这项研究得到了 SK 电信研究基金06-2013-105 号赠款的支持。这项工作得到了 Soonchunhyang 大学研究基金的支持。

这项研究获得了首尔国立大学 Bundang 医院机构审查委员会的批准, 所有参与者在筛选前都给予书面知情同意。
1. 游戏内容开发
注: 基于移动游戏的上肢虚拟现实计划 (备忘录-康复) 包括移动游戏应用。
<ol><li>使用编程语言安装工作室和环境以进行开发。</li>
	<li>通过智能手机的内置传感器收集患者移动的 x、y 和 z 轴位置的数据。</li>
	<li>
使用以下源代码为运动、位置和速度上的数据分配存储: 浮动 [] gravity_data = 新的浮游物 [3]; 浮动 [] accel_data = 新的浮游物 [3]; 浮动 [] m_acc_data = 新的浮游物 [3]; 最后的浮点数α = (浮动) 0.8; 使用以下源代码收集内置传感器测量的数据。 SensorManager sm = (SensorManager) getSystemService (SENSOR_SERVICE); 传感器 mSensor = sm getDefaultSensor (传感器 TYPE_ACCELEROMETER);</li>
	<li>通过短距离无线连接在图像处理后将数据发送到 tablet PC, 以将 x、y 和 z 坐标显示为屏幕上的图像。</li>
	<li>设计所有游戏应用, 以提高上肢运动的强度、耐力、运动范围、控制速度和准确性。 注: 经董事会认证的 physiatrists (康复医学医生) 和职业治疗师收集并讨论了哪些治疗演习适合转化为游戏项目。各关节运动的目标是基于传统的职业治疗方法, 促进上肢功能的恢复, 提高上肢运动的强度、耐力、运动范围、控制速度和准确性。</li>
	<li>根据 Brunnström 阶段测量的上肢功能, 向每个病人推荐游戏应用。 注意: Brunnström 阶段 (B 阶段) 为胳膊和手评估上肢恢复阶段 (1 = 弛缓性, 没有自愿运动; 7 = 正常函数)16。例如, 被归类为 Brunnström 阶段1的患者使用了在未受影响的手臂帮助下诱发肩部屈曲/伸展运动的应用。被归类为 Brunnström 阶段5的患者使用了需要精确控制运动的应用。</li>
	<li>分别调整游戏应用的难度水平, 通过改变速度, 维护时间为特定的姿势, 以及运动范围, 根据上肢功能障碍的严重性。有关详细信息, 请参阅下面的示例 (图 2)。</li>
</ol>2. 研究设计
注: 采用半随机双盲对照试验对该方案的可行性和有效性进行评价。参加者 (1) 被诊断为缺血性中风;(2) 有能力执行一步命令;(3) 有医疗稳定性参与积极康复, (4) 有上肢损害, 包括在内。患者被排除, 如果他们 (1) 有谵妄、混乱或其他严重知觉问题, (2) 遭受不受控制的医学情况, (3) 无法跟随命令由于严重认知损伤, (4) 有视觉干扰, 并且 (5) 的坐姿平衡不佳。参加者是在大学医院招聘的。
<ol><li>为了使参与者完全失明的小组任务, 分配给他们的控制或实验组的入场期间, 因为参与者需要共享的加班房间。</li>
	<li>确保干预组的患者接受30分钟的常规加班和30分钟的移动游戏基于虚拟现实上肢康复计划使用智能手机和平板电脑。</li>
	<li>确保对照组的病人每天只接受1小时的常规治疗。 注: 两组康复计划包括10疗程, 每周5天, 2 周。</li>
	<li>在第一次疗程中对干预组的患者进行教育, 尽管每个游戏应用程序在开始时提供了简短的说明。确保患者在学习期间自己使用该程序30分钟。</li>
	<li>在开始、治疗结束和一个月随访时对结果测量进行评估。</li>
