Towards Understanding and Improving Gait Rehabilitation in Virtual Environments Using Latency for Persons with Mobility Impairments


Book Description

Latency is an unavoidable byproduct of the modern virtual reality systems. Although it has been highly studied for several decades, the effects of latency and how it is perceived by persons suffering from mobility impairments have not been investigated. It is important to understand the effects latency has on such under-investigated populations (e.g. persons suffering from Multiple Sclerosis) with the increasing use of virtual reality technology in physical rehabilitation techniques. Therefore, the first study was conducted aiming at understanding the influences of latency and the presence of an avatar have on persons suffering from mobility impairments. The results showed that most participants failed to notice even the higher latency conditions present in the virtual environment, even though their gait was altered. To investigate the lack of latency detection noted, a second study was carried out to examine how the latency thresholds of participants suffering from Multiple Sclerosis may differ from healthy participants. The results showed considerably higher tolerance for latency in participants suffering from multiple sclerosis than healthy participants. Thus, I raised the following question: "can latency be used to create a perceptual illusion to effectively improve rehabilitation in persons suffering from mobility impairments?" To investigate, I conducted two additional experiments where differing latency levels are applied to the left and right side of a self-avatar with both healthy and participants with mobility impairments. The results showed the potential of manipulating walking patterns using latency in a virtual environment. Here, I report the results of these experiments and the implications they have in general virtual rehabilitation system design as well as gait rehabilitation for asymmetric gait. Latency can thus be potentially used as a gait altering technique in a virtual environment.




Advanced Technologies for the Rehabilitation of Gait and Balance Disorders


Book Description

The book provides readers with a comprehensive overview of the state of the art in the field of gait and balance rehabilitation. It describes technologies and devices together with the requirements and factors to be considered during their application in clinical settings. The book covers physiological and pathophysiological basis of locomotion and posture control, describes integrated approaches for the treatment of neurological diseases and spinal cord injury, as well as important principles for designing appropriate clinical studies. It presents computer and robotic technologies currently used in rehabilitation, such as exoskeleton devices, functional electrical stimulation, virtual reality and many more, highlighting the main advantages and challenges both from the clinical and engineering perspective. Written in an easy-to-understand style, the book is intended for people with different background and expertise, including medical and engineering students, clinicians and physiotherapists, as well as technical developers of rehabilitation systems and their corresponding human-compute interfaces. It aims at fostering an increased awareness of available technologies for balance and gait rehabilitation, as well as a better communication and collaboration between their users and developers.







Virtual Reality


Book Description

In recent years, humanity has seen a trend towards the use of virtual reality (VR) technologies for rehabilitation and disability support. This is partly driven not only by the decreasing cost and improved accessibility to technology, but also by the growth in expertise of virtual rehabilitation researchers and practitioners. The benefits of virtual reality are becoming well-established in a number of areas such as pain management, physical rehabilitation and cognitive interventions, and research studies have demonstrated benefits across a range of conditions including Parkinson's disease, cerebral palsy, autism and anxiety disorders. However, the diversity of hardware and software available currently has little standardisation, and patients with disabilities or health conditions often have unique interaction needs which differ from the general population. In this book, the authors explore a number of these issues, presenting recent research findings and technical developments that help them to understand the unique challenges of virtual rehabilitation design and guide future VR system development.




Human Walking in Virtual Environments


Book Description

This book presents a survey of past and recent developments on human walking in virtual environments with an emphasis on human self-motion perception, the multisensory nature of experiences of walking, conceptual design approaches, current technologies, and applications. The use of Virtual Reality and movement simulation systems is becoming increasingly popular and more accessible to a wide variety of research fields and applications. While, in the past, simulation technologies have focused on developing realistic, interactive visual environments, it is becoming increasingly obvious that our everyday interactions are highly multisensory. Therefore, investigators are beginning to understand the critical importance of developing and validating locomotor interfaces that can allow for realistic, natural behaviours. The book aims to present an overview of what is currently understood about human perception and performance when moving in virtual environments and to situate it relative to the broader scientific and engineering literature on human locomotion and locomotion interfaces. The contents include scientific background and recent empirical findings related to biomechanics, self-motion perception, and physical interactions. The book also discusses conceptual approaches to multimodal sensing, display systems, and interaction for walking in real and virtual environments. Finally, it will present current and emerging applications in areas such as gait and posture rehabilitation, gaming, sports, and architectural design.




Robotics in Physical Medicine and Rehabilitation


Book Description

Robotics and VR systems are uniquely suited to provide functional assistance with mobility and activities of daily living, especially for patients with motor and sensory disorders of the central nervous system, stroke, traumatic brain injury, multiple sclerosis, spinal cord injury, and cerebral palsy. Compiling both current knowledge and key challenges of robotic rehabilitation in one convenient text, Robotics in Physical Medicine and Rehabilitation is a comprehensive, easy-to-follow resource on robotic and VR systems in all areas of medical rehabilitation. Covers the impact of robotics and artificial intelligence on all aspects of health care delivery. Focuses on the key technologies in developing robotics for a wide range of medical rehabilitation activities, including neuroprosthesis applications of robotic exoskeletons and brain-controlled assistive robotics and prosthetics. Addresses artificial intelligence, medical robotics in acute care medicine, and robots on the battlefield and in space travel. Contains chapters on the economics of the robotic industry and the future of robots in medicine. Ideal for physiatrists and PM&R residents and fellows; clinicians in orthopaedics, sports medicine, spinal cord injury, and occupational therapy; and specialists working with orthotics and prosthetics.




