Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children
Identifieur interne : 003745 ( Main/Merge ); précédent : 003744; suivant : 003746Influence of virtual reality soccer game on walking performance in robotic assisted gait training for children
Auteurs : Karin Brütsch [Suisse] ; Tabea Schuler [Suisse] ; Alexander Koenig [Suisse] ; Lukas Zimmerli [Suisse] ; Susan Mérillat Koeneke [Suisse] ; Lars Lünenburger [Suisse] ; Robert Riener [Suisse] ; Lutz J Ncke [Suisse] ; Andreas Meyer-Heim [Suisse]Source :
- Journal of NeuroEngineering and Rehabilitation [ 1743-0003 ] ; 2010.
Abstract
Virtual reality (VR) offers powerful therapy options within a functional, purposeful and motivating context. Several studies have shown that patients' motivation plays a crucial role in determining therapy outcome. However, few studies have demonstrated the potential of VR in pediatric rehabilitation. Therefore, we developed a VR-based soccer scenario, which provided interactive elements to engage patients during robotic assisted treadmill training (RAGT). The aim of this study was to compare the immediate effect of different supportive conditions (VR versus non-VR conditions) on motor output in patients and healthy control children during training with the driven gait orthosis Lokomat®.
A total of 18 children (ten patients with different neurological gait disorders, eight healthy controls) took part in this study. They were instructed to walk on the Lokomat in four different, randomly-presented conditions: (1) walk normally without supporting assistance, (2) with therapists' instructions to promote active participation, (3) with VR as a motivating tool to walk actively and (4) with the VR tool combined with therapists' instructions. The Lokomat gait orthosis is equipped with sensors at hip and knee joint to measure man-machine interaction forces. Additionally, subjects' acceptance of the RAGT with VR was assessed using a questionnaire.
The mixed ANOVA revealed significant main effects for the factor CONDITIONS (p < 0.001) and a significant interaction CONDITIONS × GROUP (p = 0.01). Tests of between-subjects effects showed no significant main effect for the GROUP (p = 0.592). Active participation in patients and control children increased significantly when supported and motivated either by therapists' instructions or by a VR scenario compared with the baseline measurement "normal walking" (p < 0.001).
The VR scenario used here induces an immediate effect on motor output to a similar degree as the effect resulting from verbal instructions by the therapists. Further research needs to focus on the implementation of interactive design elements, which keep motivation high across and beyond RAGT sessions, especially in pediatric rehabilitation.
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DOI: 10.1186/1743-0003-7-15
PubMed: 20412572
PubMed Central: 2877051
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A., University Children's Hospital Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Rehabilitation Center Affoltern a. A., University Children's Hospital Zurich</wicri:regionArea><wicri:noRegion>University Children's Hospital Zurich</wicri:noRegion></affiliation></author><author><name sortKey="Schuler, Tabea" sort="Schuler, Tabea" uniqKey="Schuler T" first="Tabea" last="Schuler">Tabea Schuler</name><affiliation wicri:level="4"><nlm:aff id="I2">Institute of Human Movement Sciences, ETH Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Human Movement Sciences, ETH Zurich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName><orgName type="university">École polytechnique fédérale de Zurich</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="I6">Rehabilitation Center Affoltern a. A., University Children's Hospital Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Rehabilitation Center Affoltern a. A., University Children's Hospital Zurich</wicri:regionArea><wicri:noRegion>University Children's Hospital Zurich</wicri:noRegion></affiliation></author><author><name sortKey="Koenig, Alexander" sort="Koenig, Alexander" uniqKey="Koenig A" first="Alexander" last="Koenig">Alexander Koenig</name><affiliation wicri:level="4"><nlm:aff id="I3">Sensory-Motor Systems Lab, ETH Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Sensory-Motor Systems Lab, ETH Zurich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName><orgName