	<li>让一个失明的评估谁是经验丰富的职业治疗师执行所有的临床评价在所有的测试阶段。 注意: 主要的结果是 Fugl-迈耶评估的上肢 (FMA), 这是衡量的运动功能的病人的偏瘫臂 (0 = 最低评分; 66 = 最高分)。17第二个结果由 Brunnström 阶段 (B 阶段) 评估为胳膊和手和手工肌肉测试 (0–5)。</li>
</ol>3. 基于移动游戏的 VR 上肢康复计划的使用
<ol><li>让参加者坐在桌上。</li>
	<li>将 tablet pc 放在桌面上, 然后打开 tablet pc。</li>
	<li>打开智能手机, 打开智能手机上的短距离无线连接。</li>
	<li>通过触摸 tablet pc 的屏幕, 选择 tablet pc 上的游戏应用程序。</li>
	<li>启用 tablet PC 上的短距离无线连接并连接到智能手机。</li>
	<li>将智能手机放在臂章中, 并根据所需的运动, 使用商用智能手机臂章将臂章连接到上臂或前臂。</li>
	<li>选择基本版本或自定义版本。</li>
	<li>选择游戏速度, 时间, 一些目标动作, 和预期的成绩, 游戏的触摸屏上的平板电脑上的定制版根据参与者的能力。</li>
	<li>让参与者触摸开始按钮。让参与者按照游戏的命令采取姿势。移动最大运动范围以进行校准。</li>
	<li>
开始玩游戏, 并移动到下一个游戏时, 游戏结束 (一般5–10分钟长)。
	<ol>
<li>"蜂蜜壶卫兵" 游戏 注: 本游戏针对肘关节屈曲和伸展运动。<ol>
<li>请病人用肘关节的动作投掷苹果, 以此来殴打一只来自蜂蜜壶的熊。</li>
			<li>当弯曲的肘部延长时, 让病人扔苹果。</li>
			<li>调整难度的水平, 由熊出现的位置和新的熊出现的速度根据可用的运动范围和运动速度在病人的肘关节。</li>
		</ol>
</li>
		<li>"保护兔子" 游戏 注: 本游戏针对肩部诱拐和内收运动。<ol>
<li>通过使用肩关节的运动, 让病人用网捉石头来保护兔子。</li>
			<li>确保在 adducted 肩被绑架时网络移动。</li>
			<li>调整难度水平的地方, 石头出现的位置和速度, 新的石头出现的基础上可用的运动范围和运动速度在病人的肩关节。</li>
		</ol>
</li>
		<li>"扑灭火" 游戏 注: 本游戏针对肩部诱拐和内收或肩部屈曲和伸展。<ol>
<li>让病人用水管把火喷出窗外;水管是根据肩部的运动而移动的。</li>
			<li>根据肩关节的运动, 确保水管的左右移动;扑灭大火所需的时间取决于火灾的大小。</li>
			<li>根据现有的运动范围和病人肩关节运动的速度和耐力, 调整火灾发生的地点、新火灾出现的速度和火灾的大小。</li>
		</ol>
</li>
		<li>"花飞溅" 游戏 注: 本游戏的目标是肩诱拐和内收, 肘关节屈曲和伸展, 或手腕旋和旋运动。<ol>
<li>通过关节的运动, 让病人用水浇灌移动的种子, 使花朵开花。</li>
			<li>确保种子移动时, 根据关节的运动, 浇水。</li>
			<li>根据种子的移动速度, 根据运动的准确性和速度调整难度水平。</li>
		</ol>
</li>
	</ol>
</li>
	<li>通过智能手机的内置传感器 (加速度计、陀螺仪) 跟踪患者的上肢运动, 并通过短距离无线连接将移动信息传递到 tablet PC。</li>
	<li>提供视觉和听觉反馈的病人在他们的运动与显示在平板电脑上。</li>
	<li>与比赛结束时的预期成绩相比, 展示游戏的真正成就。</li>
</ol>

