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The clinical effectiveness of virtual reality rehabilitation is getting more and more interest from the scientific world at international level, as evidenced by the increasing number of Publications:

Inserm Publications IAU Virtualis VR Laboratory

Anaïs Odin, Dominique Faletto-Passy, Franck Assaban, Dominic Pérennou

Internal models of verticality: neuromodulation by suspended walking and tilted virtual reality immersion? -

The search for techniques to modulate the sense of verticality is an important challenge for the rehabilitation of balance disorders associated with lateropulsion or retropulsion (stroke, Parkinson's, etc.). In this pilot study in healthy subjects, we tested two techniques likely to modulate the sense of verticality: immersion in a tilted virtual room (visual information) and suspended walking (somesthetic information).

David Morales Tejera 1,2,*, Hector Beltran-Alacreu 3,4 , Roberto Cano-de-la-Cuerda 5 , Jose Vicente Leon Hernández 3,6 , Aitor Martín-Pintado-Zugasti 2 , César Calvo-Lobo 7 , Alfonso Gil-Martínez 4,8 and Josué Fernández-Carnero

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Active Cervical Range of Movement
To assess the active cervical range of movement (CROM) the CROM device (Performance Attainment Associates, Lindstrom, MN, USA) was used, which is composed of two goniometers that allow measuring the range of motion in the different planes of movement [39]. Each movement is recorded three times with a pause in between, and the average of the three is used for the statistical analysis [40].

Deborah Jacob, Ingunn S. Unnsteinsdóttir Kristensen, Romain Aubonnet, Marco Recenti, Leandro Donisi, Carlo Ricciardi, Halldór Á. R. Svansson, Sólveig Agnarsdóttir, Andrea Colacino, María K. Jónsdóttir, Hafrún Kristjánsdóttir, Helga Á. Sigurjónsdóttir, Mario Cesarelli, Lára Ósk Eggertsdóttir Claessen, Mahmoud Hassan, Hannes Petersen & PaoloGargiulo

Towards defining biomarkers to evaluate concussions using virtual reality and a moving platform (BioVRSea)

Current diagnosis of concussion relies on self-reported symptoms and medical records rather than objective biomarkers. This work uses a novel measurement setup called BioVRSea to quantify concussion status. The paradigm is based on brain and muscle signals (EEG, EMG), heart rate and center of pressure (CoP) measurements during a postural control task triggered by a moving platform and a virtual reality environment. Measurements were performed on 54 professional athletes who self-reported their history of concussion or...

Simon A. Stehle, Romain Aubonnet, Mahmoud Hassan, Marco Recenti, Deborah Jacob, Hannes Petersen and Paolo Gargiulo

Predicting postural control adaptation measuring EEG, EMG, and center of pressure changes: BioVRSea paradigm

Introduction: Postural control is a sensorimotor mechanism that can reveal neurophysiological disorder. The present work studies the quantitative response to a complex postural control task.
Methods: We measure electroencephalography (EEG), electromyography (EMG), and center of pressure (CoP) signals during a virtual reality (VR) experience called BioVRSea with the aim of classifying different postural control responses. The BioVRSea paradigm is based on six different phases where motion and visual stimulation are modulated throughout the experiment, inducing subjects to a different adaptive postural control strategy. The goal of the study is to assess ...

Arthur Petel, Deborah Jacob, Romain Aubonnet, Solène Frismand, Hannes Petersen, Paolo Gargiulo, Philippe Perrin

Motion sickness susceptibility and visually induced motion sickness as diagnostic signs in Parkinson's disease (2022)

Postural instability and loss of vestibular and somatosensory acuity are among the signs encountered in Parkinson's disease (PD). Visual dependency is described in PD. These modifications of sensory input hierarchy are predictors of motion sickness (MS). The aim of this study was to assess MS susceptibility and the effects of real induced MS in posture. Sixtythree PD patients, whose medication levels (levodopa) reflected the severity of the pathology were evaluated, and 27 healthy controls, filled a MS questionnaire; 11 PD patients and 41 healthy controls were assessed by posturography using virtual reality...

R. Aubonnet, A. Shoykhet, D. Jacob, G. Di. Lorenzo, H. Petersen and P. Gargiulo

Postural control paradigm (BioVRSea): towards a neurophysiological signature (2022)

Objective. To define a new neurophysiological signaturefrom electroencephalography (EEG) during a complex postural control task using the BioVRSea paradigm, consisting of virtual reality (VR) and amoving platform, mimicking the behavior of a boat on the sea.Approach. EEG(64 electrodes) datafrom 190 healthy subjectswere acquired. The experiment is composed of 6 segments(Baseline, PRE, 25%, 50%, 75%, POST). The baseline lasts 60 s while standing on the motionless platformwith amountain view in the VR goggles...

French Health Authority

Rehabilitation in the chronic phase of adult stroke: relevance, indications and modalities

Stroke rehabilitation is defined as the application of manual or instrumental therapeutic methods aimed at the secondary prevention, preservation, restoration, optimization or replacement of motor function disorders following an established stroke. Other methods use specific computer or electromechanical technologies, such as virtual reality, treadmill walking, etc.

Umile Giuseppe Longo, Arianna Carnevale, Flavia Andreoli, Ilaria Mannocchi, Marco Bravi, Mohamed Saifeddine Hadj Sassi, Fabio Santacaterina, Marco Carli, Emiliano Schena & Rocco Papalia

Immersive virtual reality for shoulder rehabilitation: evaluation of a physical therapy program executed with oculus quest 2

Virtual Reality (VR) systems have been increasingly used across several medical fields. A crucial preliminary step for developing optimized VR-based applications for rehabilitation purposes is identifying potential interventions to meet the requirements necessary to satisfy end-users' needs. This study aims to assess the acceptability, usability, and appropriateness of a VR physical therapy program executed with Oculus Quest 2 by expert physiotherapists of shoulder musculoskeletal rehabilitation.

