Immersive Virtual Reality for Motor Rehabilitation in Individuals with Neurodevelopmental Disorders
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| Title: | Immersive Virtual Reality for Motor Rehabilitation in Individuals with Neurodevelopmental Disorders |
|---|---|
| Language: | English |
| Authors: | Minxin Cheng |
| Source: | ProQuest LLC. 2024Ph.D. Dissertation, Northeastern University. |
| Availability: | ProQuest LLC. 789 East Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106. Tel: 800-521-0600; Web site: http://www.proquest.com/en-US/products/dissertations/individuals.shtml |
| Peer Reviewed: | N |
| Page Count: | 133 |
| Publication Date: | 2024 |
| Document Type: | Dissertations/Theses - Doctoral Dissertations |
| Descriptors: | Autism Spectrum Disorders, Cerebral Palsy, Neurodevelopmental Disorders, Computer Simulation, Perceptual Motor Coordination, Psychomotor Skills, Motor Development, Visual Perception, Affective Behavior, Children, Adults, Skill Development, Program Effectiveness, Accuracy |
| Assessment and Survey Identifiers: | Beery Developmental Test of Visual Motor Integration |
| ISSN: | 3465-3295 |
| ISBN: | 979-83-465-3295-8 |
| Abstract: | Background: Autism spectrum disorder and cerebral palsy are prevalent neurodevelopmental disorders. Autistic individuals or individuals with cerebral palsy often struggle with sensory processing that further impacts movement execution. Immersive virtual reality (VR) is a promising assessment and intervention modality to promote motor learning in these populations because it supports natural interaction, enables real-time eye and hand movement tracking, integrates with external sensors, allows for real-time parameter control, and provides vivid, feedback-rich environments that may enhance motivation and engagement. These features facilitate a comprehensive understanding of performance and progress, enabling individualized adjustments to meet specific therapeutic goals. However, there is limited evidence exploring how visuomotor features in VR interact with sensory processing difficulties in autistic individuals or individuals with cerebral palsy. This dissertation addresses this gap in knowledge by evaluating and comparing visuomotor integration processes, affective measures, and motor learning in VR versus flatscreen environments and the physical environment in autistic individuals, individuals with cerebral palsy, non-autistic adults, and typically developing children. Methods: Autistic adults and children with cerebral palsy were recruited. Visuospatial accuracy and visuomotor integration in VR were evaluated for autistic adults and compared to the physical environment using a special estimation task and an overhand throwing task (Chapter 2). The impact of VR on affective factors (motivation, engagement, and cognitive load), motor skill acquisition, retention, and transfer to a flatscreen environment and to a comparable real-world task was evaluated in typically developing children using a novel postural control and reach-to-touch task (Chapter 3). The use of VR as a clinical assessment tool for visuomotor integration in children with cerebral palsy was evaluated in a clinical setting using a gross motor task (reach-to-touch), and the results were compared to the gold-standard paper-and-pencil (Beery-Buktenica) visuomotor integration test (Chapter 4). Results: Visuospatial accuracy and visuomotor performance were reduced in VR for autistic and non-autistic adults. Both groups exhibited lower throwing accuracy in VR and more active scanning of the entire environment in VR, rather than focusing on the task-relevant areas. Additionally, they demonstrated different visuomotor integration patterns during the execution of throwing movement in VR. Reducing visual clutter in VR improved eye movement measures and decreased performance errors in autistic adults. Motor skill acquisition in VR led to the highest motivation and performance gain for typically developing children but did not provide additional advantages for retention, transfer to a flatscreen environment, and to a real-world equivalent task. For children with cerebral palsy, visuomotor performance was also reduced in VR, as indicated by reduced reach-to-touch accuracy and slower movement execution in VR. Incorporating additional depth cues reduced hand movement endpoint errors during reach-to-touch tasks in children with cerebral palsy. Conclusions: This dissertation investigated the impact of VR on visuospatial accuracy, visuomotor integration, and motor learning for autistic adults, typically developing children, and children with cerebral palsy. The findings revealed reduced visuospatial accuracy and different visuomotor integration process in VR compared to the identical tasks in the physical environment, and highlighted individual visual perception, visuomotor integration, affective factors and environmental factors that contribute to motor performance and motor learning outcomes in VR. However, results support the potential of immersive VR as a motor rehabilitation intervention. In particular, adjusting visual information in VR can support visual behavior and improve performance. Acquiring a new skill in immersive VR boosted motivation during motor skill acquisition in typically developing children and enabled the greatest performance gains compared to non-immersive flatscreen systems and the physical environment. These findings contribute to the fundamental understanding of visuomotor performance and motor learning in VR for individuals with autism and cerebral palsy. They encourage further research to evaluate the impact of VR on other aspects of visual perception such as motion perception, and to explore individualized content adaptations to support visuomotor integration and motor (re)learning aligned with individual motor rehabilitation goals. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.] |
