Virtual reality research synthesis

Link to article  http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=320847&Ausgabe=254742&ProduktNr=224263&filename=320847.pdf

Virtual Reality in Pediatric Neurorehabilitation: Attention Deficit Hyperactivity Disorder, Autism and Cerebral Palsy
Michelle Wang and Denise Reid  Virtual Reality and Neurorehabilitation Laboratory, Department of Rehabilitation Science,

University of Toronto, Toronto, Ont., Canada

Neuroepidemiology 2011;36:2–18

The objective of this review is to provide a synthesis on research for key impairments in three populations. The review is organized by three types of VR, not by the populations receiving treatment, and hopes, in the end, to prompt interest in discussion and further research.  This paper is very useful in that it explores the available literature on this area.

Virtual reality (VR), broadly defined by Wang and Reid, is the action-based response to an event in an artificial environment. This describes almost any computer interface except voice-activation. This definition includes computer mousing, touch screen phones and excludes biofeedback. Popularly accepted as VR activities are gesture-based interactive games like Wii and  Eyetoy. Touch-based interactions include computer mousing and using touchscreens, but at best, haptic VR involves wearing a glove that provides pressure feedback or resistance to movement in certain directions.

 

The authors further explain VR as interaction with an artificial environment in a way that hopes to maximize immersion into the experience. In therapeutic settings, control over the parameters of the VR system permit the therapist to shape the program to create an achievable, challenging activity that is safe and, at best, generalizable to the real world.

This descriptive review is based on 20 peer-reviewed articles published since 2000 where VR is used as a treatment for the primary deficit of ADHD, autism or cerebral palsy. The authors discuss the division of VR into different modalities: ‘focused’ or biofeedback, gesture- and touch-based feedback.

Biofeedback or ‘focused’ feedback is discussed extensively in this article, identified as a kind of VR. Three of the four ADHD articles fall into this category. VR serves as a means of feedback, but it is not action-based or immersive.

Gestures or motion as the controller of activities in an artificial world we can see is a compelling VR application, reviewed through seven studies using IREX, Wii or Eyetoy in the cerebral palsy population. Measures used as performance indicators for upper extremity movement include: Melbourne assessment of unilateral upper extremity function, Quality of upper extremities skills test, one item on one subtest of the Bruninks-Osertesky test of motor proficiency, Modified pediatric motor activity log. Measures used for lower extremities are: Sitting assessment for children with neuoromoter disfunction, Gross motor function measure, SWOC, Postural Scale Analyzer, Test of Visual Perceptual Skills, Fugl-Meyer assessment, and functional MRI, and the Standardized walking obstacle course.

Touch-mediated activity, or hand action controllers, can vary from computer mouse use, through touchscreens to haptic gloves that give sensory feedback. Two studies use touchscreens (slightly more interactive than a computer mouse) with autistic children, and three use sensor gloves (without feedback) looking at the upper extremity in the cerebral palsy population.

Cumulatively, no articles stand out with strong evidence for the use of VR over traditional therapies. The authors hope to encourage further use and study of VR in clinical settings.