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Lorentz L, Müller K, Suchan B. Virtual reality-based attention training in patients with neurological damage: A pilot study. Neuropsychol Rehabil 2024; 34:701-720. [PMID: 37466958 DOI: 10.1080/09602011.2023.2236349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
Virtual Reality has been shown to be a valid tool to assess cognitive functions in an ecologically valid way. However, evidence regarding its effectiveness as a treatment option for cognitive rehabilitation has been limited. Furthermore, its potential to facilitate the transfer of training effects to patients' everyday life is still poorly studied. This study aimed to evaluate the efficacy of a VR-based attention training and its transfer to attentional functioning in everyday life. Nineteen inpatients with neurological disorders and attentional deficits underwent daily 30-min VR training sessions over a two-week period. Attentional functions were assessed before and after the training period using several computerized tests, two self-constructed behavioral tasks, and a questionnaire assessing patients' subjective attentional functioning. Pre-Post-analyses show significant decreases in reaction times in the computerized alertness and selective attention tests. Transfer to the behavioral tasks and self-report data could not be observed. Despite the specificity of the changes, confounding effects cannot entirely be ruled out due to the lack of a control group. Results suggest that training was effective in improving attentional functioning along neuropsychological measures, but did not elicit transfer to an ecologically valid or subjective level. Implications for the future development of VR interventions are discussed.
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Affiliation(s)
- Lukas Lorentz
- St. Mauritius Therapieklinik, Meerbusch, Germany
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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Webster A, Poyade M, Coulter E, Forrest L, Paul L. Views of Specialist Clinicians and People With Multiple Sclerosis on Upper Limb Impairment and the Potential Role of Virtual Reality in the Rehabilitation of the Upper Limb in Multiple Sclerosis: Focus Group Study. JMIR Serious Games 2024; 12:e51508. [PMID: 38669680 PMCID: PMC11087863 DOI: 10.2196/51508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/14/2024] [Accepted: 03/14/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Finding enjoyable and effective long-term approaches to rehabilitation for improving the upper limb (UL) function of people with multiple sclerosis (MS) is challenging. Using virtual reality (VR) could be a solution to this challenge; however, there is a lack of reporting on the views of people with MS and clinicians on VR-based approaches and recommendations for games for rehabilitation. OBJECTIVE This study aims to identify common UL problems and their related current therapeutic approaches for people with MS, and to explore the opinions of people with MS and specialist clinicians on VR and obtain suggestions for the development and design of VR games. METHODS Separate focus groups were conducted with people with MS, recruited through the MS Society UK's research network, and clinicians, recruited through the MS Trust Therapists in MS network. A total of 10 people with MS (2 focus groups) and 8 clinicians (5 physiotherapists, 2 occupational therapists, and 1 MS nurse in 2 focus groups) were involved. The focus groups were recorded and transcriptions were analyzed using theme-based content analysis. RESULTS People with MS commonly reported that their UL problems interfered with activities of daily living and resulted in the loss of meaningful hobbies such as writing. Many people with MS neglected UL exercise and found strategies for adapting to the UL impairments. Similarly, clinicians stated UL rehabilitation was neglected within their service and that it was challenging to find interesting treatment strategies. VR was suggested by both participant groups as a solution, as it was convenient for people with MS to access and it could provide a more engaging and disguised approach to exercise. There were shared concerns with cybersickness and disengagement with using VR approaches. Both groups agreed games should be meaningful and adaptable for users but suggested different VR activities, with clinicians suggesting games directly reflecting activities of daily living and people with MS suggesting more abstract activities. CONCLUSIONS VR was well received by both people with MS and clinicians for UL rehabilitation. Recommendations were made for the development of VR rehabilitation games which are personalized and customizable for the varying abilities of people with MS.
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Affiliation(s)
- Amy Webster
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Matthieu Poyade
- School of Simulation and Visualisation, Glasgow School of Art, Glasgow, United Kingdom
| | - Elaine Coulter
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Lisa Forrest
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Lorna Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
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Azab AR, Elnaggar RK, Aloraini GS, Aldhafian OR, Alshahrani NN, Kamel FH, Basha MA, Morsy WE. Adolescents with hemophilic knee arthropathy can improve their gait characteristics, functional ability, and physical activity level through kinect-based virtual reality: A randomized clinical trial. Heliyon 2024; 10:e28113. [PMID: 38560162 PMCID: PMC10981017 DOI: 10.1016/j.heliyon.2024.e28113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
Background Hemophilic arthropathy is caused by recurrent intra-articular bleeding, most commonly in the knee joints. In terms of physical impact, this arthropathy causes significant disability and hampers the physical activity and functionality of he affected individuals. Objective This study intended to examine the effect of a physical rehabilitation program incorporating Kinect-based virtual reality (KBVR) on gait characteristics, functional ability, and physical activity level in adolescents diagnosed with hemophilic knee arthropathy (HKA). Materials and methods In a randomized clinical trial, 56 boys, aged 10-14 years, with moderate HKA, were randomly allocated into two groups. The control group (n = 28) received conventional physical therapy (CPT), while the KBVR group (n = 52) received a 30-min KBVR exercise program in addition to the CPT. Training was conducted three times/week for 12 successive weeks. Gait characteristics (step length, cadence, velocity, peak knee extension moment during stance, and knee flexion amplitude during swing) were assessed using a gait analysis system, the functional ability was assessed through the 6-min walk test, and physical activity level assessed by the Adolescents' Physical Activity Questionnaire on the pre- and post-treatment occasions. Results The KBVR group achieved more favorable changes in the gait characteristics [step length (P = 0.015), cadence (P = 0.004), velocity (P = 0.024), peak knee extension moment during stance (P = 0.018), and Knee flexion amplitude during swing (P = 0.032)], functional capacity (P = 0.002), and physical activity levels (P = 0.007) compared to the control group. Conclusion The use of KBVR exercises within a rehabilitation program is a potentially effective therapeutic option for the total care of adolescents with HKA.
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Affiliation(s)
- Alshimaa R. Azab
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ragab K. Elnaggar
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Ghfren S. Aloraini
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam University, Al-Kharj, Saudi Arabia
| | - Osama R. Aldhafian
- Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University, Saudi Arabia
| | - Naif N. Alshahrani
- Orthopedic surgery Department, King Fahd medical City Riyadh, Ministry of Health, Saudi Arabia
| | - FatmaAlzahraa H. Kamel
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah, Qassim, Saudi Arabia
| | - Maged A. Basha
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraidah, Qassim, Saudi Arabia
- Department of Physical Therapy, El-Sahel Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Walaa E. Morsy
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Jazan University, KSA
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4
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Sadri S, Loeb GJ, Grinshpoon A, Elvezio C, Sun SH, Ng VG, Khalique O, Moses JW, Einstein AJ, Patel AJ, George I, Hahn RT, Nazif TM, Leon MB, Kirtane AJ, Kodali SK, Feiner SK, Vahl TP. First Experience With Augmented Reality Guidance for Cerebral Embolic Protection During TAVR. JACC. ADVANCES 2024; 3:100839. [PMID: 38938839 PMCID: PMC11198681 DOI: 10.1016/j.jacadv.2024.100839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/18/2023] [Accepted: 10/23/2023] [Indexed: 06/29/2024]
Abstract
Background Augmented reality (AR) guidance holds potential to improve transcatheter interventions by enabling visualization of and interaction with patient-specific 3-dimensional virtual content. Positioning of cerebral embolic protection devices (CEP) during transcatheter aortic valve replacement (TAVR) increases patient exposure to radiation and iodinated contrast, and increases procedure time. AR may enhance procedural guidance and facilitate a safer intervention. Objectives The purpose of this study was to develop and test a novel AR guidance system with a custom user interface that displays virtual, patient-specific 3-dimensional anatomic models, and assess its intraprocedural impact during CEP placement in TAVR. Methods Patients undergoing CEP during TAVR were prospectively enrolled and assigned to either AR guidance or control groups. Primary endpoints were contrast volume used prior to filter placement, times to filter placement, and fluoroscopy time. Postprocedure questionnaires were administered to assess intraprocedural physician experience with AR guidance. Results A total of 24 patients presenting for TAVR were enrolled in the study (12 with AR guidance and 12 controls). AR guidance eliminated the need for aortic arch angiograms prior to device placement thus reducing contrast volume (0 mL vs 15 mL, P < 0.0001). There was no significant difference in the time required for filter placement or fluoroscopy time. Postprocedure questionnaires indicated that AR guidance increased confidence in wiring of the aortic arch and facilitated easier device placement. Conclusions We developed a novel AR guidance system that eliminated the need for additional intraprocedural angiograms prior to device placement without any significant difference in time to intervention and offered a subjective improvement in performance of the intervention.
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Affiliation(s)
- Shirin Sadri
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Gabrielle J. Loeb
- Department of Radiology, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Alon Grinshpoon
- Department of Computer Science, Columbia University, New York, New York, USA
| | - Carmine Elvezio
- Department of Computer Science, Columbia University, New York, New York, USA
| | - Shawn H. Sun
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
| | - Vivian G. Ng
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Omar Khalique
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Jeffrey W. Moses
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Andrew J. Einstein
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Amisha J. Patel
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Isaac George
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Rebecca T. Hahn
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Tamim M. Nazif
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Martin B. Leon
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Ajay J. Kirtane
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Susheel K. Kodali
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
| | - Steven K. Feiner
- Department of Computer Science, Columbia University, New York, New York, USA
| | - Torsten P. Vahl
- Division of Cardiology, Department of Medicine, NewYork-Presbyterian Hospital/Columbia University Irving Medical Center, New York, New York, USA
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5
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Naqvi WM, Naqvi I, Mishra GV, Vardhan V. The Dual Importance of Virtual Reality Usability in Rehabilitation: A Focus on Therapists and Patients. Cureus 2024; 16:e56724. [PMID: 38646260 PMCID: PMC11032731 DOI: 10.7759/cureus.56724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Virtual reality (VR) has advanced in medical education and rehabilitation from basic graphical applications due to its ability to generate a virtual three-dimensional (3D) environment. This environment is mostly used to practice professional skills, plan surgery procedures, simulate surgeries, display 3D anatomy, and rehabilitate various disorders. VR has transformed the field of rehabilitation therapy by providing immersive and engaging experiences that go beyond traditional bounds, significantly improving patient care and therapeutic results. Considering the direct impact of VR on the efficacy of the treatment for both therapists and patients, its dual significance for usability and user experience cannot be overstated. The purpose of this article is to determine the synergistic association between VR accessibility and the rehabilitation process, highlighting the significance of VR technology in designing the future of rehabilitation therapy and demonstrating how advancing VR technology can improve therapeutic outcomes despite overcoming obstacles encountered during VR usage. In conclusion, VR offers a personalized, efficient, interesting, and engaging rehabilitative environment for patients, while also assisting therapists in cultivating empathy and efficiency and encouraging innovative approaches in treatment procedures.
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Affiliation(s)
- Waqar M Naqvi
- Interdisciplinary Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, IND
- Physiotherapy, College of Health Sciences, Gulf Medical University, Ajman, ARE
| | - Ifat Naqvi
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gaurav V Mishra
- Radiodiagnosis, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vishnu Vardhan
- Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Zaman N, Ong J, Waisberg E, Masalkhi M, Lee AG, Tavakkoli A, Zuckerbrod S. Advanced Visualization Engineering for Vision Disorders: A Clinically Focused Guide to Current Technology and Future Applications. Ann Biomed Eng 2024; 52:178-207. [PMID: 37861913 DOI: 10.1007/s10439-023-03379-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
Head-mounted visualization technology, often in the form of virtual, augmented, and mixed reality (VAMR), has revolutionized how visual disorders may be approached clinically. In this manuscript, we review the available literature on VAMR for visual disorders and provide a clinically oriented guide to how VAMR technology has been deployed for visual impairments. The chief areas of clinical investigation with VAMR are divided include (1) vision assessment, (2) vision simulation, and (3) vision rehabilitation. We discuss in-depth the current literature of these areas in VAMR and upcoming/future applications to combat the detrimental impact of visual impairment worldwide.