| Abstractor: | As Provided |
| Entry Date: | 2025 |
| Access URL: | https://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqm&rft_dat=xri:pqdiss:31637449 |
| Accession Number: | ED664380 |
| Database: | ERIC |
| FullText | Text: Availability: 0 |
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| Header | DbId: eric DbLabel: ERIC An: ED664380 AccessLevel: 3 PubType: Dissertation/ Thesis PubTypeId: dissertation PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Immersive Virtual Reality for Motor Rehabilitation in Individuals with Neurodevelopmental Disorders – Name: Language Label: Language Group: Lang Data: English – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Minxin+Cheng%22">Minxin Cheng</searchLink> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="SO" term="%22ProQuest+LLC%22"><i>ProQuest LLC</i></searchLink>. 2024Ph.D. Dissertation, Northeastern University. – Name: Avail Label: Availability Group: Avail Data: ProQuest LLC. 789 East Eisenhower Parkway, P.O. Box 1346, Ann Arbor, MI 48106. Tel: 800-521-0600; Web site: http://www.proquest.com/en-US/products/dissertations/individuals.shtml – Name: PeerReviewed Label: Peer Reviewed Group: SrcInfo Data: N – Name: Pages Label: Page Count Group: Src Data: 133 – Name: DatePubCY Label: Publication Date Group: Date Data: 2024 – Name: TypeDocument Label: Document Type Group: TypDoc Data: Dissertations/Theses - Doctoral Dissertations – Name: Subject Label: Descriptors Group: Su Data: <searchLink fieldCode="DE" term="%22Autism+Spectrum+Disorders%22">Autism Spectrum Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Cerebral+Palsy%22">Cerebral Palsy</searchLink><br /><searchLink fieldCode="DE" term="%22Neurodevelopmental+Disorders%22">Neurodevelopmental Disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Computer+Simulation%22">Computer Simulation</searchLink><br /><searchLink fieldCode="DE" term="%22Perceptual+Motor+Coordination%22">Perceptual Motor Coordination</searchLink><br /><searchLink fieldCode="DE" term="%22Psychomotor+Skills%22">Psychomotor Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Motor+Development%22">Motor Development</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+Perception%22">Visual Perception</searchLink><br /><searchLink fieldCode="DE" term="%22Affective+Behavior%22">Affective Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Skill+Development%22">Skill Development</searchLink><br /><searchLink fieldCode="DE" term="%22Program+Effectiveness%22">Program Effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Accuracy%22">Accuracy</searchLink> – Name: SubjectThesaurus Label: Assessment and Survey Identifiers Group: Su Data: <searchLink fieldCode="SU" term="%22Beery+Developmental+Test+of+Visual+Motor+Integration%22">Beery Developmental Test of Visual Motor Integration</searchLink> – Name: ISSN Label: ISSN Group: ISSN Data: 3465-3295 – Name: ISBN Label: ISBN Group: ISBN Data: 979-83-465-3295-8 – Name: Abstract Label: Abstract Group: Ab Data: Background: Autism spectrum disorder and cerebral palsy are prevalent neurodevelopmental disorders. Autistic individuals or individuals with cerebral palsy often struggle with sensory processing that further impacts movement execution. Immersive virtual reality (VR) is a promising assessment and intervention modality to promote motor learning in these populations because it supports natural interaction, enables real-time eye and hand movement tracking, integrates with external sensors, allows for real-time parameter control, and provides vivid, feedback-rich environments that may enhance motivation and engagement. These features facilitate a comprehensive understanding of performance and progress, enabling individualized adjustments to meet specific therapeutic goals. However, there is limited evidence exploring how visuomotor features in VR interact with sensory processing difficulties in autistic individuals or individuals with cerebral palsy. This dissertation addresses this gap in knowledge by evaluating and comparing visuomotor integration processes, affective measures, and motor learning in VR versus flatscreen environments and the physical environment in autistic individuals, individuals with cerebral palsy, non-autistic adults, and typically developing children. Methods: Autistic adults and children with cerebral palsy were recruited. Visuospatial accuracy and visuomotor