Virtual reality interface devices in the reorganization of neural networks in the brain of patients with neurological diseases

Abstract

Two key characteristics of all virtual reality applications are interaction and immersion. Systemic interaction is achieved through a variety of multisensory channels (hearing, sight, touch, and smell), permitting the user to interact with the virtual world in real time. Immersion is the degree to which a person can feel wrapped in the virtual world through a defined interface. Virtual reality interface devices such as the Nintendo® Wii and its peripheral nunchuks-balance board, head mounted displays and joystick allow interaction and immersion in unreal environments created from computer software. Virtual environments are highly interactive, generating great activation of visual, vestibular and proprioceptive systems during the execution of a video game. In addition, they are entertaining and safe for the user. Recently, incorporating therapeutic purposes in virtual reality interface devices has allowed them to be used for the rehabilitation of neurological patients, e.g., balance training in older adults and dynamic stability in healthy participants. The improvements observed in neurological diseases (chronic stroke and cerebral palsy) have been shown by changes in the reorganization of neural networks in patients' brain, along with better hand function and other skills, contributing to their quality of life. The data generated by such studies could substantially contribute to physical rehabilitation strategies.

Keywords: aged; cerebral palsy; nerve regeneration; neural regeneration; nintendo wii balance board; postural balance; rehabilitation; review; stroke; virtual environment; virtual reality; virtual reality exposure therapy.

Figure 1

Structure of a virtual reality device. The participant is located in real time inside the virtual simulation; this requires a visual interface that functions as an output, in addition to an interface for interaction with the virtual environment like a joystick or balance board (input device), and finally a tracking device. ID: Input device; OD: output device (Designed and Produced by Guillermo Andrés Méndez-Rebolledo).

Figure 2

Virtual reality devices used in rehabilitation and training. (A) Visual feedback presented at the computer display is regulated from the electroencephalogram, for patients with Attention Deficit Hyperactivity Disorder, (B) Nintendo® Wii Fit and Nintendo Balance Board, (C) Haptic Glove, which provides haptic stimulus, (D) Cave Automatic Virtual Environment, virtual reality device used for high-immersion dynamic posture training (Designed and Produced by Guillermo Andrés Méndez-Rebolledo).