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Affiliation(s)
- Nasif Zaman
- Human-Machine Perception Laboratory, University of Nevada, Reno, NV, USA
| | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Mouayad Masalkhi
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Andrew G Lee
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, University of Nevada, Reno, NV, USA
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7
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Ali AS, Kumaran DS, Unni A, Sardesai S, Prabhu V, Nirmal P, Pai AR, Guddattu V, Arumugam A. Effectiveness of an Intensive, Functional, and Gamified Rehabilitation Program on Upper Limb Function in People With Stroke (EnteRtain): A Multicenter Randomized Clinical Trial. Neurorehabil Neural Repair 2024:15459683231222921. [PMID: 38284559 DOI: 10.1177/15459683231222921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
BACKGROUND1 Despite a growing interest in gaming rehabilitation for upper limb (UL) recovery post-stroke, studies investigating the effects of game-based rehabilitation incorporating functional games are lacking. OBJECTIVE To investigate the efficacy of an intensive, functional, gamified rehabilitation program compared to task-based training on UL motor function in acute/sub-acute stroke survivors. METHODS This randomized, multicenter, single-blind, clinical trial comprises 120 participants with unilateral stroke who were randomized to receive either gamified training (n = 64) using the ArmAble™ [experimental group (EG)] or task-based training (n = 56) in conjunction with conventional therapy for 2 hours per day, 6 days per week for 2 weeks, followed by UL rehabilitation for another 4 weeks at home. Primary outcomes evaluated by a blinded assessor included the Fugl-Meyer Assessment-Upper Extremity (FM-UE), and Action Research Arm Test (ARAT). Data were analyzed using a linear mixed-effect regression model. RESULTS The mean (standard deviation) age of the participants was 54.4 ± 11.7 years (78.1% men) in the EG and 57.7 ± 10.9 years (73.2% men) in the comparator group (CG). The median (interquartile range) time since stroke was 30.0 (54.0) days in the EG and 22.5 (45.0) days in the CG. Following the 2-week intervention, a statistically significant improvement was observed in the EG for the FM-UE [between-group mean differences (95% confidence interval): -3.9 (-6.5, -1.3); P = .003]; but not for the ARAT [-2.9 (-5.8, 0.0); P = .051]. Gains at 6 weeks were significantly greater in the EG for both FM-UE [-3.9 (-6.5, -1.3); P = .003]; and ARAT [-3.0 (-5.9, -0.0); P = .046]. CONCLUSION Gamified rehabilitation using the ArmAble™ device has shown immediate and short-term improvement in UL function after acute/sub-acute stroke. CLINICAL TRIALS REGISTRY NUMBER CTRI/2020/09/027651.
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Affiliation(s)
- A Sulfikar Ali
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - D Senthil Kumaran
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Amritha Unni
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sanjukta Sardesai
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Prabhu
- Department of Physiotherapy, SDM Ayurveda Hospital, Udupi, Karnataka, India
| | - Punitha Nirmal
- Department of Physiotherapy, Poovanthi Institute of Rehabilitation and Elder care, Poovanthi, Tamil Nadu, India
| | - Aparna R Pai
- Department of Neurology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Vasudeva Guddattu
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, UAE
- Adjunct Faculty, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
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8
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Faria AL, Almeida Y, Branco D, Câmara J, Cameirão M, Ferreira L, Moreira A, Paulino T, Rodrigues P, Spinola M, Vilar M, Bermúdez i Badia S, Simões M, Fermé E. NeuroAIreh@b: an artificial intelligence-based methodology for personalized and adaptive neurorehabilitation. Front Neurol 2024; 14:1258323. [PMID: 38322797 PMCID: PMC10846403 DOI: 10.3389/fneur.2023.1258323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/21/2023] [Indexed: 02/08/2024] Open
Abstract
Cognitive impairments are a prevalent consequence of acquired brain injury, dementia, and age-related cognitive decline, hampering individuals' daily functioning and independence, with significant societal and economic implications. While neurorehabilitation represents a promising avenue for addressing these deficits, traditional rehabilitation approaches face notable limitations. First, they lack adaptability, offering one-size-fits-all solutions that may not effectively meet each patient's unique needs. Furthermore, the resource-intensive nature of these interventions, often confined to clinical settings, poses barriers to widespread, cost-effective, and sustained implementation, resulting in suboptimal outcomes in terms of intervention adaptability, intensity, and duration. In response to these challenges, this paper introduces NeuroAIreh@b, an innovative cognitive profiling and training methodology that uses an AI-driven framework to optimize neurorehabilitation prescription. NeuroAIreh@b effectively bridges the gap between neuropsychological assessment and computational modeling, thereby affording highly personalized and adaptive neurorehabilitation sessions. This approach also leverages virtual reality-based simulations of daily living activities to enhance ecological validity and efficacy. The feasibility of NeuroAIreh@b has already been demonstrated through a clinical study with stroke patients employing a tablet-based intervention. The NeuroAIreh@b methodology holds the potential for efficacy studies in large randomized controlled trials in the future.
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Affiliation(s)
- Ana Lúcia Faria
- Department of Psychology, Faculty of Arts and Humanities, University of Madeira, Funchal, Portugal
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
| | - Yuri Almeida
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Diogo Branco
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Joana Câmara
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Mónica Cameirão
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Luis Ferreira
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - André Moreira
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Teresa Paulino
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Pedro Rodrigues
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Mónica Spinola
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
| | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Sergi Bermúdez i Badia
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Agência Regional para o Desenvolvimento da Investigação, Tecnologia e Inovação, Funchal, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
| | - Mario Simões
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Coimbra, Portugal
| | - Eduardo Fermé
- NOVA Laboratory for Computer Science and Informatics, Caparica, Portugal
- Department of Informatics Engineering, Faculty of Exact Sciences and Engineering University of Madeira, Funchal, Portugal
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9
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Yan S, Shen S, Lu Q, Zhong S, Lv S, Lai S, Luo Y, Ran H, Duan M, Song K, Ye K, Jia Y. Virtual reality working memory training improves cognitive performance of acute and remitted patients with major depressive disorder. J Affect Disord 2024; 344:267-276. [PMID: 37838265 DOI: 10.1016/j.jad.2023.10.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/14/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Cognitive training is effective in treating neuropsychological impairment in patients with major depressive disorder (MDD), and virtual reality (VR) is a promising tool to provide such training. However, studies using VR-based working memory (WM) training in treating depressed patients' cognitive impairment are extremely scarce and how it affects cognitive performance remains unclear. Therefore, we aimed to determine the efficacy of VR-WM training in acute and remitted depressed patients and try to investigate its potential mechanisms. METHODS Forty-two patients with MDD (22 acute patients and 20 remitted patients) received 20-session VR-WM training, while 22 healthy controls (HC) received no intervention. WM and other cognitive domains' performance were assessed by the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) and the MATRICS Consensus Cognitive Battery (MCCB) before and after the intervention. Depressive symptoms were assessed by the 24-item Hamilton Depression Rating Scale (24-HDRS) at the same time points. RESULTS Acute and remitted MDD patients both exhibited significant improvements from pre- to post-training in WM, processing speed, visual learning, reasoning and problem-solving, and total cognition (all p < 0.05). Significant groups-by-time interactions were observed for the 24-HDRS score (p < 0.05). Mediation analysis showed that 24-HDRS score partially mediated the association between the effect of VR-WM training on WM and total cognition performance in total depressive samples. CONCLUSIONS VR-WM training effectively improved WM and other cognitive domains' performance in both acute and remitted MDD patients. Besides, VR-WM training improves WM and total cognition performance in MDD patients partially via the enhancement of depressive symptoms.
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Affiliation(s)
- Shuya Yan
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shiyi Shen
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; School of Management, Jinan University, Guangzhou 510630, China
| | - Qianyi Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Guangdong University of Finance, Guangzhou 510521, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510630, China; Department of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen 518033, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510630, China; School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Manying Duan
- School of Management, Jinan University, Guangzhou 510630, China
| | - Kailin Song
- School of Management, Jinan University, Guangzhou 510630, China
| | - Kaiwei Ye
- School of Management, Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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10
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Bryant L, Sedlarevic N, Stubbs P, Bailey B, Nguyen V, Bluff A, Barnett D, Estela M, Hayes C, Jacobs C, Kneebone I, Lucas C, Mehta P, Power E, Hemsley B. Collaborative co-design and evaluation of an immersive virtual reality application prototype for communication rehabilitation (DISCOVR prototype). Disabil Rehabil Assist Technol 2024; 19:90-99. [PMID: 35442823 DOI: 10.1080/17483107.2022.2063423] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Virtual reality (VR) lends itself to communication rehabilitation by creating safe, replicable, and authentic simulated environments in which users learn and practice communication skills. The aim of this research was to obtain the views of health professionals and technology specialists on the design characteristics and usability of a prototype VR application for communication rehabilitation. MATERIALS AND METHODS Nine professionals from different health and technology disciplines participated in an online focus group or individual online interview to evaluate the application and use of the VR prototype. Data sources were analysed using a content thematic analysis. RESULTS Four main themes relating to VR design and implementation in rehabilitation were identified: (i) designing rehabilitation-focused virtual worlds; (ii) understanding and using VR hardware; (iii) making room for VR in rehabilitation and training; and (iv) implementing VR will not replace the health professional's role. DISCUSSION Health professionals and technology specialists engaged in co-design while evaluating the VR prototype. They identified software features requiring careful consideration to ensure improved usability, client safety, and success in communication rehabilitation outcomes. Continuing inclusive co-design, engaging health professionals, clients with communication disability, and their families will be essential to creating useable VR applications and integrating these successfully into rehabilitation. Implications for rehabilitationHealth and technology professionals, along with clients, are integral to the co-design of new VR technology applications.Design of VR applications needs to consider the client's communication, physical, cognitive, sensory, psychosocial, and emotional needs for greater usability of these programs.Realism and authenticity of interactions, characters, and environments are considered important factors to allow users to be fully immersed in virtual simulations to enhance rehabilitation.
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Affiliation(s)
- Lucy Bryant
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Neira Sedlarevic
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Peter Stubbs
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Benjamin Bailey
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Vincent Nguyen
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Andrew Bluff
- Faculty of Transdisciplinary Innovation, University of Technology Sydney Animal Logic Academy, Sydney, Australia
| | - Diana Barnett
- Occupational Therapist Children's Hospital, Westmead, Australia
| | | | - Carolyn Hayes
- Susan Wakil School of Nursing and Midwifery, Faculty of Health and Medicine, The University of Sydney, Sydney, Australia
| | - Chris Jacobs
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Ian Kneebone
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Cherie Lucas
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Poonam Mehta
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Emma Power
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
| | - Bronwyn Hemsley
- University of Technology Sydney Graduate School of Health, Faculty of Health, Sydney, Australia
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11
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Liu Y, Xu B, Xie Z, Yang J, Liu Y, Yang Y, Xu H. Intrinsically Stretchable, Self-Healing, and Large-Scale Epidermal Bioelectrode Arrays for Electrophysiology and Gesture Recognition. ACS APPLIED MATERIALS & INTERFACES 2023; 15:59787-59794. [PMID: 38097388 DOI: 10.1021/acsami.3c13942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Electrophysiological (EP) signals, referred to as low-level biopotentials driven by active or passive human movements, are of great importance for kinesiology, rehabilitation, and human-machine interaction. To capture high-fidelity EP signals, bioelectrodes should possess high conductivity, high stretchability, and high conformability to skin. While traditional metal bioelectrodes are endowed with stretchability via complex structural designs, they are vulnerable to external or internal inference due to their low fracture strain and large modulus. Here, we report a self-healing elastic composite of silver nanowire (AgNW), graphite nanosheet, and styrene-block-poly(ethylene-ran-butylene)-block-polystyrene, which exhibits high stretchability of ε = 500%, high conductivity of σ = ∼1923 S·cm-1, and low resistance change (ΔR/R0) of 0.14 at ε = 40% while its resistance increases ∼0.8% after a 24 h stretching operation at ε = 50%. We employed the elastic composites for accurate and stable monitoring of electrocardiograph and surface electromyography (sEMG) signals. Further, we demonstrate an all-solution and printable process to obtain a large-scale sEMG bioelectrode array, enabling highly conformal adhesion on skin and high-fidelity gesture recognition.