integration in VR were evaluated for autistic adults and compared to the physical environment using a special estimation task and an overhand throwing task (Chapter 2). The impact of VR on affective factors (motivation, engagement, and cognitive load), motor skill acquisition, retention, and transfer to a flatscreen environment and to a comparable real-world task was evaluated in typically developing children using a novel postural control and reach-to-touch task (Chapter 3). The use of VR as a clinical assessment tool for visuomotor integration in children with cerebral palsy was evaluated in a clinical setting using a gross motor task (reach-to-touch), and the results were compared to the gold-standard paper-and-pencil (Beery-Buktenica) visuomotor integration test (Chapter 4). Results: Visuospatial accuracy and visuomotor performance were reduced in VR for autistic and non-autistic adults. Both groups exhibited lower throwing accuracy in VR and more active scanning of the entire environment in VR, rather than focusing on the task-relevant areas. Additionally, they demonstrated different visuomotor integration patterns during the execution of throwing movement in VR. Reducing visual clutter in VR improved eye movement measures and decreased performance errors in autistic adults. Motor skill acquisition in VR led to the highest motivation and performance gain for typically developing children but did not provide additional advantages for retention, transfer to a flatscreen environment, and to a real-world equivalent task. For children with cerebral palsy, visuomotor performance was also reduced in VR, as indicated by reduced reach-to-touch accuracy and slower movement execution in VR. Incorporating additional depth cues reduced hand movement endpoint errors during reach-to-touch tasks in children with cerebral palsy. Conclusions: This dissertation investigated the impact of VR on visuospatial accuracy, visuomotor integration, and motor learning for autistic adults, typically developing children, and children with cerebral palsy. The findings revealed reduced visuospatial accuracy and different visuomotor integration process in VR compared to the identical tasks in the physical environment, and highlighted individual visual perception, visuomotor integration, affective factors and environmental factors that contribute to motor performance and motor learning outcomes in VR. However, results support the potential of immersive VR as a motor rehabilitation intervention. In particular, adjusting visual information in VR can support visual behavior and improve performance. Acquiring a new skill in immersive VR boosted motivation during motor skill acquisition in typically developing children and enabled the greatest performance gains compared to non-immersive flatscreen systems and the physical environment. These findings contribute to the fundamental understanding of visuomotor performance and motor learning in VR for individuals with autism and cerebral palsy. They encourage further research to evaluate the impact of VR on other aspects of visual perception such as motion perception, and to explore individualized content adaptations to support visuomotor integration and motor (re)learning aligned with individual motor rehabilitation goals. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.] – Name: AbstractInfo Label: Abstractor Group: Ab Data: As Provided – Name: DateEntry Label: Entry Date Group: Date Data: 2025 – Name: URL Label: Access URL Group: URL Data: <link linkTarget="URL" linkTerm="https://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqm&rft_dat=xri:pqdiss:31637449" linkWindow="_blank">https://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqm&rft_dat=xri:pqdiss:31637449</link> – Name: AN Label: Accession Number Group: ID Data: ED664380 |
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| RecordInfo | BibRecord: BibEntity: Languages: – Text: English PhysicalDescription: Pagination: PageCount: 133 Subjects: – SubjectFull: Autism Spectrum Disorders Type: general – SubjectFull: Cerebral Palsy Type: general – SubjectFull: Neurodevelopmental Disorders Type: general – SubjectFull: Computer Simulation Type: general – SubjectFull: Perceptual Motor Coordination Type: general – SubjectFull: Psychomotor Skills Type: general – SubjectFull: Motor Development Type: general – SubjectFull: Visual Perception Type: general – SubjectFull: Affective Behavior Type: general – SubjectFull: Children Type: general – SubjectFull: Adults Type: general – SubjectFull: Skill Development Type: general – SubjectFull: Program Effectiveness Type: general – SubjectFull: Accuracy Type: general – SubjectFull: Beery Developmental Test of Visual Motor Integration Type: general Titles: – TitleFull: Immersive Virtual Reality for Motor Rehabilitation in Individuals with Neurodevelopmental Disorders Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Minxin Cheng IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 01 Type: published Y: 2024 Identifiers: – Type: isbn-print Value: 979-83-465-3295-8 – Type: issn-print Value: 3465-3295 Titles: – TitleFull: ProQuest LLC Type: main |
| ResultId | 1 |
