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The scientific effectiveness of KineQuantum solutions

KineQuantum is part of the EBP approach.

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Immersive virtual reality is a relatively recent cutting-edge technology. However, numerous studies have already been carried out on its use in various fields, including physical rehabilitation.

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See below for studies carried out with the KineQuantum therapeutic virtual reality headset.

Study on therapeutic virtual reality for chronic neck pain at Hôpital Cochin (AP-HP)

Zauderer, J., Lefèvre-Colau, M. M., Davoine, É., Hocquart, M., Rannou, F., Roby-Brami, A., Nguyen, C., & Roren, A. (2021). Exercise therapy program using immersive virtual reality for people with non-specific chronic neck pain: A 3-month retrospective open pilot and feasibility study. Annals of Physical and Rehabilitation Medicine, 65(2), 101527. DOI : 10.1016/j.rehab.2021.101527

A study was carried out at the physiotherapy department of the hôpital Cochin (AP-HP) in Paris, to evaluate the use of a rehabilitation device with immersive virtual reality for people suffering from non-specific chronic neck pain (NsCNP).

 

The therapeutic virtual reality device KineQuantum was used.

 

The results of the study showed that using KineQuantum was feasible and led to improved pain and function in people suffering from nonspecific chronic neck pain.

Methodology

Scheme & participants

  • Pilot cross-sectional crossover study

  • Participants with neck pain: 17 people with neck pain with 5 years of chronicity on average.

  • Other participants: 26 asymptomatic people

  • The rehabilitation program was designed by :

    • 3 senior specialists in physical and rehabilitation medicine (PRM) or rheumatology

    • 1 resident in physical and rehabilitation medicine (ED)

    • 2 physiotherapists experienced in the treatment of chronic non-specific neck pain

Protocol

  • 5 supervised rehabilitation sessions

  • 3 hours of rehabilitation per session

  • Each session included  :

    • active cervical mobility exercises using the virtual reality headset KineQuantum.

    • active eye-neck coordination exercises using the virtual reality headset KineQuantum.

    • classic exercises: aerobic-type physical activities, mobility and muscle strengthening

    • a home rehabilitation exercise program

Results

Feasibility

After the 5 sessions :

  • the mean (SD) acceptability of the overall program was 75.5 (20.1)/100 for participants

  • the mean (SD) acceptability of the entire program was 84.2 (13.6)/100 for physiotherapists

  • the average satisfaction of all program participants was 79.9 (15.9)/100.

None of the participants reported "motion sickness".

This study showed that an exercise-based rehabilitation program consisting of 5 supervised sessions, including therapeutic virtual reality exercises with KineQuantum, is feasible for people with chronic non-specific neck pain.

 

Participants and health professionals found the rehabilitation program appropriate for treating chronic neck pain.

Cervical mobility

The 3 cervical mobilities are significantly improved in chronic neck sufferers in the group using the immersive virtual reality of the KineQuantum virtual reality headset:

  • for axial rotations: +12.3°, p=0.04

  • for flexion-extension: +16.3°, p=0.01

  • for inclinations: +5.6°, p=0.01

The increase in cervical flexion and left axial rotation was above the 6.5° threshold considered to reflect a real change. In asymptomatic participants, only axial rotation increased significantly (+12°) (p=0.01).

Pain intensity

Positive evolution at + 3 months after the 5 sessions:

  • -12.7 (21.5)/100 for specific neck-related activity limitations using the Neck Pain Disability Scale (NPDS)

  • -17.7 (27.8)/100 for pain intensity or -31% pain intensity at +3 months after rehabilitation including KineQuantum.

Although clinically measured cervical spine range of motion was reduced at baseline, that measured using virtual reality was close to normal values. This suggests that virtual reality immersion with KineQuantum had the effect of disinhibiting movement.

pain reduction graph

Conclusion

The results showed a reduction in pain intensity and an improvement in cervical kinematics in patients suffering from chronic non-specific neck pain.

