Virtual Reality Rehabilitation Based on Neurologic Music Therapy: A Qualitative Preliminary Clinical Study

Conference paper
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10925)


Neurological disorders, as stroke, and their consequences are a leading cause of death and disability around the world and most of the survivors experience mainly chronic motor deficits associated with reduced social and personal quality of life. Thus, there is a need to identify the best training strategy for the retraining of motor function of the UL.

In this paper, we describe a novel, therapeutic VR system combining Presence Positive Technologies for Well-being and techniques of Neurologic Music Therapy (NMT), for a more efficient retraining of the motor function of the UL of a stroke suffered patients. For the adequate movements that constitute the training exercises, a team of doctors of KAT hospital in Athens, Greece, aided us in our clinical study. The main objective of the described method is to use the Virtual Environment (VE) with natural hand tracking as the main training platform, providing a proper sensory stimulus to the process of motor control retraining. This innovative enhancement of VE rehabilitation with NMT techniques, which are based on triggering music perception and production areas in the human brain, provides a new, more effective solution to stroke patients, presenting an upper limb hemiparesis, in order to improve the fine movements of their paretic hand and support self-efficacy. We observed in our qualitative clinical study that this system has helped patients to improve their kinetic performance, in a faster, more efficient and motivating manner, encouraging them to understand mainly the mechanism of motor action and providing them with better feedback, motivational enhancement and social reward. This constitutes a holistic approach, concurrently satisfying both their multidimensional cognitive and movement needs.


Human-computer interaction Virtual Reality Neurologic music therapy Physical rehabilitation medicine Neurological disorders Stroke Self-efficacy 