Gait Analysis in the Science of Rehabilitation


Book Description

Instrumented gait analysis systems offer objective evaluation of the effectiveness of the various rehabilitation treatments that are aimed at improving gait disabilities. There are four sections in this report: clinical observation; review of the instrumental gait analysis systems; the value of information resulting from instrumented gait analysis from the perspective of a psychiatrist, an orthopedic surgeon, & a physical therapist; & discussion of future trends for gait laboratories. The authors are experts from multiple rehabilitation specialties to give you an understanding of how gait analysis can be used to evaluate a person's walking abilities to maximize function & maintain or improve quality of life. Illustrations.




Interfacing Humans and Robots for Gait Assistance and Rehabilitation


Book Description

The concepts represented in this textbook are explored for the first time in assistive and rehabilitation robotics, which is the combination of physical, cognitive, and social human-robot interaction to empower gait rehabilitation and assist human mobility. The aim is to consolidate the methodologies, modules, and technologies implemented in lower-limb exoskeletons, smart walkers, and social robots when human gait assistance and rehabilitation are the primary targets. This book presents the combination of emergent technologies in healthcare applications and robotics science, such as soft robotics, force control, novel sensing methods, brain-computer interfaces, serious games, automatic learning, and motion planning. From the clinical perspective, case studies are presented for testing and evaluating how those robots interact with humans, analyzing acceptance, perception, biomechanics factors, and physiological mechanisms of recovery during the robotic assistance or therapy. Interfacing Humans and Robots for Gait Assistance and Rehabilitation will enable undergraduate and graduate students of biomedical engineering, rehabilitation engineering, robotics, and health sciences to understand the clinical needs, technology, and science of human-robot interaction behind robotic devices for rehabilitation, and the evidence and implications related to the implementation of those devices in actual therapy and daily life applications.




Oxford Textbook of Neurorehabilitation


Book Description

Neurorehabilitation is an expanding field with an increasing clinical impact due to an ageing population. During the last 20 years, neurorehabilitation has developed from a discipline with little scientific background, separated from other medical centers, to a medical entity largely based on the principles of 'evidenced based medicine' with strong ties to basic research and clinical neurology. Today neurorehabilitation is still a work in progress and treatment standards are not yet established for all aspects of the field. There are very few books that address contemporary neurorehabilitation from this perspective. This new edition of the Oxford Textbook of Neurorehabilitation provides an understanding of the theoretical underpinnings of the subject as well as a clear perspective on how (and why) to approach treatment decisions on an individualized basis. The book has been thoroughly updated to reflect novel important developments in the field and includes new chapters on vocational rehabilitation, self-management strategies in neurorehabilitation, and music supported therapy in neurorehabilitation. This indispensable book will be of great interest to rehabilitation physicians, neurologists, and allied health care professionals who look after patients requiring neurorehabilitation.




Virtual Reality as a Clinical Modality for Retraining Balance and Mobility


Book Description

Physical rehabilitation of individuals who are experiencing a disabling illness or have survived a traumatic injury (i.e. stroke) must seek to train the body's structures and functions to reduce disability (activity limitations, participation restrictions) (Stucki, 2005). Figure 1 represents a modified version of the International Classification of Functioning (ICF), Disability and Health (World Health Organization, 2002). This figure illustrates how, for example, a stroke impacts the body structures and functions (e.g. muscle recruitment) which influences the ability to complete activities (e.g. gait) ultimately restricting participation in all areas of life (e.g. employment). The ICF model presents a framework for clinical practice and rehabilitation research studies. Although it has been shown to be strongly correlated (Schmid, Van Puymbroeck, et al., 2013) the concept of function cannot always be directly correlated with the concept of quality of life (Stucki, 2005) as the individual may not perceive, for example, impaired balance and mobility as detrimental to their quality of life. However, reduced function does put an individual at further risk of complications including falls and injuries from compensatory mechanisms and therefore must be addressed. The focus of this thesis is the study of the potential benefits of an exercise modality (virtual reality) to encourage restoration of the body's structures and functions for individuals post-stroke. As the individuals engage in physical rehabilitation through exercise, there may be improvements on the individual's abilities as seen through measurements of the control of posture and walking. The thesis comprises four studies, two of which have been published in peer reviewed journals. The progression of studies attempts to characterize outcomes following the use of virtual reality training in clinical populations (dementia and stroke) to address impairments to the body structures and functions (e.g. mobility) as measured by both clinical measures of activity and laboratory based measures of balance and to elucidate a possible mechanism (focus of attention) that makes training in a virtual environment effective.