Virtual reality in telerehabilitation

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Virtual reality in telerehabilitation is a method used first in the training of musculoskeletal patients using asynchronous patient data uploading, and an internet video link. Subsequently, therapists using virtual reality-based telerehabilitation prescribe exercise routines via the web which are then accessed and executed by patients through a web browser. Therapists then monitor the patient's progress via the web and modify the therapy asynchronously without real-time interaction or training. [1]

Contents

Background

The computer technology that allows development three-dimensional virtual environments consists of both hardware and software. The current popular, technical, and scientific interest in virtual environments is inspired, in large part, by the advent and availability of increasingly powerful and affordable visually oriented, interactive, graphical display systems and techniques lacking only sense and sensibility.

The term "virtualized reality" (VR) was coined and introduced in a paper by Kanade. The traditional virtual reality world is typically constructed using simplistic, artificially created computer-aided design (CAD) models. VR starts with the real-world scene and virtualizes it. [2] Virtual reality is a practical, affordable technology for the practice of clinical medicine, and modern, high-fidelity virtual reality systems have practical applications in areas ranging from psychiatry to surgical planning and telemedicine. [3] Through VR's capacity to allow the creation and control of dynamic 3-dimensional, ecologically valid stimulus environments within which behavioral response can be recorded and measured, it offers clinical assessment and rehabilitation options not available with traditional methods. [4]

Application

The value of VR systems for the investigation and rehabilitation of cognitive and perceptual impairments and current and potential applications of VR technology address six neurorehabilitation issues. [5] Korean researchers developed and assessed the value of a new rehabilitation training system to improve postural balance control by combining virtual reality technology with an unfixed bicycle. The system was effective as a training device; in addition, the technology might have a wider applicability to the rehabilitation field. [6]

Tracy and Lathan investigated the relationship between motor tasks and participants' spatial abilities by training participants within a VR based simulator and then observing their ability to transfer training from the simulator to the real world. The study demonstrated that subjects with lower spatial abilities achieved significant positive transfer from a simulator based training task to a similar real world robotic operation task. [7]

Virtual environments were applied to assess the training of inexperienced powered wheelchair users and demonstrated that the two virtual environments represent a potentially useful means of assessing and training novice powered wheelchair users. [8] A recently completed project at the University of Strathclyde has resulted in the development of a wheelchair motion platform which, in conjunction with a virtual reality facility, can be used to address issues of accessibility in the built environment. [9]

Many cases have applied virtual reality technology to telemedicine and telerehabilitation service development. Because telemedicine focuses principally on transmitting medical information, VR has potential to enhance the practice. State of the art of VR-based telemedicine applications is used in remote or augmented surgery as well as in surgical training, both of which are critically dependent on eye–hand coordination. Recently, however, different researchers have tried to use virtual environments in medical visualization and for assessment and rehabilitation in neuropsychology. [10]

Case studies for VR applications were conducted that were internet deliverable and they identified technical, practical, and user challenges of remote VR treatment programs. [11] To improve understanding of deficits in autism and in left visual-spatial neglect, Trepagnier et al. investigated face gaze behavior in autism and right hemisphere stroke, using virtual reality and gaze sensing technology. [12]

An at-home stroke telerehabilitation service was developed using virtual reality haptics. [13] Researchers from Rutgers University and Stanford University developed a virtual reality-based orthopedic telerehabilitation system. [14] [15] [16]

The use of virtual reality technologies in the rehabilitation of patients with vestibular system disorders and in the provision of remote medical consultation for those patients. He stated that an appropriately designed VR experience could greatly increase the rate of adaptation in these patients. [17]

See also

Related Research Articles

Virtual reality Computer-simulated environment simulating physical presence in real or imagined worlds

Virtual reality (VR) is a simulated experience that can be similar to or completely different from the real world. Applications of virtual reality include entertainment, education and business. Other distinct types of VR-style technology include augmented reality and mixed reality, sometimes referred to as extended reality or XR.

Simulation

A simulation is the imitation of the operation of a real-world process or system over time. Simulations require the use of models; the model represents the key characteristics or behaviors of the selected system or process, whereas the simulation represents the evolution of the model over time. Often, computers are used to execute the simulation.

Augmented reality View of the real world with computer-generated supplementary features

Augmented reality (AR) is an interactive experience of a real-world environment where the objects that reside in the real world are enhanced by computer-generated perceptual information, sometimes across multiple sensory modalities, including visual, auditory, haptic, somatosensory and olfactory. AR can be defined as a system that fulfills three basic features: a combination of real and virtual worlds, real-time interaction, and accurate 3D registration of virtual and real objects. The overlaid sensory information can be constructive, or destructive. This experience is seamlessly interwoven with the physical world such that it is perceived as an immersive aspect of the real environment. In this way, augmented reality alters one's ongoing perception of a real-world environment, whereas virtual reality completely replaces the user's real-world environment with a simulated one. Augmented reality is related to two largely synonymous terms: mixed reality and computer-mediated reality.

