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Effects of Virtual Reality on Cognitive Rehabilitation

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Digital Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 15351

Special Issue Editors

School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, 1749-024 Lisbon, Portugal
Interests: virtual reality; cognitive rehabilitation; avatar therapy
Special Issues, Collections and Topics in MDPI journals
School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, 1749-024 Lisbon, Portugal
Interests: virtual reality; cognitive rehabilitation; avatar therapy; neuropsychology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Virtual rehabilitation (VR) is described as the use of virtual reality for cognitive rehabilitation of cognitive impairments. Cognitive impairments derive from organic or functional brain conditions associated with clinical conditions such as stroke, traumatic brain injuries or due to the course of normal aging, which may compromise the ability of people to carry on a normal life. Cognitive improvements in these conditions typically depend on non-pharmacological approaches with behavioral exercises targeting specific cognitive domains or global cognition and functionality. However, traditional behavioral methods for cognitive rehabilitation are challenged by the need of transfer of training outcomes to daily life functioning. VR offers several advantages by contextualizing treatment in daily living activities in fully immersive, realistic, and multimodal enriched environments. Therefore, we will be looking for high-quality research on the following topics related to VR implementation for research and clinical settings:

1) Design elements that contribute to feasibility of virtual rehabilitation:

a) Serious games elements useful for improving patient motivation;
b) Multimodal feedback;
c) Avatar therapy;

2) Clinical outcomes on the efficacy of virtual rehabilitation:

a) Patient retention in different clinical populations;
b) General vs. domain-specific outcomes;
c) Dose and other moderating factors.

Dr. Jorge Oliveira
Prof. Dr. Pedro Gamito
Guest Editors

 

Keywords

  • virtual reality
  • cognitive rehabilitation
  • serious games
  • multimodal feedback
  • avatar
  • patient retention
  • cognitive impairment
  • dose
  • acquired brain injury
  • aging

Published Papers (4 papers)

