Laboratory of Synthetic Perceptive Emotive and Cognitive Systems (SPECS), Department of Technology, Universitat Pompeu Fabra, Barcelona, Spain.
Stroke. 2012 Oct;43(10):2720-8. doi: 10.1161/STROKEAHA.112.653196. Epub 2012 Aug 7.
Although there is strong evidence on the beneficial effects of virtual reality (VR)-based rehabilitation, it is not yet well understood how the different aspects of these systems affect recovery. Consequently, we do not exactly know what features of VR neurorehabilitation systems are decisive in conveying their beneficial effects.
To specifically address this issue, we developed 3 different configurations of the same VR-based rehabilitation system, the Rehabilitation Gaming System, using 3 different interface technologies: vision-based tracking, haptics, and a passive exoskeleton. Forty-four patients with chronic stroke were randomly allocated to one of the configurations and used the system for 35 minutes a day for 5 days a week during 4 weeks.
Our results revealed significant within-subject improvements at most of the standard clinical evaluation scales for all groups. Specifically we observe that the beneficial effects of VR-based training are modulated by the use/nonuse of compensatory movement strategies and the specific sensorimotor contingencies presented to the user, that is, visual feedback versus combined visual haptic feedback.
Our findings suggest that the beneficial effects of VR-based neurorehabilitation systems such as the Rehabilitation Gaming System for the treatment of chronic stroke depend on the specific interface systems used. These results have strong implications for the design of future VR rehabilitation strategies that aim at maximizing functional outcomes and their retention. Clinical Trial Registration- This trial was not registered because it is a small clinical study that evaluates the feasibility of prototype devices.
尽管虚拟现实（VR）为基础的康复具有强有力的有益效果的证据，但对于这些系统的不同方面如何影响康复，我们还没有很好地理解。因此，我们并不确切知道 VR 神经康复系统的哪些特点对传递其有益效果是决定性的。
为了专门解决这个问题，我们开发了相同的基于 VR 的康复系统（康复游戏系统）的 3 种不同配置，使用 3 种不同的接口技术：基于视觉的跟踪、触觉和被动外骨骼。44 名慢性中风患者被随机分配到 1 个配置中，并在 4 周内每天使用该系统 35 分钟，每周 5 天。
我们的结果显示，大多数标准临床评估量表在所有组中都有显著的个体内改善。具体来说，我们观察到基于 VR 的训练的有益效果是由使用/不使用补偿运动策略以及呈现给用户的特定感觉运动关联来调节的，即视觉反馈与视觉触觉反馈相结合。
我们的发现表明，基于 VR 的神经康复系统的有益效果，如康复游戏系统，用于治疗慢性中风，取决于所使用的特定接口系统。这些结果对设计未来旨在最大化功能结果及其保留的 VR 康复策略具有重要意义。
临床试验注册-本试验未注册，因为这是一项评估原型设备可行性的小型临床研究。