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Affiliation(s)
- Yifan Liu
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
| | - Baobao Xu
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
| | - Zhixin Xie
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
| | - Jiaxin Yang
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
| | - Yutong Liu
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
| | - Yiyi Yang
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
| | - Haihua Xu
- School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen 518060, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, Shenzhen 518060, China
- National-Regional Key Technology Engineering Laboratory for Medical Ultrasound, Shenzhen 518060, China
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12
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Buele J, Varela-Aldás JL, Palacios-Navarro G. Virtual reality applications based on instrumental activities of daily living (iADLs) for cognitive intervention in older adults: a systematic review. J Neuroeng Rehabil 2023; 20:168. [PMID: 38110970 PMCID: PMC10729470 DOI: 10.1186/s12984-023-01292-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/07/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND In recent years, the use of virtual reality (VR) as a complementary intervention in treating cognitive impairment has significantly increased. VR applications based on instrumental activities of daily living (iADL-VR) could offer a promising approach with greater ecological validity for intervention in groups with cognitive impairments. However, the effectiveness of this approach is still debated. OBJECTIVE This systematic review aims to synthesize the effects of iADL-VR interventions to rehabilitate, train, or stimulate cognitive functions in healthy adults and people with mild cognitive impairment (MCI) and different types of dementia. METHODS A systematic search was performed in the Scopus, PubMed, IEEE Xplore, Web of Science, and APA PsycNet databases until September 2022 and repeated in April 2023. The selected studies met the search terms, were peer-reviewed, included an iADL-VR intervention, and were written in English. Descriptive, qualitative studies, reviews, cognitive assessment, non-intervention studies, those unrelated to VR or iADL, those focused on motor aspects, and non-degenerative disorders were excluded. The PEDro scale was used to assess the methodological quality of the controlled studies. To present and synthesize the results, we organized the extracted data into three tables, including PEDro scores, participant characteristics, and study characteristics. RESULTS Nineteen studies that met the inclusion and exclusion criteria were included. The total sample reached 590 participants, mostly women (72.67%). Approximately 30% were diagnosed with Alzheimer's disease or dementia, and 20% had mild cognitive impairment. Variables such as authors and year of publication, study design, type of intervention and VR applied, duration of the intervention, main findings, and conclusions were extracted. Regarding demographic characteristics, the sample size, age, sex, years of education, neurological diagnosis, dropouts, and the city and country where the intervention took place were recorded. Almost all studies showed improvements in some or all the outcomes after the intervention, generally greater in the iADL-VR group than in the control group. CONCLUSION iADL-VR interventions could be beneficial in improving the performance of cognitive functions in older adults and people with MCI and different types of dementia. The ecological component of these tasks makes them very suitable for transferring what has been learned to the real world. However, such transfer needs to be confirmed by further studies with larger and more homogeneous samples and longer follow-up periods. This review had no primary funding source and was registered with PROSPERO under registration ID: 375166.
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Affiliation(s)
- Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción, Universidad Indoamérica, Ambato, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, Teruel, Spain
| | - José Luis Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación (CICHE), Universidad Indoamérica, Ambato, Ecuador
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13
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Mc Kittrick A, Desselle MR, Padilha Lanari Bo A, Zhang B, Laracy S, Tornatore G. Patient Experience in Adjunct Controller-Free Hand Tracking Virtual Reality Tasks for Upper-Limb Occupational Therapy Rehabilitation. J Patient Exp 2023; 10:23743735231211983. [PMID: 37941585 PMCID: PMC10629314 DOI: 10.1177/23743735231211983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023] Open
Abstract
Benefits of immersive virtual reality rehabilitation (VRR) include increased motivation and improved transfer of skills to real-world tasks. The introduction of Oculus hand-tracking technology allowed for the development of VRR games that do not need virtual reality (VR) hand controllers. This is beneficial as participants with upper limb impairments/injuries may have difficulties with/be limited in using/manipulating VR hand controllers. In this project, a VRR game was developed and evaluated. The aim of this study was to determine patient experience when using VRR as an adjunct to upper-limb rehabilitation. N = 20 participants receiving upper limb rehabilitation completed a series of VRR tasks by playing the "smoothie bar" VRR game. After the completion of the VRR tasks, the participant experience was evaluated via a study-specific questionnaire. Key findings include 95% agreement that VRR tasks were fun and engaging and 75% agreed that VR tasks will be helpful to include in their rehabilitation. Hands-tracking VRR has a high potential to be used as an adjunct intervention in upper limb rehabilitation.
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Affiliation(s)
- Andrea Mc Kittrick
- Occupational Therapy Department, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Mathilde R Desselle
- Herston Biofabrication Institute, Metro North Health, Herston, QLD, Australia
| | - Antonio Padilha Lanari Bo
- Electrical and Biomedical Engineering, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, QLD, Australia
| | - Bianca Zhang
- Electrical and Biomedical Engineering, School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, QLD, Australia
| | - Sue Laracy
- Occupational Therapy Department, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Giovanna Tornatore
- Occupational Therapy Department, Surgical Treatment and Rehabilitation Service, Herston, QLD, Australia
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14
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Lettre J, Routhier F, Giesbrecht EM, Choukou MA, Miller WC, Archambault PS. Clinical stakeholders' perspective for the integration of an immersive wheelchair simulator as a clinical tool for powered wheelchair training. Assist Technol 2023; 35:497-505. [PMID: 36701417 DOI: 10.1080/10400435.2022.2161669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2022] [Indexed: 01/27/2023] Open
Abstract
This study aimed to investigate clinical stakeholders' acceptance of an immersive wheelchair simulator as a potential powered wheelchair skills training tool. Focus groups, conducted in four rehabilitation centers, were used to obtain a rich understanding of participants' experiences and beliefs. Then, a cross-sectional survey of the simulator acceptability for clinical practice was created. Twenty-three rehabilitation therapists and clinical program directors participated in the focus groups and thirty-three responded to the survey. Participants generally expressed that use of the simulator would be complementary to training in an actual powered wheelchair, and that it could be useful for challenging situations in rehabilitation centers (e.g. anxious clients; when there is uncertainty around their potential to drive a powered wheelchair; tasks that cannot be assessed in a real-life environment). They also provided suggestions to improve the simulator (e.g. more feedback during tasks; possibility of adjusting control settings such as speed and sensitivity; possibility of adding varied control interfaces). Feedback received from key stakeholders clearly indicated that the wheelchair simulator would be complementary to training provided in a real context of use. However, some important limitations must be addressed to improve the simulator and promote its adoption by clinical programs, therapists and clients.
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Affiliation(s)
- Josiane Lettre
- Center for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - François Routhier
- Center for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - Edward M Giesbrecht
- Department of Occupational Therapy, University of Manitoba, Winnipeg, MB, Canada
| | | | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Program and GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Philippe S Archambault
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
- Center for interdisciplinary research in rehabilitation of the greater Montreal, Centre intégré de santé et de services sociaux de Laval, Laval, QC, Canada
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15
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Brown NB, Milani S, Jabs F, Kingstone A, Brotto LA. Exploring Women's State-Level Anxiety in Response to Virtual Reality Erotica. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:137-151. [PMID: 37807833 DOI: 10.1080/0092623x.2023.2265924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Virtual Reality (VR)-based treatments for anxiety disorders are efficacious but there is a lack of research examining anxious responses to VR erotica, which could innovate treatments for sexual difficulties. We examined erotica features that elicited anxiety and sexual presence in women. Thirty-eight women viewed erotic videos from different modalities (2D, VR) and points of view (1st, 3rd person) and completed anxiety and sexual presence measures before and after each video. Women experienced greater anxiety for VR than 2D films and reported the most anxiety for VR 1st person films. Sexual presence was affected by modality and point of view.
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Affiliation(s)
- Natalie B Brown
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Sonia Milani
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Faith Jabs
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Alan Kingstone
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Lori A Brotto
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, Canada
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16
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Lahude AB, Souza Corrêa P, P Cabeleira ME, Cechetti F. The impact of virtual reality on manual dexterity of Parkinson's disease subjects: a systematic review. Disabil Rehabil Assist Technol 2023; 18:1237-1244. [PMID: 35077662 DOI: 10.1080/17483107.2021.2001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To present the latest available evidence on the effects of a VR-based therapy on the manual dexterity of PD subjects. MATERIALS AND METHODS The search was conducted in PubMed, EMBASE, and PEDro databases. Were included in the systematic review Randomized Clinical Trials, Pilot and Feasibility studies published up to December 2020. The studies should include at least one of the following assessments: Box and Blocks Test, 9-Hole Peg Test; Purdue Pegboard Test. PEDro Scale was used to assess the methodological quality of the included studies. RESULTS Eight studies were included in the review. Most studies have shown an improvement in outcomes for manual dexterity, but most of them presented a high risk of bias with low methodological quality. A high heterogeneity was observed in the protocols used for each study. CONCLUSION The results suggest that VR-based therapy has great potential and feasibility to be used as a manual dexterity rehabilitation protocol in PD subjects. However, these results must be interpreted carefully and studies with greater methodological rigor must be conducted.Implications For RehabilitationRehabilitation programs using virtual reality seem to have greater adherence to the user.Immersive virtual reality systems seem to do better in manual dexterity than non-immersive systems.It is plausible to use virtual reality systems in telerehabilitation for manual dexterity training in subjects with Parkinson's' Disease.The use of Virtual Reality by the therapist in a rehabilitation program allows him to modulate the exercises, enabling a wide variety of therapeutic options.
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Affiliation(s)
- Arthur Both Lahude
- Post-Graduation Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Philipe Souza Corrêa
- Post-Graduation Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Maria Eduarda P Cabeleira
- Post-Graduation Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
| | - Fernanda Cechetti
- Post-Graduation Program in Rehabilitation Sciences, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil
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Forero J, Vette AH, Hebert JS. Technology-based balance performance assessment can eliminate floor and ceiling effects. Sci Rep 2023; 13:14488. [PMID: 37660133 PMCID: PMC10475013 DOI: 10.1038/s41598-023-41671-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023] Open
Abstract
Many clinical measurement tools for balance have ceiling effects. Technology-based assessments using virtual reality systems such as the Computer-Assisted Rehabilitation Environment (CAREN) may provide a way to develop objective, quantitative measures that scale from low to high levels of difficulty. Our objective was to: (1) develop a performance assessment tool (PAT) for the CAREN; (2) quantify the reliability of the tool; (3) validate the scores against clinical balance measures; and (4) compare the scores from a population with balance impairments to those from able-bodied individuals in a cross-sectional validation study. Three games were developed on the CAREN and tested on 49 participants (36 able-bodied and 13 with impaired mobility). For each module, the corresponding measures were transformed into scores using a series of functions such that ceiling and flooring effects would be minimized. The results showed an association between scores and age, an overlap in scores from impaired high-performance individuals and able-bodied low performance individuals, and a correlation of PAT scores with other clinical tests. Several of the limitations of current clinical tools, including floor and ceiling effects, were overcome by the PAT, suggesting that the PAT can be used to monitor the effect of rehabilitation and training.