Computer-mediated reality Ability to manipulate ones perception of reality through the use of a computer

Computer-mediated reality refers to the ability to add to, subtract information from, or otherwise manipulate one's perception of reality through the use of a wearable computer or hand-held device such as a smartphone.

Mixed reality Merging of real and virtual worlds to produce new environments

Mixed reality (MR) is the merging of real and virtual worlds to produce new environments and visualizations, where physical and digital objects co-exist and interact in real time. Mixed reality does not exclusively take place in either the physical or virtual world, but is a hybrid of reality and virtual reality. There are many practical applications of mixed reality, including design, entertainment, military training, and remote working. There are also different display technologies used to facilitate the interaction between users and mixed reality applications.

Telehealth Health care by telecommunication

Telehealth is the distribution of health-related services and information via electronic information and telecommunication technologies. It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. Telemedicine is sometimes used as a synonym, or is used in a more limited sense to describe remote clinical services, such as diagnosis and monitoring. When rural settings, lack of transport, a lack of mobility, decreased funding, or a lack of staff restrict access to care, telehealth may bridge the gap. as well as provider distance-learning; meetings, supervision, and presentations between practitioners; online information and health data management and healthcare system integration. Telehealth could include two clinicians discussing a case over video conference; a robotic surgery occurring through remote access; physical therapy done via digital monitoring instruments, live feed and application combinations; tests being forwarded between facilities for interpretation by a higher specialist; home monitoring through continuous sending of patient health data; client to practitioner online conference; or even videophone interpretation during a consult.

Fitness game, exergaming or exer-gaming, or gamercising is a term used for video games that are also a form of exercise. Exergaming relies on technology that tracks body movement or reaction. The genre has been credited with upending the stereotype of gaming as a sedentary activity, and promoting an active lifestyle. Exergames are seen as evolving from technology changes aimed at making video games more fun.

Telerehabilitation Delivery of rehabilitation services over the internet

Telerehabilitation (or e-rehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Telerehabilitation allows patients to interact with providers remotely and can be used both to assess patients and to deliver therapy. Fields of medicine that utilize telerehabilitation include: physical therapy, occupational therapy, speech-language pathology, audiology, and psychology. Therapy sessions can be individual or community-based. Types of therapy available include motor training exercises, speech therapy, virtual reality, robotic therapy, goal setting, and group exercise.

Virtual reality therapy (VRT), also known as virtual reality immersion therapy (VRIT), simulation for therapy (SFT), virtual reality exposure therapy (VRET), and computerized CBT (CCBT), is the use of virtual reality technology for psychological or occupational therapy and in affecting virtual rehabilitation. Patients receiving virtual reality therapy navigate through digitally created environments and complete specially designed tasks often tailored to treat a specific ailment; and is designed to isolate the user from their surrounding sensory inputs and give the illusion of immersion inside a computer-generated, interactive virtual environment. This technology has a demonstrated clinical benefit as an adjunctive analgesic during burn wound dressing and other painful medical procedures. Technology can range from a simple PC and keyboard setup, to a modern virtual reality headset. It is widely used as an alternative form of exposure therapy, in which patients interact with harmless virtual representations of traumatic stimuli in order to reduce fear responses. It has proven to be especially effective at treating PTSD, and shows considerable promise in treating a variety of neurological and physical conditions. Virtual reality therapy has also been used to help stroke patients regain muscle control, to treat other disorders such as body dysmorphia, and to improve social skills in those diagnosed with autism.

Immersion (virtual reality) Perception of being physically present in a non-physical world

Immersion into virtual reality (VR) is a perception of being physically present in a non-physical world. The perception is created by surrounding the user of the VR system in images, sound or other stimuli that provide an engrossing total environment.

Astronaut training describes the complex process of preparing astronauts in regions around the world for their space missions before, during and after the flight, which includes medical tests, physical training, extra-vehicular activity (EVA) training, procedure training, rehabilitation process, as well as training on experiments they will accomplish during their stay in space.

Toby Howard

Toby L. J. Howard is an Honorary Reader in the Department of Computer Science at the University of Manchester in the UK, He was Director of undergraduate studies 2011-2019. He retired from the University in July 2020.

