Keywords: augmented reality, rehabilitation, equilibrium, balance
On the use of augmented reality technology in the rehabilitation of patients with balance disorders
UDC 612.76
DOI: 10.26102/2310-6018/2023.42.3.017
Analysis of the technical aspects of augmented reality systems (AR systems) for the rehabilitation of patients with impaired balance function is an important issue in medical practice. This study is an analysis of research on the use of AR systems for rehabilitating patients with balance problems. The study covered and analyzed 31 articles published between 2018 and 2023 that used various AR systems to rehabilitate patients with balance problems. The technical characteristics of AR systems were considered such as the type of devices used, functionality, accessibility, usability and effectiveness in the rehabilitation process. The results of the review showed that AR systems can be effective in the rehabilitation of patients with balance disorders, especially when traditional therapies are limited. Some of the systems can be used at home, which can reduce the need for hospital visits and reduce treatment costs. However, many of the AR systems still require improvements to enhance accuracy and usability as well as to improve accessibility for a wide range of patients. Therefore, AR systems are a promising tool in the rehabilitation of patients with balance disorder; however, in order to increase their effectiveness, the option of using AR systems together with other rehabilitation devices, e.g. with force platforms, should be considered.
1. World Health Organisation. Falls. URL: https://www.who.int/news-room/fact-sheets/detail/falls (accessed on 01.05.2023).
2. Kevser S.K., Cihangir K. Bibliometric analysis of research in pediatrics related to virtual and augmented reality: a systematic review. Current Pediatric Reviews. 2023 Feb 14. DOI: 10.2174/1573396319666230214103103.
3. Moher D., Liberati A., Tetzlaff J., Altman D. G. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535. DOI: 10.1136/bmj.b2535.
4. Baashar Y., Alkawsi G., Wan Ahmad W.N., Alomari M.A., Alhussian H., Tiong S.K. Towards wearable augmented reality in healthcare: a comparative survey and analysis of head-mounted displays. Int. J. Environ. Res. Public Health. 2023;20(5):3940. DOI: 10.3390/ijerph20053940.
5. Guinet A., Bams M., Payan-Terral S. et al. Effect of an augmented reality active video game for gait training in children with cerebral palsy following single-event multilevel surgery: protocol for a randomised controlled trial. BMJ. 2022;12:e061580. DOI: 10.1136/bmjopen-2022-061580.
6. Riem L., Van Dehy J., Onushko T., Beardsley S. Inducing compensatory changes in gait similar to external perturbations using an immersive head mounted display. IEEE Conference on Virtual Reality and 3D User Interfaces (VR), Tuebingen/Reutlingen, Germany. 2018. p. 128–135. DOI: 10.1109/VR.2018.8446432.
7. Evans E., Dass M., Muter W.M., Tuthill C., Tan A.Q., Trumbower R.D. A wearable mixed reality platform to augment overground walking: a feasibility study. Front Hum Neurosci. 2022;16:868074. DOI: 10.3389/fnhum.2022.868074.
8. Lee A., Hellmers N., Vo M., Wang .F, Popa P., Barkan S., Patel D., Campbell C., Henchcliffe C., Sarva H. Can Google glass™ technology improve freezing of gait in parkinsonism? A pilot study. Disabil Rehabil Assist Technol. 2023;18(3):327–332. DOI: 10.1080/17483107.2020.1849433.
9. Guinet A.L., Bouyer G., Otmane S., Desailly E. Validity of hololens augmented reality head mounted display for measuring gait parameters in healthy adults and children with cerebral palsy. Sensors (Basel). 2021;21(8):2697. DOI: 10.3390/s21082697.
10. Chan Z.Y.S, MacPhail A.J.C., Au I.P.H., Zhang J.H., Lam B.M.F. et al. Walking with head-mounted virtual and augmented reality devices: Effects on position control and gait biomechanics. PLOS ONE. 2019;14(12):e0225972. DOI: 10.1371/journal.pone.0225972.
11. van de Venis L., van de Warrenburg B., Weerdesteyn V., Geurts A.C.H., Nonnekes J. Gait-adaptability training in people with hereditary spastic paraplegia: a randomized clinical trial. Neurorehabil Neural Repair. 2023;37(1):27–36. DOI: 10.1177/15459683221147839.
