The Impact of Virtual and Augmented Reality Technologies on Patient Outcomes in Physical Rehabilitation

Main Article Content

Dr Sana Kamran
Dr Hafiz Muhammad Umer Maqsood

Abstract

BACKGROUND: The adoption of virtual reality (VR) and augmented reality (AR) technologies in physical rehabilitation has been increasing over the past few years. These technologies have the potential to improve patient outcomes by enhancing traditional rehabilitation strategies.


OBJECTIVE: The study aimed to assess the impact of VR/AR technologies on patient outcomes in physical rehabilitation, focusing on physical function, cognitive function, and quality of life.


METHODS: A total of 30 patients undergoing physical rehabilitation at Link Medical Center, Lahore, were divided into two groups: a traditional rehabilitation group and a VR/AR-assisted rehabilitation group. The study utilized a pre-post design to evaluate changes in outcome measures, including the Fugl-Meyer Assessment (FMA), Timed Up and Go (TUG), Mini-Mental State Examination (MMSE), and Short Form (36) Health Survey (SF-36).


RESULTS: In the post-intervention comparison, the VR/AR-assisted group demonstrated significantly improved outcomes in all measures: FMA upper extremity (59.8 ± 9.1, p=0.02), FMA lower extremity (35.7 ± 6.3, p=0.03), TUG (10.1 ± 2.1 seconds, p=0.01), MMSE (28.3 ± 2.6, p=0.05), and SF-36 (74.1 ± 7.8, p=0.01).


CONCLUSION: The results indicate that the incorporation of VR/AR technologies in physical rehabilitation can significantly enhance both physical and cognitive functions and overall quality of life among patients, supporting their adoption in rehabilitation strategies.


KEYWORDS: Physical Rehabilitation, Virtual Reality, Augmented Reality, Patient Outcomes, Quality of Life.

Article Details

How to Cite
Sana Kamran, & Maqsood, H. M. U. (2023). The Impact of Virtual and Augmented Reality Technologies on Patient Outcomes in Physical Rehabilitation. Journal of Health and Rehabilitation Research, 3(1). Retrieved from https://jhrlmc.com/index.php/home/article/view/27
Section
Articles
Author Biographies

Dr Sana Kamran, Physiotherapist

National Hospital, Gujranwala

Dr Hafiz Muhammad Umer Maqsood, Physiotherapist

Healing Hands, Lahore

References

Wenk N, Penalver-Andres J, Buetler KA, Nef T, Müri RM, Marchal-Crespo L. Effect of immersive visualization technologies on cognitive load, motivation, usability, and embodiment. Virtual Real. 2023;27(1):307-31.

Demeco A, Zola L, Frizziero A, Martini C, Palumbo A, Foresti R, et al. Immersive Virtual Reality in Post-Stroke Rehabilitation: A Systematic Review. Sensors (Basel). 2023;23(3).

Truijen S, Abdullahi A, Bijsterbosch D, van Zoest E, Conijn M, Wang Y, et al. Effect of home-based virtual reality training and telerehabilitation on balance in individuals with Parkinson disease, multiple sclerosis, and stroke: a systematic review and meta-analysis. Neurol Sci. 2022;43(5):2995-3006.

Moussa R, Alghazaly A, Althagafi N, Eshky R, Borzangy S. Effectiveness of Virtual Reality and Interactive Simulators on Dental Education Outcomes: Systematic Review. Eur J Dent. 2022;16(1):14-31.

Mishra R, Narayanan MDK, Umana GE, Montemurro N, Chaurasia B, Deora H. Virtual Reality in Neurosurgery: Beyond Neurosurgical Planning. Int J Environ Res Public Health. 2022;19(3).

Mandal P, Ambade R. Surgery Training and Simulation Using Virtual and Augmented Reality for Knee Arthroplasty. Cureus. 2022;14(9):e28823.

Leong SC, Tang YM, Toh FM, Fong KNK. Examining the effectiveness of virtual, augmented, and mixed reality (VAMR) therapy for upper limb recovery and activities of daily living in stroke patients: a systematic review and meta-analysis. J Neuroeng Rehabil. 2022;19(1):93.

Kashif M, Ahmad A, Bandpei MAM, Gilani SA, Hanif A, Iram H. Combined effects of virtual reality techniques and motor imagery on balance, motor function and activities of daily living in patients with Parkinson's disease: a randomized controlled trial. BMC Geriatr. 2022;22(1):381.

Jung C, Wolff G, Wernly B, Bruno RR, Franz M, Schulze PC, et al. Virtual and Augmented Reality in Cardiovascular Care: State-of-the-Art and Future Perspectives. JACC Cardiovasc Imaging. 2022;15(3):519-32.

Everard G, Declerck L, Detrembleur C, Leonard S, Bower G, Dehem S, et al. New technologies promoting active upper limb rehabilitation after stroke: an overview and network meta-analysis. Eur J Phys Rehabil Med. 2022;58(4):530-48.