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Affiliation(s)
- Juan Forero
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Albert H Vette
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, AB, Canada
| | - Jacqueline S Hebert
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
- Glenrose Rehabilitation Hospital, Alberta Health Services, Edmonton, AB, Canada.
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Šlosar L, Peskar M, Pišot R, Marusic U. Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest. Front Aging Neurosci 2023; 15:1169683. [PMID: 37674784 PMCID: PMC10477372 DOI: 10.3389/fnagi.2023.1169683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
| | - Manca Peskar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
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Hurvitz N, Ilan Y. The Constrained-Disorder Principle Assists in Overcoming Significant Challenges in Digital Health: Moving from "Nice to Have" to Mandatory Systems. Clin Pract 2023; 13:994-1014. [PMID: 37623270 PMCID: PMC10453547 DOI: 10.3390/clinpract13040089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
The success of artificial intelligence depends on whether it can penetrate the boundaries of evidence-based medicine, the lack of policies, and the resistance of medical professionals to its use. The failure of digital health to meet expectations requires rethinking some of the challenges faced. We discuss some of the most significant challenges faced by patients, physicians, payers, pharmaceutical companies, and health systems in the digital world. The goal of healthcare systems is to improve outcomes. Assisting in diagnosing, collecting data, and simplifying processes is a "nice to have" tool, but it is not essential. Many of these systems have yet to be shown to improve outcomes. Current outcome-based expectations and economic constraints make "nice to have," "assists," and "ease processes" insufficient. Complex biological systems are defined by their inherent disorder, bounded by dynamic boundaries, as described by the constrained disorder principle (CDP). It provides a platform for correcting systems' malfunctions by regulating their degree of variability. A CDP-based second-generation artificial intelligence system provides solutions to some challenges digital health faces. Therapeutic interventions are held to improve outcomes with these systems. In addition to improving clinically meaningful endpoints, CDP-based second-generation algorithms ensure patient and physician engagement and reduce the health system's costs.
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Affiliation(s)
| | - Yaron Ilan
- Hadassah Medical Center, Department of Medicine, Faculty of Medicine, Hebrew University, POB 1200, Jerusalem IL91120, Israel;
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Favre J, Cantaloube A, Jolles BM. Rehabilitation for Musculoskeletal Disorders: The Emergence of Serious Games and the Promise of Personalized Versions Using Artificial Intelligence. J Clin Med 2023; 12:5310. [PMID: 37629350 PMCID: PMC10455669 DOI: 10.3390/jcm12165310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
According to the World Health Organization (WHO), musculoskeletal conditions are among the most common health problems, affecting approximately 1 [...].
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Affiliation(s)
- Julien Favre
- Swiss BioMotion Lab, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland
- The Sense Innovation and Research Center, CH-1007 Lausanne, Switzerland
| | - Alexis Cantaloube
- Swiss BioMotion Lab, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland
| | - Brigitte M. Jolles
- Swiss BioMotion Lab, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland
- Institute of Electrical and Micro Engineering, Ecole Polytechnique Fédérale Lausanne (EPFL), CH-1015 Lausanne, Switzerland
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Arntz A, Weber F, Handgraaf M, Lällä K, Korniloff K, Murtonen KP, Chichaeva J, Kidritsch A, Heller M, Sakellari E, Athanasopoulou C, Lagiou A, Tzonichaki I, Salinas-Bueno I, Martínez-Bueso P, Velasco-Roldán O, Schulz RJ, Grüneberg C. Technologies in Home-Based Digital Rehabilitation: Scoping Review. JMIR Rehabil Assist Technol 2023; 10:e43615. [PMID: 37253381 PMCID: PMC10415951 DOI: 10.2196/43615] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/10/2023] [Accepted: 05/25/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Due to growing pressure on the health care system, a shift in rehabilitation to home settings is essential. However, efficient support for home-based rehabilitation is lacking. The COVID-19 pandemic has further exacerbated these challenges and has affected individuals and health care professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet clients' needs and ease the growing pressure on the health care system, it is necessary to provide an overview of existing, relevant, and future solutions shaping the constantly evolving market of technologies for home-based DR. OBJECTIVE In this scoping review, we aimed to identify digital technologies for home-based DR, predict new or emerging DR trends, and report on the influences of the COVID-19 pandemic on DR. METHODS The scoping review followed the framework of Arksey and O'Malley, with improvements made by Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. The search spanned January 2015 to January 2022. A bibliometric analysis was performed to provide an overview of the included references, and a co-occurrence analysis identified the technologies for home-based DR. A full-text analysis of all included reviews filtered the trends for home-based DR. A gray literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic on the development of DR. RESULTS A total of 2437 records were included in the bibliometric analysis and 95 in the full-text analysis, and 40 records were included as a result of the gray literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital and mobile apps are already used in home-based DR; however, artificial intelligence and machine learning, exoskeletons, and digital and mobile apps represent new and emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches but has not led to the development of new technologies. CONCLUSIONS Multiple tools are available and implemented for home-based DR; however, some technologies face limitations in the application of home-based rehabilitation. However, artificial intelligence and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the health care system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients' needs and adhere to framework conditions, regardless of exceptional situations such as the COVID-19 pandemic.
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Affiliation(s)
- Angela Arntz
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
- Faculty of Human Sciences, University of Cologne, Cologne, Germany
| | - Franziska Weber
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
- Department of Rehabilitation, Physiotherapy Science & Sports, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marietta Handgraaf
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
| | - Kaisa Lällä
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Katariina Korniloff
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Kari-Pekka Murtonen
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Julija Chichaeva
- Institute of Rehabilitation, Jamk University of Applied Sciences, Jyväskylä, Finland
| | - Anita Kidritsch
- Institute of Health Sciences, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Mario Heller
- Department of Media & Digital Technologies, St. Pölten University of Applied Sciences, St. Pölten, Austria
| | - Evanthia Sakellari
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, University of West Attica, Athens, Greece
| | | | - Areti Lagiou
- Department of Public and Community Health, Laboratory of Hygiene and Epidemiology, University of West Attica, Athens, Greece
| | - Ioanna Tzonichaki
- Department of Occupational Therapy, University of West Attica, Athens, Greece
| | - Iosune Salinas-Bueno
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Pau Martínez-Bueso
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | - Olga Velasco-Roldán
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma de Mallorca, Spain
| | | | - Christian Grüneberg
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Health Sciences Bochum, Bochum, Germany
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Rodríguez-Mansilla J, Bedmar-Vargas C, Garrido-Ardila EM, Torres-Piles ST, González-Sánchez B, Rodríguez-Domínguez MT, Ramírez-Durán MV, Jiménez-Palomares M. Effects of Virtual Reality in the Rehabilitation of Parkinson's Disease: A Systematic Review. J Clin Med 2023; 12:4896. [PMID: 37568298 PMCID: PMC10419374 DOI: 10.3390/jcm12154896] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Parkinson's disease is characterised by the loss of balance and the presence of walking difficulties. The inclusion of rehabilitation therapies to complement pharmacological therapy allows for comprehensive management of the disease. In recent years, virtual reality has been gaining importance in the treatment of neurological diseases and their associated symptoms. Therefore, the objective of this systematic review was to analyse the effectiveness of virtual reality on balance and gait in patients with Parkinson's disease. METHODS This study is a systematic review conducted following PRISMA's statements. An electronic search of the literature was carried out in the following databases: PubMed, Cochrane, Dialnet, Scopus, Web of Science, PsycINFO and Science Direct PEDro. The inclusion criteria were controlled and non-controlled clinical trials published in the last 12 years in English or Spanish, in which virtual reality was applied to treat balance and gait impairments in patients with Parkinson's disease. RESULTS 20 studies were finally included in this review. A total of 480 patients participated in the included studies. All patients were diagnosed with Parkinson's disease. Most of the investigations used the Nintendo Wii + Balance Board or the Microsoft Kinect TM combined with the Kinect Adventures games as a virtual reality device. CONCLUSIONS According to the results of this literature review, virtual reality-based interventions achieve good adherence to treatment, bring innovation and motivation to rehabilitation, and provide feedback as well as cognitive and sensory stimulation in patients with Parkinson's disease. Therefore, virtual reality can be considered an alternative for personalised rehabilitation and for home treatment.
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Affiliation(s)
- Juan Rodríguez-Mansilla
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Medicine Faculty and Health Sciences, University of Extremadura, 06006 Badajoz, Spain; (J.R.-M.); (M.J.-P.)
| | | | - Elisa María Garrido-Ardila
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Medicine Faculty and Health Sciences, University of Extremadura, 06006 Badajoz, Spain; (J.R.-M.); (M.J.-P.)
| | - Silvia Teresa Torres-Piles
- Research Group in Immunophysiology, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, University of Extremadura, 06006 Badajoz, Spain;
| | - Blanca González-Sánchez
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Medicine Faculty and Health Sciences, University of Extremadura, 06006 Badajoz, Spain; (J.R.-M.); (M.J.-P.)
| | - María Trinidad Rodríguez-Domínguez
- Robolab Research Group, Medical and Surgical Therapy Department, Nursing and Occupational Therapy Faculty, University of Extremadura, 10003 Cáceres, Spain
| | - María Valle Ramírez-Durán
- Department of Nursing, University Centre of Plasencia, University of Extremadura, 10600 Plasencia, Spain;
| | - María Jiménez-Palomares
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Medicine Faculty and Health Sciences, University of Extremadura, 06006 Badajoz, Spain; (J.R.-M.); (M.J.-P.)
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23
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Kolk A, Saard M, Roštšinskaja A, Sepp K, Kööp C. Power of combined modern technology: Multitouch-multiuser tabletops and virtual reality platforms ( PowerVR) in social communication skills training for children with neurological disorders: A pilot study. APPLIED NEUROPSYCHOLOGY. CHILD 2023; 12:187-196. [PMID: 35508442 DOI: 10.1080/21622965.2022.2066532] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
New technologies such as multitouch-multiuser tabletops (MMT) and virtual reality (VR) provide modern neurorehabilitation options. The aim was to describe the structure of acquired social communication deficits in children with neurological disorders (ND) and implement a new PowerVR method- combined MMT/VR interfaces, into social neurorehabilitation. The study was designed based on the Structured Social Rehabilitation Model. Sixty children with ND aged 8-13 years participated: 28 with epilepsy, 10 with traumatic brain injury (TBI), 3 with tic disorders, 3 with stroke, 16 with other ND. A total of 16 patients (M = 10.5 years, SD = 1.8) completed trainings with pre- and post-intervention assessments. Forty-four patients participated in base-level assessment (M = 10.2 years, SD = 1.6). Two age-matched patients practiced in pairs on MMT and individually in VR. The most impaired components in patients were theory of mind (ToM) skills. A total of 64% of children presented behavioral problems related to executive dysfunctions. Patients lacked conflict resolution (median 38% out of 100%) and empathy skills (25%). After trainings, communication and cooperation, pragmatics, social attention, conflict resolution, and empathy skills improved. Patients' general verbal ToM and understanding false beliefs (p < .005) increased. Children's ability to start conversations improved; they experienced less bullying. Findings suggest that the combined technology-based intervention PowerVR offers increased power for multicomponent training of socio-emotional skills.
