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Alashram AR. Combined noninvasive brain stimulation virtual reality for upper limb rehabilitation poststroke: A systematic review of randomized controlled trials. Neurol Sci 2024; 45:2523-2537. [PMID: 38286919 DOI: 10.1007/s10072-024-07360-8] [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: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
Upper limb impairments are common consequences of stroke. Noninvasive brain stimulation (NIBS) and virtual reality (VR) play crucial roles in improving upper limb function poststroke. This review aims to evaluate the effects of combined NIBS and VR interventions on upper limb function post-stroke and to provide recommendations for future studies in the rehabilitation field. PubMed, MEDLINE, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched from inception to November 2023. Randomized controlled trials (RCTs) encompassed patients with a confirmed stroke diagnosis, administrated combined NIBS and VR compared with passive (i.e., rest) or active (conventional therapy), and included at least one outcome assessing upper limb function (i.e., strength, spasticity, function) were selected. The quality of the included studies was assessed using the Cochrane Collaboration tool. Seven studies met the eligibility criteria. In total, 303 stroke survivors (Mean age: 61.74 years) were included in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," while two were categorized as "moderate quality". There are mixed findings for the effects of combined NIBS and VR on upper limb function in stroke survivors. The evidence for the effects of combined transcranial direct current stimulation and VR on upper limb function post-stroke is promising. However, the evidence regarding the effects of combined repetitive transcranial magnetic stimulation and VR on upper limb function is limited. Further randomized controlled trials with long-term follow-up are strongly warranted.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Poddar J, Rangasamy SB, Pahan K. Therapeutic efficacy of cinnamein, a component of balsam of Tolu/Peru, in controlled cortical impact mouse model of TBI. Neurochem Int 2024; 176:105742. [PMID: 38641028 DOI: 10.1016/j.neuint.2024.105742] [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: 01/26/2024] [Revised: 03/29/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
Traumatic brain injury (TBI) remains a major health concern which causes long-term neurological disability particularly in war veterans, athletes and young adults. In spite of intense clinical and research investigations, there is no effective therapy to cease the pathogenesis of the disease. It is believed that axonal injury during TBI is potentiated by neuroinflammation and demyelination and/or failure to remyelination. This study highlights the use of naturally available cinnamein, also chemically known as benzyl cinnamate, in inhibiting neuroinflammation, promoting remyelination and combating the disease process of controlled cortical impact (CCI)-induced TBI in mice. Oral delivery of cinnamein through gavage brought down the activation of microglia and astrocytes to decrease the expression of inducible nitric oxide synthase (iNOS), glial fibrillary acidic protein (GFAP) and ionized calcium binding adaptor molecule 1 (Iba1) in hippocampus and cortex of TBI mice. Cinnamein treatment also stimulated remyelination in TBI mice as revealed by PLP and A2B5 double-labeling, luxol fast blue (LFB) staining and axonal double-labeling for neurofilament and MBP. Furthermore, oral cinnamein reduced the size of lesion cavity in the brain, improved locomotor functions and restored memory and learning in TBI mice. These results suggest a new neuroprotective property of cinnamein that may be valuable in the treatment of TBI.
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Affiliation(s)
- Jit Poddar
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Suresh B Rangasamy
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, 60612, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Kalipada Pahan
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, IL, 60612, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA.
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Chuaykarn U, Thato R, Crago EA. Nonpharmacological interventions to improve the cognitive function among persons with traumatic brain injury: A systematic review. J Nurs Scholarsh 2024. [PMID: 38798031 DOI: 10.1111/jnu.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE The systematic review aimed to evaluate the effectiveness of nonpharmacological interventions (NPIs) for improving cognitive function among persons with traumatic brain injury. DESIGN A systematic review. METHODS This systematic review was registered in PROSPERO and followed the PRISMA guideline. PubMed, ScienceDirect, Scopus, SpringerLink, Wiley Online Library, JSTOR, and Taylor & Francis were systematically searched for relevant articles of peer-reviewed studies published between 2008 and 2022. Two independent researchers conducted study selection, data extraction, and data quality assessment. FINDINGS Twenty-one studies met inclusion criteria, numbering a total of 757 participants. Six groups of NPIs were effective in improving cognitive functioning among persons with traumatic brain injury, including multimodal cognitive training, technology innovation, memory training, executive function training, physical activity, and sensory stimulation programs. Pooled evidence revealed that NPIs had a large effect on memory (d = 0.80, p < 0.05 to d = 2.03, p < 0.000), processing speed (d = 1.58, p < 0.05), and cognitive behavior (d = 1.63, p < 0.001 to d = 8.91, p 0.003). There was a medium effect on executive function (d = 0.5, p < 0.01 to d = 0.62, p < 0.05), attention (d = 0.5, p < 0.01), and intelligence (d = 0.57 to d = 0.59, p = 0.000). For visuospatial function and language, there was a significant increase post-intervention. CONCLUSION Evidence from this systematic review indicates that NPIs, specifically the use of multimodal cognitive training and sensory stimulation programs, were effective in improving cognitive function outcomes among persons with traumatic brain injury, with medium to large effect sizes. CLINICAL RELEVANCE Nonpharmacological interventions (NPIs) can enhance cognitive function in individuals with traumatic brain injury. These findings can guide healthcare professionals in clinical settings and support the development of technology applications for cognitive rehabilitation using NPIs.
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Affiliation(s)
- Uraporn Chuaykarn
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Boromarajonnani College of Nursing, Nakhon Si Thammarat, Faculty of Nursing, Praboromarajchanok Institute, Bangkok, Thailand
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Elizabeth A Crago
- University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
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Johansen T, Matre M, Løvstad M, Lund A, Martinsen AC, Olsen A, Becker F, Brunborg C, Ponsford J, Spikman J, Neumann D, Tornås S. Virtual reality as a method of cognitive training of processing speed, working memory, and sustained attention in persons with acquired brain injury: a protocol for a randomized controlled trial. Trials 2024; 25:340. [PMID: 38778411 PMCID: PMC11110309 DOI: 10.1186/s13063-024-08178-7] [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: 08/02/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Acquired brain injury (ABI) often leads to persisting somatic, cognitive, and social impairments. Cognitive impairments of processing speed, sustained attention, and working memory are frequently reported and may negatively affect activities of daily living and quality of life. Rehabilitation efforts aiming to retrain these cognitive functions have often consisted of computerized training programs. However, few studies have demonstrated effects that transfer beyond the trained tasks. There is a growing optimism regarding the potential usefulness of virtual reality (VR) in cognitive rehabilitation. The research literature is sparse, and existing studies are characterized by considerable methodological weaknesses. There is also a lack of knowledge about the acceptance and tolerability of VR as an intervention method for people with ABI. The present study aims to investigate whether playing a commercially available VR game is effective in training cognitive functions after ABI and to explore if the possible effects transfer into everyday functioning. METHODS One hundred participants (18-65 years), with a verified ABI, impairments of processing speed/attention, and/or working memory, and a minimum of 12 months post injury will be recruited. Participants with severe aphasia, apraxia, visual neglect, epilepsy, and severe mental illness will be excluded. Participants will be randomized into two parallel groups: (1) an intervention group playing a commercial VR game taxing processing speed, working memory, and sustained attention; (2) an active control group receiving psychoeducation regarding compensatory strategies, and general cognitive training tasks such as crossword puzzles or sudoku. The intervention period is 5 weeks. The VR group will be asked to train at home for 30 min 5 days per week. Each participant will be assessed at baseline with neuropsychological tests and questionnaires, after the end of the intervention (5 weeks), and 16 weeks after baseline. After the end of the intervention period, focus group interviews will be conducted with 10 of the participants in the intervention group, in order to investigate acceptance and tolerability of VR as a training method. DISCUSSION This study will contribute to improve understanding of how VR is tolerated and experienced by the ABI population. If proven effective, the study can contribute to new rehabilitation methods that persons with ABI can utilize in a home setting, after the post-acute rehabilitation has ended.