The physiotherapy department at the Cochin hospital continues to use the KieQuantum therapeutic virtual reality headset for all patients suffering from non-specific chronic neck pain. They appreciate the greater variety of exercises offered by KineQuantumand adjust amplitudes and difficulties according to patient feedback and preferences.

For more information on cervical spine rehabilitation with KineQuantum virtual reality devices, click here.

Study on the rehabilitation of scapular dyskinesias with therapeutic virtual reality carried out at Liège University Hospital

Tooth, C., Schwartz, C., Croisier, J.L., & Forthomme, B. (2023). Place de la réalité virtuelle dans la rééducation de l'épaule: une étude préliminaire. SEMS-Journal, 71(1). https://sems-journal.ch/12263

A preliminary study was conducted at the CHU de Liège, Belgium, to assess the short-term results of an immersive virtual reality rehabilitation protocol on pain and functionality in patients suffering from shoulder musculoskeletal disorders.

 

The therapeutic virtual reality device KineQuantum was used.

Methodology

Diagram & participants

  • Quatre patients souffrant de douleurs d'épaule et de dyskinésie scapulaire ont participé à ce protocole expérimental..

Protocol

  • Immersive virtual reality rehabilitation program for upper limb rehabilitation

  • 12 weeks with 2 sessions per week.

  • Each rehabilitation session included:

    • 15 minutes of rehabilitation with the therapeutic virtual reality KineQuantum

    • 5 minutes of classic rehabilitation

  • For virtual reality therapy exercises, the parameters were gradually increased in the same way: 

    • level of intensity: amplitude of movement, difficulty of play, precision of movements

    • speed of execution of exercises

  • Complemented by a home exercise program

  • Various assessments performed before and after surgery: pain intensity, functionality, maximum isometric force and electromyographic activity of scapula stabilizing muscles.

Results

Pain intensity

At the end of the 12 weeks :

  • A significant reduction in pain was observed in patients.

  • Reported pain was significantly lower than at the start of rehabilitation, with a reduction of 2.35 units out of 10 between the start and end of treatment.

Functional improvement

The functional score, measured by the DASH (Disability of Arm, Shoulder and Hand) questionnaire, showed significant improvement, particularly in the catégorie sport : 

  • a reduction of 8.5 to 25% was observed after 6 weeks.

  • a reduction in the order of 47-64% was noted after 12 weeks.

Graph showing changes in DASH questionnaire score before treatment, at 6 weeks and at end of treatment

Increased strength

An increase in maximal isometric strength was noted in the various positions tested. When considering the average of the subjects, the greatest increase was noted in the "Prone-v-thumbs up" position. It was 39%.

Effective rehabilitation of excessive shoulder stump elevation

Regarding the activity of stabilizing muscles of the scapula were observed:

  • a decrease in the upper trapezius/lower trapezius ratio

  • a decrease in the ratio of upper trapezius to anterior dentle

This indicates an improvement in peri-scapular muscle activity, hence effective rehabilitation of excessive shoulder stump elevation.

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  • During loaded flexion, a 37% reduction was observed in the upper trapezius/lower trapezius ratio.

  • During abduction, this reduction was of the order of 14% when the movement was performed with load, and of the order of 22% when performed without load.

  • Finally, the ratio of upper trapezius to anterior dentle was reduced by 28% in flexion. In abduction, it ranged from 6 to 37%.

Conclusion

The CHU de Liège continues to use the KineQuantum medical virtual reality headset. Several departments are already equipped.

For more information on shoulder rehabilitation with KineQuantum virtual reality devices, click here.

Doctoral thesis on the use of virtual reality to manage the fear of falling in the elderly.

Rmadi, H. (2023). Approche posturo-comportementale de la peur de tomber en réalité virtuelle : Acceptation et perspectives de prise en charge chez le sujet âgé [Unpublish doctoral thesis].

In this doctoral work 3 studies were carried out:

  • The first concerns the acceptance of immersive virtual reality by elderly people.

  • The next two studies concern reactions linked to fear of falling by exposing elderly and then young subjects aged under 30 to immersive virtual reality.

