Adamovich Sergei V, Fluet Gerard G, Tunik Eugene, Merians Alma S
New Jersey Institute of Technology, Department of Biomedical Engineering, University Heights, Newark, NJ 07102, USA.
NeuroRehabilitation. 2009;25(1):29-44. doi: 10.3233/NRE-2009-0497.
Recent experimental evidence suggests that rapid advancement of virtual reality (VR) technologies has great potential for the development of novel strategies for sensorimotor training in neurorehabilitation. We discuss what the adaptive and engaging virtual environments can provide for massive and intensive sensorimotor stimulation needed to induce brain reorganization.Second, discrepancies between the veridical and virtual feedback can be introduced in VR to facilitate activation of targeted brain networks, which in turn can potentially speed up the recovery process. Here we review the existing experimental evidence regarding the beneficial effects of training in virtual environments on the recovery of function in the areas of gait,upper extremity function and balance, in various patient populations. We also discuss possible mechanisms underlying these effects. We feel that future research in the area of virtual rehabilitation should follow several important paths. Imaging studies to evaluate the effects of sensory manipulation on brain activation patterns and the effect of various training parameters on long term changes in brain function are needed to guide future clinical inquiry. Larger clinical studies are also needed to establish the efficacy of sensorimotor rehabilitation using VR in various clinical populations and most importantly, to identify VR training parameters that are associated with optimal transfer to real-world functional improvements.
最近的实验证据表明，虚拟现实（VR）技术的迅速发展在神经康复中感觉运动训练新策略的开发方面具有巨大潜力。我们讨论了适应性强且引人入胜的虚拟环境能为诱导大脑重组所需的大量密集感觉运动刺激提供什么。其次，在VR中可以引入真实反馈与虚拟反馈之间的差异，以促进目标脑网络的激活，这反过来可能会加速恢复过程。在此，我们回顾了关于在虚拟环境中训练对不同患者群体的步态、上肢功能和平衡等方面功能恢复的有益效果的现有实验证据。我们还讨论了这些效果背后可能的机制。我们认为，虚拟康复领域未来的研究应遵循几条重要路径。需要进行成像研究，以评估感觉操纵对脑激活模式的影响以及各种训练参数对脑功能长期变化的影响，从而指导未来的临床研究。还需要开展更大规模的临床研究，以确定在各种临床人群中使用VR进行感觉运动康复的疗效，最重要的是，确定与向现实世界功能改善的最佳转化相关的VR训练参数。