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Affiliation(s)
- T Johansen
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
- Department of Occupational Therapy, Institute of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - M Matre
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - M Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - A Lund
- Department of Occupational Therapy, Institute of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - A C Martinsen
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - A Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
- NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway
| | - F Becker
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
- Department of Physical Medicine and Rehabilitation, University of Oslo, Oslo, Norway
| | - C Brunborg
- Oslo Centre for Biostatistics & Epidemiology, Oslo University Hospital, Oslo, Norway
| | - J Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - J Spikman
- Department of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical Center, Groningen, The Netherlands
| | - D Neumann
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, USA
| | - S Tornås
- Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway
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De Luca R, Calderone A, Gangemi A, Rifici C, Bonanno M, Maggio MG, Cappadona I, Veneziani I, Ielo A, Corallo F, Quartarone A, Cardile D, Calabrò RS. Is Virtual Reality Orientation Therapy Useful to Optimize Cognitive and Behavioral Functioning Following Severe Acquired Brain Injury? An Exploratory Study. Brain Sci 2024; 14:410. [PMID: 38790389 PMCID: PMC11119343 DOI: 10.3390/brainsci14050410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 04/17/2024] [Accepted: 04/21/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Severe acquired brain injury (SABI) is a leading cause of death and disability, and it is defined as a brain injury that occurs after birth due to traumatic or non-traumatic causes. Reality orientation therapy (ROT) uses repeated time-place-person orientation and meaningful stimuli to develop a better understanding of the environment and has great potential as an effective strategy to improve cognitive and behavioral functioning. OBJECTIVE This study aims to investigate the feasibility and potential effects of virtual reality orientation therapy (VR-rot) on optimizing cognitive and behavioral functioning and depressive symptoms post-SABI. METHOD Forty patients with SABI were enrolled from October 2022 to December 2023 and divided into two groups: the experimental group (EG, n = 20) received VR_rot, while the control group (CG, n = 20) received standard ROT (S_rot). All patients were evaluated with a psychometric battery, including the Mini-Mental State Examination (MMSE) and the Hamilton Rating Scale for Depression (HRS-D), administered before (T0) and after the end (T1) of rehabilitation. RESULTS Within-group comparisons indicated a statistically significant change in MMSE scores from T0 to T1 in the EG and CG, with the EG showing a greater improvement than the CG. Regarding HRS-D scores, the EG showed a statistically significant change. VR-ROT could be a valuable tool for improving cognitive-behavioral functioning in SABI patients. CONCLUSIONS The VRRS can help reduce depressive symptoms and improve the reality orientation deficit caused by traumatic brain injury and stroke on brain tissue. This study highlights the benefits of virtual reality.
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Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Andrea Calderone
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Antonio Gangemi
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Maria Grazia Maggio
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Irene Cappadona
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Isabella Veneziani
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta, 11, 27100 Pavia, Italy
| | - Augusto Ielo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy
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Murray G, Shmidheiser M. Virtual reality immerses you in your mind: the experience and stress-reduction benefits of VR mindfulness modules in persons with TBI. Brain Inj 2024; 38:355-360. [PMID: 38318793 DOI: 10.1080/02699052.2024.2311334] [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: 01/16/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This pilot study tested the feasibility and stress reduction effectiveness of a one-time virtual reality mindfulness module (VRMM) in individuals with mild-to-moderate traumatic brain injury (TBI). METHODS Thirty-eight participants participated in a pilot study utilizing a mixed methods convergent parallel design. Pretest and posttest stress levels were collected; participants engaged in a brief 4-question qualitative interview. Mann Whitney U and Wilcoxon Signed Rank Tests were used. Qualitative analysis utilized grounded theory. RESULTS Post-VRMM, two-thirds (24) of participants had a statistically significant decrease in stress levels. A key qualitative finding indicated that participants found the immersiveness and realism of the VR environments helpful in compensating for cognitive deficits resulting from TBI. There were no adverse side effects reported, indicating that well-designed VRMMs that minimize motion-induced adverse effects are well tolerated in persons with TBI. CONCLUSION A guided mindfulness activity in a VR environment was well tolerated, and participants overall found VRMM effective in reducing stress levels. VR-based environments have potential to harness guided mindfulness practice and may support persons with TBI to enhance concentration. Further application of this technology in TBI rehabilitation is promising and warrants future research to explore the benefit of VR in improving rehabilitation outcomes.
