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At least 469 records · Page 26Linked to original sources

Virtual rehabilitation--benefits and challenges.

OBJECTIVES: To discuss the advantages and disadvantages of rehabilitation applications of virtual reality. METHODS: VR can be used as an enhancement to conventional therapy for patients with conditions ranging from musculoskeletal problems, to stroke-induced paralysis, to cognitive deficits. This approach is called "VR-augmented rehabilitation." Alternately, VR can replace conventional interventions altogether, in which case the rehabilitation is "VR-based." If the intervention is done at a distance, then it is called "telerehabilitation." Simulation exercises for post-stroke patients have been developed using a "teacher object" approach or a video game approach. Simulations for musculo-skeletal patients use virtual replicas of rehabilitation devices (such as rubber ball, power putty, peg board). Phobia-inducing virtual environments are prescribed for patients with cognitive deficits. RESULTS: VR-augmented rehabilitation has been shown effective for stroke patients in the chronic phase of the disease. VR-based rehabilitation has been improving patients with fear of flying, Vietnam syndrome, fear of heights, and chronic stroke patients. Telerehabilitation interventions using VR have improved musculo-skeletal and post-stroke patients, however less data is available at this time. CONCLUSIONS: Virtual reality presents significant advantages when applied to rehabilitation of patients with varied conditions. These advantages include patient motivation, adaptability and variability based on patient baseline, transparent data storage, online remote data access, economy of scale, reduced medical costs. Challenges in VR use for rehabilitation relate to lack of computer skills on the part of therapists, lack of support infrastructure, expensive equipment (initially), inadequate communication infrastructure (for telerehabilitation in rural areas), and patient safety concerns.

Cognition Disorders↗

The development and clinical trial of a Driving Simulator for the handicapped.

We developed a Virtual Reality Driving Simulator in order to safely evaluate and improve the driving ability of the handicapped. The Virtual Environment consists of 18 sections (e.g. a speed limited road, a strait road, a curved road, a left turn course, etc) and each section is linked naturally. For the interface of our driving simulator, an actual car was adapted for realism and then connected to a computer. We also equipped it with hand control driving devices especially adapted for the handicapped. A beam projector was used so that the subjects could see the virtual scene on a large screen which was set in front of them. The subjects selected for this trial were 10 normal drivers with valid driving licenses and 15 patients with thoracicor lumber cord injuries who had prior driving experience. For evaluation, 5 driving skills were measured including average speed, steering stability, centerline violations, traffic signal violations, and driving time in various road conditions such as strait and curved roads. The normal subjects manipulated the gas pedal and the brake with their feet while the patients manipulated a hand control with their hands. After they finished driving the whole course, the participants answered the questions such as "How realistic did the Virtual Reality Driving Simulator seeme to you?" and "How much was your fear reduced". The five driving skills measured between the two groups (normal vs. handicapped) did not show any significant differences (p > 0.05). And in the three kinds of road conditions (a speed limited road and roads with a sharp curve and left-hand turn), the average speed of the handicapped group was 45.6 Km, less than 61.2 Km (p<0.05) of the normal group. In all, 11 patients (73%) reported that their fear of driving was reduced. Furthermore, their average score on the degree of realism question was 51.5%.

Adult↗

Postural instability induced by virtual reality exposure: development of a certification protocol.

Exposure to virtual environments often causes users to experience symptoms of motion sickness. An accessory manifestation of motion sickness symptoms is postural disequilibrium. If the postural disequilibrium that occurs persists beyond the time an individual is within the confines of the laboratory or system site, user safety could be compromised and products liability issues could be forthcoming. In this study, a portable, automated postural assessment system is developed that can be employed before and after exposure to a virtual reality (VR) system in order to certify that a user's balance on exiting the system is at least demonstrably as good as it was on entering. It is argued that if the "coming out" balance performance is sufficiently poorer than the "going in" balance, then the user should be retained until the pretest balance performance is regained. The results from a set of normative and validation experiments on postural equilibrium identified several reliable measures of stance that could serve as a basis for certification. Furthermore, a new automated video-based measure using only head movement showed that performance over sessions is stable and reliable. The head movement changes that occur with stimuli, such as alcohol and simulator exposure, are well behaved, predictable, and significant even with small samples. The implication is that the proposed objective measure of postural stability, in conjunction with procedures for obtaining self-reports of symptoms, can afford some measure of certification that exposure to a given VR system is without harm.

Accident Prevention↗

[Principles and current possibilities of virtual scenarios for surgery planning].

This paper describes several new visualization and interaction techniques that enable the use of virtual environments for routine medical purposes. A new volume-rendering method supports shaded and transparent visualization of medical image sequences in real-time with an interactive threshold definition. Based on these rendering algorithms a segmentation approach offers intuitive assistance for a wide range of requirements in diagnosis and therapy planning. In addition, a hierarchical data representation for geometric surface descriptions guarantees optimal use of available hardware resources and prevents inaccurate visualization. Applications such as virtual endoscopy are described.