Virtual reality sickness occurs when exposure to a virtual environment causes symptoms that are similar to motion sickness symptoms. The most common symptoms are general discomfort, headache, stomach awareness, nausea, vomiting, pallor, sweating, fatigue, drowsiness, disorientation, and apathy. Other symptoms include postural instability and retching. Virtual reality sickness is different from motion sickness in that it can be caused by the visually-induced perception of self-motion; real self-motion is not needed. It is also different from simulator sickness; non-virtual reality simulator sickness tends to be characterized by oculomotor disturbances, whereas virtual reality sickness tends to be characterized by disorientation.

CAREN protocol—is a versatile, multi-sensory virtual reality system used for treatment and rehabilitation of human locomotion, or walking, as well as pain, posture, balance spinal stability and motor control integration.

Video game rehabilitation is a process of using common video game consoles and methodology to target and improve physical and mental weaknesses through therapeutic processes. Video games are becoming an integral part of occupational therapy practice in acute, rehabilitation, and community settings. The design for video games in rehabilitation is focused on a number of fundamental principles, such as reward, goals, challenge, and meaningful play. ‘Meaningful play’ emerges from the relationship between player action and system outcome, apparent to the player through, visual, physical and aural feedback. Platforms that feature motion control, notably the Nintendo Wii, Microsoft's Xbox Kinect, Sony's Eye Toy, and virtual reality have all been effective in this field of research. Methodologies have been applied to all age groups, from toddlers to the elderly. It has been used in a variety of cases ranging from stroke rehabilitation, cerebral palsy and other neurological impairments, to tendinitis and multiple sclerosis. Researchers have promoted such technology based on the personalization of gaming systems to patients, allowing for further engagement and interaction. Additionally, gaming consoles have the ability to capture real-time data and provide instant feedback to the patients using the systems. Currently, several researchers have performed case studies to demonstrate the benefits of this technology. Repeat trials and experiments have shown that outcomes are easily replicated among various groups worldwide. Additionally, the outcomes have increased interest in the field, growing experiments beyond simple case studies to experiments with a larger participant base.

Industrial augmented reality

Industrial augmented reality (IAR) is related to the application of augmented reality (AR) to support an industrial process. The use of IAR dates back to the 1990s with the work of Thomas Caudell and David Mizell about the application of AR at Boeing. Since then several applications of this technique over the years have been proposed showing its potential in supporting some industrial processes. Although there have been several advances in technology, IAR is still considered to be at an infant developmental stage.

VR positional tracking

In virtual reality (VR), positional tracking detects the precise position of the head-mounted displays, controllers, other objects or body parts within Euclidean space. Because the purpose of VR is to emulate perceptions of reality, it is paramount that positional tracking be both accurate and precise so as not to break the illusion of three-dimensional space. Several methods of tracking the position and orientation of the display and any associated objects or devices have been developed to achieve this. All of said methods utilize sensors which repeatedly record signals from transmitters on or near the tracked object(s), and then send that data to the computer in order to maintain an approximation of their physical locations. By and large, these physical locations are identified and defined using one or more of three coordinate systems: the Cartesian rectilinear system, the spherical polar system, and the cylindrical system. Many interfaces have also been designed to monitor and control one’s movement within and interaction with the virtual 3D space; such interfaces must work closely with positional tracking systems to provide a seamless user experience.

Virtual reality (VR) is a computer application which allows users to experience immersive, three dimensional visual and audio simulations. According to Pinho (2004), virtual reality is characterized by immersion in the 3D world, interaction with virtual objects, and involvement in exploring the virtual environment. The feasibility of the virtual reality in education has been debated due to several obstacles such as affordability of VR software and hardware. The psychological effects of virtual reality are also a negative consideration. However, recent technological progress has made VR more viable and promise new learning models and styles for students. These facets of virtual reality have found applications within the primary education sphere in enhancing student learning, increasing engagement, and creating new opportunities for addressing learning preferences.

Virtual reality game Type of video game

A virtual reality game or VR game is a video game played on virtual reality (VR) hardware. Most VR games are based on player immersion, typically through head-mounted display unit or headset and one or more controllers. The headset typically provides two stereoscopic displays in front of the user's eyes to simulate a 3D space.

Virtual reality applications Overview of the various applications that make use of virtual reality

Virtual reality applications are applications that make use of virtual reality (VR), an immersive sensory experience that digitally simulates a virtual environment. Applications have been developed in a variety of domains, such as education, architectural and urban design, digital marketing and activism, engineering and robotics, entertainment, virtual communities, fine arts, healthcare and clinical therapies, heritage and archaeology, occupational safety, social science and psychology.