<ol>
	<li>Segal, M. E., Whyte, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modeling+case+mix+adjustment+of+stroke+rehabilitation+outcomes.">Modeling case mix adjustment of stroke rehabilitation outcomes.</a> American journal of physical medicine &amp; rehabilitation. 76 (2), 154-161 (1997).</li><li>Gresham, G. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Residual+disability+in+survivors+of+stroke--the+Framingham+study.">Residual disability in survivors of stroke--the Framingham study.</a> N Engl J Med. 293 (19), 954-956 (1975).</li><li>Taub, E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technique+to+improve+chronic+motor+deficit+after+stroke.">Technique to improve chronic motor deficit after stroke.</a> Arch Phys Med Rehabil. 74 (4), 347-354 (1993).</li><li>Richards, L., Pohl, P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Therapeutic+interventions+to+improve+upper+extremity+recovery+and+function.">Therapeutic interventions to improve upper extremity recovery and function.</a> Clin Geriatr Med. 15 (4), 819-832 (1999).</li><li>Arya, K. N., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Meaningful+task-specific+training+(MTST)+for+stroke+rehabilitation:+a+randomized+controlled+trial.">Meaningful task-specific training (MTST) for stroke rehabilitation: a randomized controlled trial.</a> Top Stroke Rehabil. 19 (3), 193-211 (2012).</li><li>Boyd, L. A., Vidoni, E. D., Wessel, B. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Motor+learning+after+stroke:+is+skill+acquisition+a+prerequisite+for+contralesional+neuroplastic+change?.">Motor learning after stroke: is skill acquisition a prerequisite for contralesional neuroplastic change?.</a> Neuroscience letters. 482 (1), 21-25 (2010).</li><li>Laver, K. E., George, S., Thomas, S., Deutsch, J. E., Crotty, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Virtual+reality+for+stroke+rehabilitation.">Virtual reality for stroke rehabilitation.</a> Cochrane Database Syst Rev. (2), CD008349 (2015).</li><li>Saposnik, G., Levin, M., Outcome Research Canada Working, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Virtual+reality+in+stroke+rehabilitation:+a+meta-analysis+and+implications+for+clinicians.">Virtual reality in stroke rehabilitation: a meta-analysis and implications for clinicians.</a> Stroke. 42 (5), 1380-1386 (2011).</li><li>Lohse, K. R., Hilderman, C. G., Cheung, K. L., Tatla, S., Van der Loos, H. F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Virtual+reality+therapy+for+adults+post-stroke:+a+systematic+review+and+meta-analysis+exploring+virtual+environments+and+commercial+games+in+therapy.">Virtual reality therapy for adults post-stroke: a systematic review and meta-analysis exploring virtual environments and commercial games in therapy.</a> PLoS One. 9 (3), e93318 (2014).</li><li>Venugopalan, J., Cheng, C., Stokes, T. H., Wang, M. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Engineering in Medicine and Biology Society (EMBC), 2013 35th Annual International Conference of the IEEE. , 4625-4628 (2013).</li><li>Sin, H., Lee, G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Additional+virtual+reality+training+using+Xbox+Kinect+in+stroke+survivors+with+hemiplegia.">Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia.</a> Am J Phys Med Rehabil. 92 (10), 871-880 (2013).</li><li>Joo, L. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+feasibility+study+using+interactive+commercial+off-the-shelf+computer+gaming+in+upper+limb+rehabilitation+in+patients+after+stroke.">A feasibility study using interactive commercial off-the-shelf computer gaming in upper limb rehabilitation in patients after stroke.</a> Journal of rehabilitation medicine. 42 (5), 437-441 (2010).</li><li>Chang, Y. -. J., Chen, S. -. F., Huang, J. -. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Kinect-based+system+for+physical+rehabilitation:+A+pilot+study+for+young+adults+with+motor+disabilities.">A Kinect-based system for physical rehabilitation: A pilot study for young adults with motor disabilities.</a> Research in developmental disabilities. 32 (6), 2566-2570 (2011).</li><li>Chen, M. H., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+controlled+pilot+trial+of+two+commercial+video+games+for+rehabilitation+of+arm+function+after+stroke.">A controlled pilot trial of two commercial video games for rehabilitation of arm function after stroke.</a> Clin Rehabil. 29 (7), 674-682 (2015).</li><li>Saposnik, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effectiveness+of+Virtual+Reality+Exercises+in+STroke+Rehabilitation+(EVREST):+rationale,+design,+and+protocol+of+a+pilot+randomized+clinical+trial+assessing+the+Wii+gaming+system.">Effectiveness of Virtual Reality Exercises in STroke Rehabilitation (EVREST): rationale, design, and protocol of a pilot randomized clinical trial assessing the Wii gaming system.</a> Int J Stroke. 5 (1), 47-51 (2010).</li><li>Saposnik, G., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effectiveness+of+virtual+reality+using+Wii+gaming+technology+in+stroke+rehabilitation:+a+pilot+randomized+clinical+trial+and+proof+of+principle.">Effectiveness of virtual reality using Wii gaming technology in stroke rehabilitation: a pilot randomized clinical trial and proof of principle.</a> Stroke. 41 (7), 1477-1484 (2010).</li><li>Brunnstrom, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Motor+testing+procedures+in+hemiplegia:+based+on+sequential+recovery+stages.">Motor testing procedures in hemiplegia: based on sequential recovery stages.</a> Phys Ther Sport. 46 (4), 357-375 (1966).</li><li>Gladstone, D. J., Danells, C. J., Black, S. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+fugl-meyer+assessment+of+motor+recovery+after+stroke:+a+critical+review+of+its+measurement+properties.">The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties.</a> Neurorehabil Neural Repair. 16 (3), 232-240 (2002).</li><li>Ma, H. -. I., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+virtual+reality+training+on+functional+reaching+movements+in+people+with+Parkinson's+disease:+a+randomized+controlled+pilot+trial.">Effects of virtual reality training on functional reaching movements in people with Parkinson's disease: a randomized controlled pilot trial.</a> Clinical Rehabilitation. 25 (10), 892-902 (2011).</li><li>Reiterer, V., Sauter, C., Kl&#246;sch, G., Lalouschek, W., Zeitlhofer, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Actigraphy-a+useful+tool+for+motor+activity+monitoring+in+stroke+patients.">Actigraphy-a useful tool for motor activity monitoring in stroke patients.</a> European neurology. 60 (6), 285-291 (2008).</li><li>Gebruers, N., Vanroy, C., Truijen, S., Engelborghs, S., De Deyn, P. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Monitoring+of+physical+activity+after+stroke:+a+systematic+review+of+accelerometry-based+measures.">Monitoring of physical activity after stroke: a systematic review of accelerometry-based measures.</a> Archives of physical medicine and rehabilitation. 91 (2), 288-297 (2010).</li></ol>