Computer Systems↗

A neural network for recognizing movement patterns during repetitive self-paced movements of the fingers in opposition to the thumb.

A data glove is a typical input device to control a virtual environment. At the same time it measures movements of wrist and fingers. The purposes of this investigation were to assess the ability of BrainMaker, a neural network, to recognize movement patterns during an opposition task that consisted of repetitive self-paced movements of the fingers in opposition to the thumb. The neural network contained 56 inputs, 3 hidden layers of 20 neurons, and one output. The 5th glove '95 (5DT), a commercial glove especially designed for virtual reality games, was used for finger motion capture. The training of the neural network was successful for recognizing the thumb, the index finger and the ring finger movements during the repetitive self-paced movements and neural network performed well during testing.

Adult↗

Virtual reality as assessment tool in psychology.

Virtual environments (VEs), offering a new human-computer interaction paradigm, have attracted much attention, in clinical psychology, especially in the treatment of phobias. However, a possible new application of VR in psychology is as assessment tool: VEs can be considered as an highly sophisticated form of adaptive testing. This chapter describes the context of current psychological assessment and underlines possible advantages of a VR based assessment tool. The chapter also details the characteristics of BIVRS, Body Image Virtual Reality Scale, an assessment tool designed to assess cognitive and affective components of body image. It consists of a non-immersive 3D graphical interface through which the patient is able to choose between 9 figures of different size which vary in size from underweight to overweight. The software was developed in two architectures, the first (A) running on a single user desktop computer equipped with a standard virtual reality development software and the second (B) splitted into a server (B1) accessible via Internet and actually running the same virtual ambient as in (A) and a VRML client (B2) so that anyone can access the application.

Computer Graphics↗

Humans do not switch between path knowledge and landmarks when learning a new environment.

Using a metric shortcut paradigm, we have found that like honeybees (Dyer in Animal Behaviour 41:239-246, 1991), humans do not seem to build a metric "cognitive map" from path integration. Instead, observers take novel shortcuts based on visual landmarks whenever they are available and reliable (Foo, Warren, Duchon, & Tarr in Journal of Experimental Psychology-Learning Memory and Cognition 31(2):195-215, 2005). In the present experiment we examine whether humans, like ants (Wolf & Wehner in Journal of Experimental Biology 203:857-868, 2000), first use survey-type path knowledge, built up from path integration, and then subsequently shift to reliance on landmarks. In our study participants walked in an immersive virtual environment while head position and orientation were recorded. During training, participants learned two legs of a triangle with feedback: paths from Home to Red and Home to Blue. A configuration of colored posts surrounded the Red location. To test reliance on landmarks, these posts were covertly translated, rotated, or left unchanged during six probe trials. These probe trials were interspersed during the training procedure to measure changes over learning. Dependence on visual landmarks was immediate and sustained during training, and no significant learning effects were observed other than a decrease in hesitation time. Our results suggest that while humans have at least two distinct navigational strategies available to them, unlike ants, a computationally-simpler landmark strategy dominates during novel shortcut navigation.

Adult↗

The acceptance of virtual reality devices for cognitive rehabilitation: a report of positive results with schizophrenia.

This study presents a process of virtual environment development supported by a cognitive model that is specific to cognitive deficits of diverse disorders or traumatic brain injury, and evaluates the acceptance of computer devices by a group of schizophrenic patients. The subjects that participated in this experiment accepted to work with computers and immersive glasses and demonstrated a high level of interest in the proposed tasks. No problems of illness have been observed. This experiment indicated that further research projects must be carried out to verify the value of virtual reality technology for cognitive rehabilitation of psychiatric patients. The results of the current study represent a small but necessary step in the realization of that potential.

Cognition↗

The virtual reality arthroscopy training simulator.

Arthroscopy has already become an irreplaceable method in diagnostics. The arthroscope, with optics and light source, and the exploratory probe are inserted into the knee joint through two small incisions underneath the patella. Currently, the skills required for arthroscopy are taught through hands-on clinical experience. As arthroscopies became a more common procedure even in smaller hospitals, it became obvious that special training was necessary to guarantee qualification of the surgeons. On-the-job training proved to be insufficient. Therefore, research groups from the Berufsgenossenschaftliche Unfallklinik Frankfurt am Main approached the Fraunhofer Institute for Computer Graphics to develop a training system for arthroscopy based on virtual reality (VR) techniques. Two main issues are addressed: the three-dimensional (3-D) reconstruction process and the 3-D interaction. To provide the virtual environment a realistic representation of the region of interest with all relevant anatomical structures is required. Based on a magnetic resonance image sequence a realistic representation of the knee joint was obtained suitable for computer simulation. Two main components of the VR interface can be distinguished: the 3-D interaction to guide the surgical instruments and the 2-D graphical user interface for visual feedback and control of the session. Moreover, the 3-D interaction has to be realized by means of Virtual Reality techniques providing a simulation of an arthroscope and an intuitive handling of other surgical instruments. Currently, the main drawback of the developed simulator is the missing of haptic perception, especially of force feedback. In cooperation with the Department of Electro-Mechanical Construction at the Technical University Darmstadt a haptic display is designed and built for the VR arthroscopy training simulator. In parallel we developed a concept for the integration of the haptic display in a configurable way.

