The aim of this study is to examine the effectiveness of conservative treatment and video-based games applied with virtual reality for treatment purposes on balance, pain, kinesiophobia, quality of life and depression in individuals diagnosed with lumbar disc herniation (LDH).
A total of 93 individuals diagnosed with LDH, 46 control groups and 47 virtual reality groups, aged between 18 and 60, were included in our study. Age, height, weight and gender information of the included individuals were recorded. Balance evaluation was made on the basis of the Balance System, using the Nintendo Balance Board system and the balance board as single leg-double feet, eyes open-closed. To evaluate the performance of activities necessary for daily living, Oswestry Function Test, lumbar pain assessment was evaluated with VAS, fear of movement was evaluated with Tampa Kinesiophobia Scale, quality of life was evaluated with SF-36, and depression evaluation was evaluated with Beck Depression Scale. Muscle strengthening, stretching exercises and postural correction exercises were given under the heading of conservative treatment, electrotherapy (tens, superficial and deep heaters, interferential current) and motor control exercises, which are available in the treatment of both groups. As a result, it has been observed that LDH causes low back pain, fear of movement, decrease in physical functionality, decrease in balance and increase in depression level. At the end of the treatment, it was determined that there was a significant difference in the effectiveness of conservative treatment and virtual reality application on LDH in both groups. (p<0.05) We think that taking these data into consideration when creating the treatment protocol for patients diagnosed with LDH will positively affect the treatment.

This chapter will first present health statistics for Turkey and describe conventional rehabilitation therapies used to rehabilitate patients with stroke. Next, we will present existing neurorehabilitation robotic centers that treat patients in Turkey and provide information about the upper/lower-extremity robots used in these centers. We will discuss the advantages and shortcomings of these robots and technological advances in neurorehabilitation. Then, we will describe the prototype upper/lower-extremity robots that are not yet used in the clinic but are still being developed in the universities to treat patients in Turkey. Next, we will discuss barriers to effective rehabilitation robotics and give an overview of the policies and legal and ethical issues around rehabilitation robotics in Turkey. Lastly, we will evaluate how rehabilitation has changed or is still changing during the COVID-19 pandemic, whether the need for rehabilitation robots will increase, and our opinions about the future of neurorehabilitation and what can be done further to use rehabilitation robots.

Serious games have emerged as promising tools for physiotherapy, offering an engaging way to motivate patients and improve physical functions. Stress, a common physiological response, can impede patient performance and hinder recovery in physiotherapy. However, there is limited research on stress recognition for children during physiotherapeutic serious games. This study proposes a deep and machine learning based method for stress detection from facial images of children. The contributions include the utilization of a novel dataset comprising videos of 25 children, including children with specific conditions, and the exploration of using adults’ facial images for data augmentation. The proposed method employs a modified deep network architecture, VGG-Face, for facial emotion recognition and utilizes three machine learning models for stress recognition. This study represents the first attempt to recognize stress in children’s facial images during physiotherapy with serious games. The findings hold the potential to optimize patient outcomes and contribute to monitoring patients during home therapy.

This study presents a new dataset AKTIVES for evaluating the methods for stress detection and game reaction using physiological signals. We collected data from 25 children with obstetric brachial plexus injury, dyslexia, and intellectual disabilities, and typically developed children during game therapy. A wristband was used to record physiological data (blood volume pulse (BVP), electrodermal activity (EDA), and skin temperature (ST)). Furthermore, the facial expressions of children were recorded. Three experts watched the children’s videos, and physiological data is labeled “Stress/No Stress” and “Reaction/No Reaction”, according to the videos. The technical validation supported high-quality signals and showed consistency between the experts. Becure CatchAPet and Becure LeapBall serious games were used in this study. First, the child tries to touch the rabbit on the screen in the playground with his hand in the virtual environment in the Becure CatchAPet game. The child earns points for each contact with the rabbit and loses points for each missed rabbit. The child uses his/her wrist flexion/extension movement during the game. The wrist angles are determined by the physical therapists so that each child can virtually touch a rabbit with the correct range of motion. In the Becure LeapBall game, the child tries to drop the ball on the screen into buckets of the same color. The child tries to hold and release the ball with grasping movements. The child directs the ball in the virtual environment, and if the child throws it into the correct bucket, he/she earns scores. The fail score increases when the child throws in the wrong basket. Various measures are recorded at the end of each game on the Becure E-Therapy web portal.

Technology and game-based rehabilitation systems such as exergames can contribute to the development of both motor and cognitive functions with task-specific upper extremity exercises, by providing fun and challenging tasks that enable participants to rehabilitate without being aware of it. The leap motion controller (LMC) can be used for hand exercises with advantages like cheap, no sensor needed, portable, safe and inspiratory environment. The LMC based exergame therapy (LMCBET) is widely used, particularly in pediatric rehabilitation, to evaluate hand fine motor function. Although the LMCBET has been applied for a specific disease group in previous studies to our knowledge, there is no study focusing on virtual reality and cognitive function in healthy older adults. This study is intended to be a pioneering study. The aim of this study was to evaluate the effectiveness of the SE and LMCBET in hand function, cognitive function and QoL in older adults.