所有作者声明没有利益冲突。

中风患者通常有残疾相关的运动损伤由于不完全的运动恢复。这样的残疾, 漫长的旅行时间到诊所, 或社会经济的困难, 可能会阻碍患者获得适当的康复治疗。无处不在的医疗保健 (u 健康) 计划可以是一个很好的选择, 以消除这些障碍。作为这种 u 型健康计划的一部分, 本研究开发了一种基于移动游戏的 VR 康复方案, 用于脑卒中后上肢的康复。我们的发现表明, 该方案是可行的, 更有效地促进上肢功?...

中风是成人神经功能障碍的最常见原因之一。中风后从损伤中恢复通常是不完整的, 大约50% 的患者留有残疾, 使他们依赖其他1。特别是上肢功能障碍使中风幸存者依赖其他人来帮助日常生活活动 (ADL)2。恢复上肢的丢失功能可能比将移动到下肢的正常功能更难实现。虽然双下肢运动是必不可少的运动, 病人可以执行 ADL 与单边上肢运动。这导致了受影响的肢体的一个博学的非使用的现象3。这种现象是中风幸存者上肢康复的障碍。因此, 大量的研究集中在上肢功能恢复。研究突出了广泛的实践和重复任务特定训练的重要性4,5,6。
虚拟现实 (VR) 技术最近被引入到康复领域7。VR 允许用户与模拟环境进行交互, 并接收与性能相关的连续、即时的反馈。VR 有可能在中风患者中应用神经康复的基本概念, 如强化、重复和任务导向训练 8.具体地说, 非沉浸式 VR 不需要高级图形性能或特殊硬件。因此, 非沉浸式 VR 是提供低成本、无处不在和有趣的治疗方案的好人选。以前的研究使用了计算机、显示器和特殊设备, 如控制台、传感器手套、欢乐棍和商业游戏系统, 用于非沉浸式 VR9。使用此类系统必须有更高的启动成本和足够的空间。最近, 一些低成本的工具, 如商用游戏设备, 已经被用来开发新的康复系统10,11。然而, 控制台与传感器在那些 devicesare 不足够小和轻量级为运载。然而, 为了改善非沉浸式 VR 的流行, 作为中风后上肢治疗方法, 并为中风幸存者创造无处不在的康复环境, 需要便携和廉价的工具。
此外, 基于游戏的治疗可以是中风康复的好选择。许多患者抱怨, 常规职业治疗 (OT) 为上肢功能恢复是枯燥和单调的12,13。因此, 一个更有趣和更有激励作用的治疗工具是促进患者参与康复训练的必要手段。许多涉及使用商业游戏的研究已经进行了14,15,16。然而, 使用的游戏并没有针对脑卒中患者上肢的期望运动, 也没有特别考虑中风后可能出现的痉挛。
本文介绍了一种基于移动游戏的虚拟现实程序的开发及其在经历中风和上肢功能障碍的患者中的应用 (图 1)。

