Hotz Boendermaker Eng
Fakultäten » Medizinische Fakultät » Universitätsklinik Balgrist und Schweizerisches Paraplegikerzentrum » Paraplegikerzentrum » Prof. Dr. Armin Curt » Hotz Boendermaker Eng
Completed research project
| Title / Titel | Interactive Motor Imagery in Virtual Reality for Motor Rehabilitation and Pain Treatment after Spinal Cord Injury | ||||||
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| Abstract (PDF, 14 KB) | |||||||
| Summary / Zusammenfassung | Spinal cord injury (SCI), estimated to affect about 100,000 people worldwide each year, often leads to long-lasting lower limb motor dysfunction and associated neuropathic pain. Despite evidence that the two conditions may share some underlying cortical mechanisms, they are currently treated very differently. Pharmacological interventions are typically used for neuropathic pain, while physiotherapy and exercise are used to treat motor dysfunction. Interventions which directly address the cortical causes of neuropathic pain and promote plasticity to rearrange brain areas projecting to surviving parts of the spinal tract may thus bring substantial pain reduction and locomotion benefits to incomplete SCI (iSCI) patients. Over the past two decades it has been established that observation of goal-directed actions, motor imagery and action execution activate overlapping cortical networks, known collectively as the mirror system. We have shown that the mirror system can still be activated in complete SCI patients via motor imagery and foot movement observation, suggesting that in iSCI patients it may also be possible to activate cortical areas projecting to remaining parts of the spinal cord. In addition, there is evidence that neuropathic pain in iSCI patients may be caused by mismatch between motor output and sensory feedback, which can be reduced by employing motor imagery combined with visual illusions of virtual limbs. Three major weaknesses of existing work are: (1) to date there are few extensive, systematically controlled studies of the potential for using motor imagery in iSCI patients, (2) no studies of motor imagery in iSCI patients are designed to search for possible cross-over effects between pain and motor function, and (3) the therapies themselves are relatively tedious for patients, affecting their potential efficacy. This project, a collaboration between the Institute of Neuroinformatics (University of Zurich and ETH Zurich) and the Spinal Cord Injury Centre of the Uniklinik Balgrist, will build and test the first rehabilitation system employing virtual reality (VR)-based observation, motor imagery and execution iCTuS/L (Interactive Computer-based Therapy System for Legs),) to treat neuropathic pain and motor dysfunction in incomplete SCI patients. Patients using iCTuS/L will control virtual representations of their legs to engage in entertaining gaming interactions. By using a specially designed mirrored display, the virtual legs will appear in the correct position relative to the patient’s viewpoint when they look down to facilitate motor imagery and perceived ownership of the virtual limbs. This system will build on our previous and ongoing work in VR-based treatment of arm motor function in stroke patients. In addition, the project will be a direct application of our ongoing basic science experiments, investigating motor imagery in spinal cord patients and the parameters affecting perceived ownership of virtual limbs in VR environments. The outcome of the project will provide the first evaluation of a VR-based system for lower limb rehabilitation of iSCI patients using interactive motor imagery, observation and execution. If successful, the project will provide an impetus for further experimental and modelling work probing in more detail the underlying mechanisms of cortical plasticity for pain treatment and recovery of motor function. |
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| Project leadership and contacts / Projektleitung und Kontakte |
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| Funding source(s) / Unterstützt durch |
Foundation |
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| Duration of Project / Projektdauer | Apr 2009 to Mar 2011 |