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Affiliation(s)
- Gillian Murray
- Social Worker, Drucker Brain Injury Center, MossRehab, Elkins Park, Pennsylvania, USA
| | - Max Shmidheiser
- Owner and Founder, Oasis Neurobehavioral Health, PLLC, Wynnewood, Pennsylvania, USA
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7
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Zhou Y, Yang H, You M, Feng Z, Dong X. Cognition-Enhancement Effect of Median Nerve Electrical Stimulation in Patients with Cognitive Impairment: A Retrospective Cohort Study. World Neurosurg 2024; 184:e537-e545. [PMID: 38320650 DOI: 10.1016/j.wneu.2024.01.165] [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: 01/25/2024] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE People with cognitive impairment often face quality-of-life problems and require ongoing support, which has profound consequences for caregivers and society. Noninvasive brain stimulation techniques, such as median nerve electrical stimulation (MNS), have shown promising potentials in improving cognitive ability in patients with cognitive impairment. Therefore, we aimed to investigate the positive effect and safety of MNS in cognitive impairment. METHODS Patients diagnosed with cognitive impairment from the hospital record management system of the First Affiliated Hospital of Nanchang University from April 1, 2020, to December 31, 2022, were enrolled. Data on patients' basic characteristics, treatment records, and examination results such as the Mini-Mental State Examination (MMSE), activities of daily living (ADL), and P300 event-related potentials before and after treatment were collected. RESULTS Overall, 146 patients with cognitive impairment were enrolled, including 71 patients who underwent conventional therapy (standard treatment group) and 75 patients who underwent conventional therapy and MNS operation (active MNS group). Before treatment, there were no differences between the standard treatment and active MNS groups in terms of age, sex, etiology, duration of symptoms before therapy, hospital stay, whether they had undergone surgery, MMSE score, ADL score, and amplitude and latency of the P300 event-related potentials (P > 0.05). After treatment, we observed significant improvements in the MMSE score, ADL score, amplitude of P300, and decreased latency of P300 event-related potentials in both groups compared with before treatment (P < 0.05). In addition, we observed that the active MNS group showed higher MMSE and ADL scores, higher amplitude of P300 event-related potentials, and lower latency of P300 event-related potentials than the standard treatment group after treatment (P < 0.05). Furthermore, no side effects were associated with MNS operation. CONCLUSIONS These preliminary data provide early evidence that MNS may be a positive effect and safe method for promoting the recovery of cognitive ability in patients with cognitive impairment.
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Affiliation(s)
- Yifan Zhou
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Haihua Yang
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Mengyu You
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Xiaoyang Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
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Alashram AR. Effectiveness of aerobic exercise on cognition in individuals with traumatic brain injury: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-9. [PMID: 38470898 DOI: 10.1080/23279095.2024.2327829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Cognitive deficits are among the most common impairments in individuals with traumatic brain injury (TBI). Aerobic exercise is a repetitive and structured physical activity that influences structural and functional brain alterations differently. This review aims to examine the effects of aerobic exercise on cognition in individuals with TBI. PubMed, CINAHL, EMBASE, SCOPUS, MEDLINE, and Web of Science were searched from inception to December 20, 2023. Studies designed as randomized controlled trials (RCT), clinical controlled trials (CCT), and pilot studies included individuals with a confirmed diagnosis of TBI, comparing aerobic exercise with passive, active, or no control group and included at least one outcome measure assessing any cognitive domain were selected. The quality of the selected studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Six studies met the eligibility criteria (n = 118), with 53% of participants being female. Four studies were of good quality, fair quality (n = 1), and poor quality (n = 1) on the PEDro. Two of the selected studies showed significant improvements in cognition after moderate and vigorous aerobic exercises, while four studies indicated that moderate and vigorous aerobic exercise did not improve cognition post-TBI. The evidence on the effects of moderate and vigorous aerobic exercise on cognitive function post-TBI remains limited. Additional studies are strongly warranted to understand aerobic exercise's effects on cognition post-TBI.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR. Compensatory cognitive training for people with traumatic brain injury: A systematic review of randomized controlled trial. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-9. [PMID: 38285433 DOI: 10.1080/23279095.2024.2306133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Cognitive impairments are a common consequence in people with traumatic brain injury (TBI). Compensatory cognitive training is a therapeutic strategy that offers alternative methods to manage cognitive deficits. This systematic review aims to examine the effects of compensatory cognitive training on cognitive function in people with TBI. We searched PubMed, SCOPUS, MEDLINE, PEDro, Web of Science, REHABDATA, and EMBASE from inception until October 2023. The Cochrane Collaboration tool was used to assess the methodological quality of the selected studies. Of 318 articles, eight studies (n = 615), with 8% of participants being females, were included in this review. Four studies were classified as having 'high' quality according to the Cochrane Collaboration tool, while four were categorized as 'moderate' quality. There were variations in treatment protocols and outcome measures, resulting in heterogeneous findings. The effects of compensatory cognitive training on cognitive outcomes showed inconsistency. In conclusion, the evidence for the effects of compensatory cognitive training on cognition in people with TBI is promising. Further trials are needed to investigate the effects of compensatory cognitive training on various cognitive domains in people with TBI.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Rich TL, Truty T, Muschler K, Gravely A, Marth LA, Barrett B, Mortimer D, Hansen AH. Virtual Reality Game Selection for Traumatic Brain Injury Rehabilitation: A Therapist's Wish List for Game Developers. Games Health J 2023; 12:445-449. [PMID: 37498203 DOI: 10.1089/g4h.2022.0174] [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] [Indexed: 07/28/2023] Open
Abstract
This project explored the selection process of commercially available virtual reality (VR) games for traumatic brain injury rehabilitation. Occupational therapy practitioners (OTPs) developed a classification framework that they used to evaluate VR games. The classification framework focused on movements required to effectively play the game, cognitive demand, position for game play, ease in menu navigation, and perceived therapeutic applications. OTPs used the ratings to aid in game selection and identified relevant game examples that allowed customizable settings and basic navigation with a game focus on functional activities. The OTPs and the research team identified the need for further work on accessibility and adaptability of game features (e.g., difficulty and limb usage) allowing for more individualization to optimize outcomes of VR-enhanced rehabilitation. The classification framework was useful in evaluating the potential therapeutic benefit of commercially available VR games. However, trial of the game by clinicians prior to use was still warranted.
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Affiliation(s)
- Tonya L Rich
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
- University of Minnesota, Division of Rehabilitation Medicine, Minneapolis, Minnesota, USA
| | - Timothy Truty
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, Minnesota, USA
| | - Katherine Muschler
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, Minnesota, USA
| | - Amy Gravely
- Minneapolis VA Health Care System, Research Service Line, Minneapolis, Minnesota, USA
| | - Lindsay A Marth
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
| | - Benjamin Barrett
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
| | - Diane Mortimer
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
- University of Minnesota, Division of Rehabilitation Medicine, Minneapolis, Minnesota, USA
| | - Andrew H Hansen
- Minneapolis VA Health Care System, Rehabilitation & Extended Care Service Line, Minneapolis, Minnesota, USA
- University of Minnesota, Division of Rehabilitation Medicine, Minneapolis, Minnesota, USA
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, Minnesota, USA
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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [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: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Popa LL, Chira D, Strilciuc Ș, Mureșanu DF. Non-Invasive Systems Application in Traumatic Brain Injury Rehabilitation. Brain Sci 2023; 13:1594. [PMID: 38002552 PMCID: PMC10670234 DOI: 10.3390/brainsci13111594] [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] [Received: 10/23/2023] [Revised: 11/10/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
Traumatic brain injury (TBI) is a significant public health concern, often leading to long-lasting impairments in cognitive, motor and sensory functions. The rapid development of non-invasive systems has revolutionized the field of TBI rehabilitation by offering modern and effective interventions. This narrative review explores the application of non-invasive technologies, including electroencephalography (EEG), quantitative electroencephalography (qEEG), brain-computer interface (BCI), eye tracking, near-infrared spectroscopy (NIRS), functional near-infrared spectroscopy (fNIRS), magnetic resonance imaging (MRI), functional magnetic resonance imaging (fMRI), magnetoencephalography (MEG), and transcranial magnetic stimulation (TMS) in assessing TBI consequences, and repetitive transcranial magnetic stimulation (rTMS), low-level laser therapy (LLLT), neurofeedback, transcranial direct current stimulation (tDCS), transcranial alternative current stimulation (tACS) and virtual reality (VR) as therapeutic approaches for TBI rehabilitation. In pursuit of advancing TBI rehabilitation, this narrative review highlights the promising potential of non-invasive technologies. We emphasize the need for future research and clinical trials to elucidate their mechanisms of action, refine treatment protocols, and ensure their widespread adoption in TBI rehabilitation settings.