<table>
	<tbody>
		<tr>
			<td>Galaxy Note 10.0</td>
			<td>Samsung</td>
			<td>Galaxy Note 10.0</td>
			<td>Tablet PC</td>
		</tr>
		<tr>
			<td>Galaxy S2</td>
			<td>Samsung</td>
			<td>Galaxy S2</td>
			<td>Smartphone</td>
		</tr>
		<tr>
			<td>Bluetooth</td>
			<td>Bluetooth SIG</td>
			<td>Bluetooth</td>
			<td>short-distance wireless connection&#160;</td>
		</tr>
		<tr>
			<td>Java</td>
			<td>Oracle</td>
			<td>Java</td>
			<td>programming language</td>
		</tr>
	</tbody>
</table>

mobile game-based virtual reality program for upper extremity stroke rehabilitation

中风康复需要重复的, 密集的, 目标导向的治疗。虚拟现实 (VR) 具有满足这些要求的潜力。以游戏为基础的治疗可以促进患者参与康复治疗, 作为一个更有趣和激励的工具。智能手机和平板电脑等移动设备可以提供个性化的基于家庭的治疗, 并与患者和临床医生进行互动交流。本研究开发了一种应用游戏应用的移动 VR 上肢康复方案。研究结果表明, 基于移动游戏的 VR 方案有效地促进了脑卒中患者上肢的康复。另外, 患者使用该方案完成了两周的治疗, 无不良影响, 对该方案普遍满意。这种基于移动游戏的 VR 上肢康复计划可以替代传统疗法的某些部分, 由职业治疗师一对一地提供。这一时间高效, 易于实施, 和临床有效的程序将是一个良好的候选工具, 远程康复的上肢恢复治疗中风患者。患者和治疗师可以通过这些电子健康康复计划远程协作, 同时降低经济和社会成本。

总共登记了24名患者, 并将其分配给该控件或实验组 (表 1)。在使用基于移动游戏的 VR 上肢康复计划 (图 3) 治疗后, 在 FMA、B 级和人工肌肉测试中发现了更大的改进。这种效果一直持续到一个月的随访。这意味着, 谅解备忘录的康复并不逊色于传统的治疗方法, 这是由职业治疗师一对一地提供的。
<p class="jove_content" fo:keep-together.within-page=...

Watch this Scientific Journal Video about Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation at JoVE.com

Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

在这里, 我们提出了一个协议, 开发和应用基于移动游戏的虚拟现实程序, 以恢复上肢功能障碍的中风患者。本研究表明, 该移动方案是可行的, 有效促进中风患者上肢恢复。

基于移动游戏的上肢卒中康复虚拟现实程序

Stroke rehabilitation requires repetitive, intensive, goal-oriented therapy. Virtual reality (VR) has the potential to satisfy these requirements. ...

mobile-game-based-virtual-reality-program-for-upper-extremity-stroke

Research

JoVE Journal

Behavior

18.7K 次观看.  Seoul National University College of Medicine, Seoul National University Bundang Hospital. 在这里, 我们提出了一个协议, 开发和应用基于移动游戏的虚拟现实程序, 以恢复上肢功能障碍的中风患者。本研究表明, 该移动方案是可行的, 有效促进中风患者上肢恢复。

视频: Mobile Game-based Virtual Reality Program for Upper Extremity Stroke Rehabilitation

Two-photon Calcium Imaging in Mice Navigating a Virtual Reality Environment

In recent years, two-photon imaging has become an invaluable tool in neuroscience, as it allows for chronic measurement of the activity of genetically identified cells during behavior1-6. Here we describe methods to perform two-photon imaging in mouse cortex while the animal navigates a virtual reality environment. We focus on the aspects of the experimental procedures that are key to imaging in a behaving animal in a brightly lit virtual environment. The key problems that arise in this experimental setup that we here address are: minimizing brain motion related artifacts, minimizing light leak from the virtual reality projection system, and minimizing laser induced tissue damage. We also provide sample software to control the virtual reality environment and to do pupil tracking. With these procedures and resources it should be possible to convert a conventional two-photon microscope for use in behaving mice.

Here we describe the experimental procedures involved in two-photon imaging of mouse cortex during behavior in a virtual reality environment.

在小鼠导航虚拟现实环境的双光子钙成像

In recent years, two-photon imaging has become an invaluable tool in neuroscience, as it allows for chronic measurement of the activity of genetically ...

科研

行为学

Development of a Virtual Reality Assessment of Everyday Living Skills

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.&#160; Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.&#160; Measures of &#8220;functional capacity&#8221; index the extent to which individuals have the potential to perform skills required for real world functioning. &#160;Current data do not support the recommendation of any single instrument for measurement of functional capacity.&#160; The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT&#8217;s sensitivity, reliability, validity, and practicality.&#160;This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders.

