• Interactive Three-Dimensional Simulation and Visualisation of Real Time Blood Flow in Vascular Networks

      John, Nigel; Pop, Serban; Holland, Mark, I (University of ChesterUnviersity of Chester, 2020-05)
      One of the challenges in cardiovascular disease management is the clinical decision-making process. When a clinician is dealing with complex and uncertain situations, the decision on whether or how to intervene is made based upon distinct information from diverse sources. There are several variables that can affect how the vascular system responds to treatment. These include: the extent of the damage and scarring, the efficiency of blood flow remodelling, and any associated pathology. Moreover, the effect of an intervention may lead to further unforeseen complications (e.g. another stenosis may be “hidden” further along the vessel). Currently, there is no tool for predicting or exploring such scenarios. This thesis explores the development of a highly adaptive real-time simulation of blood flow that considers patient specific data and clinician interaction. The simulation should model blood realistically, accurately, and through complex vascular networks in real-time. Developing robust flow scenarios that can be incorporated into the decision and planning medical tool set. The focus will be on specific regions of the anatomy, where accuracy is of the utmost importance and the flow can develop into specific patterns, with the aim of better understanding their condition and predicting factors of their future evolution. Results from the validation of the simulation showed promising comparisons with the literature and demonstrated a viability for clinical use.
    • Virtual and Mixed Reality Support for Activities of Daily Living

      John, Nigel; Day, Thomas W. (University of Chester, 2019-05-14)
      Rehabilitation and training are extremely important process that help people who have suffered some form of trauma to regain their ability to live independently and successfully complete activities of daily living. VR and MR have been used in rehabilitation and training, with examples in a range of areas such as physical and cognitive rehabilitation, and medical training. However, previous research has mainly used non-immersive VR such as using video games on a computer monitor or television. Immersive VR Head-Mounted Displays were first developed in 1965 but the devices were usually large, bulky and expensive. In 2016, the release of low-cost VR HMDs allowed for wider adoption of VR technology. This thesis investigates the impact of these devices in supporting activities of daily living through three novel applications: training driving skills for a powered wheelchair in both VR and MR; and using VR to help with the cognitive rehabilitation of stroke patients. Results from the acceptability study for VR in cognitive rehabilitation showed that patients would be likely to accept VR as a method of rehabilitation. However, factors such as visual issues need to be taken into consideration. The validation study for the Wheelchair-VR project showed promising results in terms of user improvement after the VR training session but the majority of the users experienced symptoms of cybersickness. Wheelchair-MR didn’t show statistically significant results in terms of improvements but did show a mean average improvement compared to the control group. The effects of cybersickness were also greatly reduced compared to VR. We conclude that VR and MR can be used in conjunction with modern games engines to develop virtual environments that can be adapted to accelerate the rehabilitation and training of patients coping with different aspects of daily life.