Arthroscopy↗

Virtual reality in medicine-computer graphics and interaction techniques.

This paper describes several new visualization and interaction techniques that enable the use of virtual environments for routine medical purposes. A new volume-rendering method supports shaded and transparent visualization of medical image sequences in real-time with an interactive threshold definition. Based on these rendering algorithms two complementary segmentation approaches offer an intuitive assistance for a wide range of requirements in diagnosis and therapy planning. In addition, a hierarchical data representation for geometric surface descriptions guarantees an optimal use of available hardware resources and prevents inaccurate visualization. The combination of the presented techniques empowers the improved human-machine interface of virtual reality to support every interactive task in medical three-dimensional (3-D) image processing, from visualization of unsegmented data volumes up to the simulation of surgical procedures.

Algorithms↗

Ocular vergence measurement in projected and collimated simulator displays.

The purpose of this study was to investigate electrooculography (EOG) as a measurement of ocular vergence in both collimated and projected simulator environments. The task required participants to shift their gaze between a central fixation point and a target appearing at one of three eccentricities. EOG was effective in recording ocular vergence. The EOG results were similar between collimated and projected displays, except for differences in vergence changes during lateral movement of the eyes, and ocular excursions downward elicited a greater EOG response than the reverse upward movement. The computer-based technique of recording vergence was found to produce measurable traces from a majority of participants. The technique has potential for further development as a tool for measuring ocular vergence in virtual environments where methods that require the wearing of head-mounted apparatus to track ocular structures (e.g., the pupil), which cannot be worn at the same time as a flight or flight-simulator helmet, are unsuitable.

Computer Simulation↗

Adaptive control: a review of the ability to acquire and maintain high sensorimotor performance.

When the relationship which relates us to the environment through vision, often named visual mapping, is durably modified, our behaviour is altered at sensory, motor and cognitive levels. The brain has the ability through the so-called adaptive control to progressively decrease the motor errors despite visual image alteration. Adaptive control in both the visuo-manual and the vestibulo-ocular systems is reviewed. A parallel is tentatively made between adaptation to ordinary optical alterations (resulting from the use of refraction-corrective glasses) in the visual mapping of these two systems and the adaptation to more complex visuo-motor relationships experienced by people working in virtual environments.

Adaptation, Ocular↗

Human adaptation to interaction forces in visuo-motor coordination.

We tested whether humans can learn to sense and compensate for interaction forces in contact tasks. Many tasks, such as use of hand tools, involve significant interaction forces between hand and environment. One control strategy would be to use high hand impedance to reduce sensitivity to these forces. But an alternative would be to learn feedback compensation for the extrinsic dynamics and associated interaction forces, with the potential for lower control effort. We observed subjects as they learned control of a ball-and-beam system, a visuo-motor task where the goal was to quickly position a ball rolling atop a rotating beam, through manual rotation of the beam alone. We devised a ball-and-beam apparatus that could be operated in a real mode, where a physical ball was present; or in a virtual training mode, where the ball's dynamics were simulated in real time. The apparatus presented the same visual feedback in all cases, and optionally produced haptic feedback of the interaction forces associated with the ball's motion. Two healthy adult subject groups, vision-only and vision-haptics (each n= 10), both trained for 80 trials on the simulated system, and then were evaluated on the real system to test for skill transfer effects. If humans incorporate interaction forces in their learning, the vision-haptics group would be expected to exhibit a smoother transfer, as quantified by changes in completion time of a ball-positioning task. During training, both groups adapted well to the task, with reductions of 64%-70% in completion time. At skill transfer to the real system, the vision-only group had a significant 35% increase in completion time (p < 0.05). There was no significant change in the vision-haptics group, indicating that subjects had learned to compensate for interaction forces. These forces could potentially be incorporated in virtual environments to assist with motor training or rehabilitation.

Adaptation, Physiological↗

Virtual reality treatment versus exposure in vivo: a comparative evaluation in acrophobia.

