Virtual reality in telerehabilitation
Encyclopedia
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.
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. 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
. 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.
issues. 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.
Tracy and Lathan investigated the relationship between motor task
s 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.
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. 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.
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.
Case studies for VR applications were conducted that were internet
deliverable and they identified technical, practical, and user challenges of remote VR treatment programs. 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.
An at-home stroke telerehabilitation service was developed using virtual reality haptics. Researchers from Rutgers University
and Stanford University
developed a virtual reality-based orthopedic telerehabilitation system.
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.
Asynchrony
Asynchrony, in the general meaning, is the state of not being synchronized.* Asynchronous learning* Collaborative editing systemsIn specific terms of digital logic and physical layer of communication, an asynchronous process does not require a clock signal, in contrast with synchronous and...
patient data uploading, and an internet video link. Subsequently, therapists using virtual reality-based telerehabilitation
Telerehabilitation
Telerehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Most types of services fall into two categories: clinical assessment , and clinical therapy...
prescribe exercise routines via the web which are then accessed and executed by patients through a web browser
Web browser
A web browser is a software application for retrieving, presenting, and traversing information resources on the World Wide Web. An information resource is identified by a Uniform Resource Identifier and may be a web page, image, video, or other piece of content...
. Therapists then monitor the patient's progress via the web and modify the therapy asynchronously
Asynchronous learning
Asynchronous learning is a student-centered teaching method that uses online learning resources to facilitate information sharing outside the constraints of time and place among a network of people. Asynchronous learning is based on constructivist theory, a student-centered approach that...
without real-time interaction or training.
Background
The computer technology that allows development three-dimensional3D computer graphics
3D computer graphics are graphics that use a three-dimensional representation of geometric data that is stored in the computer for the purposes of performing calculations and rendering 2D images...
virtual
Virtual reality
Virtual reality , also known as virtuality, is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds...
environments consists of both hardware
Hardware
Hardware is a general term for equipment such as keys, locks, hinges, latches, handles, wire, chains, plumbing supplies, tools, utensils, cutlery and machine parts. Household hardware is typically sold in hardware stores....
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
Computer-aided design
Computer-aided design , also known as computer-aided design and drafting , is the use of computer technology for the process of design and design-documentation. Computer Aided Drafting describes the process of drafting with a computer...
(CAD) models. VR starts with the real-world scene and virtualizes it. Virtual reality is a practical, affordable technology for the practice of clinical medicine
Clinical Medicine
Clinical Medicine is a peer-reviewed medical journal published bimonthly by the Royal College of Physicians. It was established in 1966 as the Journal of the Royal College of Physicians of London. It was doubly named between 1998 and 2000, and since 2001 it has appeared as Clinical Medicine. Its...
, and modern, high-fidelity virtual reality systems have practical applications in areas ranging from psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
to surgical planning
Surgical planning
The surgical planning is the preoperative method of pre-visualising a surgical intervention, in order to predefine the surgical steps and furthermore the bone segment navigation in the context of computer assisted surgery....
and telemedicine
Telemedicine
Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities...
. 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
Physical medicine and rehabilitation
Physical medicine and rehabilitation , physiatry or rehabilitation medicine, is a branch of medicine that aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. A physician having completed training in this field is referred to as a...
options not available with traditional methods.
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 neurorehabilitationNeurorehabilitation
Neurorehabilitation is a complex medical process which aims to aid recovery from a nervous system injury, and to minimize and/or compensate for any functional alterations resulting from it....
issues. Korean researchers developed and assessed the value of a new rehabilitation training system to improve postural balance control
Equilibrioception
Equilibrioception or sense of balance is one of the physiological senses. It helps prevent humans and animals from falling over when walking or standing still. Balance is the result of a number of body systems working together: the eyes , ears and the body's sense of where it is in space ideally...
by combining virtual reality technology with an unfixed bicycle
Bicycle
A bicycle, also known as a bike, pushbike or cycle, is a human-powered, pedal-driven, single-track vehicle, having two wheels attached to a frame, one behind the other. A person who rides a bicycle is called a cyclist, or bicyclist....
. The system was effective as a training device; in addition, the technology might have a wider applicability to the rehabilitation field.
Tracy and Lathan investigated the relationship between motor task
Motor skill
A motor skill is a learned sequence of movements that combine to produce a smooth, efficient action in order to master a particular task. The development of motor skill occurs in the motor cortex, the region of the cerebral cortex that controls voluntary muscle groups.- Development of motor skills...
s and participants' spatial abilities
Spatial-temporal reasoning
Spatial–temporal reasoning is used in both the fields of psychology and computer science.-Spatial–temporal reasoning in psychology:Spatial-temporal reasoning is the ability to visualize spatial patterns and mentally manipulate them over a time-ordered sequence of spatial transformations.This...
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.
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. A recently completed project at the University of Strathclyde
University of Strathclyde
The University of Strathclyde , Glasgow, Scotland, is Glasgow's second university by age, founded in 1796, and receiving its Royal Charter in 1964 as the UK's first technological university...
has resulted in the development of a wheelchair
Wheelchair
A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing...
motion platform which, in conjunction with a virtual reality facility, can be used to address issues of accessibility
Accessibility
Accessibility is a general term used to describe the degree to which a product, device, service, or environment is available to as many people as possible. Accessibility can be viewed as the "ability to access" and benefit from some system or entity...
in the built environment.
Many cases have applied virtual reality technology to telemedicine
Telemedicine
Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps eliminate distance barriers and can improve access to medical services that would often not be consistently available in distant rural communities...
and telerehabilitation
Telerehabilitation
Telerehabilitation is the delivery of rehabilitation services over telecommunication networks and the internet. Most types of services fall into two categories: clinical assessment , and clinical therapy...
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
Eye–hand coordination
Eye–hand coordination is the coordinated control of eye movement with hand movement, and the processing of visual input to guide reaching and grasping along with the use of proprioception of the hands to guide the eyes. In simple terms, eye-hand coordination involves the coordinated vision and...
. Recently, however, different researchers have tried to use virtual environments in medical visualization and for assessment and rehabilitation in neuropsychology.
Case studies for VR applications were conducted that were internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...
deliverable and they identified technical, practical, and user challenges of remote VR treatment programs. To improve understanding of deficits in autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
and in left visual-spatial neglect, Trepagnier et al. investigated face gaze behavior in autism and right hemisphere stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
, using virtual reality and gaze sensing technology.
An at-home stroke telerehabilitation service was developed using virtual reality haptics. Researchers from Rutgers University
Rutgers University
Rutgers, The State University of New Jersey , is the largest institution for higher education in New Jersey, United States. It was originally chartered as Queen's College in 1766. It is the eighth-oldest college in the United States and one of the nine Colonial colleges founded before the American...
and Stanford University
Stanford University
The Leland Stanford Junior University, commonly referred to as Stanford University or Stanford, is a private research university on an campus located near Palo Alto, California. It is situated in the northwestern Santa Clara Valley on the San Francisco Peninsula, approximately northwest of San...
developed a virtual reality-based orthopedic telerehabilitation system.
The use of virtual reality technologies in the rehabilitation of patients with vestibular system
Vestibular system
The vestibular system, which contributes to balance in most mammals and to the sense of spatial orientation, is the sensory system that provides the leading contribution about movement and sense of balance. Together with the cochlea, a part of the auditory system, it constitutes the labyrinth of...
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.