Virtual rehabilitation in an activity centre for community-dwelling persons with stroke. The possibilities of 3-dimensional computer games.

BACKGROUND: The main purpose of this study was to place a virtual reality (VR) system, designed to assess and to promote motor performance in the affected upper extremity in subjects after stroke, in a nonhospital environment. We also wanted to investigate if playing computer games resulted in improved motor function in persons with prior stroke. METHODS: The intervention involved 11 patients after stroke who received extra rehabilitation by training on a computer 3 times a week during a 4-week period. The control group involved 11 patients after stroke who continued their previous rehabilitation (no extra computer training) during this period. The mean age of all was 68 years (range = 47-85) and the average time after stroke 66 months (range = 15-140). The VR training consisted of challenging games, which provided a range of difficulty levels that allow practice to be fun and motivating. An additional group of 11 right-handed aged matched individuals without history of neurological or psychiatric illnesses served as reference subjects. RESULTS: All the participants reported that they were novel computer game players. After an initial introduction they learned to use the VR system quickly. The treatment group demonstrated improvements in motor outcome for the trained upper extremity, but this was not detected in real-life activities. CONCLUSIONS: The results of this research suggest the usefulness of computer games in training motor performance. VR can be used beneficially not only by younger participants but also by older persons to enhance their motor performance after stroke.

Virtual rehabilitation after stroke.

The purpose of this project was to investigate the effects of Virtual Reality technology and haptics for stroke rehabilitation. Twenty-nine stroke subjects, 17 women, and 12 men aged 44-85 years, participated in three different studies. All participants responded favorable to the use of the VR activity station. A change of attitude took place after the subjects were exposed to playing computer games. The general experience with the VR application approach suggests that this treatment concept is promising in stroke rehabilitation, with a wide range of applicability.

Game design in virtual reality systems for stroke rehabilitation.

We propose a model for the structured design of games for post-stroke rehabilitation. The model is based on experiences with game development for a haptic and stereo vision immersive workbench intended for daily use in stroke patients' homes. A central component of this rehabilitation system is a library of games that are simultaneously entertaining for the patient and beneficial for rehabilitation [1], and where each game is designed for specific training tasks through the use of the model.

Alcohol consumption, the metabolic syndrome and insulin resistance in 58-year-old clinically healthy men (AIR study).

It has been shown that a light-to-moderate intake of alcohol may enhance insulin sensitivity; a decrease in insulin sensitivity is a component of the clustering of risk factors known as the metabolic syndrome. However, previous studies have been limited to relatively small or heterogeneous study groups, or have used suboptimal methods of measuring insulin action. Hence the aim of the present study was to examine whether the metabolic syndrome (as recently defined),components of this syndrome and smoking are associated with alcohol consumption. The study was performed in a population-based sample of clinically healthy men (n=391), all 58 years old and not undergoing any treatment with cardiovascular drugs. Insulin-mediated glucose uptake (euglycaemic hyperinsulinaemic clamp) was measured in a subgroup of these subjects (n=104). Trend analysis showed no difference in alcohol intake across the groups of men with none of the criteria in the definition of the metabolic syndrome (n=77),men with one or more of the criteria (n=252) and men fulfilling all criteria (n=62). However, in the whole group (n=391), alcohol consumption was significantly positively associated with serum triacylglycerols (triglycerides), high-density lipoprotein (HDL) cholesterol and cigarette-years. Furthermore, alcohol consumption was positively associated with insulin-mediated glucose uptake (r=0.20, P<0.05). In multiple regression analyses, body mass index, alcohol consumption and serum triacylglycerols were independent co-variates to insulin-mediated glucose uptake. Thus, in 58-year-old healthy men recruited from the general population, there was a significant association between alcohol consumption, serum triacylglycerols, HDL cholesterol and cigarette-years. In a subgroup of 104 subjects, alcohol consumption was independently and positively associated with insulin-mediated glucose uptake. To our knowledge, this is the first study to show an independent relationship between insulin sensitivity, as measured by the clamp technique, and alcohol intake.