type="university">École polytechnique fédérale de Zurich</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">SCI Center, University Hospital Balgrist, Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>SCI Center, University Hospital Balgrist, Zurich</wicri:regionArea><wicri:noRegion>Zurich</wicri:noRegion></affiliation></author><author><name sortKey="Zimmerli, Lukas" sort="Zimmerli, Lukas" uniqKey="Zimmerli L" first="Lukas" last="Zimmerli">Lukas Zimmerli</name><affiliation wicri:level="4"><nlm:aff id="I3">Sensory-Motor Systems Lab, ETH Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Sensory-Motor Systems Lab, ETH Zurich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName><orgName type="university">École polytechnique fédérale de Zurich</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Hocoma AG, Volketswil, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Hocoma AG, Volketswil</wicri:regionArea><wicri:noRegion>Volketswil</wicri:noRegion></affiliation></author><author><name sortKey=" Koeneke, Susan Merillat" sort=" Koeneke, Susan Merillat" uniqKey=" Koeneke S" first="Susan Mérillat" last=" Koeneke">Susan Mérillat Koeneke</name><affiliation wicri:level="4"><nlm:aff id="I1">Institute of Psychology, Division Neuropsychology, University of Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Psychology, Division Neuropsychology, University of Zurich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName><orgName type="university">Université de Zurich</orgName></affiliation></author><author><name sortKey="Lunenburger, Lars" sort="Lunenburger, Lars" uniqKey="Lunenburger L" first="Lars" last="Lünenburger">Lars Lünenburger</name><affiliation wicri:level="1"><nlm:aff id="I4">Hocoma AG, Volketswil, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Hocoma AG, Volketswil</wicri:regionArea><wicri:noRegion>Volketswil</wicri:noRegion></affiliation></author><author><name sortKey="Riener, Robert" sort="Riener, Robert" uniqKey="Riener R" first="Robert" last="Riener">Robert Riener</name><affiliation wicri:level="4"><nlm:aff id="I3">Sensory-Motor Systems Lab, ETH Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Sensory-Motor Systems Lab, ETH Zurich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName><orgName type="university">École polytechnique fédérale de Zurich</orgName></affiliation><affiliation wicri:level="1"><nlm:aff id="I5">SCI Center, University Hospital Balgrist, Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>SCI Center, University Hospital Balgrist, Zurich</wicri:regionArea><wicri:noRegion>Zurich</wicri:noRegion></affiliation></author><author><name sortKey="J Ncke, Lutz" sort="J Ncke, Lutz" uniqKey="J Ncke L" first="Lutz" last="J Ncke">Lutz J Ncke</name><affiliation wicri:level="4"><nlm:aff id="I1">Institute of Psychology, Division Neuropsychology, University of Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Psychology, Division Neuropsychology, University of Zurich</wicri:regionArea><placeName><settlement type="city">Zurich</settlement><region nuts="3" type="region">Canton de Zurich</region></placeName><orgName type="university">Université de Zurich</orgName></affiliation></author><author><name sortKey="Meyer Heim, Andreas" sort="Meyer Heim, Andreas" uniqKey="Meyer Heim A" first="Andreas" last="Meyer-Heim">Andreas Meyer-Heim</name><affiliation wicri:level="1"><nlm:aff id="I6">Rehabilitation Center Affoltern a. A., University Children's Hospital Zurich, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Rehabilitation Center Affoltern a. A., University Children's Hospital Zurich</wicri:regionArea><wicri:noRegion>University Children's Hospital Zurich</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of NeuroEngineering and Rehabilitation</title><idno type="eISSN">1743-0003</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Virtual reality (VR) offers powerful therapy options within a functional, purposeful and motivating context. Several studies have shown that patients' motivation plays a crucial role in determining therapy outcome. However, few studies have demonstrated the potential of VR in pediatric rehabilitation. Therefore, we developed a VR-based soccer scenario, which provided interactive elements to engage patients during robotic assisted treadmill training (RAGT). The aim of this study was to compare the immediate effect of different supportive conditions (VR versus non-VR conditions) on motor output in patients and healthy control children during training with the driven gait orthosis Lokomat<sup>®</sup>.