12. Jin Y., Monge J., Postolache O., Niu W. Augmented reality with application in physical rehabilitation. 2019 International Conference on Sensing and Instrumentation in IoT Era (ISSI), Lisbon, Portugal. 2019. p. 1–6. DOI: 10.1109/ISSI47111.2019.9043665.
13. Beatriz P., Campos P., Azadegan A. Digitally augmenting the physical ground space with timed visual cues for crutch-assisted walking. CHI EA '19: 2019 CHI Conference on Human Factors in Computing Systems. 1-6. DOI: 10.1145/3290607.3312891.
14. Hidayah R., Chamarthy S., Shah A., Fitzgerald-Maguire M., Agrawal S.K. Walking with augmented reality: a preliminary assessment of visual feedback with a cable-driven active leg exoskeleton (C-ALEX). IEEE Robotics and Automation Letters. 2019;4(4):3948–3954. DOI: 10.1109/LRA.2019.2929989.
15. Koop M.M., Rosenfeldt A.B., Johnston J.D., Streicher M.C., Qu J., Alberts J.L. The HoloLens augmented reality system provides valid measures of gait performance in healthy adults. IEEE Transactions on Human-Machine Systems. 2020;50(6):584–592. DOI: 10.1109/THMS.2020.3016082.
16. Miller D.A.L., Ogata T., Sasabe G., Shan L., Tsumura N., Miyake Y. Spatiotemporal gait guidance using audiovisual cues of synchronized walking avatar in augmented reality. IEEE Access. 2022;10:90498–90506. DOI: 10.1109/ACCESS.2022.3200744.
17. Hurtado J., Saint-Priest Y., Caicedo E. Development of a gait recognition visualization system using augmented reality. International Conference on Virtual Reality and Visualization (ICVRV), Hong Kong, China. 2019. p. 196–199. DOI: 10.1109/ICVRV47840.2019.00046.
18. Lupo A, Cinnera AM, Pucello A, Iosa M, Coiro P, Personeni S, Gimigliano F, Iolascon G, Paolucci S, Morone G. Effects on balance skills and patient compliance of biofeedback training with inertial measurement units and exergaming in subacute stroke: a pilot randomized controlled trial. Funct Neurol. 2018;33(3):131–136. PMID: 30457965.
19. Lupo A., Martino Cinnera A., Pucello A., Iosa M., Coiro P., Personeni S., Gimigliano F., Iolascon G., Paolucci S., Morone G. Effects on balance skills and patient compliance of biofeedback training with inertial measurement units and exergaming in subacute stroke: a pilot randomized controlled trial. Functional neurology. 2018;33:131–136. PMID: 30457965.
20. Miller Koop M, Rosenfeldt A.B., Owen K., Penko A.L., Streicher M.C., Albright A., Alberts J.L. The Microsoft HoloLens 2 provides accurate measures of gait, turning, and functional mobility in healthy adults. Sensors (Basel). 2022;22(5):2009. DOI: 10.3390/s22052009.
21. Günaydin T., Arslan R. B., LOWER-LIMB FOLLOW-UP: A surface electromyography based serious computer game and patient follow-up system for lower extremity muscle strengthening exercises in physiotherapy and rehabilitation. IEEE 32nd International Symposium on Computer-Based Medical Systems (CBMS), Cordoba, Spain. 2019. p. 507–512. DOI: 10.1109/CBMS.2019.00103.
22. Held J.P.O., Yu K., Pyles C., Veerbeek J.M., Bork F., Heining S.M., Navab N., Luft A.R. Augmented reality-based rehabilitation of gait impairments: case report. JMIR Mhealth Uhealth. 2020;8(5):e17804. DOI: 10.2196/17804.
23. Vinolo Gil M.J., Gonzalez-Medina G., Lucena-Anton D., Perez-Cabezas V., Ruiz-Molinero M.D.C., Martín-Valero R. Augmented reality in physical therapy: systematic review and meta-analysis. JMIR Serious Games. 2021;9(4):e30985. DOI: 10.2196/30985.
