment in double- (stabilometric test) and single-leg stance (monopodalic test) by a computerized postural recorder device, patients were submitted to a run-in period lasting 6 weeks without any rehabilitative intervention. Two further clinical and postural evaluations before and after a 6-week period of training were performed. The training protocol provided static and dynamic exercises both in double- and single-leg stance, with and without a translating Freeman-like board. Visual feedback was shown on the computer screen during the exercises. We recruited 40 consecutive patients and 12 controls. Patients had significantly poorer postural performances than controls. Twenty-eight patients completed the study follow-up. No significant changes in risk of falls emerged after the run-in period. A significant reduction in the median percentage of risk of falls in single-leg stance (open eyes: 39.3 versus 15.7; closed eyes: 67.3 versus 52.6; p < 0.001, respectively) were observed after rehabilitation. Moreover, an improvement in walking speed (median time: 7.4 s versus 6.3; p = 0.001) was detected in the absence of Expanded Disability Status Scale changes. We conclude that visuo-proprioceptive training improves balance and reduces falls in multiple sclerosis.
Collapse
Affiliation(s)
- Luca Prosperini
- Multiple Sclerosis Centre, S. Andrea Hospital, University “La Sapienza “, Rome, Italy
| | - Laura Leonardi
- Multiple Sclerosis Centre, S. Andrea Hospital, University “La Sapienza “, Rome, Italy
| | | | | | - Carlo Pozzilli
- Multiple Sclerosis Centre, S. Andrea Hospital, University “La Sapienza “, Rome, Italy,
| |
Collapse
|
11
|
Cattaneo D, Regola A, Meotti M. Validity of six balance disorders scales in persons with multiple sclerosis. Disabil Rehabil 2009; 28:789-95. [PMID: 16754576 DOI: 10.1080/09638280500404289] [Citation(s) in RCA: 271] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to test concurrent and discriminant validity of several tests of static and dynamic balance in a sample of subjects suffering from MS. METHOD A group of 51 patients were enrolled in the study. The following tests were administered: Berg Balance Scale (BBS), Timed Up and Go Test (TUG), Dynamic Gait Index (DGI), Hauser Deambulation Index (DI), Dizziness Handicap Inventory (DHI), and Activities-specific Balance Confidence (ABC). The scales used in this study were initially translated into Italian. RESULTS The sample of subjects reported a mean of 0.98 (1.8 SD) falls in the month prior to evaluation. The tests demonstrated good concurrent validity: Higher correlation coefficients among tests tapping the same aspect and lower correlation coefficients among tests tapping slightly different aspects. ABC and DHI tests discriminated better than the others between fallers and non-fallers and appeared the best predictors of fall status. BBS and DGI were not as efficient in discriminating between groups. Conversely all tests showed good difference validity in the prediction of patients who used an assistive device. CONCLUSION BBS, TUG, DI, DGI, ABC, DHI have acceptable concurrent validity. The scales have poor performance in discriminating between faller and non-faller.
Collapse
Affiliation(s)
- Davide Cattaneo
- LaRiCE: Gait and Balance Disorders Laboratory, Servizio riabilitazione neurologica adulti (Int. 282); Don Gnocchi Foundation, V. Capecelatro 66, 20148 Milan, Italy.
| | | | | |
Collapse
|
12
|
Thornton M, Marshall S, McComas J, Finestone H, McCormick A, Sveistrup H. Benefits of activity and virtual reality based balance exercise programmes for adults with traumatic brain injury: Perceptions of participants and their caregivers. Brain Inj 2009; 19:989-1000. [PMID: 16263641 DOI: 10.1080/02699050500109944] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To explore multi-dimensional benefits of exercise participation perceived by adults with traumatic brain injury (TBI) and their caregivers. METHODS Adults (n=27, aged 18-66) with moderate or severe TBI 6 months or more earlier participated in focus groups following 6 weeks of an activity-based (ABE) or a virtual reality (VR) delivered balance exercise programme. Family members and care providers participated in separate focus groups. Perceptions related to programme participation as well as balance confidence and lower extremity function were extracted from focus group verbatim and quantitative scales, respectively. OUTCOMES Benefits in three domains, psychosocial, physical and programme, were identified from transcription and analyses of focus group verbatim. Improvements were noted in balance confidence and function in both groups. Substantially greater enthusiasm and knowledge was expressed by participants in the VR group and their caregivers. CONCLUSIONS Both exercise programmes offered benefits in addition to improved balance. The VR participants had greater improvements on quantitative measures and provided more comments expressing enjoyment and improved confidence. Applications in terms of community reintegration and quality of life are discussed.
Collapse
Affiliation(s)
- M Thornton
- School of Human Kinetics, University of Ottawa, and Children's Hospital of Eastern Ontario, Canada
| | | | | | | | | | | |
Collapse
|
13
|
Danion F, Duarte M, Grosjean M. Variability of reciprocal aiming movements during standing: the effect of amplitude and frequency. Gait Posture 2006; 23:173-9. [PMID: 16399513 DOI: 10.1016/j.gaitpost.2005.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2004] [Revised: 12/28/2004] [Accepted: 01/20/2005] [Indexed: 02/02/2023]
Abstract
This study investigated the variability of the center of pressure (COP) trajectory during voluntary whole-body oscillations. While standing upright on a force platform, eight subjects leaned forward and backward so as to perform reciprocal aiming movements with their COP at a prescribed frequency (F) and amplitude (A) using online visual feedback of their COP location. A total of 25 F-A combinations were tested for each subject (3 < A < 9 cm, and 0.35 < F < 1.35 Hz). Spatial and temporal variability of the COP was assessed by computing the standard deviation (SD) and coefficient of variation (CV) of the amplitude (trough to peak) and frequency (peak to peak) of the COP cycles within each trial, respectively. The results revealed that all variability indices depended on the prescribed F and A. Concerning the effect of spatial constraints on spatial variability, SD spatial increased as a function of A, while CV spatial decreased as function of A. A similar pattern was observed with respect to the effect of temporal constraints on temporal variability (SD temporal increased as a function of F, while CV temporal decreased). As for "cross-over" effects, there was an effect of F on spatial variability, such that SD spatial and CV spatial were minimal at 0.6 Hz. For the "cross over" effect of A on temporal variability, both SD spatial and CV spatial decreased as a function of A. Across the experimental conditions, there were weak or no correlations between variability in the time and space domain. Comparisons with an earlier study on human gait (Danion F, Varraine E, Bonnard M, Pailhous J. Stride variability in human gait: the effect of stride frequency and stride length. Gait Posture 2003;18:69-77) suggest that the effects of spatial constraints are relatively task independent, whereas the effects of temporal constraints depend on the nature of the motor task that is performed.
Collapse
Affiliation(s)
- Frédéric Danion
- UMR 6559 Mouvement et Perception, Université de la Méditerranée, CNRS, Faculté des Sciences du Sport, 163 avenue de Luminy, 13288 Marseille Cedex 09, France.
| | | | | |
Collapse
|
14
|
Abstract
BACKGROUND The progressive ataxias are a diverse group of neurologic diseases that share features of degeneration of the cerebellum and its inflow/outflow pathways but differ in etiology, course, and associated noncerebellar system involvement. Some will have treatable causes, but for most, the pathophysiology is incompletely known. REVIEW SUMMARY Treatment strategies will include (1) definitive therapy when available, (2) symptomatic treatment and prevention of complications, and (3) rehabilitation and support resources. The physician will have to decide whether to introduce or approve the use of therapies based on as yet-unproven mechanisms or the use of complementary medicine approaches. CONCLUSIONS There are as yet no drugs that have been approved by the Food and Drug Administration for the treatment of the progressive ataxias and relatively few disease-modifying therapies, but symptomatic and rehabilitation interventions can greatly improve the quality of life of individuals with these disabling neurodegenerative disorders.
Collapse
Affiliation(s)
- Susan L Perlman
- David Geffen School of Medicine at the University of California, Los Angeles 90095, USA.
| |
Collapse
|