Errante A, Saviola D, Cantoni M, Iannuzzelli K, Ziccarelli S, Togni F, et al. Effectiveness of action observation therapy based on virtual reality technology in the motor rehabilitation of paretic stroke patients: a randomized clinical trial. BMC Neurol. 2022;22(1):109.

Chen X, Liu F, Lin S, Yu L, Lin R. Effects of Virtual Reality Rehabilitation Training on Cognitive Function and Activities of Daily Living of Patients With Poststroke Cognitive Impairment: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2022;103(7):1422-35.

Chatterjee K, Buchanan A, Cottrell K, Hughes S, Day TW, John NW. Immersive Virtual Reality for the Cognitive Rehabilitation of Stroke Survivors. IEEE Trans Neural Syst Rehabil Eng. 2022;30:719-28.

Bruno RR, Wolff G, Wernly B, Masyuk M, Piayda K, Leaver S, et al. Virtual and augmented reality in critical care medicine: the patient's, clinician's, and researcher's perspective. Crit Care. 2022;26(1):326.

Amparore D, Piramide F, De Cillis S, Verri P, Piana A, Pecoraro A, et al. Robotic partial nephrectomy in 3D virtual reconstructions era: is the paradigm changed? World J Urol. 2022;40(3):659-70.

Zhou Z, Li J, Wang H, Luan Z, Li Y, Peng X. Upper limb rehabilitation system based on virtual reality for breast cancer patients: Development and usability study. PLoS One. 2021;16(12):e0261220.

Zasadzka E, Trzmiel T, Pieczyńska A, Hojan K. Modern Technologies in the Rehabilitation of Patients with Multiple Sclerosis and Their Potential Application in Times of COVID-19. Medicina (Kaunas). 2021;57(6).

Yeung AWK, Tosevska A, Klager E, Eibensteiner F, Laxar D, Stoyanov J, et al. Virtual and Augmented Reality Applications in Medicine: Analysis of the Scientific Literature. J Med Internet Res. 2021;23(2):e25499.

Winter C, Kern F, Gall D, Latoschik ME, Pauli P, Käthner I. Immersive virtual reality during gait rehabilitation increases walking speed and motivation: a usability evaluation with healthy participants and patients with multiple sclerosis and stroke. J Neuroeng Rehabil. 2021;18(1):68.

Schiavina R, Bianchi L, Lodi S, Cercenelli L, Chessa F, Bortolani B, et al. Real-time Augmented Reality Three-dimensional Guided Robotic Radical Prostatectomy: Preliminary Experience and Evaluation of the Impact on Surgical Planning. Eur Urol Focus. 2021;7(6):1260-7.

Lin H, Han K, Ruan B. Effect of Virtual Reality on Functional Ankle Instability Rehabilitation: A Systematic Review. J Healthc Eng. 2021;2021:7363403.

Li R, Zhang Y, Jiang Y, Wang M, Ang WHD, Lau Y. Rehabilitation training based on virtual reality for patients with Parkinson's disease in improving balance, quality of life, activities of daily living, and depressive symptoms: A systematic review and meta-regression analysis. Clin Rehabil. 2021;35(8):1089-102.

Kayabinar B, Alemdaroğlu-Gürbüz İ, Yilmaz Ö. The effects of virtual reality augmented robot-assisted gait training on dual-task performance and functional measures in chronic stroke: a randomized controlled single-blind trial. Eur J Phys Rehabil Med. 2021;57(2):227-37.

Gulick V, Graves D, Ames S, Krishnamani PP. Effect of a Virtual Reality-Enhanced Exercise and Education Intervention on Patient Engagement and Learning in Cardiac Rehabilitation: Randomized Controlled Trial. J Med Internet Res. 2021;23(4):e23882.

Golse N, Petit A, Lewin M, Vibert E, Cotin S. Augmented Reality during Open Liver Surgery Using a Markerless Non-rigid Registration System. J Gastrointest Surg. 2021;25(3):662-71.

Chen YH, Chen CL, Huang YZ, Chen HC, Chen CY, Wu CY, et al. Augmented efficacy of intermittent theta burst stimulation on the virtual reality-based cycling training for upper limb function in patients with stroke: a double-blinded, randomized controlled trial. J Neuroeng Rehabil. 2021;18(1):91.

Tieri G, Morone G, Paolucci S, Iosa M. Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies. Expert Rev Med Devices. 2018;15(2):107-17.

Bergmann J, Krewer C, Bauer P, Koenig A, Riener R, Müller F. Virtual reality to augment robot-assisted gait training in non-ambulatory patients with a subacute stroke: a pilot randomized controlled trial. Eur J Phys Rehabil Med. 2018;54(3):397-407.