References

  1. ↑ Westwood, James D.; Helene M. Hoffman, Randy S. Haluck, Greg T. Mogel, R. Phillips, Richard A. Robb, K.G. Vosburgh (2005). Medicine Meets Virtual Reality 13: The Magical Next Becomes The Medical Now . IOS Press. p.  294. ISBN   978-1-58603-498-6.CS1 maint: multiple names: authors list (link)
  2. ↑ Kanade, T.; P.J. Narayanan and P.W. Rander (1995). "Virtualized Reality: Concepts and Early Results". IEEE Workshop on Representation of Visual Scenes, 1995, Proceedings. Los Alamitos, Calif. : IEEE Computer Society Press, c1995. pp. 69–76. CiteSeerX   10.1.1.187.7689 . doi:10.1109/WVRS.1995.476854. ISBN   978-0-8186-7122-7.
  3. ↑ Bergeron, B. (2003). "Virtual reality applications in clinical medicine". Journal of Medical Practice Management. 18 (4): 211–5. PMID   12661483.
  4. ↑ Schultheis, Maria T.; Albert A. Rizzo (August 2001). "The application of virtual reality technology in rehabilitation". Rehabilitation Psychology. 46 (3): 296–311. doi:10.1037/0090-5550.46.3.296.
  5. ↑ Trepagnier, Cheryl C. (January 1999). "Virtual environments for the investigation and rehabilitation of cognitive and perceptual impairments". NeuroRehabilitation. 12 (1): 63–72. doi:10.3233/NRE-1999-12107 . Retrieved 2007-07-26.
  6. ↑ Song, Chul Gyu; Jong Yun Kim and Nam Gyun Kim (June 2004). "A new postural balance control system for rehabilitation training based on virtual cycling". IEEE Transactions on Information Technology in Biomedicine. 8 (2): 200–207. doi:10.1109/TITB.2004.828887. PMID   15217265.
  7. ↑ Tracey, M. R.; C. E. Lathan (2001). The interaction of spatial ability and motor learning in the transfer of training from a simulator to a real task. Studies in Health Technology and Informatics. 81. pp. 521–7. ISBN   978-1-58603-143-5. PMID   11317801.
  8. ↑ Harrison, A.; G. Derwent; A. Enticknap; F. D. Rose; E. A. Attree (2002). "The role of virtual reality technology in the assessment and training of inexperienced powered wheelchair users". Disability & Rehabilitation. 24 (11–12): 599–606. doi:10.1080/09638280110111360. PMID   12182799.
  9. ↑ Grant, M. "Wheelchair Simulation in Virtual Reality". Space Requirements for Wheeled Mobility: An International Workshop, Amherst, 2003. Retrieved 2006-07-26.
  10. ↑ Riva, Giuseppe; Luciano Gamberini (2000). "Virtual reality in telemedicine". Telemedicine Journal and E-Health. 6 (3): 327–40. CiteSeerX   10.1.1.3.8473 . doi:10.1089/153056200750040183. PMID   11110636.
  11. ↑ Rizzo, Albert A.; Dorothy Strickland and Stéphane Bouchard (2004). "The challenge of using virtual reality in telerehabilitation". Telemedicine Journal and E-Health. 10 (2): 184–95. doi:10.1089/tmj.2004.10.184. PMID   15319048.
  12. ↑ Trepagnier, Cheryl; Michael J. Rosen; Corinna Lathan. "Telerehabilitation and virtual reality technology for rehabilitation: preliminary results". Conference on Technology and Persons with Disabilities, California State University at Northridge, 1999.
  13. ↑ Rydmark, M.; J. Boeren and R. Pasher; Pascher, R (2002). Stroke rehabilitation at home using virtual reality, haptics and telemedicine. Studies in Health Technology and Informatics. 85. pp. 434–7. ISBN   978-1-58603-203-6. PMID   15458128.
  14. ↑ Burdea, G. C.; V. G. Popescu, V. R. Hentz and K. Colbert (September 2000). "Virtual reality-based orthopedic telerehabilitation". IEEE Transactions on Rehabilitation Engineering. 8 (3): 430–2. CiteSeerX   10.1.1.456.2349 . doi:10.1109/86.867886. PMID   11001524.
  15. ↑ Popescu, V. G.; G. C. Burdea, M. Bouzit and V. R. Hentz (March 2000). "A virtual-reality-based telerehabilitation system with force feedback". IEEE Transactions on Information Technology in Biomedicine. 4 (1): 45–51. CiteSeerX   10.1.1.131.7620 . doi:10.1109/4233.826858. PMID   10761773.
  16. ↑ Burdea, G. C. (2003). "Virtual rehabilitation—benefits and challenges". Methods of Information in Medicine. 42 (5): 519–23. doi:10.1055/s-0038-1634378. PMID   14654886.
  17. ↑ Viirre, E. (1996). Vestibular telemedicine and rehabilitation. Studies in Health Technology and Informatics. 29. pp. 299–305. ISBN   978-90-5199-250-2. PMID   10163763.
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