Virtual Reality and Upper Limb Function Following TBI in Children

wafflejourneyΤεχνίτη Νοημοσύνη και Ρομποτική

14 Νοε 2013 (πριν από 3 χρόνια και 9 μήνες)

71 εμφανίσεις

Virtual Reality and Upper Limb Function Following
TBI in Children


An investigation of the clinical utility of virtual reality technology to improve the
upper limb function of children with traumatic brain injury


Chief Investigator:
Ms Jane Galvin, Melind
a Randall

Lead Organisation:

Murdoch Childrens Research Institute

TAC Neurotrauma Funding
:

$
162,388


Project Start Date:
5 May 2008

Background:

Virtual reality (VR) as an intervention for motor and cognitive rehabilitation is a
relatively new area of prac
tice. Studies with adults who have sustained strokes or
traumatic brain injuries have suggested that practice within a virtual environment may
lead to improvements in upper limb function.VR is a promising area for paediatric
rehabilitation as it meets the
intervention requirements of being motivating and
engaging, while providing an opportunity for practice and repetition. Despite the
potential benefits, there is currently a lack of information that specifically addresses
children’s motor and functional ou
tcomes following VR interventions in
rehabilitation.


The use of new technologies, such as VR, in paediatric rehabilitation is frequently
reported in the popular media as facilitating and promoting recovery of motor skills.
A clinical decision to incorpo
rate the use of VR in mainstream practice requires
empirical evidence of effectiveness that addresses the potential of the technology, but
which scientifically evaluates whether it offers advantages in comparison to other
therapies.


Aims:

This project ai
med to determine whether VR is clinically useful for improving upper
limb skills in children who have sustained a traumatic brain injury.


Objectives:

1.

To establish clinical practice guidelines for the use of VR
-
based therapy for
children with TBI.

2.

To dete
rmine or identify appropriate outcome measures that are sensitive to
detecting clinically significant change in children’s upper limb function
following VR intervention

3.

To carry out a pilot study on the implementation and effectiveness of VR
therapy in up
per limb rehabilitation of children with TBI.

4.

To determine whether engagement in VR results in improved upper limb
function.


Methods:

A comprehensive literature review and critique was carried out. This information
provided a basis to develop clinical pr
otocols that were implemented in a pilot
intervention trial. The pilot intervention trial recruited children who had sustained
traumatic brain injuries and who presented with motor impairments in one or both
upper limbs. Children were aged between 6 and
15 years and participated in VR
based therapy two times per week for six weeks.


Results:

There is currently little research to support the use of VR for children with acquired
neurological disabilities. This study has provided support for children’s abil
ity to be
engaged and motivated by VR and has shown the feasibility of VR within a
rehabilitation setting. Children demonstrated improvement in upper limb function,
and
made gains in self
-
chosen goals.


Conclusions:

We believe that VR is a clinically appl
icable tool for rehabilitation based on
children’s ability to access the system, engagement with the games and set up, and
ability to remain engaged over the time of the intervention. Children showed changes
in their ability to complete self care tasks, an
d in self identified goals. Further studies
that compare the efficacy of VR to traditional therapies for improving upper limb
function are warranted.


Publications:


DAVIS, GALVIN J, SOO. Reliability of the Assisting Hand Assessment (AHA) for children and
youth
with ABI. Brain Impairment. 2010:11(2): 113
-
124.


LEVAC, GALVIN. A comparative analysis of virtual reality systems within ABI motor rehabilitation:
Development of a treatment model. Brain Injury. 2010: 24(3): 160
-
161


GALVIN J, HEWISH S, RICE J, MACK
AY MT. Functional outcome following paediatric stroke.
Developmental Neurorehabilitation. 2011;14(2):67
-
71.


GALVIN J, MCDONALD R, CATROPPA C, ANDERSON V. Does intervention using virtual reality
improve upper limb function in children with neurological imp
airment: A systematic review of the
evidence. Brain Injury. 2011;25(5):435
-
442.


LEVAC DE, GALVIN J. Facilitating clinical decision
-
making about the use of virtual reality within
paediatric motor rehabilitation: Application of a classification framework. D
evelopmental
Neuro
r
ehabilitation. 2011;14(3):177
-
184.


GALVIN J, ANDERSON, MCDONALD, CATROPPA. Does intervention using virtual reality
improve upper limb function in children with neurological impairment: A systematic review of the
evidence. Australian Occ
upational Therapy Journal. 2011: 58(Supplement 1): 96
-
97.


GALVIN, ANDERSON, MCDONALD, CATROPPA. Preliminary results for a controlled trial of
virtual reality in motor rehabilitation following paediatric TBI. Australian Occupational Therapy
Journal. 2011:5
8(Supplement 1): 98.


GALVIN, LEVAC. Describing and classifying virtual reality systems for use in paediatric motor
rehabilitation. Australian Occupational Therapy Journal. 2011:58(Supplement 1):137.


GALVIN J, LEVAC DE. Facilitating clinical decision
-
maki
ng about the use of virtual reality within
paediatric motor rehabilitation: Describing and classifying virtual reality systems. Developmental
Neurorehabilitation. 2011;14(2):112
-
122.


Presentations:


GALVIN J, RANDALL M. Virtual reality in upper limb rehab
ilitation following paediatric TBI. OT
Australia National Conference & Exhibition; 2008 September 11
-
13; Melbourne, Australia.


GALVIN J, ANDERSON V, MCDONALD R, CATROPPA C. Virtual Reality and Paediatric TBI:
Pilot and possibilities. 6th Satellite Symposi
um on Neuropsychological Rehabilitation; 2009 August 3
-
4, Tallinn, Estonia.


LEVAC D, GALVIN J. A comparative analysis of virtual reality systems within motor rehabilitation
for children and youth with acquired brain injury: Development of a treatment mode
l. International
Brain Injury Association 8th World Conference; 2010 March 10
-
14, Washington, USA.


FRENCH S, GALVIN J, McDONALD R. A pilot study investigating the reliability and potential of
virtual reality for use in therapy. Rehabilitation 2010: Mind a
nd Body Conference; 2010 October 6
-
8,
Melbourne, Australia.


GALVIN J, LEVAC DE. Describing and classifying virtual reality systems for use in paediatric motor
rehabilitation. Occupational Therapy Australia, National Conference; 2011 June 29
-
31, Gold Coast
,
Australia.


GALVIN J, ANDERSON V, MCDONALD R, CATROPPA C. Does intervention using virtual reality
improve upper limb function in children with neurological impairment: A systematic review of the
evidence. Occupational Therapy Australia, National Conferen
ce; 2011 June 29
-
31, Gold Coast,
Australia.


GALVIN J, ANDERSON V, MCDONALD R, CATROPPA C. Preliminary results for a controlled
trial of virtual reality in motor rehabilitation following paediatric TBI. Occupational Therapy Australia,
National Conference;
2011 June 29
-
31, Gold Coast, Australia.


GALVIN J. Virtual Reality in Paediatric Rehabilitation. Innovations in Paediatric Neuropsychology:
Paediatric Satellite Symposium, ASSBI Conference; 2011 July 5 Auckland, New Zealand
.