Abstract
Multiple sclerosis (MS) is a debilitating disease which gradually reduces motor function and mobility. Virtual reality (VR) has been successfully utilised in support of existing therapeutic approaches for many different conditions, and new innovative and experimental features could be the future of VR rehabilitation. The Quest is a new headset by Oculus, with its built-in tracking, relatively low cost, portability and lack of reliance on expensive processing heavy PCs to power it, and could be an ideal system to facilitate at-home or clinic-based upper limb rehabilitation. A hand-tracking-based rehabilitation game aimed at people with MS was developed for Oculus Quest using Unity. Two distinct games were made to replicate different types of hand exercises, piano playing for isolated finger flexion and maze tracking for coordination and arm flexion. This pilot study assesses the value of such approach along with evaluating intrinsic and extrinsic methods of providing feedback, namely, positive scoring, negative scoring and audio response. One physiotherapist and two individuals with MS were surveyed. Participant response was positive although small sample size impacts the user testing validity of the results. Future research is recommended to build off the data gathered as a pilot study and increase sample size to collect richer feedback.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Adamovich SV et al (2005) A virtual reality-based exercise system for hand rehabilitation post-stroke. Presence, New Jersey
Alankus, G. et al (2010) Towards customizable games for stroke rehabilitation
Ascherio A, Munger KL (2007) Environmental risk factors for multiple sclerosis. Part I: the role of infection. Ann Neurol 61(4):288–299. https://doi.org/10.1002/ana.21117
Berkman MI, Akan E (2019) Presence and immersion in virtual reality. In: Encyclopedia of computer graphics and games. Springer International Publishing, pp 1–10. https://doi.org/10.1007/978-3-319-08234-9_162-1
Borrego A et al (2018) Comparison of oculus rift and HTC vive: feasibility for virtual reality-based exploration, navigation, exergaming, and rehabilitation. Games for Health J Mary Ann Liebert Inc 7(3):151–156. https://doi.org/10.1089/g4h.2017.0114
Burke JW et al (2009) Optimising engagement for stroke rehabilitation using serious games. Vis Comput 25(12):1085–1099. https://doi.org/10.1007/s00371009-0387-4
Carter S, Taylor D, Levenson R (2003) A question of choice: compliance in medicine taking, London
Causes of MS (2020). Accessed Jun 24, 2020, from https://www.mstrust.org.uk/about-ms/what-ms/causesms
Chan EA et al (2006) Application of a virtual reality prototype for pain relief of pediatric burn in Taiwan. https://doi.org/10.1111/j.1365-2702.2006.01719.x
Chen J (2007) Flow in games (and everything else)
Choi JH et al (2014) Effectiveness of commercial gaming-based virtual reality movement therapy on functional recovery of upper extremity in subacute stroke patients. Ann Rehabilitation Med. Korean Academy of Rehabilitation Medicine 38(4):485–493. https://doi.org/10.5535/arm.2014.38.4.485
Cordella, F. et al (2012). Patient performance evaluation using Kinect and Monte CarloBased finger tracking
Dias P et al (2019). Using virtual reality to increase motivation in post-stroke rehabilitation. Accessed Jun 25, 2020, from www.oculus.com/rift
Elor A, Teodorescu M, Kurniawan S (2018) Project star catcher: a novel immersive virtual reality experience for upper limb rehabilitation. ACM Trans Access Comput 11. https://doi.org/10.1145/3265755
Engström LO, Öberg B (2005) Patient adherence in an individualized rehabilitation programme: a clinical follow-up. Scand J Public Health 33(1):11–18. https://doi.org/10.1080/14034940410028299
Enrique Sucar L et al (2013) Gesture therapy: an upper limb virtual reality-based motor rehabilitation platform. IEEE Transactions on Neural Systems and Rehabilitation Engineering
Guo R, Quarles J (2012, March) Differences in presence between healthy users and users with multiple sclerosis. In 2012 IEEE VR Workshop on Perceptual Illusions in Virtual Environments (pp. 1–6). IEEE
Hartveld A, Hegarty JR (1996) Augmented feedback and physiotherapy practice motor programme. https://doi.org/10.1016/S0031-9406(05)66414-0
Hayden JA, Van Tulder MW, Tomlinson G (2005) Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain. Ann Intern Med:776–785. https://doi.org/10.7326/0003-4819-142-9-200505030-00014
HidayetoÄŸlu ML, Ozkan A (2011) Effects of interior colors on mood and preference: comparisons of two living rooms article in perceptual and motor skills. https://doi.org/10.2466/24.27.PMS.112.2.509-524