</p></sec><sec><title>Methods</title><p>A total of 18 children (ten patients with different neurological gait disorders, eight healthy controls) took part in this study. They were instructed to walk on the Lokomat in four different, randomly-presented conditions: (1) walk normally without supporting assistance, (2) with therapists' instructions to promote active participation, (3) with VR as a motivating tool to walk actively and (4) with the VR tool combined with therapists' instructions. The Lokomat gait orthosis is equipped with sensors at hip and knee joint to measure man-machine interaction forces. Additionally, subjects' acceptance of the RAGT with VR was assessed using a questionnaire.</p></sec><sec><title>Results</title><p>The mixed ANOVA revealed significant main effects for the factor CONDITIONS (p < 0.001) and a significant interaction CONDITIONS × GROUP (p = 0.01). Tests of between-subjects effects showed no significant main effect for the GROUP (p = 0.592). Active participation in patients and control children increased significantly when supported and motivated either by therapists' instructions or by a VR scenario compared with the baseline measurement "normal walking" (p < 0.001).</p></sec><sec><title>Conclusions</title><p>The VR scenario used here induces an immediate effect on motor output to a similar degree as the effect resulting from verbal instructions by the therapists. Further research needs to focus on the implementation of interactive design elements, which keep motivation high across and beyond RAGT sessions, especially in pediatric rehabilitation.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Mirelman, A" uniqKey="Mirelman A">A Mirelman</name></author><author><name sortKey="Bonato, P" uniqKey="Bonato P">P Bonato</name></author><author><name sortKey="Deutsch, Je" uniqKey="Deutsch J">JE Deutsch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bohannon, Rw" uniqKey="Bohannon R">RW Bohannon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bohannon, Rw" uniqKey="Bohannon R">RW Bohannon</name></author><author><name sortKey="Horton, Mg" uniqKey="Horton M">MG Horton</name></author><author><name sortKey="Wikholm, Jb" uniqKey="Wikholm J">JB Wikholm</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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sortKey="Meyer Heim, A" uniqKey="Meyer Heim A">A Meyer-Heim</name></author><author><name sortKey="Lunenburger, L" uniqKey="Lunenburger L">L Lünenburger</name></author><author><name sortKey="Koneke, S" uniqKey="Koneke S">S Köneke</name></author><author><name sortKey="J Ncke, L" uniqKey="J Ncke L">L Jäncke</name></author><author><name sortKey="Riener, R" uniqKey="Riener R">R Riener</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Banz, R" uniqKey="Banz R">R Banz</name></author><author><name sortKey="Riener, R" uniqKey="Riener R">R Riener</name></author><author><name sortKey="Lunenburger, L" uniqKey="Lunenburger L">L Lunenburger</name></author><author><name sortKey="Bolliger, M" uniqKey="Bolliger M">M Bolliger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Holm, S" uniqKey="Holm S">S Holm</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnson, Mj" uniqKey="Johnson M">MJ Johnson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Damiano, Dl" uniqKey="Damiano D">DL Damiano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Papavasiliou, As" uniqKey="Papavasiliou A">AS Papavasiliou</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jack, D" uniqKey="Jack D">D Jack</name></author><author><name sortKey="Boian, R" uniqKey="Boian R">R Boian</name></author><author><name sortKey="Merians, As" uniqKey="Merians A">AS Merians</name></author><author><name sortKey="Tremaine, M" uniqKey="Tremaine M">M Tremaine</name></author><author><name sortKey="Burdea, Gc" uniqKey="Burdea G">GC Burdea</name></author><author><name sortKey="Adamovich, Sv" uniqKey="Adamovich S">SV Adamovich</name></author><author><name sortKey="Recce, M" uniqKey="Recce M">M Recce</name></author><author><name sortKey="Poizner, H" uniqKey="Poizner H">H Poizner</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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