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Increasing patient engagement during virtual reality-based motor rehabilitation

Arch Phys Med Rehabil. 2013 Sep;94(9):1737-46. doi: 10.1016/j.apmr.2013.01.029. Epub 2013 Mar 7.

Abstract

Objective: To investigate the influence of different design characteristics of virtual reality exercises on engagement during lower extremity motor rehabilitation.

Design: Correlational study.

Setting: Spinal cord injury (SCI) rehabilitation center.

Participants: Subjects with SCI (n=12) and control subjects (n=10).

Interventions: Not applicable.

Main outcome measures: Heart rate and electromyographic activity from both legs at the tibialis anterior, the gastrocnemius medialis, the rectus femoris, and the biceps femoris were recorded.

Results: Interactivity (ie, functionally meaningful reactions to motor performance) was crucial for the engagement of subjects. No significant differences in engagement were found between exercises that differed in feedback frequency, explicit task goals, or aspects of competition.

Conclusions: Functional feedback is highly important for the active participation of patients during robotic-assisted rehabilitation. Further investigations on the design characteristics of virtual reality exercises are of great importance. Exercises should thoroughly be analyzed regarding their effectiveness, while user preferences and expectations should be considered when designing virtual reality exercises for everyday clinical motor rehabilitation.

Keywords: BDI II; Beck Depression Inventory II; EMG; Gait; LEMS; Motor activity; RMS; Rehabilitation; SCI; SCIM III; Spinal Cord Independence Measure III; Spinal cord injuries; VR; Virtual systems; WISCI II; Walking Index for Spinal Cord Injury II; electromyogram; lower extremity motor score; root mean square; spinal cord injury; virtual reality.

MeSH terms

  • Adult
  • Electromyography
  • Exercise Therapy / instrumentation*
  • Exercise Therapy / methods*
  • Feedback*
  • Female
  • Gait
  • Heart Rate
  • Humans
  • Leg
  • Male
  • Physical Therapy Modalities
  • Recovery of Function
  • Rehabilitation Centers
  • Robotics
  • Spinal Cord Injuries / rehabilitation*
  • User-Computer Interface*