Hondori HM, Khademi M (2014) A review on technical and clinical impact of Microsoft Kinect on physical therapy and rehabilitation. https://doi.org/10.1155/2014/846514
Housley SN et al (2016) ‘Increasing access to cost effective home-based rehabilitation for rural veteran stroke survivors.’, Austin J Cerebrovasc Dis Stroke, 3(2), pp. 1–11. Accessed Jun 17, 2020, from http://www.ncbi.nlm.nih.gov/pubmed/28018979
Ijsselsteijn WA et al (2004) Virtual cycling: effects of immersion and a virtual coach on motivation and presence in a home fitness application
Jack D et al (2001) Virtual reality-enhanced stroke rehabilitation, IEEE Transactions on Neural Systems and Rehabilitation Engineering
Janardhan V, Bakshi R (2002) Quality of life in patients with multiple sclerosis: the impact of fatigue and depression. J Neurol Sci 205(1):51–58. https://doi.org/10.1016/S0022-510X(02)00312-X
Jones T, Moore T, Choo J (2016) The impact of virtual reality on chronic pain. https://doi.org/10.1371/journal.pone.0167523
Kearns PKA et al (2019) Regional variation in the incidence rate and sex ratio of multiple sclerosis in Scotland 2010–2017: findings from the Scottish multiple sclerosis register. J Neurol 266(10):2376–2386. https://doi.org/10.1007/s00415-019-09413-x
Kern F, Winter C, Gall D, Käthner I, Pauli P, Latoschik ME, (2019, March). Immersive virtual reality and gamification within procedurally generated environments to increase motivation during gait rehabilitation. In 2019 IEEE Conference on Virtual Reality and 3D User Interfaces (VR) (pp. 500–509). IEEE
Kim M, Jeon C, Kim J (2017) A study on immersion and presence of a portable hand haptic system for immersive virtual reality. Sensors 17(5):1141. https://doi.org/10.3390/s17051141
Kwakkel G et al (2004) Effects of augmented exercise therapy time after stroke: a metaanalysis. Stroke 35(11):2529–2539. https://doi.org/10.1161/01.STR.0000143153.76460.7d
Lamers I (2016) Anneleen Maris, Deborah Severijns, Wouter Dielkens, Sander Geurts, Bart van Wijmeersch, and Peter Feys. "upper limb rehabilitation in people with multiple sclerosis: a systematic review.". Neurorehabil Neural Repair 30(8):773–793
Lang B (2013) Road to VR. https://www.roadtovr.com/mixed-reality-pianotrainer-makes-learning-piano-easy/
Latimer-Cheung AE et al (2013) Effects of exercise training on fitness, mobility, fatigue, and health-related quality of life among adults with multiple sclerosis: a systematic review to inform guideline development. Arch Phys Med Rehabil:1800–1828.e3. https://doi.org/10.1016/j.apmr.2013.04.020
Lau HM et al (2017) Serious games for mental health: are they accessible, feasible, and effective? A systematic review and meta-analysis. Front Psych. https://doi.org/10.3389/fpsyt.2016.00209
Laver KE et al (2017) Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD008349.pub4
Lohse K et al (2013) Video games and rehabilitation: using design principles to enhance engagement in physical therapy. https://doi.org/10.1097/NPT.0000000000000017
Magill RA (2001) Motor learning as a function of KR schedule and characteristics of task-intrinsic feedback the effects of erroneous information on performance and learning view project. https://doi.org/10.1080/00222890109601903
Magill RA, Anderson DI (2014) Motor learning and control concepts and applications. Accessed Jun 24, 2020, from www.mhhe.com
Mantovani E, Zucchella C, Bottiroli S, Federico A, Giugno R, Sandrini G, Chiamulera C, Tamburin S (2020) Telemedicine and virtual reality for cognitive rehabilitation: a roadmap for the COVID-19 pandemic. Front Neurol 11:926
Mcnevin NH et al (2011) An examination of feedback use in rehabilitation settings supra-postural task constraints on optimizing postural control view project the effects of erroneous information on performance and learning view project an examination of feedback use in rehabilitation settings. Critical Rev Phys Rehabilitation Med 23(4):147–160. https://doi.org/10.1615/CritRevPhysRehabilMed.v23.i1-4.110
Mousavi Hondori H, Khademi M (2014) A review on technical and clinical impact of microsoft kinect on physical therapy and rehabilitation. J Med Eng 2014
MS: the facts (2020) Accessed Jun 24, 2020, from https://www.mstrust.org.uk/about-ms/what-ms/msfacts
Müri R et al (2015) Mult Scler-2015-Kamm multiple sclerosis Msj Journal. https://doi.org/10.1177/1352458514565959
National Multiple Sclerosis Society (2020) Types of MS, New York. Accessed Jun 15, 2020, from http://www.nationalmssociety.org/What-is-MS/Types-of-MS
