Virtual body representation for rehabilitation influences on motor performance of cerebral palsy children
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ORIGINAL ARTICLE
Virtual body representation for rehabilitation influences on motor performance of cerebral palsy children Nadia Garcia‑Hernandez1,2 · Miguel Guzman‑Alvarado1 · Vicente Parra‑Vega1 Received: 17 January 2020 / Accepted: 13 October 2020 © Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract Game-based virtual reality systems have been shown to enhance motor function, motivation and therapy adherence in cerebral palsy (CP) children. In these systems, several types of virtual body representations have been implemented, however without conclusive support of guidelines nor the most appropriate choice for enhancing motor performance. Thus, the purpose of this study is to examine how the subjective experience of seeing and controlling a half-body avatar, or an abstract hand representation in a moderate immersion virtual environment (VE), for training upper limb movements may affect CP children’s motor performance. To achieve that purpose, a game-like VE for training the reaching-releasing of objects was designed. Unlike previous studies, relevant task performance and cost function metrics were obtained from the analysis of kinematic and kinetic parameters of movement. Results show that visualizing the hand movement through an abstract object makes children perform faster, correct less to produce smoother movements, and use less mechanical energy than visualizing the arm movement through a realistic Avatar. These effects were more noticeable in the reaching than in the releasing phase of the task. Based on these findings, some recommendations are provided for the effective design and use of VE’s for upper limb rehabilitation of CP children. Keywords Virtual body representation · Virtual environments · Cerebral palsy · Movement analysis · Rehabilitation
1 Introduction Cerebral Palsy is a permanent and non-progressive group of neurological disorders that appear in the developing fetal or neonatal brain (Ajami and Maghsodlorad 2015). It affects 2 to 3 out of every 1000 live births with motor disabilities in childhood. To provoke changes at neuronal level that produce improvements in motor function, CP children need intensive, task-oriented and long-lasting training (Tinderholt Myrhaug et al. 2014). For this to happen, the voluntary and active participation of the child are necessary, which are difficult to maintain due to the long and repetitive nature of the treatment. Therefore, the current trend is to develop alternative solutions or strategies for children to perform * Nadia Garcia‑Hernandez [email protected] 1
Robotics and Advanced Manufacturing Department, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Saltillo, Mexico
National Council of Science and Technology (CONACYT), Mexico City, Mexico
2
their therapeutic motor training in a safe and challenging way, maintaining children’s motivation and experimental control over the delivery of stimuli. One such strategy is the use of game-based training environments that are att
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