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Affiliation(s)
- Anneli Kolk
- Department of Pediatrics, Faculty of Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Children's Clinic, Tartu, Estonia
| | - Marianne Saard
- Department of Pediatrics, Faculty of Medicine, University of Tartu, Tartu, Estonia
- Tartu University Hospital Children's Clinic, Tartu, Estonia
| | - Alina Roštšinskaja
- Department of Pediatrics, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Kirsi Sepp
- Tartu University Hospital Children's Clinic, Tartu, Estonia
| | - Christen Kööp
- Department of Pediatrics, Faculty of Medicine, University of Tartu, Tartu, Estonia
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24
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Hao J, Buster TW, Cesar GM, Burnfield JM. Virtual reality augments effectiveness of treadmill walking training in patients with walking and balance impairments: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37:603-619. [PMID: 36366806 DOI: 10.1177/02692155221138309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To systematically summarize and examine current evidence regarding the combination of virtual reality and treadmill training in patients with walking and balance impairments. DATA SOURCES English language randomized controlled trials, participants with walking and balance impairments, intervention group used virtual reality and treadmill, control group only used treadmill with the same training frequency and number of sessions. Six bioscience and engineering databases were searched. METHODS Two independent reviewers conducted study selection, data extraction, and quality assessment. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. RESULTS Sixteen randomized controlled trials including 829 participants were identified. Compared to treadmill-only training, virtual reality augmented treadmill training induced significantly faster walking (p < 0.001; standardized mean difference (SMD) = 0.55, 95%CI: 0.30 to 0.81), longer step length (p < 0.001; SMD = 0.74, 95%CI: 0.42 to 1.06), narrower step width (p = 0.03; SMD = -0.52, 95%CI: -0.97 to -0.06), longer single leg stance period (p = 0.003; SMD = 0.77, 95%CI: 0.27 to 1.27), better functional mobility (p = 0.003; SMD = -0.44, 95%CI: - 0.74 to -0.15), improved balance function (p = 0.04; SMD = 0.24, 95%CI: 0.01 to 0.47), and enhanced balance confidence (p = 0.03; SMD = 0.73, 95%CI: 0.08 to 1.37). Walking endurance did not differ significantly between groups (p = 0.21; SMD = 0.13, 95%CI: -0.07 to 0.34). CONCLUSIONS Virtual reality augmented treadmill walking training enhances outcomes compared to treadmill-only training in patients with walking and balance impairments. The results of this review support the clinical significance of combining virtual reality with treadmill training with level 1A empirical evidence.
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Affiliation(s)
- Jie Hao
- Institute for Rehabilitation Science and Engineering, 20936Madonna Rehabilitation Hospitals, Lincoln, NE, USA
- Division of Physical Therapy Education, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Thad W Buster
- Institute for Rehabilitation Science and Engineering, 20936Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Guilherme M Cesar
- Institute for Rehabilitation Science and Engineering, 20936Madonna Rehabilitation Hospitals, Lincoln, NE, USA
| | - Judith M Burnfield
- Institute for Rehabilitation Science and Engineering, 20936Madonna Rehabilitation Hospitals, Lincoln, NE, USA
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25
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Wang L, Huang M, Yang R, Liang HN, Han J, Sun Y. Survey of Movement Reproduction in Immersive Virtual Rehabilitation. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:2184-2202. [PMID: 35015645 DOI: 10.1109/tvcg.2022.3142198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Virtual reality (VR) has emerged as a powerful tool for rehabilitation. Many effective VR applications have been developed to support motor rehabilitation of people affected by motor issues. Movement reproduction, which transfers users' movements from the physical world to the virtual environment, is commonly used in VR rehabilitation applications. Three major components are required for movement reproduction in VR: (1) movement input, (2) movement representation, and (3) movement modulation. Until now, movement reproduction in virtual rehabilitation has not yet been systematically studied. This article aims to provide a state-of-the-art review on this subject by focusing on existing literature on immersive motor rehabilitation using VR. In this review, we provided in-depth discussions on the rehabilitation goals and outcomes, technology issues behind virtual rehabilitation, and user experience regarding movement reproduction. Similarly, we present good practices and highlight challenges and opportunities that can form constructive suggestions for the design and development of fit-for-purpose VR rehabilitation applications and can help frame future research directions for this emerging area that combines VR and health.
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26
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Molhemi F, Mehravar M, Monjezi S, Salehi R, Negahban H, Shaterzadeh-Yazdi MJ, Majdinasab N. Effects of exergaming on cognition, lower limb functional coordination, and stepping time in people with multiple sclerosis: a randomized controlled trial. Disabil Rehabil 2023; 45:1343-1351. [PMID: 35443843 DOI: 10.1080/09638288.2022.2060332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare the effects of exergaming versus conventional exercises on cognition, lower-limb functional coordination, and stepping time in people with multiple sclerosis (PwMS). METHODS Thirty-six PwMS were randomly assigned to either intervention (n = 18) or control (n = 18) group and received 18 training sessions during six weeks. The intervention group performed exergames that required multidirectional timed-stepping, weight-shifting, and walking while the control group performed conventional matched exercises. Trail making test (TMT part A, B; TMT-A, TMT-B, TMT B-A), six-spot step test (SSST), and choice stepping reaction time (CSRT-including reaction time (RT), movement time (MVT), and total response time (TRT)) were assessed pre- and post-intervention (short-term), and after three-month follow-up (mid-term). RESULTS The intervention group showed faster TMT-B (p = 0.003) and TMT B-A (p = 0.002) at post-intervention and faster SSST at both post-intervention (p = 0.002) and follow-up (p = 0.04). The CSRT components showed no between-group differences at post-intervention; however, at follow-up, the intervention group had lower TRT (p = 0.046) and MVT (p = 0.015). TMT-A and RT had no significant between-group differences. CONCLUSIONS In short-term, exergames led to more improvements in complex attention, executive function, and lower-limb functional coordination comparing to the matched conventional exercises. In mid-term, exergaming was more effective for improving stepping time and lower-limb functional coordination. However, the two approaches did not show any superiority over each other for improving simple attention and RT.Implications for rehabilitationWhen designed properly, exergames have great potential to improve attention and executive function of people with multiple sclerosis (PwMS), at least in the short-term.Exergames seem like an appropriate option for improving lower limb coordination and decreasing choice stepping response time among PwMS in the mid-term.Exergames do not have superiority in improving the choice stepping reaction time compared to their matched conventional treatment.
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Affiliation(s)
- Farshad Molhemi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Mehravar
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeideh Monjezi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Salehi
- Department of Rehabilitation Management, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad-Jafar Shaterzadeh-Yazdi
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nastaran Majdinasab
- Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Placidi G, Di Matteo A, Lozzi D, Polsinelli M, Theodoridou E. Patient-Therapist Cooperative Hand Telerehabilitation through a Novel Framework Involving the Virtual Glove System. SENSORS (BASEL, SWITZERLAND) 2023; 23:3463. [PMID: 37050523 PMCID: PMC10098681 DOI: 10.3390/s23073463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 06/19/2023]
Abstract
Telerehabilitation is important for post-stroke or post-surgery rehabilitation because the tasks it uses are reproducible. When combined with assistive technologies, such as robots, virtual reality, tracking systems, or a combination of them, it can also allow the recording of a patient's progression and rehabilitation monitoring, along with an objective evaluation. In this paper, we present the structure, from actors and functionalities to software and hardware views, of a novel framework that allows cooperation between patients and therapists. The system uses a computer-vision-based system named virtual glove for real-time hand tracking (40 fps), which is translated into a light and precise system. The novelty of this work lies in the fact that it gives the therapist quantitative, not only qualitative, information about the hand's mobility, for every hand joint separately, while at the same time providing control of the result of the rehabilitation by also quantitatively monitoring the progress of the hand mobility. Finally, it also offers a strategy for patient-therapist interaction and therapist-therapist data sharing.
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Affiliation(s)
- Giuseppe Placidi
- AVI-Lab, Department of Life, Health & Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
| | - Alessandro Di Matteo
- AVI-Lab, Department of Information Engineering, Computer Science and Mathematics, University of L’Aquila, 67100 L’Aquila, Italy
| | - Daniele Lozzi
- AVI-Lab, Department of Information Engineering, Computer Science and Mathematics, University of L’Aquila, 67100 L’Aquila, Italy
| | - Matteo Polsinelli
- Department of Computer Science, University of Salerno, 84084 Fisciano, Italy
| | - Eleni Theodoridou
- AVI-Lab, Department of Life, Health & Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy
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28
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Zanatta F, Farhane-Medina NZ, Adorni R, Steca P, Giardini A, D'Addario M, Pierobon A. Combining robot-assisted therapy with virtual reality or using it alone? A systematic review on health-related quality of life in neurological patients. Health Qual Life Outcomes 2023; 21:18. [PMID: 36810124 PMCID: PMC9942343 DOI: 10.1186/s12955-023-02097-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/07/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND In the field of neurorehabilitation, robot-assisted therapy (RAT) and virtual reality (VR) have so far shown promising evidence on multiple motor and functional outcomes. The related effectiveness on patients' health-related quality of life (HRQoL) has been investigated across neurological populations but still remains unclear. The present study aimed to systematically review the studies investigating the effects of RAT alone and with VR on HRQoL in patients with different neurological diseases. METHODS A systematic review of the studies evaluating the impact of RAT alone and combined with VR on HRQoL in patients affected by neurological diseases (i.e., stroke, multiple sclerosis, spinal cord injury, Parkinson's Disease) was conducted according to PRISMA guidelines. Electronic searches of PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsychINFO (2000-2022) were performed. Risk of bias was evaluated through the National Institute of Health Quality Assessment Tool. Descriptive data regarding the study design, participants, intervention, rehabilitation outcomes, robotic device typology, HRQoL measures, non-motor factors concurrently investigated, and main results were extracted and meta-synthetized. RESULTS The searches identified 3025 studies, of which 70 met the inclusion criteria. An overall heterogeneous configuration was found regarding the study design adopted, intervention procedures and technological devices implemented, rehabilitation outcomes (i.e., related to both upper and lower limb impairment), HRQoL measures administered, and main evidence. Most of the studies reported significant effects of both RAT and RAT plus VR on patients HRQoL, whether they adopted generic or disease-specific HRQoL measures. Significant post-intervention within-group changes were mainly found across neurological populations, while fewer studies reported significant between-group comparisons, and then, mostly in patients with stroke. Longitudinal investigations were also observed (up to 36 months), but significant longitudinal effects were exclusively found in patients with stroke or multiple sclerosis. Finally, concurrent evaluations on non-motor outcomes beside HRQoL included cognitive (i.e., memory, attention, executive functions) and psychological (i.e., mood, satisfaction with the treatment, device usability, fear of falling, motivation, self-efficacy, coping, and well-being) variables. CONCLUSIONS Despite the heterogeneity observed among the studies included, promising evidence was found on the effectiveness of RAT and RAT plus VR on HRQoL. However, further targeted short- and long-term investigations, are strongly recommended for specific HRQoL subcomponents and neurological populations, through the adoption of defined intervention procedures and disease-specific assessment methodology.
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Naima Z Farhane-Medina
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Psychology, University of Córdoba, Córdoba, Spain
| | - Roberta Adorni
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy
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29
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Chen K, Chen KB. Task-Oriented and Imitation-Oriented Movements in Virtual Reality Exercise Performance and Design. HUMAN FACTORS 2023; 65:125-136. [PMID: 33874773 DOI: 10.1177/00187208211010100] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study investigated the influence of game features and practice type on human kinematic and muscular performance in a virtual reality exercise (VRE). Participants demonstrated changes in shoulder flexion angle and muscle activation under different virtual scenarios. BACKGROUND Conventional VRE studies often compared the outcomes between an experimental group that underwent exercise in VR and a real-world exercise control group, whereas comparisons between VRE programs are lacking. Besides, the attributes of VREs received little attention. METHOD Thirteen able-bodied participants performed upper extremity exercise movements in immersive VR using a head-mounted display. Participants performed task-oriented and imitation-oriented movements with different game features. Shoulder muscle activity (the deltoid, supraspinatus, and infraspinatus) and shoulder motion were collected. RESULTS Practice type (task-oriented, imitation-oriented) significantly influenced the flexion angle of the shoulder complex (F(1,11) = 9.53, p = .01), and the muscle activity of the supraspinatus (F(1,9) = 12.61, p = .006) and the infraspinatus (F(1,9) = 12.71, p = .006). Game features did not have a statistically significant effect on shoulder flexion angle or shoulder muscles' activations. CONCLUSIONS Compared to imitation-oriented practice, task-oriented practice elicited more intensive shoulder movements and muscular efforts but also induced greater movement variations. Substantial differences across game features levels should be further investigated to have significant effects. APPLICATIONS This research may help guide the design of future VREs. For strength training or rehabilitation where intensive practice is required, task-oriented practice should be considered; for movement learning where movement consistency is required, imitation oriented practice should be adopted.