Neale H, Nichols S (2001) Theme-based content analysis: a flexible method for virtual environment evaluation. Int J Human Comp Stud 55(2):167–189. https://doi.org/10.1006/ijhc.2001.0475
Nielsen J (2005) Ten usability heuristics. Accessed July 4, 2020, from http://www.useit.com/papers/heuristic/heuristic_list.html
Olsson T, Alfredsson L (2017) Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis individual-participant data meta-analysis in working populations view project multiple sclerosis research view project. https://doi.org/10.1038/nrneurol.2016.187
Ozkul C, Guclu-Gunduz A, Yazici G, Guzel NA, Irkec C (2020) Effect of immersive virtual reality on balance, mobility, and fatigue in patients with multiple sclerosis: a single-blinded randomized controlled trial. Eur J Integr Med 35:101092
Parker J et al (2014) Stroke patients’ utilisation of extrinsic feedback from computerbased technology in the home: a multiple case study realistic evaluation. BMC Med Inform Decis Mak 14(1):46. https://doi.org/10.1186/14726947-14-46
Peretti A, Amenta F, Tayebati SK, Nittari G, Mahdi SS (2017) Telerehabilitation: review of the state-of-the-art and areas of application. JMIR Rehabilitation and Assistive Technologies 4(2):e7
Platz T et al (2001) Arm ability training for stroke and traumatic brain injury patients with mild arm paresis: a single-blind, randomized, controlled trial. Arch Phys Med Rehabil 82(7):961–968. https://doi.org/10.1053/apmr.2001.23982
Polygerinos P et al (2015) Soft robotic glove for hand rehabilitation and task specific training
Rohrig M (2018) A resource for healthcare professionals physical therapy in multiple sclerosis
Rose T et al (2018) Immersion of virtual reality for rehabilitation–review. https://doi.org/10.1016/j.apergo.2018.01.009
Saunders W (2015) Effectiveness, usability, and cost-benefit of a virtual reality-based telerehabilitation program for balance recovery after stroke: a randomized controlled trial. Arch Phys Med Rehabil 96(3):418–425. https://doi.org/10.1016/j.apmr.2014.10.019
Schneider EJ et al (2016) Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review. J Physiother 62(4):182–187. https://doi.org/10.1016/j.jphys.2016.08.006
Sigrist R et al (2013) Augmented visual, auditory, haptic, and multimodal feedback in motor learning: a review. Psychon Bull Rev:21–53. https://doi.org/10.3758/s13423-012-0333-8
Slater M (2018) Immersion and the illusion of presence in virtual reality. Br J Psychol 109(3):431–433
Slater M, Wilbur S (1997) A framework for immersive virtual environments (FIVE): Speculations on the role of presence in virtual environments. Accessed Jun 24, 200, from http://www.cs.ucl.ac.uk/staff/M.Slater
Soomal HK et al (2020) Enabling more accessible MS rehabilitation training using virtual reality, pp 95–114. https://doi.org/10.1007/978-3-030-43961-3_5
Standen PJ et al (2015) Patients’ use of a home-based virtual reality system to provide rehabilitation of the upper limb following stroke. Phys Ther 95(3):350–359. https://doi.org/10.2522/ptj.20130564
Sulimanov L, Olano M (2019) Virtual reality Mirror therapy rehabilitation for post-stroke patients. https://doi.org/10.1145/3306214
Systems HM (2005) Guitar Hero
Tao G et al (2013) Evaluation of Kinect skeletal tracking in a virtual reality rehabilitation system for upper limb hemiparesis. https://doi.org/10.1109/ICVR.2013.6662084
Van Vliet PM, Wulf G (2006) Extrinsic feedback for motor learning after stroke: what is the evidence? https://doi.org/10.1080/09638280500534937
Webster A, Poyade M, Rea P, Paul L (2019) The co-design of hand rehabilitation exercises for multiple sclerosis using hand tracking system. In: Biomedical Visualisation. Springer, Cham, pp 83–96
Witmer BG, Singer MJ (1998) Measuring presence in virtual environments: a presence questionnaire., Presence
Zhou H, Hu H (2007) Human motion tracking for rehabilitation-a survey. https://doi.org/10.1016/j.bspc.2007.09.001
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Hollywood, RA., Poyade, M., Paul, L., Webster, A. (2022). Proof of Concept for the Use of Immersive Virtual Reality in Upper Limb Rehabilitation of Multiple Sclerosis Patients. In: Rea, P.M. (eds) Biomedical Visualisation. Advances in Experimental Medicine and Biology, vol 1356. Springer, Cham. https://doi.org/10.1007/978-3-030-87779-8_4
Download citation
DOI: https://doi.org/10.1007/978-3-030-87779-8_4
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-87778-1
Online ISBN: 978-3-030-87779-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)