Leap Motion Controller–based training for upper extremity rehabilitation in children and adolescents with physical disabilities: A randomized controlled trial

Study DesignRandomized controlled trial.IntroductionJuvenile idiopathic arthritis (JIA), cerebral palsy (CP), and brachial plexus birth injury (BPBI) are the most common disorders that cause upper extremity impairments in children and adolescents. Leap Motion Controller–based training (LMCBT) is a novel therapeutic method for upper extremity rehabilitation.Purpose of the StudyThe aim of the present study was to investigate the potential efficacy of an 8-week LMCBT program set as an upper extremity rehabilitation program by comparing conventional rehabilitation program in children and adolescents with physical disabilities such as JIA, CP, and BPBI.MethodsA randomized control trial which included children and adolescents of different disabilities (JIA, CP, BPBI) were grouped according to their diagnosis. All patients were randomized into 2 groups namely LMCBT (group I) and conventional treatment (group II) for the treatment (3 days/8 weeks). Duruoz Hand Index and Jebson Taylor Hand Function Test were used as primary outcomes. Secondary outcomes included the nine-hole peg test, Childhood Health Assessment Questionnaire, and assessments of grip and pinch strength using a dynamometer.ResultsOne hundred three patients were included in the study, and 92 of them completed the treatment. After treatment, significant differences were found in Childhood Health Assessment Questionnaire, Duruoz Hand Index, Jebson Taylor Hand Function Test, nine-hole peg test, and grip and pinch strength scores in almost all groups (effect size [ES] = 0.10 to −0.77 for group I and 0.09 to −0.70 for group II in CP; ES = 0.31 to 2.65 for the group I and 0.12 to 1.66 for group II in JIA; and ES = 0 to −0.44 for group I and 0.08 to −0.62 for group II in BPBI) (P < .05). Comparisons between LMCBT and conventional treatment groups showed similar results in all parameters in all disease groups (P > .05).ConclusionsThis study has quantitatively shown that LMCBT should be used as an effective alternative treatment option in children and adolescents with physical disabilities.     

Neural Correlates of Reward-Based Spatial Learning in Persons with Cocaine Dependence

Dysfunctional learning systems are thought to be central to the pathogenesis of and impair recovery from addictions. The functioning of the brain circuits for episodic memory or learning that support goal-directed behavior has not been studied previously in persons with cocaine dependence (CD). Thirteen abstinent CD and 13 healthy participants underwent MRI scanning while performing a task that requires the use of spatial cues to navigate a virtual-reality environment and find monetary rewards, allowing the functional assessment of the brain systems for spatial learning, a form of episodic memory. Whereas both groups performed similarly on the reward-based spatial learning task, we identified disturbances in brain regions involved in learning and reward in CD participants. In particular, CD was associated with impaired functioning of medial temporal lobe (MTL), a brain region that is crucial for spatial learning (and episodic memory) with concomitant recruitment of striatum (which normally participates in stimulus-response, or habit, learning), and prefrontal cortex. CD was also associated with enhanced sensitivity of the ventral striatum to unexpected rewards but not to expected rewards earned during spatial learning. We provide evidence that spatial learning in CD is characterized by disturbances in functioning of an MTL-based system for episodic memory and a striatum-based system for stimulus-response learning and reward. We have found additional abnormalities in distributed cortical regions. Consistent with findings from animal studies, we provide the first evidence in humans describing the disruptive effects of cocaine on the coordinated functioning of multiple neural systems for learning and memory.     

Training of goal directed arm movements with motion interactive video games in children with cerebral palsy – A kinematic evaluation

Objective: The main aim of this study was to evaluate the quality of goal-directed arm movements in 15 children with cerebral palsy (CP) following four weeks of home-based training with motion interactive video games. A further aim was to investigate the applicability and characteristics of kinematic parameters in a virtual context in comparison to a physical context.

Method: Kinematics and kinetics were captured while the children performed arm movements directed towards both virtual and physical targets.

Results: The children’s movement precision improved, their centre of pressure paths decreased, as did the variability in maximal shoulder angles when reaching for virtual objects. Transfer to a situation with physical targets was mainly indicated by increased movement smoothness.

Conclusion: Training with motion interactive games seems to improve arm motor control in children with CP. The results highlight the importance of considering both the context and the task itself when investigating kinematic parameters.     