Hamid Bateni ,1 Jenna Carruthers ,1 Rebecca Mohan ,1 and Seyedamirhossein Pishva 2

Use of Virtual Reality in Physical Therapy as an Intervention and Diagnostic Tool

Within the past decade, the integration of computer-generated virtual realities (VRs) has witnessed a significant rise in the field of healthcare, particularly in diagnosis and treatment applications. These VR systems have found extensive use in physical therapy, rehabilitation, research, and assessment. This narrative review article is aimed at providing a comprehensive overview of the literature regarding the implementation of VR in the physical therapy profession. The primary objective of this review is to provide information to clinicians about the diverse applications of VR and its potential advantages in intervening across various patient populations and diagnoses during rehabilitation therapy. Through in-depth discussions with experts and a thorough review of pertinent literature, several significant aspects of the topic were identified. Subsequently, we carried out an online search to investigate the prevalent utilization of VR systems within healthcare, both as assessment tools and for therapeutic interventions. Our examination encompassed a total of 56 articles, with supplementary references incorporated as required.

David Morales Tejera, Hector Beltran-Alacreu, Roberto Cano-de-la-Cuerda, Jose Vicente Leon Hernández, Aitor Martín-Pintado-Zugasti, César Calvo-Lobo, Alfonso Gil-Martínez and Josué Fernández-Carnero

Effects of Virtual Reality versus Exercise on Pain, Functional, Somatosensory and Psychosocial Outcomes in Patients with Non-specific Chronic Neck Pain: A Randomized Clinical Trial

Virtual reality (VR) applied to patients with neck pain is a promising intervention to produce positive effects when used alone or combined with exercise. Therefore, the objective of this manuscript is to compare the effects of VR versus exercise treatment on pain intensity, conditioned pain modulation (CPM), temporal summation (TS) and functional and somatosensory outcomes in patients with non-specific chronic neck pain (NS-CNP).

Recenti M, Ricciardi C, Aubonnet R, Picone I, Jacob D, Svansson HÁR, Agnarsdóttir S, Karlsson GH, Baeringsdóttir V, Petersen H and Gargiulo P (2021)

Toward Predicting Motion Sickness Using Virtual Reality and a Moving Platform Assessing Brain, Muscles, and Heart Signals. Front. Bioeng. Biotechnol. 9:635661. doi: 10.3389/fbioe.2021.635661

Many theories explaining a probable cause for MS have been proposed but the most prominent is the sensory conflict theory, stating that a mismatch between vestibular and visual signals causes MS. Few measurements have been made to understand and quantify the interplay between muscle activation, brain activity, and heart behavior during this condition. We introduce here a novel multimetric system called BioVRSea based on virtual reality (VR), a mechanical platform and several biomedical sensors to study the physiology associated with MS and seasickness...

Matthew William Wittstein, BSc, MSc, PhD, Anthony Crider, PhD, [...], and Mariana Guerena Gonzalez, BSc

Use of Virtual Reality to Assess Dynamic Posturography and Sensory Organization: Instrument Validation Study. JMIR Serious Games, 2020 Oct-Dec; 8(4): e19580

Conclusion: This research demonstrated the plausibility of using VR as an alternative method to conduct the SOT. Ongoing development and testing of virtual environments are necessary before employing the technology as a replacement to current clinical tests.

Y. Libois, A. De Beer, M. Ghislain, M. Grimée, A. Libois and F. Assaban,

La Réalité Virtuelle, outil de réactivation de la neuroplasticité dans l'hémiplégie chronique ", Revue Neurologique, 175, S1, pages S75-S76 (2019).

Pavlou M, Kanegaonkar RG, Swapp D, Bamiou DE, Slater M, Luxon LM.

The effect of virtual reality on visual vertigo symptoms in patients with peripheral vestibular dysfunction: a pilot study. J Vestib Res. 2012;22(5-6):273-281

Pavlou M, Bronstein AM, Davies RA.

Randomized trial of supervised versus unsupervised optokinetic exercise in persons with peripheral vestibular disorders. Neurorehabil Neural Repair. 2013;27(3):208-218.

Pavlou M, Bronstein AM, Davies RA.

Randomized trial of supervised versus unsupervised optokinetic exercise in persons with peripheral vestibular disorders. Neurorehabil Neural Repair. 2013;27(3):208-218.

Lauber B, Keller M.

Improving motor performance: selected aspects of augmented feedback in exercise and health. Eur J SportSci. 2014 ;14 :36-43.

Feng H, Li C, Liu J, et al.

Virtual Reality Rehabilitation Versus Conventional Physical Therapy for Improving Balance and Gait in Parkinson's Disease Patients:

A Randomized Controlled Trial. Med Sci Monit. 2019;25:4186-4192.

Bohil CJ, Alicea B, Biocca FA.

Virtual reality in neuroscience research and therapy. Nat Rev Neurosci. 2011;12(12):752–762.

Hoffman, H. G., Richards, T. L., Coda, B., Bills, A. R., Blough, D., Richards, A. L., and Shararar, S. R. (2004).

Modulation of thermal pain-related brain activity with virtual reality:

evidence from fMRI. Neuroreport, 15(8), 1245-1248.

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