[Telerehabilitation: from the virtual world to reality-Medicine in the twenty-first century : Video-assisted treatment in times of COVID-19]

Digitale Gesundheitsanwendungen in der Rehabilitation: Eine Forschungsagenda

Wenn es um den Begriff „Gesundheit“ geht, richtet sich unser Blick zunehmend auf Digitalisierungspotenziale, welche vielfältig in Form von webbasierten Informationsangeboten im Internet oder auch in Form von mobilen Anwendungen (Apps) zur eigenen Gesunderhaltung oder Kontrolle der eigenen Gesundheit eingesetzt werden können. Diese Angebote sind jederzeit bzw. nahezu ständig und von überall aus verfügbar und können problemlos auf mobilen und auf anderen geeigneten Endgeräten installiert werden 1. Aufgrund ihrer Flexibilität und Individualisierbarkeit erfahren sie intensiviertes Interesse, größere Aufmerksamkeit und eine immer weitere Verbreitung im Gesundheitsmarkt.

Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature

Rehabilitation plays a crucial role in cancer care, as the functioning of cancer survivors is frequently compromised by impairments that can result from the disease itself but also from the long-term sequelae of the treatment. Nevertheless, the current literature shows that only a minority of patients receive physical and/or cognitive rehabilitation. This lack of rehabilitative care is a consequence of many factors, one of which includes the transportation issues linked to disability that limit the patient’s access to rehabilitation facilities. The recent COVID-19 pandemic has further shown the benefits of improving telemedicine and home-based rehabilitative interventions to facilitate the delivery of rehabilitation programs when attendance at healthcare facilities is an obstacle. In recent years, researchers have been investigating the benefits of the application of virtual reality to rehabilitation. Virtual reality is shown to improve adherence and training intensity through gamification, allow the replication of real-life scenarios, and stimulate patients in a multimodal manner. In our present work, we offer an overview of the present literature on virtual reality-implemented cancer rehabilitation. The existence of wide margins for technological development allows us to expect further improvements, but more randomized controlled trials are needed to confirm the hypothesis that VRR may improve adherence rates and facilitate telerehabilitation.

[The "Fourth Wave"? COVID-19 and consecutive cognitive impairment]

The COVID-19 pandemic poses new challenges for the healthcare systems world-wide which will go beyond prevention, acute and intensive care treatment of patients with severe illness. A large proportion of "COVID-survivors" - and not only elderly patients - suffers from "post-COVID-syndrome". Risk factors are preexisting somatic multimorbidity, cognitive and cerebral changes together with pneumonia and hypoxemia, intensive care treatment and confusional states during the acute phase of illness. Post-COVID cognitive deficits usually manifest as a frontal dysexecutive syndrome combined with fatigue and dysphoria and/or with attentional and memory deficits. Several pathogenetic mechanisms of COVID encephalopathy are understood, but no specific treatment strategies have been established so far. We assume that general practitioners, psychiatrists, neurologists and social workers will need to take care of the activation, reintegration and expert appraisals of patients with post-COVID fatigue and cognitive deficits during the years to come.