title: Upper-limb virtual rehabilitation for traumatic brain injury: a preliminary within-group evaluation of the elements system.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI).
  
  
  METHODS
  Using a within-group design, patients were tested three times, each 4 weeks apart: Pre-intervention 1 and 2 and Post-intervention. During intervention, participants received 12 1-hour training sessions over 4 weeks in addition to their usual care. Five males and four females aged 18-48 years with severe TBI were recruited. The Elements system consisted of a 100-cm tabletop LCD, camera tracking system, tangible user interfaces (i.e. graspable objects of basic shape) and software. The system provided two modes of interaction with augmented feedback: goal-directed and exploratory. Upper-limb performance was assessed using system-rated measures (movement speed, accuracy and efficiency) and standardized tests.
  
  
  RESULTS
  Planned comparisons revealed little change in performance over the pre-test period apart from an increase in movement speed. There were significant training effects, with large effect sizes on all measures except the nuts-and-bolts task.
  
  
  CONCLUSIONS
  These preliminary findings support the results of an early case study of the Elements system, further demonstrating that VR training is a viable adjunct to conventional physical therapy in facilitating motor learning in patients with TBI.
authors.affiliation: Discipline of Psychology, RMIT University, Melbourne, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Mumford
authors.forename: Jonathan
authors.initials: J
authors.lastname: Duckworth
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Thomas
authors.forename: David
authors.initials: D
authors.lastname: Shum
authors.forename: Gavin
authors.initials: G
authors.lastname: Williams
authors.forename: Peter H
authors.initials: PH
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D013647:Task Performance and Analysis; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology; D014584:User-Computer Interface; D055815:Young Adult