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Affiliation(s)
- Livia Livinț Popa
- RoNeuro Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania; (L.L.P.); (D.F.M.)
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania
| | - Diana Chira
- RoNeuro Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania; (L.L.P.); (D.F.M.)
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania
| | - Ștefan Strilciuc
- Research Center for Functional Genomics, Biomedicine, and Translational Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
| | - Dafin F. Mureșanu
- RoNeuro Institute for Neurological Research and Diagnostic, 400364 Cluj-Napoca, Romania; (L.L.P.); (D.F.M.)
- Department of Neuroscience, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania
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Alashram AR, Padua E, Annino G. Noninvasive brain stimulation for cognitive rehabilitation following traumatic brain injury: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:814-829. [PMID: 35771044 DOI: 10.1080/23279095.2022.2091440] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Traumatic brain injury (TBI) can cause numerous cognitive deficits. These deficits are associated with disability and reduction in quality of life. Noninvasive brain stimulation (NIBS) provides excitatory or inhibitory stimuli to the cerebral cortex. This review aimed to examine the effectiveness of NIBS (i.e., rTMS and tDCS) on cognitive functions in patients with TBI. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched from inception to May 2021. The risk of bias in the randomized controlled trials was assessed using the Cochrane Collaboration's instrument. The Physiotherapy Evidence Database (PEDro) scale was applied to evaluate the risk of bias in the non-randomized controlled trials. Ten studies met our inclusion criteria. Six studies used repetitive Transcranial Magnetic Stimulation (rTMS), and four used transcranial Direct Current Stimulation (tDCS) as cognitive rehabilitation interventions. The results showed heterogenous evidence for the effects of rTMS and tDCS on cognitive function outcomes in individuals with TBI. The evidence for the effects of NIBS on cognition following TBI was limited. TDCS and rTMS are safe and well-tolerated interventions post-TBI. The optimal stimulation sites and stimulation parameters remain unknown. Combining NIBS with traditional rehabilitation interventions may contribute to greater enhancements in cognitive functions post-TBI.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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Nunnerley J, King M, Hodge K, Hopkins P, Stockwell R, Thorne N, Snell D, Gozdzikowska K. Co-design of a therapeutic virtual reality tool to increase awareness and self-management of cognitive fatigue after traumatic brain injury. Disabil Rehabil Assist Technol 2023; 18:1404-1410. [PMID: 35286813 DOI: 10.1080/17483107.2021.2014993] [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: 05/05/2021] [Accepted: 12/01/2021] [Indexed: 10/18/2022]
Abstract
PURPOSE The symptom of cognitive fatigue is reported as one of the longest lasting and most debilitating symptoms of traumatic brain injury (TBI). Virtual reality may be one of the most suitable technologies for neurorehabilitation, able to integrate evidence-based neuroscientific principles into motivating rehabilitation simulations. The purpose of this study was to seek perspectives of individuals with lived experience of TBI and experienced rehabilitation clinicians in the co-design of a novel technology-based tool for cognitive fatigue after TBI. MATERIALS AND METHOD Co-design focus groups with a sample of clinicians and individuals with lived experience of TBI were used to identify the design parameters. A prototype was developed using inter-disciplinary design iterations. Focus groups were repeated with participants testing the prototype. Qualitative data were analysed using a general inductive approach. RESULTS Feasibility of VR in this population was well tolerated. The focus groups guided development of domains including environment, tasks, level progression, outcome measures and considerations about clinical implementation of VR. CONCLUSIONS By merging advancements in VR science with a translational approach, a co-designed virtual reality tool to increase awareness and self-management of cognitive fatigue has been developed, suitable for use in persons with TBI.Implications for rehabilitationImmersive virtual reality tools show promise for addressing awareness of cognitive fatigue after traumatic brain injury in rehabilitation settings.Early engagement with consumers is recommended to produce a usable rehabilitation product.
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Affiliation(s)
- Joanne Nunnerley
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
- Burwood Academy, Christchurch, New Zealand
| | - Marcus King
- Advanced Manufacturing, Callaghan Innovation, Christchurch, New Zealand
| | - Katie Hodge
- Laura Fergusson Trust, Christchurch, New Zealand
| | - Pat Hopkins
- Laura Fergusson Trust, Christchurch, New Zealand
| | | | | | - Deborah Snell
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
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15
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Shi Y, Wu W. Multimodal non-invasive non-pharmacological therapies for chronic pain: mechanisms and progress. BMC Med 2023; 21:372. [PMID: 37775758 PMCID: PMC10542257 DOI: 10.1186/s12916-023-03076-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Chronic pain conditions impose significant burdens worldwide. Pharmacological treatments like opioids have limitations. Non-invasive non-pharmacological therapies (NINPT) encompass diverse interventions including physical, psychological, complementary and alternative approaches, and other innovative techniques that provide analgesic options for chronic pain without medications. MAIN BODY This review elucidates the mechanisms of major NINPT modalities and synthesizes evidence for their clinical potential across chronic pain populations. NINPT leverages peripheral, spinal, and supraspinal mechanisms to restore normal pain processing and limit central sensitization. However, heterogeneity in treatment protocols and individual responses warrants optimization through precision medicine approaches. CONCLUSION Future adoption of NINPT requires addressing limitations in standardization and accessibility as well as synergistic combination with emerging therapies. Overall, this review highlights the promise of NINPT as a valuable complementary option ready for integration into contemporary pain medicine paradigms to improve patient care and outcomes.
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Affiliation(s)
- Yu Shi
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China
| | - Wen Wu
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.