A challenge for proving treatment efficacy for cognitive impairments in schizophrenia is finding the optimizing measurement of skills related to everyday functioning.&#160; The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is an interactive gaming based computerized measure aimed at skills associated with everyday functioning, including baseline impairments and treatment related changes.

每天生活技能的虚拟现实评估的发展

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.&#160; ...

Multifunctional Setup for Studying Human Motor Control Using Transcranial Magnetic Stimulation, Electromyography, Motion Capture, and Virtual Reality

The study of neuromuscular control of movement in humans is accomplished with numerous technologies. Non-invasive methods for investigating neuromuscular function include transcranial magnetic stimulation, electromyography, and three-dimensional motion capture. The advent of readily available and cost-effective virtual reality solutions has expanded the capabilities of researchers in recreating &#8220;real-world&#8221; environments and movements in a laboratory setting. Naturalistic movement analysis will not only garner a greater understanding of motor control in healthy individuals, but also permit the design of experiments and rehabilitation strategies that target specific motor impairments (e.g. stroke). The combined use of these tools will lead to increasingly deeper understanding of neural mechanisms of motor control. A key requirement when combining these data acquisition systems is fine temporal correspondence between the various data streams. This protocol describes a multifunctional system&#8217;s overall connectivity, intersystem signaling, and the temporal synchronization of recorded data. Synchronization of the component systems is primarily accomplished through the use of a customizable circuit, readily made with off the shelf components and minimal electronics assembly skills.

Transcranial magnetic stimulation, electromyography, and 3D motion capture are commonly used non-invasive techniques for investigating neuromuscular function in humans. In this paper, we describe a protocol that synchronously samples data generated by all three of these tools along with the unique addition of virtual reality stimulus presentation and feedback.

多功能设置研究人类电机控制用经颅磁刺激，肌电图，运动捕捉和虚拟现实

The study of neuromuscular control of movement in humans is accomplished with numerous technologies. Non-invasive methods for investigating neuromuscular ...

A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study

Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated systems require upper limb amputees to learn complex control schemes. Humans have the ability to learn new movements through imitation and other learning strategies. This protocol describes a structured rehabilitation method, which includes imitation, repetition, and reinforcement learning, and aims to assess if this method can improve multifunctional prosthetic control. A left below elbow amputee, with 4 years of experience in prosthetic use, took part in this case study. The prosthesis used was a Michelangelo hand with wrist rotation, and the added features of wrist flexion and extension, which allowed more combinations of hand movements. The participant&#8217;s Southampton Hand Assessment Procedure score improved from 58 to 71 following structured training. This suggests that a structured training protocol of imitation, repetition and reinforcement may have a role in learning to control a new prosthetic hand. A larger clinical study is however required to support these findings.

As prosthetic development moves towards the goal of natural control, harnessing amputees&#8217; inherent ability to learn new motor skills may enable proficiency. This manuscript describes a structured rehabilitation protocol, which includes imitation, repetition, and reinforcement learning strategies, for improved multifunctional prosthetic control.

结构化的康复协议改进的多功能假肢控制:一个案例研究

Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated ...

Using Virtual Reality to Transfer Motor Skill Knowledge from One Hand to Another

As far as acquiring motor skills is concerned, training by voluntary physical movement is superior to all other forms of training (e.g. training by observation or passive movement of trainee&#39;s hands by a robotic device). This obviously presents a major challenge in the rehabilitation of a paretic limb since voluntary control of physical movement is limited. Here, we describe a novel training scheme we have developed that has the potential to circumvent this major challenge. We exploited the voluntary control of one hand and provided real-time movement-based manipulated sensory feedback as if the other hand is moving. Visual manipulation through virtual reality (VR) was combined with a device that yokes left-hand fingers to passively follow right-hand voluntary finger movements. In healthy subjects, we demonstrate enhanced within-session performance gains of a limb in the absence of voluntary physical training. Results in healthy subjects suggest that training with the unique VR setup might also be beneficial for patients with upper limb hemiparesis by exploiting the voluntary control of their healthy hand to improve rehabilitation of their affected hand.

We describe a novel virtual-reality based setup which exploits voluntary control of one hand to improve motor-skill performance in the other (non-trained) hand. This is achieved by providing real-time movement-based sensory feedback as if the non-trained hand is moving. This new approach may be used to enhance rehabilitation of patients with unilateral hemiparesis.

