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The purpose of this study was to assess the changes in neural activations when performing the box and block test (BBT) in virtual reality (VR) compared to the physical BBT. Young healthy participants performed three trials of the BBT with their left and right hands in both the VR BBT, using VR hand controllers, and physical BBT conditions. Electromyography sensors were placed on the upper extremity of both arms and functional near-infrared spectroscopy was used to measure motor cortex activations throughout each condition. While a reduction in BBT score and increased wrist extensor neuromuscular activity is exhibited during the VR condition, there is no statistical difference in motor cortex activation between the two BBT conditions. This work provides a basis for exploring cortical and neuromuscular responses to VR in patient populations.

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PURPOSE: Immersive Virtual Reality (VR) systems allow for highly repetitive tasks to be performed within a virtual environment that increases practice in home environments. VR can increase access to rehabilitation by reducing access barriers. However, rehabilitation outcomes between immersive VR systems and conventional physical rehabilitation are not well understood. The purpose of this case study was to assess the use of a custom clinically based VR simulation for testing gross hand dexterity with an individual with chronic stroke. MATERIALS AND METHODS: The participant performed the box and blocks test (BBT) in an immersive VR environment and a physical environment. Three trials of the BBT were performed with their less-affected and affected hands each in both environments while measuring cortical activity using fNIRS. Rests were given between trials and environment conditions. RESULTS: Our results show that there was no statistical difference in the number of blocks moved between the physical and VR BBT for both the affected and less-affected hands. Furthermore, our results also indicate no statistically significant difference between the physical BBT and VR BBT conditions on contralateral motor cortex activation, suggesting that cortical involvement is comparable between physical and VR conditions. CONCLUSIONS: These results suggest that an immersive VR system may be able to elicit functional and motor cortex activations that are comparable to the conventional physical BBT. Importantly, these findings highlights the potential benefits of VR therapy as a remote therapy intervention and/or to increase the effectiveness and practicality of current in-person rehabilitation programs.Implications for rehabilitationThese findings highlight the potential benefits of immersive virtual reality as a remote therapy intervention.Immersive virtual reality use has potential benefits to increase the effectiveness and practicality of current in-person rehabilitation programs.

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INTRODUCTION: Many individuals with stroke still have functional difficulties with their affected hand after going through a rehabilitation program. A 3D printed upper limb exoskeleton was designed for an individual who had a stroke. Functional and neuromuscular outcomes were measured using his affected hand with and without a 3D printed passive exoskeleton. The goal of this study was to determine the functional and neuromuscular changes induced by the 3D printed exoskeleton in a participant with stroke. MATERIALS AND METHODS: The functional ability of the exoskeleton was assessed using the Fugl-Meyer Assessment and the Box and Block Test. Strength testing and muscle activation of the participant's forearms were measured during maximal voluntary contractions. Furthermore, EMG was measured during the Box and Block Test and satisfaction and usability of the 3D printed exoskeleton were assessed using standardized questionnaires. RESULTS: The exoskeleton improved both the participant's Fugl-Meyer Assessment scores and Box and Block test scores compared to not wearing the device. The subject had increased EMG activation in his extensor when wearing the exoskeleton. CONCLUSION: The inexpensive 3D printed exoskeleton was effective in assisting the participant with stroke during the functional assessments and has the potential to be used to help regain function of the hand in the home setting of an individual with stroke.IMPLICATIONS FOR REHABILITATIONA 3D printed passive hand exoskeleton may assist to accomplish rehabilitation outcomes by increasing function of the affected hand of patients with stroke.The use of this hand exoskeleton may be used to improve gross hand dexterity and assist with functional grasps during rehabilitation sessions with a lower patient's level of perceived exertion.The use of new antimicrobial 3D printing polymers can be effectively implemented to manufacture assistive devices to prevent skin infections during rehabilitation.

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Recent crowd simulation algorithms do path planning on complex surfaces by breaking 3D surfaces into a series of 2.5D planes. This allows for path planning on surfaces that can be mapped from 3D to 2D without distortion, such as multistory buildings. However, the 2.5D approach does not handle path planning on curved surfaces such as spheres, asteroids, or insect colonies. Additionally, the 2.5D approach does not handle the complexity of dynamic obstacle avoidance when agents can walk on walls or ceilings. We propose novel path planning and obstacle avoidance algorithms that work on surfaces as a whole instead of breaking them into a 2.5D series of planes. Our "whole surfaceâ approach simulates crowds on both multistory structures and highly curved topologies without changing parameters. We validate our work on a suite of 30 different meshes, some with over 100,000 triangles, with crowds of 1,000 agents. Our algorithm always averaged more than 40 FPS with virtually no stalling.

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The March 2005 British Petroleum (BP) Texas City Refinery disaster provided a stimulus to examine the state of process safety in the U.S. refining industry. Participatory action researchers conducted a nation-wide mail-back survey of United Steelworkers local unions and collected data from 51 unionized refineries. The study examined the prevalence of highly hazardous conditions key to the Texas City disaster, refinery actions to address those conditions, emergency preparedness and response, process safety systems, and worker training. Findings indicate that the key highly hazardous conditions were pervasive and often resulted in incidents or near-misses. Respondents reported worker training was insufficient and less than a third characterized their refineries as very prepared to respond safely to a hazardous materials emergency. The authors conclude that the potential for future disasters plagues the refining industry. In response, they call for effective proactive OSHA regulation and outline ten urgent and critical actions to improve refinery process safety.

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