Age Differences in Computer Input Device Use: A Comparison of Touchscreen, Trackball, and Mouse

Effectiveness of Using Virtual Reality-Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials

Background

In recent years, efforts have been made to implement virtual reality (VR) to support the delivery of poststroke upper extremity motor rehabilitation exercises. Therefore, it is important to review and analyze the existing research evidence of its effectiveness.

Objective

Through a systematic review and meta-analysis of randomized controlled trials, this study examined the effectiveness of using VR-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke.

Methods

This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The CINAHL Plus, MEDLINE, Web of Science, Embase, and Cochrane Library databases were searched on December 31, 2021. Changes in outcomes related to impairments in upper extremity functions and structures, activity limitations, and participation restrictions in life situations from baseline to after intervention, after intervention to follow-up assessment, and baseline to follow-up assessment were examined. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup analyses were performed to determine whether the differences in treatment outcomes depended on age, stroke recovery stage, VR program type, therapy delivery format, similarities in intervention duration between study groups, intervention duration in VR groups, and trial length.

Results

A total of 42 publications representing 43 trials (aggregated sample size=1893) were analyzed. Compared with the control groups that used either conventional therapy or no therapy, the intervention groups that used VR to support exercise therapy showed significant improvements in upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity; SMD 0.45, 95% CI 0.21-0.68; P<.001), range of motion (goniometer; SMD 1.01, 95% CI 0.50-1.52; P<.001), muscle strength (Manual Muscle Testing; SMD 0.79, 95% CI 0.28-1.30; P=.002), and independence in day-to-day activities (Functional Independence Measure; SMD 0.23, 95% CI 0.06-0.40; P=.01, and modified Rankin Scale; SMD 0.57, 95% CI 0.01-1.12; P=.046). Significant subgroup differences were observed in hand dexterity (Box and Block Test), spasticity (Ashworth Scale or modified Ashworth Scale), arm and hand motor ability (Wolf Motor Function Test and Manual Function Test), hand motor ability (Jebsen Hand Function Test), and quality of life (Stroke Impact Scale). There was no evidence that the benefits of VR-supported exercise therapy were maintained after the intervention ended.

Conclusions

VR-supported upper extremity exercise therapy can be effective in improving motor rehabilitation results. Our review showed that of the 12 rehabilitation outcomes examined during the course of VR-based therapy, significant improvements were detected in 2 (upper extremity motor function and range of motion), and both significant and nonsignificant improvements were observed in another 2 (muscle strength and independence in day-to-day activities), depending on the measurement tools or methods used.

Trial Registration

PROSPERO CRD42021256826; https://tinyurl.com/2uarftbh

The Usability of Blood Glucose Meters: Task Performance Differences Between Younger and Older Age Groups

This study examines the overall usability of current, commercially available self-monitoring blood glucose (SMBG) meters in order to highlight how the design affects the performance of younger and older adults. Sixteen younger participants (18-27) and 29 elderly participants (65-85) attempted to complete two tasks: 1) set date/time and 2) perform a control solution test, using two meters: the Accu-Check Compact Plus® and 2) the One Touch Ultra 2®. Overall, elderly participants had significantly more difficulty completing the two tasks and committed significantly more errors than younger participants. When using the Accu-Chek® meter to set the date and time 79% of elderly adults failed compared to 12% of younger adults. When using the One Touch® meter, 21% of elderly adults failed to complete the task while none of the younger adults failed. Across the two tasks, elderly participants made, on average, an additional 1.6 errors compared to those in the younger group.

The Influence of Computer Experience and Screen Size on Use Performance and Perceptions of a Tablet-Based Chronic Illness Self-Management System for Older Adults

A usability study of a tablet-based chronic illness self-management system was conducted to evaluate the system’s usability and to examine the effects of screen size and computer experience on use performance and perceptions of the system. A two-factor, between-subjects design was implemented, in which 40 older adults aged from 55 to 88 years were equally assigned to two screen size groups and required to perform a set of self-management tasks. The results showed that screen size had no effect on either the use performance or perceptions of the system, and that computer experience had significant effects on the former but no effect on the latter. Older adults without computer experience tended to perceive the large tablet screen system as more useful. This study verified the usability of the tablet-based self-management system with older adults. Its findings suggest the need to determine an optimal screen size for consumer health information technologies, and highlight the importance of computer experience in usability studies. Future studies may address its limitations.