 

The 1st study demonstrates positive adhesion to immersive virtual reality technology in 33 people, aged 89.3 on average, living in 8 different EHPAD. Immersive virtual reality has not only been well tolerated, but also well accepted by a senior audience.

2 studies were then carried out on elderly and young subjects to compare the indicators assessed.

Study methodology for elderly subjects

Diagram & participants

  • Randomized bi-centric cross-over study.

  • 27 participants over 65 with the ability to maintain a bipodal station for at least 5 minutes.

Protocol

  • They were exposed to two virtual scenarios:

    • a scene from Bascule forward simulating a anterior fall.

    • a scene from Translation reproducing an advance without a fall.

  • These two scenes were created in collaboration with the development team at KineQuantum.

  • The participants were then exposed to these scenes several times.

Results

Emotional habituation

A gradual decrease in fear was measured over the course of exposure to the Bascule scene, with a decrease on the numerical fear scale (NFS) from 4.57 initially to 1.52 after several occurrences, highlighting a significant emotional habituation phenomenon.

Thanks to this process, participants perceive the previous void and the fall less and less as worrying, reducing the fear and imbalance felt.

Post-behavioral adaptations

Postural adjustments became progressively more automatic and postural control less demanding. This adaptation resulted in a reduction in the area of the phase diagram from the 2nd exposure onwards, and continued to fall during the 11 subsequent exposures.

 

Participants acclimatized quickly to the threat of falling, adopting a more effective balancing strategy.

 

What's more, the visual anchorage initially attributed to the threat decreased as exposures progressed, reducing visual dependence and improving postural attitude.

Psychomotor Disadaptation Syndrome (PMDS)

Individuals with Psychomotor Disadaptation Syndrome (PMDS) assess certain situations as more threatening than they actually are, and respond with an exaggerated defensive postural stance. The study shows that by repeatedly exposing participants to a scene simulating a fall, overall responses can be reduced.

 

The virtual reality scenario thus meets the necessary conditions for the application of cognitive-behavioral therapy (CBT) to re-educate the psychological and post-behavioral components of PMSD.

Conclusion

This work demonstrates :

  • that immersive virtual reality can be used safely in elderly subjects,

  • that an immersive virtual reality scene simulating a fall is a phobic constituent of the fear of falling,

  • and the positive effect of repeated exposure to the phobic element on attenuating the psychological and postural components of the fear of falling.

Applied progressively and adapted to the capabilities of the elderly, it could reduce both the psychological and postural component of thePsychomotor Disadaptation Syndrome. The usefulness of immersive virtual reality therapy associated with a physiotherapy program for seniors with PMDS is therefore validated.

For more information on balance rehabilitation with KineQuantum virtual reality devices, click here and for more information on vestibular rehabilitation with virtual reality click here.

Physiotherapy dissertation on rehabilitation after shoulder surgery with KineQuantum

Riga, Y. (2020). Rééducation après chirurgie d’épaule avec KineQuantum chez des patients après sevrage de l’attelle [Unpublished master's thesis]. IFMK Montpellier.

In his dissertation in kinésithérapie, the student explored the impact of medical virtual rality with KineQuantum in shoulder post-surgery rehabilitation.

Methodology

Diagram & participants

  • Therapeutic comparative trial in triple-blind versus a randomized reference treatment (TTT).

  • Inclusion criteria :

    • Shoulder surgery patients.

    • Post-op 3 to 4 weeks.

    • All shoulder pathologies requiring surgery were included.

  • 22 participants .

    • 11 participants in the virtual reality rehabilitation group.

    • 11 participants in the standard rehabilitation group.

  • Diagram :

    • 1 initial assessment.

    • 15 rehabilitation sessions.

    • 1 final assessment.

Protocol

  • In the classic rehabilitation group :

    • Relaxing massage of the paravertebrae, small circle, rhomboid and infraspinatus.

    • Passive and active assisted mobilization in R1, R2, R3.

    • Global and specific mobilization in the glenohumeral region.

    • Work on co-contraction and muscle locking.

    • Trigger Point.