Bond S, Laddu DR, Ozemek C, Lavie CJ, Arena R. Exergaming and Virtual Reality for Health: Implications for Cardiac Rehabilitation. Curr Probl Cardiol. 2021;46(3):100472.

Austin PD, Siddall PJ. Virtual reality for the treatment of neuropathic pain in people with spinal cord injuries: A scoping review. J Spinal Cord Med. 2021;44(1):8-18.

Wake N, Nussbaum JE, Elias MI, Nikas CV, Bjurlin MA. 3D Printing, Augmented Reality, and Virtual Reality for the Assessment and Management of Kidney and Prostate Cancer: A Systematic Review. Urology. 2020;143:20-32.

Qian J, McDonough DJ, Gao Z. The Effectiveness of Virtual Reality Exercise on Individual's Physiological, Psychological and Rehabilitative Outcomes: A Systematic Review. Int J Environ Res Public Health. 2020;17(11).

Manuli A, Maggio MG, Latella D, Cannavò A, Balletta T, De Luca R, et al. Can robotic gait rehabilitation plus Virtual Reality affect cognitive and behavioural outcomes in patients with chronic stroke? A randomized controlled trial involving three different protocols. J Stroke Cerebrovasc Dis. 2020;29(8):104994.

Hoffman HG, Boe DA, Rombokas E, Khadra C, LeMay S, Meyer WJ, et al. Virtual reality hand therapy: A new tool for nonopioid analgesia for acute procedural pain, hand rehabilitation, and VR embodiment therapy for phantom limb pain. J Hand Ther. 2020;33(2):254-62.

Saposnik G, Cohen LG, Mamdani M, Pooyania S, Ploughman M, Cheung D, et al. Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial. Lancet Neurol. 2016;15(10):1019-27.

Liao YY, Tseng HY, Lin YJ, Wang CJ, Hsu WC. Using virtual reality-based training to improve cognitive function, instrumental activities of daily living and neural efficiency in older adults with mild cognitive impairment. Eur J Phys Rehabil Med. 2020;56(1):47-57.

In T, Lee K, Song C. Virtual Reality Reflection Therapy Improves Balance and Gait in Patients with Chronic Stroke: Randomized Controlled Trials. Med Sci Monit. 2016;22:4046-53.

Berton A, Longo UG, Candela V, Fioravanti S, Giannone L, Arcangeli V, et al. Virtual Reality, Augmented Reality, Gamification, and Telerehabilitation: Psychological Impact on Orthopedic Patients' Rehabilitation. J Clin Med. 2020;9(8).

Laver KE, George S, Thomas S, Deutsch JE, Crotty M. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev. 2015;2015(2):Cd008349.

Park M, Ko MH, Oh SW, Lee JY, Ham Y, Yi H, et al. Effects of virtual reality-based planar motion exercises on upper extremity function, range of motion, and health-related quality of life: a multicenter, single-blinded, randomized, controlled pilot study. J Neuroeng Rehabil. 2019;16(1):122.

Norouzi-Gheidari N, Hernandez A, Archambault PS, Higgins J, Poissant L, Kairy D. Feasibility, Safety and Efficacy of a Virtual Reality Exergame System to Supplement Upper Extremity Rehabilitation Post-Stroke: A Pilot Randomized Clinical Trial and Proof of Principle. Int J Environ Res Public Health. 2019;17(1).

da Silva Ribeiro NM, Ferraz DD, Pedreira É, Pinheiro Í, da Silva Pinto AC, Neto MG, et al. Virtual rehabilitation via Nintendo Wii® and conventional physical therapy effectively treat post-stroke hemiparetic patients. Top Stroke Rehabil. 2015;22(4):299-305.

Galea MD. Telemedicine in Rehabilitation. Phys Med Rehabil Clin N Am. 2019;30(2):473-83.

Cikajlo I, Peterlin Potisk K. Advantages of using 3D virtual reality based training in persons with Parkinson's disease: a parallel study. J Neuroeng Rehabil. 2019;16(1):119.

Chughtai M, Kelly JJ, Newman JM, Sultan AA, Khlopas A, Sodhi N, et al. The Role of Virtual Rehabilitation in Total and Unicompartmental Knee Arthroplasty. J Knee Surg. 2019;32(1):105-10.

Alemanno F, Houdayer E, Emedoli D, Locatelli M, Mortini P, Mandelli C, et al. Efficacy of virtual reality to reduce chronic low back pain: Proof-of-concept of a non-pharmacological approach on pain, quality of life, neuropsychological and functional outcome. PLoS One. 2019;14(5):e0216858.

Vieira Á, Melo C, Machado J, Gabriel J. Virtual reality exercise on a home-based phase III cardiac rehabilitation program, effect on executive function, quality of life and depression, anxiety and stress: a randomized controlled trial. Disabil Rehabil Assist Technol. 2018;13(2):112-23.