利用虚拟现实技术将运动技能知识从一只手转移到另一个

As far as acquiring motor skills is concerned, training by voluntary physical movement is superior to all other forms of training (e.g. training by ...

Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with numerous cardiometabolic health consequences. These changes are likely to increase the risk of developing chronic secondary conditions and impact the quality of life in persons with SCI. Surface neuromuscular electrical stimulation evoked resistance training (NMES-RT) was developed as a strategy to attenuate the process of skeletal muscle atrophy, decrease ectopic adiposity, improve insulin sensitivity and enhance mitochondrial capacity. However, NMES-RT is limited to only a single muscle group. Involving multiple muscle groups of the lower extremities may maximize the health benefits of training. Functional electrical stimulation-lower extremity cycling (FES-LEC) allows for the activation of 6 muscle groups, which is likely to evoke greater metabolic and cardiovascular adaptation. Appropriate knowledge of the stimulation parameters is key to maximizing the outcomes of electrical stimulation training in persons with SCI. Adopting strategies for long-term use of NMES-RT and FES-LEC during rehabilitation may maintain the integrity of the musculoskeletal system, a pre-requisite for clinical trials aiming to restore walking after injury. The current manuscript presents a combined protocol using NMES-RT prior to FES-LEC. We hypothesize that muscles conditioned for 12 weeks prior to cycling will be capable of generating greater power, cycle against higher resistance and result in greater adaptation in persons with SCI.

Spinal cord injury is a traumatic medical condition that may result in elevated risks of chronic secondary metabolic disorders. Here, we presented a protocol using surface neuromuscular electrical stimulation-resistance training in conjunction with functional electrical stimulation-lower extremities cycling as a strategy to ameliorate several of these medical problems.

脊髓损伤后下肢电刺激训练的模式

Skeletal muscle atrophy, increased adiposity and reduced physical activity are key changes observed after spinal cord injury (SCI) and are associated with ...

A Networked Desktop Virtual Reality Setup for Decision Science and Navigation Experiments with Multiple Participants

Investigating the interactions among multiple participants is a challenge for researchers from various disciplines, including the decision sciences and spatial cognition. With a local area network and dedicated software platform, experimenters can efficiently monitor the behavior of the participants that are simultaneously immersed in a desktop virtual environment and digitalize the collected data. These capabilities allow for experimental designs in spatial cognition and navigation research that would be difficult (if not impossible) to conduct in the real world. Possible experimental variations include stress during an evacuation, cooperative and competitive search tasks, and other contextual factors that may influence emergent crowd behavior. However, such a laboratory requires maintenance and strict protocols for data collection in a controlled setting. While the external validity of laboratory studies with human participants is sometimes questioned, a number of recent papers suggest that the correspondence between real and virtual environments may be sufficient for studying social behavior in terms of trajectories, hesitations, and spatial decisions. In this article, we describe a method for conducting experiments on decision-making and navigation with up to 36 participants in a networked desktop virtual reality setup (i.e., the Decision Science Laboratory or DeSciL). This experiment protocol can be adapted and applied by other researchers in order to set up a networked desktop virtual reality laboratory.

This paper describes a method for conducting multi-user experiments on decision-making and navigation using a networked computer laboratory.

面向多参与者的决策科学与导航实验的网络化桌面虚拟现实设置

Investigating the interactions among multiple participants is a challenge for researchers from various disciplines, including the decision sciences and ...

Virtual Reality Experiments with Physiological Measures

Virtual reality (VR) experiments are increasingly employed because of their internal and external validity compared to real-world observation and laboratory experiments, respectively. VR is especially useful for geographic visualizations and investigations of spatial behavior. In spatial behavior research, VR provides a platform for studying the relationship between navigation and physiological measures (e.g., skin conductance, heart rate, blood pressure). Specifically, physiological measures allow researchers to address novel questions and constrain previous theories of spatial abilities, strategies, and performance. For example, individual differences in navigation performance may be explained by the extent to which changes in arousal mediate the effects of task difficulty. However, the complexities in the design and implementation of VR experiments can distract experimenters from their primary research goals and introduce irregularities in data collection and analysis. To address these challenges, the Experiments in Virtual Environments (EVE) framework includes standardized modules such as participant training with the control interface, data collection using questionnaires, the synchronization of physiological measurements, and data storage. EVE also provides the necessary infrastructure for data management, visualization, and evaluation. The present paper describes a protocol that employs the EVE framework to conduct navigation experiments in VR with physiological sensors. The protocol lists the steps necessary for recruiting participants, attaching the physiological sensors, administering the experiment using EVE, and assessing the collected data with EVE evaluation tools. Overall, this protocol will facilitate future research by streamlining the design and implementation of VR experiments with physiological sensors.

