Quantifying Cognitive-Motor Interference in Virtual Reality Training after Stroke: the Role of Interfaces
Authors: Athanasios Vourvopoulos, Ana Lúcia Faria, Mónica Cameirão, Sergi Bermudez i Badia
Globally, stroke is the second leading cause of death above the age of 60 years, with the actual number of strokes to increase because of the ageing population. Stroke results into chronic conditions, loss of independence, affecting both the families of stroke survivors but also public health systems. Virtual Reality (VR) for rehabilitation is considered a novel and effective low-cost approach to re-train motor and cognitive function through strictly defined training tasks in a safe simulated environment. However, little is known about how the choice of VR interfacing technology affects motor and cognitive performance, or what the most cost-effective rehabilitation approach for patients with different prognostics is. In this paper we assessed the effect of four different interfaces in the training of the motor and cognitive domains within a VR neurorehabilitation task. In this study we have evaluated the effect of training using 2-dimensional and 3-dimensional as well as traditional and natural user interfaces with both stroke survivors and healthy participants. Results indicate that 3-dimensional interfaces contribute towards better results in the motor domain at the cost of lower performance in the cognitive domain, suggesting the use 2-dimensional natural user interfaces as a trade-off. Our results provide useful pointers for future directions towards a cost-effective and meaningful interaction in virtual rehabilitation tasks in both motor and cognitive domains.
An integrative virtual reality cognitive-motor intervention approach in stroke rehabilitation: a pilot study
Authors: Ana Lúcia Faria, Athanasios Vourvopoulos, Mónica Cameirão, Jean-Claude Fernandes, Sergi Bermudez i Badia
Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patient's capability to live independently. In post-stroke it is imperative to initiate a process of intensive rehabilitation and personalized objectives to maximize functional cognitive and motor recovery. Virtual Reality (VR) technology is being widely applied to rehabilitation of stroke, however, not in an integrative manner. Like traditional rehabilitation, these new tools mostly focus either in the cognitive or in the motor domain, which can take to a reduced impact in the performance of activities of daily living, most of them dual-task. Assuming the existence of cognitive and motor recovery interdependence, RehabNet proposes a holistic approach. Here we present a one-month long pilot study with three stroke patients whose training was a game-like VR version of the Toulouse-Piéron cancellation test, adapted to be performed by repetitive arm reaching movements. A standardized motor and cognitive assessment was performed pre and post intervention. The first results on this intervention support a holistic model for rehabilitation of stroke patients, sustaining interdependence on cognitive and motor recovery. Furthermore, we observed that the impact of the integrative VR approach generalizes to the performance of the activities of daily living.