# Review on BCI Virtual Rehabilitation and Remote Technology Based on EEG for Assistive Devices
## 9 BCI Applications for Rehabilitation
### Virtual Rehabilitation  
VRh is the use of virtual reality and virtual environments within the rehabilitation process [4]. This can be described as a real-world simulation using a computer and its human-machine interface (HMI). Simulating a natural environment that seems real allows people to focus on rehabilitation tasks and facilitates therapy, as it is a controlled environment, in addition to the fact that said therapy can be carried out in non-clinical environments. The use of VRh therapy makes people more motivated and willing to continue with it. VRh is differentiated from remote rehabilitation (RR) (also known as Telex rehabilitation) because RR is the implementation of rehabilitation in places of difficult access, and VRh is the implementation of rehabilitation in a virtual environment. Together, they have the power to facilitate therapy services in rural settings and provide home therapy programs; this makes it easy to continue with therapy exercises and stay motivated. The appearance of VRh commercial devices, such as those integrated with video game consoles, addresses one of the downsides of this technology, leading to the emergence of different types of applications, as described below. Types of Virtual Rehabilitation  
**By the type of population**  
* Musculoskeletal virtual rehabilitation. Orthopedic patients who suffer from bone or muscle/ligament injury are the targets. This is the numerous group that needs rehabilitation. * Post-stroke virtual rehabilitation. These patients survived a neural hemorrhage or blood clot to the brain, resulting in body paralysis. * Cognitive VRh. Population or groups of individuals with various psychological disorders such as deficit/hyperactivity, eating disorders, post-traumatic stress, and phobias. * Telex rehabilitation. As mentioned before, this type of rehabilitation is focused on a population far from their clinical or lives in places of difficult access. **By rehabilitation protocol*** Augmented virtual reality. The patients receive a mixture of conventional exercises with clinical or home equipment and a VRh regimen of simulation exercises. * Virtual reality-based. This type of rehabilitation differs from the therapeutic approach and includes exercises that are similar to playing a video game. One of the first attempts to introduce a therapy with the use of virtual reality or games in rehabilitation was made in 2008 by a group of occupational therapist at the Glenrose Rehabilitation Hospital [4], located downtown in Edmonton, Alberta, using a Wii console with Wii sports software. In recent times, diverse studies that develop a rehabilitation service using virtual reality systems or technology greatly benefit because one of the intentions of using VRy in rehabilitation is that the user or patient enhances the treatment and avoids abandoning the therapy. In this context, the authors of [85] used Unity 3D software and Kinect device to develop a game that emulates a medieval village (that was called Physionland), showing through questionnaires that the patients are more willing to accept a therapy with the use of games and virtual reality. Gamification rehabilitation is an important topic for VRh, and studies use this concept to deliver the service needed. For example, in the study of [86] the context of telemedhilitation or remote rehabilitation using the tools of exergames was found. The exergames are games designed to involve physical activity; this paper presents a case study for an exergame for the upper-limb rehabilitation of stroke patients, which is an important application of rehabilitation because, in 2016, researchers [87] designed a videogame in the Unity platform focused on the rehabilitation post-stroke of 12 participants divided into three groups. After various sessions, they measured the game and FMA UE scores, finding improvements in both measures. A couple of years later, in 2019, the team that presented [88] also proposed a VRh system to rehabilitate the upper limb after a stroke.