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Pilli K, Worne B, Simpson G. Clinician experiences with using assistive technology in brain injury rehabilitation: a survey of clinician capability, attitudes, and barriers. BRAIN IMPAIR 2023; 24:185-203. [PMID: 38167181 DOI: 10.1017/brimp.2023.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND The rise in assistive technology (AT) solutions to support people with an acquired brain injury (ABI) has warranted clinicians to build capability in assisting clients to select goal-centred AT. The study explored, amongst ABI clinicians, (a) capability, attitudes, and barriers with AT implementation, (b) age-related differences in technology self-efficacy and capability (c) strategies to support AT use in rehabilitation and (d) thematic analysis of AT-related experiences. METHOD Mixed methods design. Online survey circulated to ABI clinicians across New South Wales, Australia, comprising purpose-designed items as well as the Modified Computer Self-Efficacy Scale (MCSES; range 0-100). RESULTS Clinicians (n = 123) were evenly distributed across decadal age groups. The majority were female (90%, n = 111) and one-third were occupational therapists.Clinicians scored strongly on the MCSES (Mdn = 76, IQR = 19), with younger age groups significantly associated with higher scores (H[3] = 9.667, p = .022). Most clinicians (92%) were knowledgeable of mainstream technology for personal use, but over half (65%) reported insufficient knowledge of suitable AT for clients. Clinicians reported positive attitudes towards AT, however, time to research and develop proficiency with a range of AT was the primary barrier (81%).Thematic analysis suggested that whilst the ideal AT experience is client-motivated requiring multidisciplinary guidance, the clinician role and experience with AT is evolving, influenced by rapid technological advancement and extrinsic opportunities to access AT. CONCLUSIONS Whilst clinicians have positive attitudes towards AT, there is a gap in clinician implementation. There is need to support further resources to build clinician capability and access to AT.
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Affiliation(s)
- Kavya Pilli
- Liverpool Brain Injury Unit, Liverpool Hospital, Sydney, Australia
| | - Brendan Worne
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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De Luca R, Bonanno M, Marra A, Rifici C, Pollicino P, Caminiti A, Castorina MV, Santamato A, Quartarone A, Calabrò RS. Can Virtual Reality Cognitive Rehabilitation Improve Executive Functioning and Coping Strategies in Traumatic Brain Injury? A Pilot Study. Brain Sci 2023; 13:brainsci13040578. [PMID: 37190543 DOI: 10.3390/brainsci13040578] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 05/17/2023] Open
Abstract
Executive dysfunction is among the most common and disabling facets of cognitive impairment following traumatic brain injury (TBI), and may include deficits in reasoning, planning, mental flexibility, some aspects of attention and orientation, awareness and behavior. Rehabilitation programs based on cognitive-behavioral approaches to retrain planning and problem-solving and other executive deficits may improve such cognitive dysfunction. The purpose of this study is to investigate the effects of non-immersive virtual reality-based training to improve executive abilities and to reduce anxiety and depression symptoms in patients with TBI. Twenty patients with moderate to severe TBI were enrolled at our Neurorehabilitation Unit and divided to receive either the standard cognitive training or the virtual reality (VR) based cognitive training using the virtual reality rehabilitation system (VRRS-Evo). Each group received the same amount of rehabilitative training, including ROT (Reality Orientation Therapy) and Executive Training (ET), but using a different approach, i.e., a paper and pencil and an advanced approach. All patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. Comparing pre- and post- treatment scores, in the VR-CT group, we found statistically significant differences in all administered outcome measures for cognitive and executive functioning, i.e., MoCA (p < 0.005), FAB (p < 0.005), TMT-A (p < 0.005), TMT-B (p < 0.005), TMT-BA (p < 0.001), and mood, i.e., HRS-D (p < 0.008). In the Conventional cognitive training (C-CT) group, we found a significant improvement only in MoCA (p < 0.03), FAB (p < 0.02) and in TMT-BA (p < 0.01). Coping strategies also improved, with better results in the VR-CT group. Our results suggest that VR rehabilitation, using the VRRS system, may be a valuable and motivational approach to improve visuo-executive abilities and coping strategies as well as mood in chronic TBI patients.
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Affiliation(s)
- Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Angela Marra
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | - Carmela Rifici
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | | | - Angelo Caminiti
- IRCCS Centro Neurolesi "Bonino Pulejo", 98123 Messina, Italy
| | | | - Andrea Santamato
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
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Varela-Aldás J, Buele J, López I, Palacios-Navarro G. Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4609. [PMID: 36901618 PMCID: PMC10002257 DOI: 10.3390/ijerph20054609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Few works analyze the parameters inherent to immersive virtual reality (IVR) in applications for memory evaluation. Specifically, hand tracking adds to the immersion of the system, placing the user in the first person with full awareness of the position of their hands. Thus, this work addresses the influence of hand tracking in memory assessment with IVR systems. For this, an application based on activities of daily living was developed, where the user must remember the location of the elements. The data collected by the application are the accuracy of the answers and the response time; the participants are 20 healthy subjects who pass the MoCA test with an age range between 18 to 60 years of age; the application was evaluated with classic controllers and with the hand tracking of the Oculus Quest 2. After the experimentation, the participants carried out presence (PQ), usability (UMUX), and satisfaction (USEQ) tests. The results indicate no difference with statistical significance between both experiments; controller experiments have 7.08% higher accuracy and 0.27 ys. faster response time. Contrary to expectations, presence was 1.3% lower for hand tracking, and usability (0.18%) and satisfaction (1.43%) had similar results. The findings indicate no evidence to determine better conditions in the evaluation of memory in this case of IVR with hand tracking.
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Affiliation(s)
- José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
| | - Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, 44003 Teruel, Spain
| | - Irene López
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
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LeMarshall SJ, Stevens LM, Ragg NP, Barnes L, Foster J, Canetti EFD. Virtual reality-based interventions for the rehabilitation of vestibular and balance impairments post-concussion: a scoping review. J Neuroeng Rehabil 2023; 20:31. [PMID: 36869367 PMCID: PMC9985280 DOI: 10.1186/s12984-023-01145-4] [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: 05/30/2022] [Accepted: 01/27/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Concussions and mild traumatic brain injuries are the most common causes of physical and cognitive disability worldwide. Concussion can result in post-injury vestibular and balance impairments that can present up to five years post initial concussion event, ultimately affecting many daily and functional activities. While current clinical treatment aims to reduce symptoms, the developing use of technology in everyday life has seen the emergence of virtual reality. Current literature has failed to identify substantial evidence regarding the use of virtual reality in rehabilitation. The primary aim of this scoping review is to identify, synthesise, and assess the quality of studies reporting on the effectiveness of virtual reality for the rehabilitation of vestibular and balance impairments post-concussion. Additionally, this review aims to summarise the volume of scientific literature and identify the knowledge gaps in current research pertaining to this topic. METHODS A scoping review of six databases (PubMed, Embase, CINAHL, ProQuest, SportDiscus, Scopus) and a grey literature (Google Scholar) was conducted using three key concepts (virtual reality, vestibular symptoms, and post-concussion). Data was charted from studies and outcomes were categorised into one of three categories: (1) balance; (2) gait; or (3) functional outcome measures. Critical appraisal of each study was conducted using the Joanna Briggs Institute checklists. A critical appraisal of each outcome measure was also completed utilising a modified GRADE appraisal tool to summarise the quality of evidence. Effectiveness was assessed using calculations of change in performance and change per exposure time. RESULTS Three randomised controlled trials, three quasi-experimental studies, three case studies, and one retrospective cohort study were ultimately included, using a thorough eligibility criteria. All studies were inclusive of different virtual reality interventions. The ten studies had a 10-year range and identified 19 different outcome measures. CONCLUSION The findings from this review suggests that virtual reality is an effective tool for the rehabilitation of vestibular and balance impairments post-concussion. Current literature shows sufficient but low level of evidence, and more research is necessary to develop a quantitative standard and to better understand appropriate dosage of virtual reality intervention.