The aim of the present study was to evaluate the effectiveness of low-budget virtual reality (VR) exposure versus exposure in vivo in a between-group design in 33 patients suffering from acrophobia. The virtual environments used in treatment were exactly copied from the real environments used in the exposure in vivo program. VR exposure was found to be as effective as exposure in vivo on anxiety and avoidance as measured with the Acrophobia Questionnaire (AQ), the Attitude Towards Heights Questionnaire (ATHQ) and the Behavioral Avoidance Test (BAT). Results were maintained up to six months follow-up. The present study shows that VR exposure can be effective with relatively cheap hardware and software on stand-alone computers currently on the market. Further studies into the effectiveness of VR exposure are recommended in other clinical groups as agoraphobics and social phobics and studies in which VR exposure is compared with more emerging virtual worlds as presented in CAVE-type systems.

Adult↗

Use of surgical videos for realistic simulation of surgical procedures.

One of the major challenges in the development of virtual environments for medical simulations is photorealistic rendering, permitting high fidelity visual effects and user interaction. Digitized videos recorded from the laparoscopic camera are a rich source of information about surgical scenarios. How to fully utilize the information is important for improving the realism of the simulated scenarios. In reality, the camera viewpoint changes frequently and even for the same viewpoint, the scene is dynamic due to rhythmic heartbeat. Hence, the results of classical texture mapping are usually visually unappealing as they fail to capture the pulsatile effect, as well as other global illumination properties of the scene. In this paper we present a hybrid technique to improve the photorealistic rendering of the virtual surgery scenarios by spatio-temporally utilizing videos recorded during actual surgical procedures.

Computer Simulation↗

Pilot study for assessing the behaviors of patients with schizophrenia towards a virtual avatar.

This study examined whether a virtual avatar could be perceived as a real human by patients with mental disease, especially schizophrenia, as well as whether a virtual avatar could be applied to acquiring patients' behavior characteristics in a short conversation situation. The virtual avatar has been used for various applications which need to communicate with other person or to train or educate by showing humanlike behavior. Recently, many researches have shown that the virtual avatar technology has been enhanced and the avatar could be perceived like real human. A virtual avatar, standing in a virtual room, was designed for this study. Tasks to approach, initiate a talk, and answer to avatar's questions was assigned to the 11 patients with schizophrenia. As behavioral parameters in the virtual environment, the interpersonal distance and the verbal response time were acquired. In addition, the Positive and Negative Syndrome Scale (PANSS) for patients was administered in order to investigate the relationship between patients' symptomatic characteristics and behavior parameters. The interpersonal distance was negatively correlated with the negative syndrome scale, a subscale of PANSS, which is consistent with previous research reporting the relationship between interpersonal distance and a real person's image. The verbal response time, however, was not correlated with any other subscale of PANSS. After analyzing subitems of the negative syndrome of PANSS, two positive correlations were found: one was with blunted affect and the other was with poor rapport. We concluded that the virtual avatar could be perceived as a real human by schizophrenic patients and the avatar could draw the schizophrenic patients' behavior characteristics.

Adult↗

Improving contact realism through event-based haptic feedback.

Tapping on surfaces in a typical virtual environment feels like contact with soft foam rather than a hard object. The realism of such interactions can be dramatically improved by superimposing event-based, high-frequency transient forces over traditional position-based feedback. When scaled by impact velocity, hand-tuned pulses and decaying sinusoids produce haptic cues that resemble those experienced during real impacts. Our new method for generating appropriate transients inverts a dynamic model of the haptic device to determine the motor forces required to create prerecorded acceleration profiles at the user's fingertips. After development, the event-based haptic paradigm and the method of acceleration matching were evaluated in a carefully controlled user study. Sixteen individuals blindly tapped on nine virtual and three real samples, rating the degree to which each felt like real wood. Event-based feedback achieved significantly higher realism ratings than the traditional rendering method. The display of transient signals made virtual objects feel similar to a real sample of wood on a foam substrate, while position feedback alone received ratings similar to those of foam. This work provides an important new avenue for increasing the realism of contact in haptic interactions.

Computer Graphics↗

Soft tissue deformation using a Hierarchical Finite Element Model.

Simulating soft tissue deformation in real-time has become increasingly important in order to provide a realistic virtual environment for training surgical skills. Several methods have been proposed with the aim of rendering in real-time the mechanical and physiological behaviour of human organs, one of the most popular being Finite Element Method (FEM). In this paper we present a new approach to the solution of the FEM problem introducing the concept of parent and child mesh within the development of a hierarchical FEM. The online selection of the child mesh is presented with the purpose to adapt the mesh hierarchy in real-time. This permits further refinement of the child mesh increasing the detail of the deformation without slowing down the simulation and giving the possibility of integrating force feedback. The results presented demonstrate the application of our proposed framework using a desktop virtual reality (VR) system that incorporates stereo vision with integrated haptics co-location via a desktop Phantom force feedback device.

Connective Tissue↗