Virtual reality (VR) experiments can be difficult to implement and require meticulous planning. This protocol describes a method for the design and implementation of VR experiments that collect physiological data from human participants. The Experiments in Virtual Environments (EVE) framework is employed to accelerate this process.

用生理学方法进行虚拟现实实验

Virtual reality (VR) experiments are increasingly employed because of their internal and external validity compared to real-world observation and ...

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

Despite the evidence that cardiac rehabilitation (CR) reduces the risk of recurrent cardiac events, only a minority of eligible patients are willing to join existing programs at cardiac rehabilitation centers. The unique remote patient monitoring system presented here enables healthcare providers to monitor CR patients at home in real-time and at low cost. The system combines mobile technology, artificial intelligence, and supportive services, expanding the delivery of medical care to the patient&#39;s home. The primary aim of the study is to increase the long-term adherence to physical activity in patients who participate in CR via the addition of a home-based digitally monitored CR component to the standard CR program in patients with ischemic heart disease (IHD), with the idea of forming new habitual health behaviors and increasing the long-term motivation for physical exercise (PE) habits at home. Secondary aims are to assess the program&#39;s impact on the physical activity level measured by average steps per day, minutes of exercise per week, blood pressure, metabolic parameters, body mass index, and waist-to-hip ratio, as well as a quality-of-life (QoL) questionnaire.The study has two arms: (1) home-based monitored exercise using a smart digital garment and wristband, in addition to motivation and reinforcement via text messages; (2) standard CR facility-based exercise. The study design is a randomized, controlled trial comparing standard CR to a home-based monitoring and reinforcement program. The study program is designed for 12 weeks.Clinical tests and anthropometric measurements are performed before and after the study, measuring height, weight, waist circumference, visceral fat and body mass index (BMI), blood pressure, and HbA1c and lipid profile. Patients have to complete a baseline survey including socio-demographic characteristics and QoL questionnaire SF-36. At the end of the study, patients complete a survey regarding the use of the smart digital garment&#39;s benefits and usability. The study is currently underway.

The aim is to promote a new approach to cardiac rehabilitation (CR), using a unique remote patient monitoring system that will enable healthcare providers to monitor CR patients at home at low cost, with the intention of making CR services more accessible and improving compliance. The study is currently underway.

一种新型的家庭心脏康复监控数字平台

Despite the evidence that cardiac rehabilitation (CR) reduces the risk of recurrent cardiac events, only a minority of eligible patients are willing to ...

Online Explorative Study on the Learning Uses of Virtual Reality Among Early Adopters

Virtual reality (VR) has shown great educational potential because it makes it possible to simulate any desired situation or event, thus playing an important role in addressing current educational challenges. Despite the unlimited learning possibilities that VR may offer, unless users are willing to apply virtual devices to education, the investment of time, money, and effort will be fruitless. It is therefore crucial to assess the educational interest of the first generation of VR users and to identify their current needs. To this end, in this study we designed an online questionnaire and applied it through the SaaS (Software as a service) of a private server. The sample consisted of 117 early VR adopters recruited via a main portal of communication and information technologies in Spain. In order to engage participants, we posted a thread in the main forum, which is dedicated to the advances and potential uses of VR. Once the responses were gathered, we analyzed the relationship between 12 variables (mean contrasts with Snedecor&#39;s F, and contingency analysis with chi-square and Sommer&#39;s d). The results showed that the current profile of a VR user is a male over 35 years old, with university studies, and who has purchased his viewer recently (&#60;1 year). As for the learning and teaching applications that these users were interested in, only 13.7% of the participants in this study use VR for educational purposes, although 28.2% were interested, indicating that perhaps the lack of applications or learning experiences may be hampering the use of VR within education. Almost half of the early adopters surveyed would like to learn using VR technology and are somehow optimistic about the relationship between VR and education, particularly those who are younger.

This article describes the profile of Spanish early adopters of virtual reality and their interests and preferences regarding learning and educational applications for this technology. To this aim, we designed an online questionnaire and interviewed 117 users of the main virtual reality forum on the Internet.

早期采用者虚拟现实学习应用的在线探索研究

Virtual reality (VR) has shown great educational potential because it makes it possible to simulate any desired situation or event, thus playing an ...