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Affiliation(s)
- Soraya J LeMarshall
- Doctor of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Lachlan M Stevens
- Doctor of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Nicholas P Ragg
- Doctor of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Leia Barnes
- Integrated Specialist ENT Service, Logan Hospital, Meadowbrook, Australia
| | - Jacinta Foster
- Integrated Specialist ENT Service, Logan Hospital, Meadowbrook, Australia
| | - Elisa F D Canetti
- Doctor of Physiotherapy, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia. .,Tactical Research Unit, Bond University, Gold Coast, Australia.
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Demeco A, Zola L, Frizziero A, Martini C, Palumbo A, Foresti R, Buccino G, Costantino C. Immersive Virtual Reality in Post-Stroke Rehabilitation: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:1712. [PMID: 36772757 PMCID: PMC9919580 DOI: 10.3390/s23031712] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/24/2023] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
In recent years, next to conventional rehabilitation's techniques, new technologies have been applied in stroke rehabilitation. In this context, fully immersive virtual reality (FIVR) has showed interesting results thanks to the level of immersion of the subject in the illusional world, with the feeling of being a real part of the virtual environment. This study aims to investigate the efficacy of FIVR in stroke rehabilitation. PubMed, Web of Science and Scopus were screened up to November 2022 to identify eligible randomized controlled trials (RCTs). Out of 4623, we included 12 RCTs involving post-acute and chronic stroke survivors, with a total of 350 patients (234 men and 115 women; mean age 58.36 years). High heterogeneity of the outcomes considered, the results showed that FIVR provides additional benefits, in comparison with standard rehabilitation. In particular, results showed an improvement in upper limb dexterity, gait performance and dynamic balance, influencing patient independence. Therefore, FIVR represents an adaptable, multi-faceted rehabilitation tool that can be considered in post-stroke rehabilitation, improving the compliance of the patients to the treatment and increasing the level of functioning and quality of life of stroke survivors.
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Affiliation(s)
- Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Laura Zola
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Antonio Frizziero
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Chiara Martini
- Department of Diagnostic, Parma University Hospital, 43126 Parma, Italy
| | - Arrigo Palumbo
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Ruben Foresti
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Giovanni Buccino
- Division of Neuroscience, IRCCS San Raffaele, University Vita-Salute San Raffaele, 20132 Milan, Italy
| | - Cosimo Costantino
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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Protection of Mice from Controlled Cortical Impact Injury by Food Additive Glyceryl Tribenzoate. Int J Mol Sci 2023; 24:ijms24032083. [PMID: 36768402 PMCID: PMC9917251 DOI: 10.3390/ijms24032083] [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: 01/07/2023] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023] Open
Abstract
Despite intense investigations, no effective therapy is available to halt the pathogenesis of traumatic brain injury (TBI), a major health concern, which sometimes leads to long-term neurological disability, especially in war veterans and young adults. This study highlights the use of glyceryl tribenzoate (GTB), a flavoring ingredient, in ameliorating the disease process of controlled cortical impact (CCI)-induced TBI in mice. Oral administration of GTB decreased the activation of microglia and astrocytes to inhibit the expression of inducible nitric oxide synthase (iNOS) in hippocampus and cortex of TBI mice. Accordingly, GTB treatment protected and/or restored synaptic maturation in the hippocampus of TBI mice as revealed by the status of PSD-95, NR-2A and GluR1. Furthermore, oral GTB also reduced the size of lesion cavity in the brain of TBI mice. Finally, GTB treatment improved locomotor functions and protected spatial learning and memory in TBI mice. These results outline a novel neuroprotective property of GTB which may be beneficial in treatment of TBI.
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22
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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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Features and effects of computer-based games on cognitive impairments in children with autism spectrum disorder: an evidence-based systematic literature review. BMC Psychiatry 2023; 23:2. [PMID: 36597046 PMCID: PMC9809031 DOI: 10.1186/s12888-022-04501-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Children with Autism Spectrum Disorder (ASD) have different cognitive and intelligence profiles than typical developing individuals. Some of these children need cognitive rehabilitation. This study's main purpose is to provide a systematic review about applying computerized cognitive games for autistic children and to determine the effectiveness of such interventions. MATERIAL AND METHODS A thorough search of the ISI Web of Science, Medline (through PubMed), Scopus, IEEE Xplore, and APA PsycInfo databases was performed for articles published from inception to May 17, 2022. RESULTS Of 1746 papers, 28 studies were found to be eligible in this systematic review. Fifteen studies (53.57%) compared a Control Group (CG) with Experimental Groups (EGs), while 13 papers (46.42%) evaluated only the impact of the applied intervention in an experimental group. Major domains of cognitive functions are divided into five main categories: 1. Executive functions, 2. Social cognition/emotions, 3. Attention/concentration, 4. Learning and memory, and 5. Language. In 42.85% (12 studies) of the screened papers, social cognition and emotions were assessed after cognitive rehabilitation. The highest rate of effects reported by studies were related to social cognition enhancement. Of the total number of included studies, 17 studies reported a positive effect at all scales, of which nine were quasi-experimental, and seven were fully experimental. CONCLUSION Using suitable computerized game-based solutions could enhance cognition indexes in autistic children. Hence, further investigation is needed to determine the real effectiveness of these novel technologies.