24. Guinet A.L., Neijib K., Otmane S., Bouyer G., Desailly E. Exploring visual feedback modalities in augmented reality to control the walking speed of children with cerebral palsy. Experimental design protocol. Gait & Posture. 2020;81:120–121. DOI: 10.1016/j.gaitpost.2020.07.094.
25. Abbruzzese G., Pelosin E. Rehabilitation of Parkinson’s disease. Advanced Technologies for the Rehabilitation of Gait and Balance Disorders. DOI: 10.1007/978-3-319-72736-3_10.
26. Enam N., Veerubhotla A., Ehrenberg N., Kirshblum S., Nolan K.J., Pilkar R. Augmented-reality guided treadmill training as a modality to improve functional mobility post-stroke: A proof-of-concept case series. Top Stroke Rehabil. 2021;28(8):624–630. DOI: 10.1080/10749357.2020.1864987.
27. Alberts J.L., Kaya R.D., Scelina K., Scelina L., Zimmerman E.M., Walter B.L., Rosenfeldt A.B. Digitizing a therapeutic: development of an augmented reality dual-task training platform for parkinson’s disease. Sensors. 2022;22(22):8756, DOI: 10.3390/s22228756.
28. Gulcan K., Guclu-Gunduz A., Yasar E., Ar U., Sucullu Karadag Y., Saygili F. The effects of augmented and virtual reality gait training on balance and gait in patients with Parkinson's disease. Acta Neurol Belg. 2022 Nov 28:1–9. DOI: 10.1007/s13760-022-02147-0.
29. Timmermans C., Roerdink M., Meskers C.G.M. et al. Walking-adaptability therapy after stroke: results of a randomized controlled trial. Trials. 2022;1:923. DOI: 10.1186/s13063-021-05742-3
30. Phan H.L., Le T.H., Lim J.M., Hwang C.H., Koo K.-i. Effectiveness of augmented reality in stroke rehabilitation: a meta-analysis. Appl. Sci. 2022;12:1848. DOI: 10.3390/app12041848.
31. Ulrich B., Pereira L.C., Jolles B.M., Favre J. Walking with shorter stride length could improve knee kinetics of patients with medial knee osteoarthritis. J Biomech. 2023;147:111449. DOI: 10.1016/j.jbiomech.2023.111449.
32. Chang H., Song Y., Cen X. Effectiveness of augmented reality for lower limb rehabilitation: a systematic review. Appl Bionics Biomech. 2022;2022:4047845. DOI: 10.1155/2022/4047845.
33. Hall C.D., Herdman S.J., Whitney S.L., Anson E.R., Carender W.J., Hoppes C.W., Cass S.P., Christy J.B., Cohen H.S., Fife T.D., Furman J.M., Shepard N.T., Clendaniel R.A., Dishman J.D., Goebel J.A., Meldrum D., Ryan C., Wallace R.L., Woodward N.J. Vestibular rehabilitation for peripheral vestibular hypofunction: an updated clinical practice guideline from the academy of neurologic physical therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022;46(2):118–177. DOI: 10.1097/NPT.0000000000000382.
34. Boerger T.F., Hyngstrom A.S., Furlan J.C., Kalsi-Ryan S., Curt A., Kwon B.K., Kurpad S.N., Fehlings M.G., Harrop J.S., Aarabi B., Rahimi-Movaghar V., Guest J.D., Wilson J.R., Davies B.M., Kotter M.R.N., Koljonen P.A. Developing peri-operative rehabilitation in degenerative cervical myelopathy. AO Spine RECODE-DCM Research Priority Number 6: An Unexplored Opportunity? Global Spine J. 2022;12(1_suppl):97S–108S. DOI: 10.1177/21925682211050925.
Keywords: augmented reality, rehabilitation, equilibrium, balance
For citation: Galushka M.S., Vishnevetsky V.Y. On the use of augmented reality technology in the rehabilitation of patients with balance disorders. Modeling, Optimization and Information Technology. 2023;11(3). URL: https://moitvivt.ru/ru/journal/pdf?id=1392 DOI: 10.26102/2310-6018/2023.42.3.017 (In Russ).
Received 18.07.2023
Revised 03.08.2023
Accepted 13.09.2023
Published 30.09.2023