Considerations for the future development of virtual technology as a rehabilitation tool

Abstract

BACKGROUND: Virtual environments (VE) are a powerful tool for various forms of rehabilitation. Coupling VE with high-speed networking [Tele-Immersion] that approaches speeds of 100 Gb/sec can greatly expand its influence in rehabilitation. Accordingly, these new networks will permit various peripherals attached to computers on this network to be connected and to act as fast as if connected to a local PC. This innovation may soon allow the development of previously unheard of networked rehabilitation systems. Rapid advances in this technology need to be coupled with an understanding of how human behavior is affected when immersed in the VE. METHODS: This paper will discuss various forms of VE that are currently available for rehabilitation. The characteristic of these new networks and examine how such networks might be used for extending the rehabilitation clinic to remote areas will be explained. In addition, we will present data from an immersive dynamic virtual environment united with motion of a posture platform to record biomechanical and physiological responses to combined visual, vestibular, and proprioceptive inputs. A 6 degree-of-freedom force plate provides measurements of moments exerted on the base of support. Kinematic data from the head, trunk, and lower limb was collected using 3-D video motion analysis. RESULTS: Our data suggest that when there is a confluence of meaningful inputs, neither vision, vestibular, or proprioceptive inputs are suppressed in healthy adults; the postural response is modulated by all existing sensory signals in a non-additive fashion. Individual perception of the sensory structure appears to be a significant component of the response to these protocols and underlies much of the observed response variability. CONCLUSION: The ability to provide new technology for rehabilitation services is emerging as an important option for clinicians and patients. The use of data mining software would help analyze the incoming data to provide both the patient and the therapist with evaluation of the current treatment and modifications needed for future therapies. Quantification of individual perceptual styles in the VE will support development of individualized treatment programs. The virtual environment can be a valuable tool for therapeutic interventions that require adaptation to complex, multimodal environments.

Figure 1

Possible tele-rehabilitation scenario facilitated by high bandwidth networking.

Figure 2

An illustration of the virtual environment image in our laboratory.

Figure 3

Relative angles of the head to trunk (blue), trunk to shank (red) and shank to sled (green) are plotted for a 60 sec period of the trial during sled motion only, scene motion only, and combined sled and scene motion (the same data are plotted against both the sled and the scene).

Figure 4

Overall weighting of the input variables derived from the PCA for 3 subjects. The first 3 bars (blue) represent a subsequent non-overlapping 40 sec time period to sled motion only. The next 3 bars (red) represent non-overlapping 40 sec time periods to scene motion only. The last 6 bars represent non-overlapping 40 sec time periods to both sled (blue) and scene (red) motion. The direction of each bar indicates the relative phase between the response and the input signal.