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INCOG 2.0 Guidelines for Cognitive Rehabilitation Following Traumatic Brain Injury, Part III: Executive Functions. J Head Trauma Rehabil 2023; 38:52-64. [PMID: 36594859 DOI: 10.1097/htr.0000000000000834] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Moderate-to-severe traumatic brain injury (MS-TBI) causes debilitating and enduring impairments of executive functioning and self-awareness, which clinicians often find challenging to address. Here, we provide an update to the INCOG 2014 guidelines for the clinical management of these impairments. METHODS An expert panel of clinicians/researchers (known as INCOG) reviewed evidence published from 2014 and developed updated recommendations for the management of executive functioning and self-awareness post-MS-TBI, as well as a decision-making algorithm, and an audit tool for review of clinical practice. RESULTS A total of 8 recommendations are provided regarding executive functioning and self-awareness. Since INCOG 2014, 4 new recommendations were made and 4 were modified and updated from previous recommendations. Six recommendations are based on level A evidence, and 2 are based on level C. Recommendations retained from the previous guidelines and updated, where new evidence was available, focus on enhancement of self-awareness (eg, feedback to increase self-monitoring; training with video-feedback), meta-cognitive strategy instruction (eg, goal management training), enhancement of reasoning skills, and group-based treatments. New recommendations addressing music therapy, virtual therapy, telerehabilitation-delivered metacognitive strategies, and caution regarding other group-based telerehabilitation (due to a lack of evidence) have been made. CONCLUSIONS Effective management of impairments in executive functioning can increase the success and well-being of individuals with MS-TBI in their day-to-day lives. These guidelines provide management recommendations based on the latest evidence, with support for their implementation, and encourage researchers to explore and validate additional factors such as predictors of treatment response.
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Bonanno M, De Luca R, De Nunzio AM, Quartarone A, Calabrò RS. Innovative Technologies in the Neurorehabilitation of Traumatic Brain Injury: A Systematic Review. Brain Sci 2022; 12:brainsci12121678. [PMID: 36552138 PMCID: PMC9775990 DOI: 10.3390/brainsci12121678] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
Motor and cognitive rehabilitation in individuals with traumatic brain injury (TBI) is a growing field of clinical and research interest. In fact, novel rehabilitative approaches allow a very early verticalization and gait training through robotic devices and other innovative tools boosting neuroplasticity, thanks to the high-intensity, repetitive and task-oriented training. In the same way, cognitive rehabilitation is also evolving towards advanced interventions using virtual reality (VR), computer-based approaches, telerehabilitation and neuromodulation devices. This review aimed to systematically investigate the existing evidence concerning the role of innovative technologies in the motor and cognitive neurorehabilitation of TBI patients. We searched and reviewed the studies published in the Cochrane Library, PEDro, PubMed and Scopus between January 2012 and September 2022. After an accurate screening, only 29 papers were included in this review. This systematic review has demonstrated the beneficial role of innovative technologies when applied to cognitive rehabilitation in patients with TBI, while evidence of their effect on motor rehabilitation in this patient population is poor and still controversial.
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Affiliation(s)
- Mirjam Bonanno
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
| | - Rosaria De Luca
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
- Correspondence:
| | - Alessandro Marco De Nunzio
- Department of Research and Development, LUNEX International University of Health, Exercise and Sports, Avenue du Parc des Sports, 50, 4671 Differdange, Luxembourg
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
- Department of Research and Development, LUNEX International University of Health, Exercise and Sports, Avenue du Parc des Sports, 50, 4671 Differdange, Luxembourg
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Alashram AR, Annino G, Padua E. Rehabilitation interventions for cognitive deficits in stroke survivors: A systematic review of randomized controlled trials. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-27. [PMID: 36194642 DOI: 10.1080/23279095.2022.2130319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Cognitive deficits are one of the most common impairments after stroke. It negatively affects physical and social functioning. Rehabilitation interventions for cognitive deficits post-stroke have taken less consideration. The present study aimed to provide an overview of the effects of various rehabilitation interventions on cognitive functions in patients with stroke. PUBMED, SCOPUS, PEDro, EMBASE, MEDLINE, and REHABDATA were searched for randomized controlled trials (RCTs) investigating the effects of rehabilitation interventions on cognitive domains poststroke until August 2021. The methodological quality of the selected studies was evaluated using the Cochrane Collaboration tool, and the effect sizes were calculated. Forty-four studies met the inclusion criteria. A total of 3561 individuals with stroke, 57.60% of whom were males. The mean age for all participants was 65.48 years. Eighteen RCTs were high, moderate (n = 17), and low methodological quality (n = 9). The results showed evidence for the beneficial effects of many rehabilitation interventions on cognition in individuals with stroke. Rehabilitation plays a crucial role in improving cognitive functions in stroke patients with mild cognitive deficits. Virtual reality (VR), computer-based cognitive rehabilitation (CBCR), and non-aerobic exercises may promote cognitive functions in patients with stroke.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR, Padua E, Annino G. Virtual reality for balance and mobility rehabilitation following traumatic brain injury: A systematic review of randomized controlled trials. J Clin Neurosci 2022; 105:115-121. [PMID: 36182811 DOI: 10.1016/j.jocn.2022.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Balance and mobility deficits are most prevalent impairments in patients with traumatic brain injury (TBI). The evidence has proposed that rehabilitation plays an important role in improving balance and mobility post-TBI. Virtual reality (VR) is a computer technology that provides immersed users to generate feedback such as visual, audio, and haptic. OBJECTIVE This review aimed to examine the effects of the VR treatment intervention on balance and mobility in patients with TBI and to define the most effective VR treatment protocol. METHODS SCOPUS, PEDro, PubMed, REHABDATA, EMBASE, and the web of science were searched for experimental trials examining the impacts of VR training on balance and mobility in patients with TBI from inception until July 2022. Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies. RESULTS Five randomized controlled trials (RCTs) met the inclusion criteria. The PEDro scores ranged from 6 to 8, with a median of 6. A total of 157 patients with TBI were included in this review, 31.2% of whom were females. The findings showed that VR intervention is not superior to traditional physiotherapy interventions in improving balance and mobility post- TBI. CONCLUSIONS The preliminary findings showed that the influence of VR on the balance and mobility ability in patients with TBI is promising. Combining VR with other concurrent rehabilitation interventions may show more significant improvements in balance and mobility compared to VR interventions alone. The optimal VR treatment protocol remains unclear. Further randomized controlled trials are strongly needed.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Italy
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Polanowska KE, Iwański S, Leśniak MM, Seniów J. Computer-assisted training of executive functions in adult patients with non-progressive acquired brain damage - a pilot study on efficacy of a new therapeutic application. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-12. [PMID: 36002035 DOI: 10.1080/23279095.2022.2114354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Executive dysfunction is most often caused by post-traumatic or post-stroke damage to the prefrontal regions of the brain. The aim of this study was to compare the efficacy of two computer-assisted therapy programs for executive dysfunctions in patients with acquired brain injury. Patients were trained using either a newly developed application ExeSystem (designed to help improve the ability to manage and control one's own behavior by performing tasks imitating natural, everyday situations) or a combination of two commercial applications RehaCom and CogniPlus. Data collected after a three-week period of therapy conducted in two 15-person groups of participants indicated comparable efficacy of both therapy programs in improving quality of daily functioning, executive attention, as well as planning and problem-solving but not memory. The improvement in social competence (p = .028) was the only advantage of therapy with the ExeSystem. Therapeutic interactions using computer programs were shown to be positively evaluated by patients (p < .01). This study confirmed at least equal efficacy of computer-based executive function therapy using ExeSystem compared to RehaCom and CogniPlus. However, despite the implementation of a more ecological and comprehensive approach to the content of a new application, the benefits of this approach were limited.
