Lecture 11 - Virtual Reality in Rehabilitation

Question 1

Why use VR in rehabilitation?

Answer 1

Conventional training without VR can be monotonous and boring. The underlying hypothesis is that it provides higher motivation, which results in higher active participation, which in turn leads to better therapeutic outcomes.

Question 2

What is the goal of VR in rehabilitation?

Answer 2

To increase motivation in terms of active participation.

Question 3

List the 3 specific objectives of VR in rehab.

Answer 3

1. Provide a practical training setting
2. Improve feedback and assessment
3. Stronger neurophysiological effects

Question 4

How does VR in rehab seek to provide a practical training setting?

Answer 4

• Enable training of quasi-realistic tasks, e.g. ADL tasks
• Individual and gradual difficulty adjustments to patient
• Intuitive use by context-specific instructions
• Larger variety of different tasks, e.g. challenging/dangerous

Question 5

How does VR seek to provide improved feedback and assessment?

Answer 5

• Inform patient about their efforts (bars, graphs, colours)

- Measured scores inform therapist about rehabilitation status

Question 6

How does VR seek to result in stronger neurophysiological effects?

Answer 6

• Further brain stimulating modalities (vision and sounds)
• Increased cognitive challenge
• Increase of motivation by provision of reward (“game instinct”)

Question 7

Define Virtual Reality.

Answer 7

An advanced form of a human-computer interface that allows the user to ‘interact’ with and become immersed in a computer-generated environment in a naturalistic fashion.

Question 8

How can Virtual Reality be used in the context of rehab?

Answer 8

Virtual environments can be created to assess and rehabilitate cognitive and functional abilities through exposure to stimulated real-world or analog tasks.

Question 9

List 5 different types of VR display types.

Answer 9

1. Visual
2. Tactile
3. Haptic/Kinesthetic
4. Olfactory
5. Acoustic

Question 10

What 4 types of cues are used for depth perception?

Answer 10

1. Static monocular cues (retinal information)
2. Dynamic monocular cues (motion of objects/observer)
3. Binocular cues (movements related to both eyes)
4. Oculomotor cues (muscular activity of the eye)

Question 11

Give 6 examples of static monocular cues for depth perception.

Answer 11

1. Retinal image size
2. Linear perspective
3. Texture gradients
4. Aerial perspective
5. Occlusion
6. Shadows

Question 12

Give 2 examples of dynamic monocular cues for depth perception.

Answer 12

1. Motion parallax (distant objects move slower than close ones)
2. Kinetic depth effects (3D structures can be recognised by motion of 2D patterns)

Question 13

Give an example of a binocular cue for depth perception.

Answer 13

Stereopsis (binocular disparity) - slightly different projections on retinas of the 2 eyes due to the eye’s different lateral (i.e. horizontal) positions on the head

Question 14

Give 2 examples of oculomotor cues for depth perception.

Answer 14

1. Accomodation - change of the lens shape to focus at certain depth due to ciliary muscle activity (most effective in near vision)
2. Convergence - inward movement of both eyes when focusing on close object due to rotational eye muscle activity (most effective in near vision)

Question 15

Describe an example of visual stereodisplay technology.

Answer 15

Head-Mounted Displays (HMD)

• 2 separate images produced by small LCD displays
• inertial head tracking sensors to account for head motion in graphics

Question 16

What is the difference between isometric projection and perspective projection? What about oblique projection?

Answer 16

Isometric - size of object does not change with distance to projection screen
Perspective - size of object is a function of distance to projection screen
Oblique - shape depends on projection angle only

Question 17

What is motivation?

Answer 17

• Forces acting on or within a person to initiate behaviour
• Distinguish extrinsic and intrinsic motivation
• The direction and intensity of one’s effort

Question 18

When is motivation in rehabilitation considered high?

Answer 18

• When the patient is willing to participate at repeating sessions (high compliance)
• When the patient is actively participating to the movement during the session

Question 19

How can games be beneficial to mental activity during rehabilitation?

Answer 19

• Games increase mental activity and therefore neuroplasticity
• Immersive, fast, action video games via feedback strategies increase neuromodulation, neuroplasticity and learning in the adult brain
• Games increase long-term participation and short-term engagement
• Games increase fun and enjoyment; they produce emotions

Question 20

Define emotions.

Answer 20

An emtoin is a psychological state that arises spontaneously rather than through conscious effort and is sometimes accompanied by physiological changes. Emotions can be described by different levels of arousal and valence.

Question 21

Define arousal.

Answer 21

Arousal refers to emotional activation ranging from very excited or energised to very calm or sleepy. It includes emotional responses such as anxiety, fear, nervousness and tension.

Question 22

Define valence.

Answer 22

Valence is a hedonic quality or pleasantness of an affective experience ranging from unpleasant to pleasant.

Question 23

What does Yerkes-Dodson’s Law tells us about the relationship between performance and arousal?

Answer 23

• Performance increases with physiological or mental arousal

- However, when levels of arousal become too high, performance decreases

Question 24

What does learning potential depend on?

Answer 24

1. Skill level of performer

2. Task complexity and environment

Question 25

What 3 features could be used to modulate engagement?

Answer 25

1. Biomechanical stimulus
2. Audiovisual features
3. Task difficulty