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Research

12 pages, 2124 KiB  
Article
Intensive Training with Virtual Reality on Mobility in Adolescents with Cerebral Palsy—Single Subject Design
by Elisa Valenzuela, Renata Rosa, Carlos Monteiro, Leslie Keniston, Kênnea Ayupe, Jaqueline Frônio and Paula Chagas
Int. J. Environ. Res. Public Health 2021, 18(19), 10455; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910455 - 05 Oct 2021
Cited by 2 | Viewed by 2663
Abstract
Purpose: To evaluate the effects of a short-term intensive virtual reality intervention in adolescents with cerebral palsy (CP). Methods: Single-subject design, type A–B-follow-up, with four participants (P) with CP, 15–18 years, GMFCS level II. A two-week intervention phase was performed with twelve Nintendo [...] Read more.
Purpose: To evaluate the effects of a short-term intensive virtual reality intervention in adolescents with cerebral palsy (CP). Methods: Single-subject design, type A–B-follow-up, with four participants (P) with CP, 15–18 years, GMFCS level II. A two-week intervention phase was performed with twelve Nintendo® Wii games in six sessions (90 min) per week. Outcome variables were semi-static balance (Pressure Center Oscillation—PCO), gait speed (Ten Meter Walk Test at usual speed—TMWT-U; and fast speed—TMWT-F), mobility (Timed Up and Go test—TUG), endurance (sit-to-stand test 5 times—STS-5), and gross motor activity (Gross Motor Function Measure—GMFM). Results: Statistical improvements were observed in GMFM-D (P2–P3), TMWT-F (P2–P3–P4) and TMWT-U (P2), STS-5 (P3–P4), TUG (P3), and PCO (P2–P3), assessed by level, trend, latency, and visual inspection to analyze change. Conclusions: This study shows that a short-term intensive intervention using Nintendo® Wii-based games in adolescents, GMFCS level II, can be an effective therapy, leading to some recovery of functioning in these young people. Full article
(This article belongs to the Special Issue Effects of Virtual Reality on Cognitive Rehabilitation)
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15 pages, 1278 KiB  
Article
Cognitive Remediation in Virtual Environments for Patients with Schizophrenia and Major Depressive Disorder: A Feasibility Study
by Adéla Plechatá, Lukáš Hejtmánek, Martina Bednářová and Iveta Fajnerová
Int. J. Environ. Res. Public Health 2021, 18(17), 9081; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18179081 - 28 Aug 2021
Cited by 2 | Viewed by 1852
Abstract
Standard approaches to cognitive remediation can suffer from limited skill transferability to patients’ life. Complex virtual environments (VEs) enable us to create ecologically valid remediation scenarios while preserving laboratory conditions. Nevertheless, the feasibility and efficacy of these programs in psychiatric patients are still [...] Read more.
Standard approaches to cognitive remediation can suffer from limited skill transferability to patients’ life. Complex virtual environments (VEs) enable us to create ecologically valid remediation scenarios while preserving laboratory conditions. Nevertheless, the feasibility and efficacy of these programs in psychiatric patients are still unknown. Our aim was to compare the feasibility and efficacy of a novel rehabilitation program, designed in complex VEs, with standard paper–pencil treatment in patients with schizophrenia and major depressive disorder. We recruited 35 participants to complete a VE rehabilitation program and standard treatment in a crossover pilot study. Twenty-eight participants completed at least one program, 22 were diagnosed with schizophrenia and 6 with major depressive disorder. Participant’s performance in the representative VE training task significantly improved in terms of maximum achieved difficulty (p ≤ 0.001), speed (p < 0.001) and efficacy (p ≤ 0.001) but not in item performance measure. Neither the standard treatment nor the VE program led to improvement in standardized cognitive measures. Participants perceived both programs as enjoyable and beneficial. The refusal rate was higher in the VE program (8.6%) than in the standard treatment (0%). But in general, the VE program was well-accepted by the psychiatric patients and it required minimal involvement of the clinician due to automatic difficulty level adjustment and performance recording. However, the VE program did not prove to be effective in improving cognitive performance in the standardized measures. Full article
(This article belongs to the Special Issue Effects of Virtual Reality on Cognitive Rehabilitation)
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16 pages, 832 KiB  
Article
Motivation, Usability, and Credibility of an Intelligent Activity-Based Client-Centred Training System to Improve Functional Performance in Neurological Rehabilitation: An Exploratory Cohort Study
by Els Knippenberg, Ilse Lamers, Annick Timmermans and Annemie Spooren
Int. J. Environ. Res. Public Health 2021, 18(14), 7641; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18147641 - 18 Jul 2021
Cited by 6 | Viewed by 2735
Abstract
(1) Background: technology-based training systems are increasingly integrated in neurorehabilitation but are rarely combined with a client-centred task-oriented approach. To provide a low-cost client-centred task-oriented system, the intelligent activity-based client-centred task-oriented training (i-ACT) was developed. The objective was to evaluate the usability, credibility [...] Read more.
(1) Background: technology-based training systems are increasingly integrated in neurorehabilitation but are rarely combined with a client-centred task-oriented approach. To provide a low-cost client-centred task-oriented system, the intelligent activity-based client-centred task-oriented training (i-ACT) was developed. The objective was to evaluate the usability, credibility and treatment expectancy of i-ACT, and the motivation towards i-ACT use in rehabilitation over time. Additionally, this study will evaluate the upper limb treatment effects after training with i-ACT. (2) Methods: a mixed-method study was performed in four rehabilitation centres. Training with i-ACT was provided during six weeks, three times per week, forty-five minutes per day, additional to conventional care. (3) Results: seventeen persons with central nervous system diseases were included. High scores were seen in the system usability scale (score ≥ 73.8/100), credibility (score ≥ 22.0/27.0)/expectancy (score ≥ 15.8/27.0) questionnaire, and intrinsic motivation inventory (score ≥ 5.2/7.0), except the subscale pressure (score ≤ 2.0/7.0). Results from the interviews corroborate these findings and showed that clients and therapists believe in the i-ACT system as an additional training support system. Upper limb functional ability improved significantly (p < 0.05) over time on the Wolf motor function test. (4) Conclusion: i-ACT is a client-centred task-oriented usable and motivational system which has the potential to enhance upper limb functional training in persons with neurological diseases. Full article
(This article belongs to the Special Issue Effects of Virtual Reality on Cognitive Rehabilitation)
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13 pages, 912 KiB  
Article
Virtual Reality-Based Cognitive Stimulation on People with Mild to Moderate Dementia due to Alzheimer’s Disease: A Pilot Randomized Controlled Trial
by Jorge Oliveira, Pedro Gamito, Teresa Souto, Rita Conde, Maria Ferreira, Tatiana Corotnean, Adriano Fernandes, Henrique Silva and Teresa Neto
Int. J. Environ. Res. Public Health 2021, 18(10), 5290; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105290 - 16 May 2021
Cited by 45 | Viewed by 6667
Abstract
The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still [...] Read more.
The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD. Full article
(This article belongs to the Special Issue Effects of Virtual Reality on Cognitive Rehabilitation)
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