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Affiliation(s)
- Ken Chen
- 6798 North Carolina State University, Raleigh, USA
| | - Karen B Chen
- 6798 North Carolina State University, Raleigh, USA
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30
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McLean E, Cornwell MA, Bender HA, Sacks-Zimmerman A, Mandelbaum S, Koay JM, Raja N, Kohn A, Meli G, Spat-Lemus J. Innovations in Neuropsychology: Future Applications in Neurosurgical Patient Care. World Neurosurg 2023; 170:286-295. [PMID: 36782427 DOI: 10.1016/j.wneu.2022.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/11/2023]
Abstract
Over the last century, collaboration between clinical neuropsychologists and neurosurgeons has advanced the state of the science in both disciplines. These advances have provided the field of neuropsychology with many opportunities for innovation in the care of patients prior to, during, and following neurosurgical intervention. Beyond giving a general overview of how present-day advances in technology are being applied in the practice of neuropsychology within a neurological surgery department, this article outlines new developments that are currently unfolding. Improvements in remote platform, computer interface, "real-time" analytics, mobile devices, and immersive virtual reality have the capacity to increase the customization, precision, and accessibility of neuropsychological services. In doing so, such innovations have the potential to improve outcomes and ameliorate health care disparities.
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Affiliation(s)
- Erin McLean
- Department of Psychology, Hofstra University, Hempstead, New York, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Jun Min Koay
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Noreen Raja
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
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Hao J, Li Y, Swanson R, Chen Z, Siu KC. Effects of virtual reality on physical, cognitive, and psychological outcomes in cancer rehabilitation: a systematic review and meta-analysis. Support Care Cancer 2023; 31:112. [PMID: 36633695 DOI: 10.1007/s00520-022-07568-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE To systematically examine and summarize the current evidence regarding the effects of virtual reality (VR) on physical, cognitive, and psychological outcomes in cancer rehabilitation. METHODS Six bioscience and engineering databases were searched. Two independent reviewers screened the titles and abstracts of 2397 records and retrieved 25 full-text articles. Inclusion criteria included patients with a current or previous diagnosis of cancer; VR was used as an intervention for physical, cognitive, or psychological impairments and functional limitations; and clinical trials with at least two arms and with both pre- and post-intervention assessments. Reviewers assessed methodological quality using the Physiotherapy Evidence Database scale. RESULTS Seventeen studies including 799 patients with cancer were identified. Within-group pooled analysis indicated that patients demonstrated significant improvement in pain (P < 0.001), fatigue (P < 0.001), anxiety (P < 0.001), upper extremity function (P < 0.001), and quality of life (P = 0.008) after VR intervention. Between-group pooled analysis indicated significant improvements with VR in pain (P = 0.004), anxiety (P < 0.001), and upper extremity function (P < 0.001) compared with the control. Three studies reported the positive effects of VR on cognition. CONCLUSIONS VR demonstrates promising effects in physical, cognitive, and psychological aspects of patients with cancer. VR can be incorporated into a comprehensive cancer rehabilitation program to alleviate impairments and functional limitations.
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Affiliation(s)
- Jie Hao
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA
| | - Yanfei Li
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA
| | - Rebecca Swanson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-6878, USA
| | - Zhen Chen
- Department of Neurorehabilitation, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Ka-Chun Siu
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA.
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Zanatta F, Steca P, Fundarò C, Giardini A, Felicetti G, Panigazzi M, Arbasi G, Grilli C, D’Addario M, Pierobon A. Biopsychosocial effects and experience of use of robotic and virtual reality devices in neuromotor rehabilitation: A study protocol. PLoS One 2023; 18:e0282925. [PMID: 36897863 PMCID: PMC10004562 DOI: 10.1371/journal.pone.0282925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/18/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Robot-assisted therapy (RAT) and virtual reality (VR)-based neuromotor rehabilitation have shown promising evidence in terms of patient's neuromotor recovery, so far. However, still little is known on the perceived experience of use of robotic and VR devices and the related psychosocial impact. The present study outlines a study protocol aiming to investigate the biopsychosocial effects and the experience of use of robotic and non-immersive VR devices in patients undergoing neuromotor rehabilitation. METHODS Adopting a prospective, two-arm, non-randomized study design, patients with different neuromotor diseases (i.e., acquired brain injury, Parkinson's Disease, and total knee/hip arthroplasty) undergoing rehabilitation will be included. In a real-world clinical setting, short- (4 weeks) and long-term (6 months) changes in multiple patient's health domains will be investigated, including the functional status (i.e., motor functioning, ADLs, risk of falls), cognitive functioning (i.e., attention and executive functions), physical and mental health-related quality of life (HRQoL), and the psychological status (i.e., anxiety and depression, quality of life satisfaction). At post-intervention, the overall rehabilitation experience, the psychosocial impact of the robotic and VR devices will be assessed, and technology perceived usability and experience of use will be evaluated through a mixed-methods approach, including both patients' and physiotherapists' perspectives. Repeated measures within-between interaction effects will be estimated, and association analyses will be performed to explore the inter-relationships among the variables investigated. Data collection is currently ongoing. IMPLICATIONS The biopsychosocial framework adopted will contribute to expanding the perspective on patient's recovery within the technology-based rehabilitation field beyond motor improvement. Moreover, the investigation of devices experience of use and usability will provide further insight into technology deployment in neuromotor rehabilitation programs, thereby maximising therapy engagement and effectiveness. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05399043.
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Cira Fundarò
- Istituti Clinici Scientifici Maugeri IRCCS, Neurophysiopathology Unit of Montescano Institute, Montescano, Italy
- * E-mail:
| | - Anna Giardini
- Istituti Clinici Scientifici Maugeri IRCCS, Information Technology Department of Pavia Institute, Pavia, Italy
| | - Guido Felicetti
- Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit of Montescano Institute, Montescano, Italy
| | - Monica Panigazzi
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Physiatry and Ergonomics Unit of Montescano Institute, Montescano, Italy
| | - Giovanni Arbasi
- Istituti Clinici Scientifici Maugeri IRCCS, Neuromotor Rehabilitation Unit of Montescano Institute, Montescano, Italy
| | - Cesare Grilli
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Physiatry and Ergonomics Unit of Montescano Institute, Montescano, Italy
| | - Marco D’Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Antonia Pierobon
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Montescano Institute, Montescano, Italy
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Nguyen AT, Hemphill S, Donahue B, Menendez M, Rodriguez S, Caruso TJ. Use of virtual reality for targeted physical rehabilitation: Case report on managing functional motor disorder. J Pediatr Rehabil Med 2023; 16:415-423. [PMID: 36120795 DOI: 10.3233/prm-210009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Virtual reality (VR) technology has seen increasing use in physical rehabilitation and in the management of acute and chronic pain. Functional movement disorders (FMDs) are a source of disability with no known association to neurologic pathology, and patients are generally offered multidisciplinary treatment approaches to improve functional movement. However, patients who are not compliant with rehabilitation may have persistent FMD and long-term disability. Given VR's use in physical rehabilitation, it may serve as a useful adjunct for the management of FMD. Utilizing an application called MovementTM to create a playlist of targeted applications for the restoration of motor function and balance, this case study presents the application of VR as a tool to engage patients in physical therapy for the management of FMD. The VR games were selected to encourage movement while customization of levels within the games facilitated achievement of physical therapy goals. Physical rehabilitation aided by VR, when used in collaboration with a multidisciplinary care team, may be used to facilitate recovery from FMD.
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Affiliation(s)
- Alan T Nguyen
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Sydney Hemphill
- Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Bridgette Donahue
- Department of Physical Therapy and Rehabilitation, Lucile Packard Children'sHospital Stanford, Stanford University School of Medicine, PaloAlto, CA, USA
| | - Maria Menendez
- Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Samuel Rodriguez
- Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Thomas J Caruso
- Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital Stanford, Stanford University School of Medicine, Palo Alto, CA, USA
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Bofanova NS, Tychkov AY, Khanfar YA, Zolotarev RV. [Virtual reality technology as a promising direction in neurorehabilitation]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:131-136. [PMID: 36719129 DOI: 10.17116/jnevro2023123011131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Nervous system damage affects more than a billion people worldwide and is one of the leading causes of cognitive impairment. An urgent issue in modern medicine is the neurorehabilitation of this particular group of patients. The purpose of this article is to search for new approaches to achieve more effective recovery of cognitive functions, precisely by using virtual reality technology as a promising direction in neurorehabilitation. It has been shown that neurobiological effects of virtual reality have a positive effect on the plasticity of neurons, improve cognitive functions and positively affect the psychoemotional state. A case of the positive impact of being in the virtual environment «Outer Space» in a female patient with cognitive impairment and chronic pain is presented.
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Radhakrishnan U, Chinello F, Koumaditis K. Investigating the effectiveness of immersive VR skill training and its link to physiological arousal. VIRTUAL REALITY 2022; 27:1091-1115. [PMID: 36405878 PMCID: PMC9663202 DOI: 10.1007/s10055-022-00699-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 09/13/2022] [Indexed: 06/05/2023]
Abstract
This paper details the motivations, design, and analysis of a study using a fine motor skill training task in both VR and physical conditions. The objective of this between-subjects study was to (a) investigate the effectiveness of immersive virtual reality for training participants in the 'buzz-wire' fine motor skill task compared to physical training and (b) investigate the link between participants' arousal with their improvements in task performance. Physiological arousal levels in the form of electro-dermal activity (EDA) and ECG (Electrocardiogram) data were collected from 87 participants, randomly distributed across the two conditions. Results indicated that VR training is as good as, or even slightly better than, training in physical training in improving task performance. Moreover, the participants in the VR condition reported an increase in self-efficacy and immersion, while marginally significant differences were observed in the presence and the temporal demand (retrieved from NASA-TLX measurements). Participants in the VR condition showed on average less arousal than those in the physical condition. Though correlation analyses between performance metrics and arousal levels did not depict any statistically significant results, a closer examination of EDA values revealed that participants with lower arousal levels during training, across conditions, demonstrated better improvements in performance than those with higher arousal. These findings demonstrate the effectiveness of VR in training and the potential of using arousal and training performance data for designing adaptive VR training systems. This paper also discusses implications for researchers who consider using biosensors and VR for motor skill experiments. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-022-00699-3.