    • TheraGun for tension relief.

    • Analytical work on the sternoclavicular, acromioclavicular and sternocostal joints.

    • Specific mobilization of the cervical spine.

    • Lifting tension in scalene and trapezius.

    • Arthromotor.

    • Electrotherapy on the infraspinatus and supraspinatus.

  • Session duration: 20 minutes

  • In the virtual reality rehabilitation group:

    • The same re-education as the classic re-education group for 15 minutes.

    • Virtual rehabilitation sessions with the KineQuantum medical device for 15 minutes including :

      • External rotation exercise

      • Horizontal shoulder elevation and abduction exercise

      • Shoulder flexion lowering and return exercise

      • Exercise to train all shoulder joint mobility

      • Shoulder rotation, antepulsion and extension exercises

Results

Patient tolerance of virtual reality

No intolerance to virtual reality sessions was noted.

All patients completed 15±1 sessions during the data collection period.

Rehabilitation times were respected.

Functional effects of virtual reality

Several joint amplitude parameters improved significantly for the group using the therapeutic virtual reality headset KineQuantum :

 

  • For the reflection, a mean (± standard deviation) improvement in the virtual reality group of 51.96° (± 19.34°) versus 25.90° (± 31.57°) for the control group (p=0.036).

  • For the internal rotation, a mean (± standard deviation) improvement in the virtual reality group of 21.73° (± 9.98°) versus 2.20° (± 22.60°) in the control group (p=0.019). 

  • For external rotation, a mean (± standard deviation) improvement in the virtual reality group of 30.03° (± 15.45°) versus 5.98° (± 27.67°) in the control group (p=0.024).

  • For the abduction, a mean (± standard deviation) improvement in the virtual reality group of 57.58° (± 25.81°) versus 36.23° (± 18.31°) in the control group (p=0.05).

A greater improvement in joint amplitudes is observed in the group using KineQuantum than in the control group, for all joint amplitudes.

Effects of virtual reality on kinesiophobia

Definition of kinesiophobia

Kinesiophobia is defined as fear of movement. It encompasses three types of fear: the fear of being hurt, the fear of movement that may cause present or anticipated pain, and the fear of movement that may lead to injury or aggravation of the lesion already present.

 

The circle puts in place restrictions that will serve as defenses in prevention of pain, which can cause disruptions to joint amplitudes.

Reduced kinesiophobia

Patients in both groups had two measurements for all amplitudes at their first assessment: one using virtual reality and one using the goniometer. To avoid material bias, both techniques were compared on healthy subjects. Equal data were observed with both techniques.

 

To observe kinesiophobia, all patient data obtained during the first assessment were compared between those obtained with virtual reality and those obtained with the goniometer.

Measurements with virtual reality or the goniometer give similar results in terms of progression or regression. However, the results obtained with therapeutic virtual reality are higher than those obtained with the goniometer.

Conclusion

Conventional rehabilitation combined with virtual reality improves joint mobility of the complex shoulder postoperatively after splint weaning in operated patients. Patients in the group using the KineQuantum device had greater progression than patients in the control group.

 

Patients were motivated while using virtual reality, and largely expressed their desire to continue rehabilitation with the help of the kine KineQuantum machine.

 

A reduction in kinesiophobia was observed in patients using the KineQuantum device.

 

This virtual reality rehabilitation tool could become a real asset in therapeutic management and bring even more variety in terms of approach and technique to the physiotherapy profession.
 

The physiotherapy software virtual reality software offers a wide range of exercises, for the upper limb as well as for lumbar, cervical, neurological and balance disorders. As far as the upper limb is concerned, the diversity of exercises on offer enables you to work on the entire shoulder joint complex, in all its amplitudes.

 

This also allows vary the exercises so as not to stick to something repetitive. 

 

Learn more about upper limb rehabilitation with the KineQuantum therapeutic virtual reality headset click here.

Would you like to test medical virtual reality in your institution?

 

Your local virtual reality expert can come and show you what therapeutic virtual reality can do for you.

 

Make an appointment now.

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