Virtual rehabilitation in a school setting: is it feasible for children with cerebral palsy?

PURPOSE: To determine the feasibility of a school-based virtual rehabilitation intervention for children with cerebral palsy. METHODS: A feasibility study was conducted using a mixed method approach. Participants were five children with cerebral palsy who were currently attending a rural school. Each child received an 8-week rehabilitation programme involving an Interactive Virtual Reality Exercise (IREX) system. The IREX was placed in the child's school for the duration of the intervention. Each child's programme was designed by a physiotherapist but supervised by a teacher aide at the school. Feasibility of the intervention was assessed through a questionnaire completed by the child and an interview conducted with the teacher supervisor. RESULTS: The children all rated the IREX intervention as fun, easy to use, and beneficial for their arm. Categories from the supervisor interviews centred on resolving technical issues, the enjoyment of taking part due to the child's progress, and the central role of interacting with the child. Input from the research physiotherapist was critical to the success of the intervention. CONCLUSIONS: The IREX is feasible to implement in a school-based setting supervised by teachers. This provides an option for delivering physiotherapy to children in isolated areas who do not receive on-going therapy. Implication for Rehabilitation Virtual rehabilitation programmes using the IREX are feasible in a school-based setting. The negative impact of technical difficulties is likely to be overcome by the user's enjoyment and rehabilitation benefits gained. Input from a therapist in designing and monitoring the programme is critical.

Virtual reality games for movement rehabilitation in neurological conditions: how do we meet the needs and expectations of the users?

PURPOSE: To review quantitative and qualitative studies that have examined the users' response to virtual reality game-based interventions in people with movement disorders associated with chronic neurological conditions. We aimed to determine key themes that influenced users' enjoyment and engagement in the games and develop suggestions as to how future systems could best address their needs and expectations. KEY MESSAGE AND IMPLICATIONS: There were a limited number of studies that evaluated user opinions. From those found, seven common themes emerged: technology limitations, user control and therapist assistance, the novel physical and cognitive challenge, feedback, social interaction, game purpose and expectations, and the virtual environments. Our key recommendations derived from the review were to avoid technology failure, maintain overt therapeutic principles within the games, encompass progression to promote continuing physical and cognitive challenge, and to provide feedback that is easily and readily associated with success. CONCLUSIONS: While there have been few studies that have evaluated the users' perspective of virtual rehabilitation games, our findings indicate that canvassing these experiences provides valuable information on the needs of the intended users. Incorporating our recommendations may enhance the efficacy of future systems to optimize the rehabilitation benefits of virtual reality games.

Virtual reality games for rehabilitation of people with stroke: perspectives from the users.

PURPOSE. The purpose of this study is to evaluate the feasibility and users' perspectives of a novel virtual reality (VR) game-based rehabilitation intervention for people with stroke. METHOD. Six people with upper limb hemiplegia participated in a 6-week intervention that involved VR games. A series of eight progressively complex games was developed that required participants to navigate a submarine in a virtual ocean environment. Movement of the submarine was directed by forces applied to an arm interface by the affected limb. Outcome measures included assessments of arm function, questionnaires evaluating the intervention and a semi-structured interview concerning the participants' opinion of the intervention. RESULTS. All participants improved their performance on the games, although there were limited changes in clinical measures of arm function. All participants reported that they enjoyed the intervention with a wide range of overall perceptions of the experience of using VR. Three themes emerging from the interview data were: stretching myself, purpose and expectations of the intervention and future improvements. CONCLUSIONS. Participants found that taking part in this pilot study was enjoyable and challenging. Participants' feedback suggested that the games may be motivating and engaging for future users and have provided a basis for further development of the intervention.