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Special Issue "Virtual Reality and Robotics Interventions for Neurological Diseases"

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Artificial Intelligence in Medicine".

Deadline for manuscript submissions: 31 January 2024 | Viewed by 10912

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Special Issue Editors

Dr. Pawel Kiper

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Guest Editor

Physical Medicine and Rehabilitation Unit, Azienda ULSS 3 Serenissima, 30126 Venice, Italy
Interests: stroke; virtual reality; robotics; rehabilitation; neurorehabilitation; neurological diseases, motor learning

Prof. Dr. Carlos Luque Moreno

E-Mail Website
Guest Editor

Physiotherapy Department, University of Seville, 41004 Sevilla, Spain
Interests: virtual reality; gait analysis; physiotherapy; neurorehabilitation; dry needling; neurological disorders, stroke, multiple sclerosis

Dr. Błażej Cieślik

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Guest Editor

Faculty of Health Science, Jan Dlugosz University, 42-200 Częstochowa, Poland
Interests: mental health; psychiatric disorders; body balance; postural stability; telerehabilitation; virtual reality

Special Issue Information

Dear Colleagues,

In the 21st century, the use of technology in the field of medicine looks promising. The utilization of robotics, health wearables, and telemedicine, in general, is becoming more common in clinical practice. Another form of new technology, virtual reality (VR), has become a subject of interest among researchers around the world. VR can cover a wide spectrum of technologies, starting from simple feedback using a monitor, through the very popular head-mounted display (VR goggle), to advanced EMG-based robotic devices that can be integrated within the VR environment. Apart from physical therapy, VR has also been used to improve the mental state of neurological patients. Immersion through VR is also related to the notion of “escapism”, meaning an escape from reality into the world of fiction and illusion, which in turn can positively affect mental health. The above examples show the spectrum of VR applications at random; however, this area is still a technological novelty. Studies focusing on acceptability, feasibility, tolerability, and initial clinical efficacy studies are still needed, but so are randomized controlled trials that compare clinically important outcomes between intervention and control conditions, as well as high-quality systematic reviews and meta-analyses.

Therefore, in light of the rapid expansion of the virtual reality field, we propose this Special Issue for a contribution within the innovative technologies field. We invite the submission of original research on VR support, treatment, and/or assessment in neurological diseases. Systematic reviews and meta-analyses will also be welcomed.

Dr. Pawel Kiper
Prof. Dr. Carlos Luque Moreno
Dr. Błażej Cieślik
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

virtual reality
neurorehabilitation
stroke
recovery of function
neurological diseases
multiple sclerosis
cerebral palsy
robotics
parkinson’s disease
mental health

Published Papers (6 papers)

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Open AccessArticle

Effects of Therapist Intervention during Upper-Extremity Robotic Rehabilitation in Patients with Stroke

and

Healthcare 2023, 11(10), 1369; https://doi.org/10.3390/healthcare11101369 - 10 May 2023

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Abstract

This study aimed to determine whether the treatment effect differs for patients with stroke who perform robot-assisted upper-extremity rehabilitation by themselves compared to those whose rehabilitation is actively assisted by a therapist. Stroke patients with hemiplegia were randomly divided into two groups and received robot-assisted upper-limb rehabilitation for four weeks. In the experimental group, a therapist actively intervened in the treatment, while in the control group, the therapist only observed. After four weeks of rehabilitation, the manual muscle strength, Brunnstrom stage, Fugl-Meyer assessment of the upper-extremity (FMA-UE), box and block test, and functional independence measure (FIM) showed significant improvement in both groups compared to that before treatment; however, no interval change in spasticity was noted. The post-treatment values showed that the FMA-UE and box and block tests were significantly improved in the experimental group compared to those in the control group. Comparing the changes in the pre- and post-treatment values, the FMA-UE, box and block test, and FIM of the experimental group were significantly improved compared to those in the control group. Our results suggest that active intervention by therapists during robot-assisted upper-limb rehabilitation positively impacts upper-extremity function outcomes in patients with stroke. Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

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Open AccessArticle

Clinical Predictors for Upper Limb Recovery after Stroke Rehabilitation: Retrospective Cohort Study

and

Healthcare 2023, 11(3), 335; https://doi.org/10.3390/healthcare11030335 - 23 Jan 2023

Cited by 1 | Viewed by 2059

Abstract

After stroke, recovery of upper limb (UL) motor function is enhanced by a high dose of rehabilitation and is supposed to be supported by attentive functions. However, their mutual influence during rehabilitation is not well known yet. The aim of this retrospective observational cohort study was to investigate the association between rehabilitation dose and motor and cognitive functions, during UL motor recovery. Inpatients with first unilateral stroke, without time restrictions from onset, and undergoing at least 15 h of rehabilitation were enrolled. Data on dose and modalities of rehabilitation received, together with motor and cognitive outcomes before and after therapy, were collected. Fugl–Meyer values for the Upper Extremity were the primary outcome measure. Logistic regression models were used to detect any associations between UL motor improvement and motor and cognitive-linguistic features at acceptance, regarding dose of rehabilitation received. Thirty-five patients were enrolled and received 80.57 ± 30.1 h of rehabilitation on average. Manual dexterity, level of independence and UL motor function improved after rehabilitation, with no influence of attentive functions on motor recovery. The total amount of rehabilitation delivered was the strongest factor (p = 0.031) influencing the recovery of UL motor function after stroke, whereas cognitive-linguistic characteristics were not found to influence UL motor gains. Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

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Open AccessArticle

Virtual Feedback for Arm Motor Function Rehabilitation after Stroke: A Randomized Controlled Trial