  1. 1.
    Alankus, G., Lazar. A., May, M., Kelleher, C.: Towards customizable games for stroke rehabilitation. In: Proceedings of 28th International Conference on Human Factors Computing System - CHI 2010, p. 2113. ACM Press, New York (2010)Google Scholar
  2. 2.
    Argento, E., Papagiannakis, G., Baka, E., Maniadakis, M., Trahanias, P.: Augmented cognition via brain entrainment in virtual reality: an open integrated human augmentation system approach. Augment. Hum. Res. 2, 3 (2017)CrossRefGoogle Scholar
  3. 3.
    Barcala, L., Grecco, L.A., Colella, F., et al.: Visual biofeedback balance training using Wii fit after stroke: a randomized controlled trial. J. Phys. Ther. Sci. 25, 1027–1032 (2013)CrossRefGoogle Scholar
  4. 4.
    Brunner, I., Skouen, J.S., Hofstad, H., Strand, L.I., Becker, F., Sanders, A.M., Pallesen, H., Kristensen, T., Michielsen, M., Verheyden, G.: Virtual reality training for upper extremity in subacute stroke (VIRTUES): study protocol for a randomized controlled multicenter trial. BMC Neurol. 14, 186 (2014)CrossRefGoogle Scholar
  5. 5.
    Cameirāo, M.S., et al.: Neurorehabilitation using the virtual reality-based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation. J. Neuroeng. Rehab. 7, 48 (2010)CrossRefGoogle Scholar
  6. 6.
    Dohle, C., Püllen, J., Nakaten, A., Küst, J., Rietz, C., Karbe, H.: Mirror therapy promotes recovery from severe hemiparesis: a randomizes controlled trial. Neurorehabil. Neural Repair 23, 209–217 (2008)CrossRefGoogle Scholar
  7. 7.
    Ekbia, H.R., Lee, J., Wiley, S.: Rehab games as components of workflow: a case study. Games Health J. 3(4), 215–226 (2014) CrossRefGoogle Scholar
  8. 8.
    Greenleaf, W.J., Tovar, M.A.: Augmenting reality in rehabilitation medicine. Artif. Intell. Med. 6(4), 289–299 (1994)CrossRefGoogle Scholar
  9. 9.
    Hung, Y.-X., Huand, P.-C., Chen, K.-T., Chu, W.-C.: What do stroke patients look for in game-based rehabilitation: a survey study. Medicine 95(11), e3032 (2016)CrossRefGoogle Scholar
  10. 10.
    Jaffe, D.L., Brown, D.A., Pierson-Carey, C.D., Buckley, E.L., Lew, H.L.: Stepping over obstacles to improve walking in individuals with poststroke hemiplegia. J. Rehabil. Res. Dev. 41, 283–292 (2004). Scholar
  11. 11.
    Jung, J., Yu, J., Kang, H.: Effects of virtual reality treadmill training on balance and balance self-efficacy in stroke patients with a history of falling. J. Phys. Ther. Sci. 24, 1133–1136 (2012). Scholar
  12. 12.
    Keshner, E.A.: Virtual reality and physical rehabilitation: a new toy or a new research and rehabilitation tool. J. Neuroeng. Rehab. 1, 8 (2004)CrossRefGoogle Scholar
  13. 13.
    Laver, K.E., George, S., Thomas, S., Deutsch, J.R., Crotty, M.: Virtual reality for stroke rehabilitation. Cochrane Database Syst. Rev. (2) (2015). Art No: CD008349 Google Scholar
  14. 14.
    Mirelman, A., Maidan, I., Herman, T., Deutsch, J.E., Giladi, H.J.M.: Virtual reality for gait training: can it induce motor learning to enhance complex walking and reduce fall risk in patients with Parkinson’s disease? J. Gerontol. A Biol. Sci. Med. Sci. 66A(2), 234–240 (2011)CrossRefGoogle Scholar
  15. 15.
    Piron, L., Turolla, A., Agostini, M., Zucconi, C., Cortese, F., Zampolini, M., Zannini, M., Dam, M., Ventura, L., Battauz, M., Tonin, P.: Exercices for paretic upper limb after stroke: a combined virtual-reality and telemedicine approach. J. Rehabil. Med. 41, 1016–1020 (2009)CrossRefGoogle Scholar
  16. 16.
    Piron, L., Turolla, A., Agostini, M., Zucconi, C.S., Ventura, L., Tonin, P., Dam, M.: Motor learning principles for rehabilitation: a pilot randomized controlled study in poststroke patients. Neurorehabil. Neural Repair 24(6), 501–508 (2010)CrossRefGoogle Scholar
  17. 17.
    Rand, D., Kizony, R., Weiss, P.L.: VR rehabilitation for all: Vivid GX versus Sony PlayStation II EyeToy. In: Proceedings of the 5th International Conference on Disability, Virtual Reality and Associated Technologies, Oxford, UK (2004)Google Scholar
  18. 18.
    Sin, H.H., Lee, G.C.: Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia. Am. J. Phys. Med. Rehabil. 92, 871–880 (2013)CrossRefGoogle Scholar
  19. 19.
    Street, A.J., Magee, W.L., Odell-Miller, H., Bateman, A., Fachner, J.C.: Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage – a feasibility study protocol. Front Hum. Neurosci. 9, 480 (2015)CrossRefGoogle Scholar
  20. 20.
    Strzemecka, J.: Music therapy in stroke rehabilitation. J. Pre-Clin. Clin. Res. 7(1), 23–26 (2013)Google Scholar
  21. 21.
    Subramanian, S.K., Lourenco, C.B., Chilingaryan, G., Sveistrup, H., Lenib, M.F.: Arm motor recovery using a virtual reality intervention in chronic stroke: randomized control trial. Neurorehabil. Neural Repair 27(1), 13–23 (2013)CrossRefGoogle Scholar
  22. 22.
    Vourvopoulos, A., Cardona, J.E.M., Bermudez, I., Badia, S.: Optimizing motor imagery neurofeedback through the use of multimodal virtual reality and motor priming. In: Proceedings of the International Conference of Virtual Rehabilitation, ICVR (2015) Google Scholar
  23. 23.
    Zatorre, R.J., Chen, J.L., Penhune, V.B.: When the brain plays music: auditory-motor interactions in music perception and production. Nat. Rev. 8, 547–558 (2008)CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.MIRALabUniversity of GenevaGenevaSwitzerland
  2. 2.Foundation for Research and TechnologyHeraklion, CreteGreece
  3. 3.Computer Science DepartmentUniversity of CreteHeraklionGreece

Personalised recommendations