RehAtt - scanning training for neglect enhanced by multi-sensory stimulation in Virtual Reality.

BACKGROUND: There is a lack of effective treatment for neglect. We have developed a new training method, RehAtt™. The objective of this study was to determine whether RehAtt™ improves spatial attention in chronic neglect after stroke. METHODS: RehAtt™ consists of a computer with monitor, 3D glasses, and a force feedback interface (Robotic pen) giving sensory motor activation to the contra-lesional arm. The software combines visual scanning training with multi-sensory stimulation in 3D virtual reality (VR) game environment. Fifteen stroke patients with chronic neglect (duration > 6 month) had repeated baseline evaluations to confirm stability of symptoms. There were no test-retest effects for any of the tests. Thereafter, all patients trained 15 h in RehAtt™ (3 × 1 h for 5 weeks). A neglect test battery and Catherine Bergego Scale, CBS, were used to assess behavioral outcome after intervention. CBS was also used at a 6-month follow-up. RESULTS: Using repeated measurement analysis improvements due to the training were found for Star cancellation test (p = 0.006), Baking tray task (p < 0.001), and Extinction test (p = 0.05). In the Posner task improvements were seen fewer missed targets (p = 0.024). CBS showed improvements in activities of daily life immediately after training (p < 0.01). After 6 months the patients still reported improvement in CBS. CONCLUSION: RehAtt™ is a new concept for rehabilitation of neglect. Training with the VR-method improved spatial attention and showed transfer to improved spatial attention in activities of daily living in chronic neglect. Our results are promising and merit further studies.

Representing fluid with smoothed particle hydrodynamics in a cranial base simulator.

We describe the implementation of irrigation and blood simulation using Smoothed Particle Hydrodynamics (SPH) in a cranial base surgical simulator. Graphical accuracy of virtual surgery is a significant goal for improving the realism and immersive experience of computerized training environments. For temporal bone micro-surgery fluids contribute not only to the visual integrity of the surgical field but provide relevant anatomic cues as well. The skill of 3-D sensory and navigation has become increasingly viable in surgery with the rising popularity of laparoscopic, catheter angiography and other minimally invasive approaches. The introduction of realistic simulated blood and irrigation enables the practice and coordination of two-handed microdissection techniques and the timing needed for safe bone removal and cautery.

Constraint fluids.

We present a fluid simulation method based on Smoothed Particle Hydrodynamics (SPH) in which incompressibility and boundary conditions are enforced using holonomic kinematic constraints on the density. This formulation enables systematic multiphysics integration in which interactions are modeled via similar constraints between the fluid pseudoparticles and impenetrable surfaces of other bodies. These conditions embody Archimede's principle for solids and thus buoyancy results as a direct consequence. We use a variational time stepping scheme suitable for general constrained multibody systems we call SPOOK. Each step requires the solution of only one Mixed Linear Complementarity Problem (MLCP) with very few inequalities, corresponding to solid boundary conditions. We solve this MLCP with a fast iterative method. Overall stability is vastly improved in comparison to the unconstrained version of SPH, and this allows much larger time steps, and an increase in overall performance by two orders of magnitude. Proof of concept is given for computer graphics applications and interactive simulations.

Hybrid, Multiresolution Wires with Massless Frictional Contacts.

We describe a method for the visual interactive simulation of wires contacting with rigid multibodies. The physical model used is a hybrid combining lumped elements and massless quasistatic representations. The latter is based on a kinematic constraint preserving the total length of the wire along a segmented path which can involve multiple bodies simultaneously and dry frictional contact nodes used for roping, lassoing, and fastening. These nodes provide stick and slide friction along the edges of the contacting geometries. The lumped element resolution is adapted dynamically based on local stability criteria, becoming coarser as the tension increases, and up to the purely kinematic representation. Kinematic segments and contact nodes are added, deleted, and propagated based on contact geometries and dry friction configurations. The method gives a dramatic increase in both performance and robustness because it quickly decimates superfluous nodes without loosing stability, yet adapts to complex configurations with many contacts and high curvature, keeping a fixed, large integration time step. Numerical results demonstrating the performance and stability of the adaptive multiresolution scheme are presented along with an array of representative simulation examples illustrating the versatility of the frictional contact model.