Lledó Luis D, Díez Jorge A, Bertomeu-Motos Arturo, Ezquerro Santiago, Badesa Francisco J, Sabater-Navarro José M, García-Aracil Nicolás
Biomedical Neuroengineering Group, Miguel Hernández University of Elche Elche, Spain.
Front Aging Neurosci. 2016 Aug 26;8:205. doi: 10.3389/fnagi.2016.00205. eCollection 2016.
Post-stroke neurorehabilitation based on virtual therapies are performed completing repetitive exercises shown in visual electronic devices, whose content represents imaginary or daily life tasks. Currently, there are two ways of visualization of these task. 3D virtual environments are used to get a three dimensional space that represents the real world with a high level of detail, whose realism is determinated by the resolucion and fidelity of the objects of the task. Furthermore, 2D virtual environments are used to represent the tasks with a low degree of realism using techniques of bidimensional graphics. However, the type of visualization can influence the quality of perception of the task, affecting the patient's sensorimotor performance. The purpose of this paper was to evaluate if there were differences in patterns of kinematic movements when post-stroke patients performed a reach task viewing a virtual therapeutic game with two different type of visualization of virtual environment: 2D and 3D. Nine post-stroke patients have participated in the study receiving a virtual therapy assisted by PUPArm rehabilitation robot. Horizontal movements of the upper limb were performed to complete the aim of the tasks, which consist in reaching peripheral or perspective targets depending on the virtual environment shown. Various parameter types such as the maximum speed, reaction time, path length, or initial movement are analyzed from the data acquired objectively by the robotic device to evaluate the influence of the task visualization. At the end of the study, a usability survey was provided to each patient to analysis his/her satisfaction level. For all patients, the movement trajectories were enhanced when they completed the therapy. This fact suggests that patient's motor recovery was increased. Despite of the similarity in majority of the kinematic parameters, differences in reaction time and path length were higher using the 3D task. Regarding the success rates were very similar. In conclusion, the using of 2D environments in virtual therapy may be a more appropriate and comfortable way to perform tasks for upper limb rehabilitation of post-stroke patients, in terms of accuracy in order to effectuate optimal kinematic trajectories.
基于虚拟疗法的中风后神经康复是通过在视觉电子设备上完成重复练习来进行的，这些设备显示的内容代表想象或日常生活任务。目前，这些任务有两种可视化方式。3D虚拟环境用于获得一个三维空间，该空间以高度细节呈现现实世界，其真实感由任务对象的分辨率和逼真度决定。此外，2D虚拟环境用于使用二维图形技术以较低的真实感呈现任务。然而，可视化类型会影响对任务的感知质量，进而影响患者的感觉运动表现。本文的目的是评估中风后患者在观看具有两种不同虚拟环境可视化类型（2D和3D）的虚拟治疗游戏来执行伸手任务时，其运动学运动模式是否存在差异。九名中风后患者参与了这项研究，接受了由PUPArm康复机器人辅助的虚拟治疗。上肢进行水平运动以完成任务目标，任务目标包括根据所显示的虚拟环境触及周边或透视目标。从机器人设备客观获取的数据中分析各种参数类型，如最大速度、反应时间、路径长度或初始运动，以评估任务可视化的影响。在研究结束时，向每位患者提供了一份可用性调查问卷，以分析其满意度水平。对于所有患者，当他们完成治疗时，运动轨迹都得到了改善。这一事实表明患者的运动恢复得到了提高。尽管大多数运动学参数相似，但使用3D任务时反应时间和路径长度的差异更大。关于成功率则非常相似。总之，就实现最佳运动学轨迹的准确性而言，在虚拟治疗中使用2D环境可能是中风后患者上肢康复执行任务的更合适、更舒适的方式。