A three-dimensional printing navigational template combined with mixed reality technique for localizing pulmonary nodules

OBJECTIVESLocalizing non-palpable pulmonary nodules is challenging for thoracic surgeons. Here, we investigated the accuracy of three-dimensional (3D) printing technology combined with mixed reality (MR) for localizing ground glass opacity-dominant pulmonary nodules.Open in a separate windowMETHODSIn this single-arm study, we prospectively enrolled patients with small pulmonary nodules (<2 cm) that required accurate localization. A 3D-printing physical navigational template was designed based on the reconstruction of computed tomography images, and a 3D model was generated through the MR glasses. We set the deviation distance as the primary end point for efficacy evaluation. Clinicopathological and surgical data were obtained for further analysis.RESULTSSixteen patients with 17 non-palpable pulmonary nodules were enrolled in this study. Sixteen nodules were localized successfully (16/17; 94.1%) using this novel approach with a median deviation of 9 mm. The mean time required for localization was 25 ± 5.2 min. For the nodules in the upper/middle and lower lobes, the median deviation was 6 mm (range, 0–12.0) and 16 mm (range, 15.0–20.0), respectively. The deviation difference between the groups was significant (Z = −2.957, P = 0.003). The pathological evaluation of resection margins was negative.CONCLUSIONSThe 3D printing navigational template combined with MR can be a feasible approach for localizing pulmonary nodules.     

Postural instability according to virtual reality program

Background: The popularity of virtual reality (VR) grew rapidly. Short guidelines with a lack of emphasis on safe use appears prior to usage. It is necessary for the user to realize how much potentially dangerous VR is.

Aims/objectives: The aim of this study is to investigate the effect of VR on balance in normal people.

Materials and methods: Mean equilibrium score (MES) of 15 adults who have normal sense of balance were obtained by using the sensory organization test (SOT). Conditions 1 and 2 were performed. Multiple VR programs were classified as three levels (Easy, Average, and Challenging) by the visual analog scale. Further SOT tests were performed during watching VR programs. MES of each test was used for statistical analysis.

Results: MES of condition 1 was significantly higher than condition 2. Although there was no statistical difference between Eye open and Easy program (p?=?.097), MES of average and Challenging programs showed significantly decreased scores compared to Eye open. In addition, MES of Average and Challenging programs were significantly decreased than that of Easy program.

Conclusions and significance: VR can cause postural imbalance to users. It is necessary to establish quantifiable and objective methods to measure imbalance caused by VR use.     

基于云端服务的缺血性脑卒中虚拟体感康复训练平台设计

以虚拟智能设备为基础,结合远程网络、智能传感和云技术,建设基于云端服务的缺血性脑卒中虚拟现实体感康复训练平台,阐述该平台主要架构、功能模块设计,并分析其应用情况。     

基于虚拟现实技术的脊柱三维仿真模型的建立及应用

目的 建立基于虚拟现实技术的计算机辅助三维立体脊柱虚拟模型,构建出适用于虚拟手术中实时复杂交互的脊柱三维仿真模型. 方法 对高分辨率的人体64排CT切片数据进行感兴趣区域图像分割和边缘提取,采用面绘制技术对提取的轮廓序列进行三维数据生成,对重建的模型根据实时交互的需要进行优化. 结果 重建出的脊柱模型保持了较高的几何分辨率和光滑性,读入虚拟手术系统后,在实时交互下能表现出较好的解剖精确性和实时绘制的真实感.结论基于人体切片数据重建出的三维模型可较好地适用于虚拟手术中的复杂交互操作.     

An innovative cycling exergame to promote cardiovascular fitness in youth with cerebral palsy

Objective: To evaluate the effects of an internet-platform exergame cycling programme on cardiovascular fitness of youth with cerebral palsy (CP). Methods: In this pilot prospective case series, eight youth with bilateral spastic CP, Gross Motor Functional Classification System (GMFCS) level III, completed a six-week exergame programme. Outcomes were obtained at baseline and post-intervention. The primary outcome measure was the GMFCS III-specific shuttle run test (SRT-III). Secondary outcomes included health-related quality of life (HQL) as measured by the KIDSCREEN-52 questionnaire, six-minute walk test, Wingate arm cranking test and anthropomorphic measurements. Results: There were significant improvements in the SRT-III (t?=??2.5, p?=?0.04, d?=?0.88) post-intervention. There were no significant changes in secondary outcomes. Conclusion: An exergame cycling programme may lead to improvement in cardiovascular fitness in youth with CP. This study was limited by small sample size and lack of a comparison group. Future research is warranted.