Neurorehabilitace Dotaz Zobrazit nápovědu
This article focuses on the development of algorithms for a smart neurorehabilitation system, whose core is made up of artificial neural networks. The authors of the article have proposed a completely unique transfer of ACE-R results to the CHC model. This unique approach allows for the saturation of the CHC model domains according to modified ACE-R factor analysis. The outputs of the proposed algorithm thus enable the automatic creation of a personalized and optimized neurorehabilitation plan for individual patients to train their cognitive functions. A set of tasks in 6 levels of difficulty (level 1 to level 6) was designed for each of the nine CHC model domains. For each patient, the results of the ACE-R screening helped deter-mine the specific CHC domains to be rehabilitated, as well as the initial gaming level for rehabilitation in each domain. The proposed artificial neural network algorithm was adapted to real data from 703 patients. Experimental outputs were compared to the outputs of the initially designed fuzzy expert system, which was trained on the same real data, and all outputs from both systems were statistically evaluated against expert conclusions that were available. It is evident from the conducted experimental study that the smart neurorehabilitation system using artificial neural networks achieved significantly better results than the neurorehabilitation system whose core is a fuzzy expert system. Both algorithms are implemented into a comprehensive neurorehabilitation portal (Eddie), which was supported by a research project from the Technology Agency of the Czech Republic.
- Klíčová slova
- ACE-R, CHC, Fuzzy expert system model, Neural network model, Neurocognitive rehabilitation,
- MeSH
- algoritmy MeSH
- expertní systémy * MeSH
- fuzzy logika MeSH
- lidé MeSH
- neuronové sítě (počítačové) MeSH
- neurorehabilitace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: A growing interest in non-pharmacological approaches aimed at cognitive rehabilitation and cognitive enhancement pointed towards the application of new technologies. The complex virtual reality (VR) presented using immersive devices has been considered a promising approach. OBJECTIVE: The article provides a systematic review of studies aimed at the efficacy of VR-based rehabilitation. First, we shortly summarize literature relevant to the role of immersion in memory assessment and rehabilitation. METHODS: We searched Web of Science, ScienceDirect, and PubMed with the search terms "memory rehabilitation", "virtual reality", "memory deficit". Only original studies investigating the efficacy of complex three-dimensional VR in rehabilitation and reporting specific memory output measures were included. RESULTS: We identified 412 citations, of which 21 met our inclusion criteria. We calculated appropriate effect sizes for 10 studies including control groups and providing descriptive data. The effect sizes range from large to small, or no effect of memory rehabilitation was present, depending on the control condition applied. Summarized studies with missing control groups point out to potential positive effects of VR but do not allow any generalization. CONCLUSIONS: Even though there are some theoretical advantages of immersive VE over non-immersive technology, there is not enough evidence yet to draw any conclusions.
- Klíčová slova
- Virtual reality, immersion, memory, rehabilitation,
- MeSH
- lidé MeSH
- neurorehabilitace * metody MeSH
- paměť MeSH
- poruchy paměti * rehabilitace MeSH
- terapie pomocí virtuální reality * přístrojové vybavení metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- systematický přehled MeSH
PURPOSE: Vestibular schwannoma removal causes unilateral vestibular deafferentation, which results in dizziness and postural unsteadiness. Vertigo and balance problems together are among the most important aspects affecting quality of life. Intensive vestibular rehabilitation, which starts before surgery, with following postsurgical supervised rehabilitation, using visual biofeedback propose an instrument to accelerate a recovery process. Another option how to accelerate the vestibular compensation, is employment of presurgical gentamicin ablation together with vestibular rehabilitation (prehabilitation) of vestibular function. Purpose of present study was to examine the dynamics of vestibular compensation process using supervised intensive vestibular rehabilitation with visual biofeedback in the short-term postsurgical period. The second aim was to compare both studied groups mainly to evaluate if prehabilitation has potential to accelerate the compensation process in the early postoperative course. METHODS: The study included 52 patients who underwent the retrosigmoid vestibular schwannoma removal. They were divided into two groups. The first group was prehabilitated with intratympanic application of gentamicin before surgery to cause unilateral vestibular loss (14 patients), the second group (38 patients) was treated in standard protocol without prehabilitation. All patients underwent at home vestibular training before surgery to learn new movement patterns. Following the surgery supervised intensive vestibular rehabilitation including visual biofeedback was employed daily in both groups between the 5th and 14th postoperative day. Outcome measurements included an evaluation of subjective visual vertical (SVV), posturography and the Activities-Specific Balance Confidence Scale (ABC). ANOVA for repeated measurements was used for statistical analysis. RESULTS: We observed significant improvement in SVV (p < 0.05), posturography parameters (p < 0.05) and ABC scores (p < 0.05) with postoperative rehabilitation program following surgery in both groups. There was no statistically significant difference between group treated by prehabilitation and group without prehabilitation. CONCLUSIONS: Results of this study showed that intensive postsurgical rehabilitation represents key factor in compensation process following retrosigmoid vestibular schwannoma surgery. Prehabilitation did not speed up recovery process.
- Klíčová slova
- Compensation, Posturography, Prehabilitation, Rehabilitation, Subjective visual vertical, Vestibular schwannoma,
- MeSH
- kvalita života * MeSH
- lidé středního věku MeSH
- lidé MeSH
- neurorehabilitace metody MeSH
- otologické chirurgické výkony škodlivé účinky metody rehabilitace MeSH
- pooperační komplikace * psychologie rehabilitace MeSH
- premedikace metody MeSH
- vertigo * etiologie rehabilitace MeSH
- vestibulární schwannom chirurgie MeSH
- výsledek terapie MeSH
- závrať * etiologie rehabilitace MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH