Virtual reality for mobile lower limb motor rehabilitation in patients with neurological disorders

Schärer, Susanne and Broggi, Simon and Mingorance, Jose and Pyk, Pawel and Kiper, Daniel and Kobashi, Nagisa and Bolliger, Marc and Eng, Kynan and Villiger, Michael (2013) Virtual reality for mobile lower limb motor rehabilitation in patients with neurological disorders. In: International Neurorehabilitation Symposium (INRS).

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Stroke and other neurological disorders cause physical limitations leading to problems with activities in daily life. Key factors influencing successful rehabilitation and functional recovery include variety in training, intensive movement repetition and a motivating training environment. Technologies which can provide all of these features, independent of the patient’s location, may thus provide significant benefits for rehabilitation. For our study we use a prototype of a mobile lower limb virtual reality (VR) training system (YouKicker®) combining action observation and execution using motivating training scenarios. Patients using YouKicker control virtual representations of their legs and feet designed to facilitate observation of goal-directed actions presumed to activate overlapping cortical networks, in the “mirror system“ (Rizzolatti and Craighero, 2004). Clinically relevant movements are trained in four different scenarios, as specified in design discussions with therapists. We have previously tested a stationary version of the system on incomplete spinal cord injury (iSCI) patients and found significant improvements in lower limb function (Villiger et al., 2013). We hypothesize that the system also has beneficial effects on movements in patients with other neurological disorders, eg. stroke. This study is designed as a single-case series of up to six patients. Each patient receives a target treatment dosage of 18 45-minute sessions completed within six weeks. Assessments are conducted immediately before the start of treatment, after treatment (week 7), and at follow-up (week 14-18). During the intervention, patients train three to five times per week. No other training/therapy for the lower extremity takes place during the study. The assessments performed quantify motor function such as balance during functional activities, gait speed, walking aids and/or personal assistance and activities of daily life and independence.

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