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Affiliation(s)
- Unnikrishnan Radhakrishnan
- Department of Business Development and Technology, Aarhus University, Birk Centerpark 15, 7400 Herning, Denmark
| | - Francesco Chinello
- Department of Business Development and Technology, Aarhus University, Birk Centerpark 15, 7400 Herning, Denmark
| | - Konstantinos Koumaditis
- Department of Business Development and Technology, Aarhus University, Birk Centerpark 15, 7400 Herning, Denmark
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Gustavsson M, Kjörk EK, Erhardsson M, Alt Murphy M. Virtual reality gaming in rehabilitation after stroke - user experiences and perceptions. Disabil Rehabil 2022; 44:6759-6765. [PMID: 34465269 DOI: 10.1080/09638288.2021.1972351] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The present study explored participants' experiences with and perceptions of using fully immersive head-mounted virtual reality (VR) gaming as rehabilitation after stroke. METHODS Four men and three women (median age 64 years) with chronic stroke and varying motor impairment (mild to severe) were interviewed after 10 weeks of VR training on the commercial HTC Vive system, focusing on the upper extremities. Inductive qualitative thematic analysis was performed. RESULTS The analysis revealed three main themes: playing the game, benefits and effects, and personalizing the game. Playing the game encompasses both the feeling of being immersed in the game and descriptions of the gaming being motivating and fun. Benefits and effects describe the participants' expectations of potential benefits, the importance of getting feed-back, and the impact in daily life. Personalizing the game includes finding the right game and level, and the participants' need for support to achieve full use of the training. CONCLUSIONS Participants with chronic stroke described the fully immersive VR gaming intervention as a fun and motivating way to improve their functioning in everyday life. Qualitative studies are needed to explore how people with stroke perceive VR gaming when it is implemented in real clinical environments.Clinical implicationsVR gaming was perceived as a positive and motivating rehabilitation after stroke.Getting feedback and perceiving benefits are essential parts of VR rehabilitation.Commercial fully immersive VR-games might be an option for stroke rehabilitation when the game can be personalized and support is available.
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Affiliation(s)
- Martha Gustavsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Occupational Therapy, Linköping University, Linköping, Sweden
| | - Emma K Kjörk
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Erhardsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Biochemistry and Cell Biology, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Margit Alt Murphy
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Eckert M, Aglio A, Martín-Ruiz ML, Osma-Ruiz V. A New Architecture for Customizable Exergames: User Evaluation for Different Neuromuscular Disorders. Healthcare (Basel) 2022; 10:healthcare10102115. [PMID: 36292562 PMCID: PMC9602287 DOI: 10.3390/healthcare10102115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/09/2022] [Accepted: 10/19/2022] [Indexed: 11/04/2022] Open
Abstract
This paper presents a modular approach to generic exergame design that combines custom physical exercises in a meaningful and motivating story. This aims to provide a tool that can be individually tailored and adapted to people with different needs, making it applicable to different diseases and states of disease. The game is based on motion capturing and integrates four example exercises that can be configured via our therapeutic web platform “Blexer-med”. To prove the feasibility for a wide range of different users, evaluation tests were performed on 14 patients with various types and degrees of neuromuscular disorders, classified into three groups based on strength and autonomy. The users were free to choose their schedule and frequency. The game scores and three surveys (before, during, and after the intervention) showed similar experiences for all groups, with the most vulnerable having the most fun and satisfaction. The players were motivated by the story and by achieving high scores. The average usage time was 2.5 times per week, 20 min per session. The pure exercise time was about half of the game time. The concept has proven feasible and forms a reasonable basis for further developments. The full 3D exercise needs further fine-tuning to enhance the fun and motivation.
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Affiliation(s)
- Martina Eckert
- Group on Acoustics and MultiMedia Applications (GAMMA), Centro de Investigación en Tecnologías Software y Sistemas Multimedia Para la Sostenibilidad (CITSEM), Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
- Correspondence:
| | - Alicia Aglio
- Group on Acoustics and MultiMedia Applications (GAMMA), Centro de Investigación en Tecnologías Software y Sistemas Multimedia Para la Sostenibilidad (CITSEM), Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
| | - María-Luisa Martín-Ruiz
- InnoTep Research Group, ETSIS de Telecomunicación, Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
| | - Víctor Osma-Ruiz
- Group on Acoustics and MultiMedia Applications (GAMMA), Centro de Investigación en Tecnologías Software y Sistemas Multimedia Para la Sostenibilidad (CITSEM), Universidad Politécnica de Madrid (UPM), 28031 Madrid, Spain
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Zolfaghari E, Ridout B, Medlow S, Campbell A, Coggins A, Murphy M, Jani S, Thosar D, Wiederhold BK, Wiederhold M, Steinbeck K. Exploring the use of virtual reality to manage distress in adolescent patients in emergency departments: A feasibility study. Emerg Med Australas 2022; 34:687-693. [PMID: 35238143 PMCID: PMC9790434 DOI: 10.1111/1742-6723.13945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/31/2022] [Accepted: 02/05/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The present study aimed to explore the feasibility and potential benefits of deploying virtual reality (VR) for adolescents in the ED. METHODS This multi-centre study was undertaken in paediatric and adult EDs in two university teaching hospitals. Twenty-six participants who had voluntarily attended the ED received the VR intervention. Pre- and post-measures assessing changes in state anxiety, stress and affect, and physical biomarkers were obtained. RESULTS The use of VR intervention was associated with significant reductions in distress (Short State Stress Questionnaire - Distress Subscale; t = 4.55, P < 0.001) and negative affect (the International Positive and Negative Affect Scale - Short Form version; t = 4.99, P < 0.001). Most participants chose 'Netflix' as their content of choice. The technology was well received by the participants with subjective reports indicating that receiving VR intervention was 'insanely cool', 'takes you away from what's actually happening' and some participants felt 'privileged to get this experience in a hospital'. CONCLUSIONS VR technology can effectively be used in EDs to assist adolescents and young adults better manage their distress and take steps towards activating more self-control mechanisms that will in turn allow for more meaningful engagements to be established with health clinicians. This technology has broad implications for reducing distress in adolescents in a variety of clinical contexts.
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Affiliation(s)
- Elham Zolfaghari
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brad Ridout
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Sharon Medlow
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Andrew Campbell
- Discipline of Biomedical Informatics and Digital HealthCyberpsychology Research Group, Faculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia
| | - Andrew Coggins
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Margaret Murphy
- Department of Emergency Medicine, Westmead HospitalWestern Sydney Local Health DistrictSydneyNew South WalesAustralia,Discipline of Emergency MedicineSydney Medical School, The University of SydneySydneyNew South WalesAustralia
| | - Shefali Jani
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Deepali Thosar
- Department of Emergency MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
| | - Brenda K Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Mark Wiederhold
- Virtual Reality Medical CenterScripps Memorial HospitalLa JollaCaliforniaUSA
| | - Katharine Steinbeck
- Specialty of Child and Adolescent HealthFaculty of Medicine and Health, The University of SydneySydneyNew South WalesAustralia,Academic Department of Adolescent MedicineThe Children's Hospital at WestmeadSydneyNew South WalesAustralia
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Delbes L, Mascret N, Goulon C, Montagne G. Validation of an immersive virtual reality device accepted by seniors that preserves the adaptive behavior produced in the real world. Front Bioeng Biotechnol 2022; 10:917486. [PMID: 36118569 PMCID: PMC9479106 DOI: 10.3389/fbioe.2022.917486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Falls in the elderly are a major societal issue. Virtual reality appears as a relevant tool to propose gait training programs to prevent the occurrence of falls. The use of a head-mounted display allows overground walking during fully immersive virtual training sessions. Our long-term ambition is to develop gait training programs with a head-mounted display to propose enjoyable and personalized training content for the elderly. Before proposing these programs, several methodological precautions must be taken. The first concerns the supposed similarity of the adaptive behavior produced in the real world and in virtual reality. The second concerns the acceptance of the virtual reality device before and after use. Twenty older adults performed a locomotor pointing task in three conditions including a real-world condition, a virtual-world condition consisting in a replica of the real-world condition, and a virtual condition in which the locomotor pointing task was performed in a different context. From feet positions in relation to the position of a target, gait adaptability behavior was investigated. In line with previous studies, step adjustments (needed and produced) were investigated through a combination of inter-trial and trial-by-trial analyses. The results highlighted that participants adopted the same gait adaptability behavior whatever the type of environment (real vs. virtual). Gait analyses suggested the use of a generic control mechanism based on information-movement coupling. We also demonstrated that older adults accepted the virtual reality device before and after use. With these methodological locks removed, it is now possible to design training programs in virtual reality to prevent falls in the elderly.
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Fregna G, Schincaglia N, Baroni A, Straudi S, Casile A. A novel immersive virtual reality environment for the motor rehabilitation of stroke patients: A feasibility study. Front Robot AI 2022; 9:906424. [PMID: 36105763 PMCID: PMC9465047 DOI: 10.3389/frobt.2022.906424] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
We designed and implemented an immersive virtual reality (VR) environment for upper limb rehabilitation, which possesses several notable features. First, by exploiting modern computer graphics its can present a variety of scenarios that make the rehabilitation routines challenging yet enjoyable for patients, thus enhancing their adherence to the therapy. Second, immersion in a virtual 3D space allows the patients to execute tasks that are closely related to everyday gestures, thus enhancing the transfer of the acquired motor skills to real-life routines. Third, in addition to the VR environment, we also developed a client app running on a PC that allows to monitor in real-time and remotely the patients’ routines thus paving the way for telerehabilitation scenarios. Here, we report the results of a feasibility study in a cohort of 16 stroke patients. All our patients showed a high degree of comfort in our immersive VR system and they reported very high scores of ownership and agency in embodiment and satisfaction questionnaires. Furthermore, and notably, we found that behavioral performances in our VR tasks correlated with the patients’ clinical scores (Fugl-Meyer scale) and they could thus be used to assess improvements during the rehabilitation program. While further studies are needed, our results clearly support the feasibility and effectiveness of VR-based motor rehabilitation processes.
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Affiliation(s)
- Giulia Fregna
- Doctoral Program in Translational Neurosciences and Neurotechnologies, University of Ferrara, Ferrara, Italy
| | - Nicola Schincaglia
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Andrea Baroni
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
| | - Sofia Straudi
- Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Antonino Casile
- Istituto Italiano di Tecnologia, Center for Translational Neurophysiology of Speech and Communication, Ferrara, Italy
- *Correspondence: Antonino Casile, ,
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Straatmann T, Schumacher JP, Koßmann C, Poehler L, Teuteberg F, Mueller K, Hamborg KC. Advantages of virtual reality for the participative design of work processes: An integrative perspective. Work 2022; 72:1765-1788. [DOI: 10.3233/wor-211260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The participative design of work processes is hampered by as-yet unresolved challenges. A root cause is seen in high information-pass-on-barriers. Virtual Reality (VR) may have a significant potential to overcome these challenges. Yet, there is no systematic understanding of which advantages provided by VR can support the participative design of work processes. OBJECTIVE: The present study aims to assess the potential of VR to support the participative design of work processes by conducting an integrative literature review identifying the advantages of VR in general work contexts and mapping them to known challenges in participative design of work processes. METHODS: The integrative literature review was conducted based on 268 sources of which 52 were considered for an in-depth analysis of the advantages offered by VR. RESULTS: The resulting conceptual framework consisted of 13 characteristic-related advantages (e.g., immersion, interactivity, flexibility) and 10 effect-related advantages (e.g., attractivity, involvement, cost efficiency) which readily address known challenges in the participative design of work processes. CONCLUSION: Mapping the advantages of VR to the challenges in participative design of work processes revealed a substantial potential of VR to overcome high information-pass-on-barriers. As such, employing VR in work process design initiatives represents a fruitful avenue for the promotion of prevention and employee health.
