Graphics and Imaging Laboratory, Institut Informàtica i Aplicacions, Universitat de Girona, Campus de Montilivi, 17003, Girona, Catalunya, Spain.
Sci Rep. 2023 Sep 7;13(1):14780. doi: 10.1038/s41598-023-40546-2.
Mirror therapy is applied to reduce phantom pain and as a rehabilitation technique in post-stroke patients. Using Virtual Reality and head-mounted displays this therapy can be performed in virtual scenarios. However, for its efficient use in clinical settings, some hardware limitations need to be solved. A new system to perform mirror therapy in virtual scenarios for post-stroke patients is proposed. The system requires the patient a standalone virtual reality headset with hand-tracking features and for the rehabilitator an external computer or tablet device. The system provides functionalities for the rehabilitator to prepare and follow-up rehabilitation sessions and a virtual scenario for the patient to perform rehabilitation. The system has been tested on a real scenario with the support of three experienced rehabilitators and considering ten post-stroke patients in individual sessions focused on upper limb motor rehabilitation. The development team observed all the sessions and took note of detected errors regarding technological aspects. Solutions to solve detected problems will be proposed and evaluated in terms of feasibility, performance cost, additional system cost, number of solved issues, new limitations, or advantages for the patient. Three types of errors were detected and solved. The first error is related to the position of the hands relative to the head-mounted display. To solve it the exercise area can be limited to avoid objectives that require turning the head too far. The second error is related to the interaction between the hands and the virtual objects. It can be solved making the main hand non-interactive. The last type of error is due to patient limitations and can be mitigated by having a virtual hand play out an example motion to bring the patient's attention back to the exercise. Other solutions have been evaluated positively and can be used in addition or instead of the selected ones. For mirror therapy based on virtual reality to be efficient in post-stroke rehabilitation the current head-mounted display-based solutions need to be complemented with specific strategies that avoid or mitigate the limitations of the technology and the patient. Solutions that help with the most common issues have been proposed.
镜像疗法用于减轻幻痛，并作为中风患者的康复技术。通过虚拟现实和头戴式显示器，可以在虚拟场景中进行这种治疗。然而，为了在临床环境中高效使用，需要解决一些硬件限制。提出了一种用于中风患者虚拟场景中镜像治疗的新系统。该系统要求患者使用具有手部跟踪功能的独立虚拟现实头戴式设备，而康复治疗师则使用外部计算机或平板电脑设备。系统为康复治疗师提供了准备和跟踪康复治疗的功能，以及患者进行康复治疗的虚拟场景。该系统已在实际场景中进行了测试，得到了三位经验丰富的康复治疗师的支持，并考虑了十位专注于上肢运动康复的中风患者的个体治疗。开发团队观察了所有的治疗，并记录了与技术方面相关的错误。将针对可行性、性能成本、额外系统成本、解决问题的数量、新限制或患者优势，提出并评估解决方案。检测到了三种类型的错误，并进行了解决。第一种错误与手相对于头戴式显示器的位置有关。为了解决这个问题，可以将练习区域限制在一定范围内，以避免需要转头过大的目标。第二种错误与手和虚拟物体之间的交互有关。可以通过使主手失去交互性来解决。最后一种类型的错误是由于患者的限制造成的，可以通过播放虚拟手的示例运动来引起患者的注意，从而减轻这种错误。其他解决方案也得到了积极的评估，可以作为附加或替代选择使用。为了使基于虚拟现实的镜像疗法在中风康复中更加有效，目前基于头戴式显示器的解决方案需要补充特定的策略，以避免或减轻技术和患者的限制。已经提出了一些帮助解决最常见问题的解决方案。
