Scimex: The Rehabilitation Gaming System (RGS), which uses Microsoft's Kinect camera to generate a virtual body onscreen that reflects the movements of stroke patients, can help them regain full movement of impaired arms, say Spanish researchers. Virtual reality could assist arm rehabilitation in some stroke patients, according to a clinical pilot study published in the open access Journal of NeuroEngineering and Rehabilitation. The researchers found that using virtual reality to increase a patient's confidence in using their paralyzed arm may be critical for recovery.
patients with 'hemiparesis' - reduced muscle strength on one side of
the body - often underuse their affected limbs even though they still
have some motor function.
Using their healthy limb may immediately
improve the ease of their daily activities, but a long period of
non-use of the affected 'paretic' limb can lead to further loss of
function. This so-called 'learned non-use' is a well-known effect in
stroke patients and has been associated with a reduced quality of life.
small pilot study involved 20 hemiparetic stroke patients using the
'Rehabilitation Gaming System' with a Microsoft Kinect sensor. The
system allows users to control a virtual body via their own movements,
seen from a first-person perspective on a computer screen, with which
they perform tasks in a virtual world.
Lead author, Belén Rubio
from the Laboratory of Synthetic, Perceptive, Emotive and Cognitive
Systems, Universitat Pompeu Fabra, Spain, said: "There is a need for
designing new rehabilitation strategies that promote the use of the
affected limb in performing daily activities. Often we neglect the
remarkable contribution of the patient's emotional and psychological
states to recovery, and this includes their confidence."
were asked to reach targets appearing in a virtual environment over
several blocks of trials. In some of these trials, the researchers
enhanced the movement of the paretic limb's virtual representation,
making it appear faster, more accurate and easier to reach the target on
screen. These amplifications were introduced and suppressed in a
gradual fashion to keep participants unaware of the manipulations.
these manipulations, the participants' performance in the unamplified
task was recorded, including the likelihood of them using their paretic
Belén Rubio said: "After enhancement of movement, patients
started using their paretic limb more frequently. This suggests that
changing patients' beliefs on their capabilities significantly improves
the use of their paretic limb. Surprisingly, only ten minutes of
enhancement was enough to induce significant changes in the amount of
spontaneous use of the affected limb."
Following the intervention,
there was a significantly higher probability that the patient would
select their paretic limb for reaching towards a virtual target. This
was despite there being no amplification of movement in that session,
and the patient reporting no awareness of the previous session's
Some current therapies for stroke patients involve
forcing the patient to use the affected limb by constraining movement of
the healthy limb, for example, in 'Constraint Induced Movement
Therapy'. This study suggests that an alternative focus on increasing
the patient's confidence in using the paretic arm may instead be
critical for full recovery.
Belén Rubio said: "This therapy could
create a virtuous circle of recovery, in which positive feedback,
spontaneous arm use and motor performance can reinforce each other.
Engaging patients in this ongoing cycle of spontaneous arm use, training
and learning could produce a remarkable impact on their recovery
"This study is one among many in which the Rehabilitation
Gaming System (RGS) has been validated over the last ten years. There
is now overwhelming evidence that RGS has a significant impact on
recovery of functionality for both acute and chronic patients, and it is
currently in daily use in a number of hospitals and treatment centers
The study will need to be repeated with a larger number
of participants to provide more insight into the use of the RGS-based
virtual reality intervention as an effective therapy.
RGS is being commercialized via a spin-off company Eodyne.com.