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Healthcare 2022, 10(7), 1175; https://doi.org/10.3390/healthcare10071175 - 23 Jun 2022

Cited by 2 | Viewed by 1719

Abstract

A single-blind randomized controlled trial was conducted to compare whether the continuous visualization of a virtual teacher, during virtual reality rehabilitation, is more effective than the same treatment provided without a virtual teacher visualization, for the recovery of arm motor function after stroke. Teacher and no-teacher groups received the same amount of virtual reality therapy (i.e., 1 h/d, 5 dd/w, 4 ww) and an additional hour of conventional therapy. In the teacher group, specific feedback (“virtual-teacher”) showing the correct kinematic to be emulated by the patient was always displayed online during exercises. In the no-teacher group patients performed the same exercises, without the virtual-teacher assistance. The primary outcome measure was Fugl-Meyer Upper Extremity after treatment. 124 patients were enrolled and randomized, 62 per group. No differences were observed between the groups, but the same number of patients (χ² = 0.29, p = 0.59) responded to experimental and control interventions in each group. The results confirm that the manipulation of a single instant feedback does not provide clinical advantages over multimodal feedback for arm rehabilitation after stroke, but combining 40 h conventional therapy and virtual reality provides large effect of intervention (i.e., Cohen’s d 1.14 and 0.92 for the two groups, respectively). Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

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Open AccessArticle

The Use of Virtual Therapy in Cardiac Rehabilitation of Male Patients with Coronary Heart Disease: A Randomized Pilot Study

Joanna Szczepańska-Gieracha

and

Robert Gajda

Healthcare 2022, 10(4), 745; https://doi.org/10.3390/healthcare10040745 - 16 Apr 2022

Cited by 2 | Viewed by 1623

Abstract

The study aimed to evaluate the effectiveness of virtual reality therapy (VRT) in the treatment of anxiety–depressive disorders and in reducing stress levels in a group of men with coronary heart disease (CHD) participating in cardiac rehabilitation (CR). The study included 34 men with CHD who were assigned to the experimental group (EG) or the control group (CG). CR in the EG was supported by 8 VRT sessions, while CR in the CG was supplemented with 8 SAT sessions. Anxiety–depressive disorders were assessed using the Hospital Anxiety and Depression Scale (HADS). Perceived stress was assessed using the Perception of Stress Questionnaire (PSQ). In the EG, all measured parameters improved after the intervention. Significant reductions in HADS total score, the HADS-A, general stress score, emotional tension, and the external stress were obtained. In the CG, a deterioration in all measured parameters was observed. Significant changes were obtained in the general stress score and intrapsychic stress. The analysis between groups showed that the effectiveness of psychological interventions significantly differed between groups. The study results confirmed that supplementing standard CR with VRT leads to an improvement in the mental state of the patients and thus has a positive effect on the course of CR. However, the small sample size and high withdrawal rate prompt cautious interpretation of the results. Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

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Open AccessCommunication

The Application of Balance Exercise Using Virtual Reality for Rehabilitation

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Healthcare 2022, 10(4), 680; https://doi.org/10.3390/healthcare10040680 - 04 Apr 2022

Cited by 1 | Viewed by 1890

Abstract

To prevent falls, it is important to devise a safe balance training program that can be easily performed. This study investigated whether tilting an image in virtual reality (VR) can generate a center-of-gravity sway. Five men and five women were asked to rest standing upright (control condition) and to rest standing upright with a head-mounted display showing a tilted virtual image (VR condition), and changes in their standing balance were observed. Standing balance was assessed by measuring the distance traveled by the center of pressure (COP) of each of the participants’ legs. In order to investigate the effects of different tilt speeds and angles on COP, four different images were displayed in VR: an image tilting to 10° moving at a rate of 1°/s; an image tilting to 20° moving 1°/s; an image tilting to 10° moving 10°/s; an image tilting to 20° moving 10°/s. Change in COP was significantly greater in the VR than in the control condition (p < 0.01), and a tilt of 10° moving 1°/s showed the greatest change in COP (p < 0.01). Tilting an image in VR while in a resting standing position can change an individual’s COP; thus, VR may be applied to balance training. Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

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Open AccessSystematic Review

Neurologic Music Therapy in Geriatric Rehabilitation: A Systematic Review

Jagoda Rusowicz

Joanna Szczepańska-Gieracha

and

Paweł Kiper

Healthcare 2022, 10(11), 2187; https://doi.org/10.3390/healthcare10112187 - 31 Oct 2022

Viewed by 1919

Abstract

(1) Introduction: Neurologic music therapy (NMT) is a non-pharmacological approach of interaction through the therapeutic use of music in motor, sensory and cognitive dysfunctions caused by damage or diseases of the nervous system. (2) Objective: This study aimed to critically appraise the available literature on the application of particular NMT techniques in the rehabilitation of geriatric disorders. (3) Methods: PubMed, ScienceDirect and EBSCOhost databases were searched. We considered randomized controlled trials (RCTs) from the last 12 years using at least one of the NMT techniques from the sensorimotor, speech/language and cognitive domains in the therapy of patients over 60 years old and with psychogeriatric disorders. (4) Results: Of the 255 articles, 8 met the inclusion criteria. All papers in the final phase concerned the use of rhythmic auditory stimulation (RAS) (sensorimotor technique) in the rehabilitation of both Parkinson’s disease (PD) patients (six studies) and stroke patients (SPs) (two studies). (5) Conclusion: All reports suggest that the RAS technique has a significant effect on the improvement of gait parameters and the balance of PD patients and SPs, as well as the risk of falls in PD patients. Full article

(This article belongs to the Special Issue Virtual Reality and Robotics Interventions for Neurological Diseases)

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