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Affiliation(s)
- Tammo Straatmann
- Department of Industrial and Organizational Psychology, Osnabrueck University, Osnabrueck, Germany
| | - Jan-Philip Schumacher
- Department of Industrial and Organizational Psychology, Osnabrueck University, Osnabrueck, Germany
| | - Cosima Koßmann
- Department of Industrial and Organizational Psychology, Osnabrueck University, Osnabrueck, Germany
| | - Ludger Poehler
- Department of Accounting and Information Systems, Osnabrueck University, Osnabrueck, Germany
| | - Frank Teuteberg
- Department of Accounting and Information Systems, Osnabrueck University, Osnabrueck, Germany
| | - Karsten Mueller
- Department of Industrial and Organizational Psychology, Osnabrueck University, Osnabrueck, Germany
| | - Kai-Christoph Hamborg
- Department of Industrial and Organizational Psychology, Osnabrueck University, Osnabrueck, Germany
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Hashim NA, Abd Razak NA, Shanmuganathan T, Jaladin RA, Gholizadeh H, Abu Osman NA. On the use of virtual reality for individuals with upper limb loss: a systematic scoping review. Eur J Phys Rehabil Med 2022; 58:612-620. [PMID: 35044131 PMCID: PMC9987328 DOI: 10.23736/s1973-9087.22.06794-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 09/02/2021] [Accepted: 01/03/2022] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Virtual reality has recently become a popular application for rehabilitation and motor control research. This technology has emerged as a valid addition to conventional therapy and promises a successful rehabilitation. This study describes recent research related to the use of virtual reality applications in the rehabilitation of individuals with upper limb loss and to see whether this technology has enough proof of its applicability. EVIDENCE ACQUISITION Searches were conducted with the Web of Science, Google Scholar, IEEE Xplore, and PubMed databases from inception up to September 2020. Articles that employed virtual reality in the rehabilitation of individual with upper limb loss were included in the research if it is written in English, the keyword exists in the title and abstract; it uses visual feedback in nonimmersive, semi-immersive, or fully immersive virtual environments. Data extraction was carried out by two independent researchers. The study was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA). EVIDENCE SYNTHESIS A total of 38 articles met the inclusion criteria. Most studies were published between 2010 and 2020. Thirty-nine percent of the studies (N.=15), originates from North America; 55% of the studies (N.=21), were publicly funded; 61% of the studies (N.=24), was without disclosure of conflict of interest; 82% of the studies (N.=31), were cited in other studies. All the studies were published in journals and conference proceedings. Sixty-six percent of the studies (N.=25) has come out with positive outcome. The design studies were mostly case reports, case series, and poorly designed cohort studies that made up 55% (N.=21) of all the studies cited here. CONCLUSIONS The research conducted on the use of virtual reality in individual with upper limb loss rehabilitation is of very low quality. The improvements to the research protocol are much needed. It is not necessary to develop new devices, but rather to assess existing devices with well-conducted randomized controlled trials.
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Affiliation(s)
- Nur A Hashim
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | - Nasrul A Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia -
| | | | - Rafidah A Jaladin
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Noor A Abu Osman
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia
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Effectiveness of Augmented Reality for Lower Limb Rehabilitation: A Systematic Review. Appl Bionics Biomech 2022; 2022:4047845. [PMID: 35898600 PMCID: PMC9314155 DOI: 10.1155/2022/4047845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/17/2022] [Accepted: 07/09/2022] [Indexed: 11/18/2022] Open
Abstract
Augmented reality- (AR-) based interventions have shown potential benefits for lower limb rehabilitation. However, current literature has not revealed these benefits as a whole. The main purposes of this systematic review were to determine the efficacy of AR-based interventions on lower limb recovery of the larger population based on the current process that has been made in this regard. Relevant studies were retrieved from five electronic databases (Web of Science, PubMed, ScienceDirect, Scopus, and Cochrane Library) using “augmented reality” OR “AR” AND “lower limb” OR “lower extremity” AND “intervention” OR “treatment”. Sixteen studies that met the eligibility criteria were included in this review, and they were further grouped into three categories based on the participant types. Seven studies focused on the elderly adults, six on the stroke patients, and the last three on Parkinson patients. Based on the findings of these trials, the significant effects of AR-based interventions on lower limb rehabilitation (i.e., balance, gait, muscle, physical performance, and fall efficacy) have been initially confirmed. Favorable results were achieved at least the same as the interventions without AR except for the turning and timing in the freezing of gait of Parkinson patients. However, given the infancy of this technology in clinical practices, more robust trials with larger sample sizes and greater homogeneity in terms of devices and treatment settings are warranted for further verification.
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Cognitive Computation in Ideological and Political Classroom Teaching Based on Digital Sensor Technology. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:8723327. [PMID: 35898789 PMCID: PMC9313915 DOI: 10.1155/2022/8723327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/26/2022] [Accepted: 06/30/2022] [Indexed: 01/06/2023]
Abstract
Numerous new ideas and concepts have changed the behavior and value orientation of university students as a result of the internet's rising popularity on college campuses. This study performs research on digital sensor technologies in order to enhance the intelligent effect of ideological and political classroom instruction. In addition, this study combines the fast Fourier transform principle to enhance digital sensor technology, digital sensor and cognitive computation technology to investigate the ideological and political classroom teaching process, and the actual situation of the ideological and political teaching to digitally process the ideological and political teaching process. In addition, this study employs sensor technology to convey data and digital sensor technology to increase the quality of ideological and political classroom instruction by enhancing the traditional teaching paradigm. In addition, on this premise, this study conducts a performance evaluation of the system, primarily focusing on the digital effect and the enhancement of ideological and political teaching quality. In conclusion, this study proves its teaching system through test research. According to the test results, the intelligent teaching method described in this study has a certain practical effect.
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FarmDay: A Gamified Virtual Reality Neurorehabilitation Application for Upper Limb Based on Activities of Daily Living. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with upper limb disorders are limited in their activities of daily living and impose an important healthcare burden due to the repetitive rehabilitation they require. A way to reduce this burden is through home-based therapy using virtual reality solutions, since they are readily available, provide immersion, and enable accurate motion tracking, and custom applications can be developed for them. However, there is lack of guidelines for the design of effective VR rehabilitation applications in the literature, particularly for bimanual training. This work introduces a VR telerehabilitation system that uses off-the-shelf hardware, a real-time remote setup, and a bimanual training application that aims to improve upper extremity motor function. It is made of six activities and was evaluated by five physiotherapists specialised in (1) neuromotor disorders and (2) functional rehabilitation and (3) occupational therapy. A descriptive analysis of the results obtained from the System Usability Scale test of the application and a collection of qualitative assessments of each game have been carried out. The application obtained a mean score of 86.25 (±8.96 SD) in the System Usability Scale, and the experts concluded that it accurately reproduces activities of daily living movements except for wrist and finger movements. They also offer a set of design guidelines.
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Denecke K, Baudoin CR. A Review of Artificial Intelligence and Robotics in Transformed Health Ecosystems. Front Med (Lausanne) 2022; 9:795957. [PMID: 35872767 PMCID: PMC9299071 DOI: 10.3389/fmed.2022.795957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Health care is shifting toward become proactive according to the concept of P5 medicine-a predictive, personalized, preventive, participatory and precision discipline. This patient-centered care heavily leverages the latest technologies of artificial intelligence (AI) and robotics that support diagnosis, decision making and treatment. In this paper, we present the role of AI and robotic systems in this evolution, including example use cases. We categorize systems along multiple dimensions such as the type of system, the degree of autonomy, the care setting where the systems are applied, and the application area. These technologies have already achieved notable results in the prediction of sepsis or cardiovascular risk, the monitoring of vital parameters in intensive care units, or in the form of home care robots. Still, while much research is conducted around AI and robotics in health care, adoption in real world care settings is still limited. To remove adoption barriers, we need to address issues such as safety, security, privacy and ethical principles; detect and eliminate bias that could result in harmful or unfair clinical decisions; and build trust in and societal acceptance of AI.
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Affiliation(s)
- Kerstin Denecke
- Institute for Medical Information, Bern University of Applied Sciences, Bern, Switzerland
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Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature. Cancers (Basel) 2022; 14:cancers14133163. [PMID: 35804933 PMCID: PMC9264833 DOI: 10.3390/cancers14133163] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
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.
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Martingano AJ, Brown E, Telaak SH, Dolwick AP, Persky S. Cybersickness Variability by Race: Findings From 6 Studies and a Mini Meta-analysis. J Med Internet Res 2022; 24:e36843. [PMID: 35648477 PMCID: PMC9201708 DOI: 10.2196/36843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/22/2022] [Accepted: 04/20/2022] [Indexed: 12/04/2022] Open
Abstract
Background With the influx of medical virtual reality (VR) technologies, cybersickness has transitioned from a nuisance experienced during leisure activities to a potential safety and efficacy concern for patients and clinicians. To improve health equity, it is important to understand any potential differences in cybersickness propensity among demographic groups, including racial groups. Objective This study aims to explore whether cybersickness propensity differs across racial groups. Methods We collected self-reported cybersickness ratings from 6 racially diverse independent samples within 1 laboratory group (N=931). In these studies, the participants were asked to perform tasks in VR such as traversing environments, pointing at and selecting objects, and interacting with virtual humans. Results Significant racial differences in cybersickness were found in 50% (3/6) of studies. A mini meta-analysis revealed that, on average, Black participants reported approximately one-third of SD less cybersickness than White participants (Cohen d=−0.31; P<.001), regardless of the nature of the VR experience. There was no overall difference in reported cybersickness between the Asian and White participants (Cohen d=−0.11; P=.51). Conclusions Racial differences in cybersickness indicate that researchers, practitioners, and regulators should consider patient demographics when evaluating VR health intervention outcomes. These findings lay the groundwork for future studies that may explore racial differences in cybersickness directly.
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Affiliation(s)
- Alison Jane Martingano
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Ellenor Brown
- Office of Science and Engineering Laboratories, US Food and Drug Administration, Silver Spring, MD, United States
| | - Sydney H Telaak
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Alexander P Dolwick
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
| | - Susan Persky
- Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States
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Dincelli E, Yayla A. Immersive virtual reality in the age of the Metaverse: A hybrid-narrative review based on the technology affordance perspective. JOURNAL OF STRATEGIC INFORMATION SYSTEMS 2022. [DOI: 10.1016/j.jsis.2022.101717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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So BPH, Lai DKH, Cheung DSK, Lam WK, Cheung JCW, Wong DWC. Virtual Reality-Based Immersive Rehabilitation for Cognitive- and Behavioral-Impairment-Related Eating Disorders: A VREHAB Framework Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105821. [PMID: 35627357 PMCID: PMC9141870 DOI: 10.3390/ijerph19105821] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022]
Abstract
Virtual reality (VR) technology is one of the promising directions for rehabilitation, especially cognitive rehabilitation. Previous studies demonstrated successful rehabilitation in motor, cognitive, and sensorial functions using VR. The objective of this review is to summarize the current designs and evidence on immersive rehabilitation interventions using VR on cognitive- or behavioral-related eating disorders, which was mapped using a VREHAB framework. Two authors independently searched electronic databases, including PubMed, Web of Science, Scopus, CINAHL, EMBASE, and Cochrane Library. Ten (n = 10) articles were eligible for review. Treatments for anorexia nervosa and binge eating disorder/bulimia nervosa were reported through enhanced/experimental cognitive behavior therapy (ECT), cue exposure therapy (CET), and body exposure therapy (BET) via the virtual environment. Some studies reported that the VR effects were superior or comparable to traditional treatments, while the effects may last longer using VR technology. In addition, VR was perceived as acceptable and feasible among patients and therapists and could be valuable for supplementing existing therapies, relieving manpower and caregiver burdens. Future studies may consider incorporating haptic, smell, and biofeedback to improve the experience, and thus the effects of the treatments for the users.
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Affiliation(s)
- Bryan Pak-Hei So
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Derek Ka-Hei Lai
- Department of Computing, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Daphne Sze-Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong 999077, China
| | - Wing-Kai Lam
- Sports Information and External Affairs Centre, Hong Kong Sports Institute, Hong Kong 999077, China;
| | - James Chung-Wai Cheung
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Research Institute of Smart Ageing, The Hong Kong Polytechnic University, Hong Kong 999077, China
- Correspondence: (J.C.-W.C.); (D.W.-C.W.); Tel.: +852-2766-7673 (J.C.-W.C.); +852-2766-7669 (D.W.-C.W.)
| | - Duo Wai-Chi Wong
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China;
- Correspondence: (J.C.-W.C.); (D.W.-C.W.); Tel.: +852-2766-7673 (J.C.-W.C.); +852-2766-7669 (D.W.-C.W.)
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