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Affiliation(s)
| | - Szczepan Iwański
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Joanna Seniów
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
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Bruni F, Mancuso V, Stramba-Badiale C, Greci L, Cavallo M, Borghesi F, Riva G, Cipresso P, Stramba-Badiale M, Pedroli E. ObReco-2: Two-step validation of a tool to assess memory deficits using 360° videos. Front Aging Neurosci 2022; 14:875748. [PMID: 35966782 PMCID: PMC9366856 DOI: 10.3389/fnagi.2022.875748] [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: 02/14/2022] [Accepted: 07/05/2022] [Indexed: 11/29/2022] Open
Abstract
Traditional neuropsychological evaluations are usually carried out using psychometric paper and pencil tests. Nevertheless, there is a continuous discussion concerning their efficacy to capture life-like abilities. The introduction of new technologies, such as Virtual Reality (VR) and 360° spherical photos and videos, has improved the ecological validity of the neuropsychological assessment. The possibility of simulating realistic environments and situations allows clinicians to evaluate patients in realistic activities. Moreover, 360° photos and videos seem to provide higher levels of graphical realism and technical user-friendliness compared to standard VR, regardless of their limitations in terms of interactivity. We developed a novel 360° tool, ObReco-2 (Object Recognition version 2), for the assessment of visual memory which simulates a daily situation in a virtual house. More precisely, patients are asked to memorize some objects that need to be moved for a relocation. After this phase, they are asked to recall them after 15 min and later to recognize them in the same environment. Here we present a first study about the usability of ObReco-2, and a second one exploring its clinical efficacy and updated usability data. We focused on Free Recall and Recognition scores, comparing the performances obtained by the participants in the standard and the 360° test. The preliminary results support the use of 360° technology for enhancing the ecological value of standard memory assessment tests.
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Affiliation(s)
- Francesca Bruni
- Faculty of Psychology, eCampus University, Novedrate, Italy
- *Correspondence: Francesca Bruni,
| | | | - Chiara Stramba-Badiale
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Luca Greci
- Institute of Intelligent Industrial Technologies and System for Advanced Manufacturing, Milan, Italy
| | - Marco Cavallo
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Francesca Borghesi
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Human Technology Lab, Catholic University of the Sacred Heart, Milan, Italy
| | - Pietro Cipresso
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Turin, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Elisa Pedroli
- Faculty of Psychology, eCampus University, Novedrate, Italy
- Applied Technology for Neuropsychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
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Cavedoni S, Cipresso P, Mancuso V, Bruni F, Pedroli E. Virtual reality for the assessment and rehabilitation of neglect: where are we now? A 6-year review update. VIRTUAL REALITY 2022; 26:1663-1704. [PMID: 35669614 PMCID: PMC9148943 DOI: 10.1007/s10055-022-00648-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/24/2022] [Indexed: 06/13/2023]
Abstract
Unilateral spatial neglect (USN) is a frequent repercussion of a cerebrovascular accident, typically a stroke. USN patients fail to orient their attention to the contralesional side to detect auditory, visual, and somatosensory stimuli, as well as to collect and purposely use this information. Traditional methods for USN assessment and rehabilitation include paper-and-pencil procedures, which address cognitive functions as isolated from other aspects of patients' functioning within a real-life context. This might compromise the ecological validity of these procedures and limit their generalizability; moreover, USN evaluation and treatment currently lacks a gold standard. The field of technology has provided several promising tools that have been integrated within the clinical practice; over the years, a "first wave" has promoted computerized methods, which cannot provide an ecological and realistic environment and tasks. Thus, a "second wave" has fostered the implementation of virtual reality (VR) devices that, with different degrees of immersiveness, induce a sense of presence and allow patients to actively interact within the life-like setting. The present paper provides an updated, comprehensive picture of VR devices in the assessment and rehabilitation of USN, building on the review of Pedroli et al. (2015). The present paper analyzes the methodological and technological aspects of the studies selected, considering the issue of usability and ecological validity of virtual environments and tasks. Despite the technological advancement, the studies in this field lack methodological rigor as well as a proper evaluation of VR usability and should improve the ecological validity of VR-based assessment and rehabilitation of USN.
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Affiliation(s)
- S. Cavedoni
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - P. Cipresso
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, University of Turin, Via Verdi, 10, 10124 Turin, TO Italy
| | - V. Mancuso
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - F. Bruni
- Faculty of Psychology, eCampus University, Novedrate, Italy
| | - E. Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, eCampus University, Novedrate, Italy
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Bruschetta R, Maggio MG, Naro A, Ciancarelli I, Morone G, Arcuri F, Tonin P, Tartarisco G, Pioggia G, Cerasa A, Calabrò RS. Gender Influences Virtual Reality-Based Recovery of Cognitive Functions in Patients with Traumatic Brain Injury: A Secondary Analysis of a Randomized Clinical Trial. Brain Sci 2022; 12:brainsci12040491. [PMID: 35448022 PMCID: PMC9024763 DOI: 10.3390/brainsci12040491] [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: 03/23/2022] [Revised: 04/07/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023] Open
Abstract
The rehabilitation of cognitive deficits in individuals with traumatic brain injury is essential for promoting patients’ recovery and autonomy. Virtual reality (VR) training is a powerful tool for reaching this target, although the effectiveness of this intervention could be interfered with by several factors. In this study, we evaluated if demographical and clinical variables could be related to the recovery of cognitive function in TBI patients after a well-validated VR training. One hundred patients with TBI were enrolled in this study and equally randomized into the Traditional Cognitive Rehabilitation Group (TCRG: n = 50) or Virtual Reality Training Group (VRTG: n = 50). The VRTG underwent a VRT with BTs-N, whereas the TCRG received standard cognitive treatment. All the patients were evaluated by a complete neuropsychological battery before (T0) and after the end of the training (T1). We found that the VR-related improvement in mood, as well as cognitive flexibility, and selective attention were influenced by gender. Indeed, females who underwent VR training were those showing better cognitive recovery. This study highlights the importance of evaluating gender effects in planning cognitive rehabilitation programs. The inclusion of different repetitions and modalities of VR training should be considered for TBI male patients.
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Affiliation(s)
- Roberta Bruschetta
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy; (R.B.); (G.T.); (G.P.)
- Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 21, 00128 Rome, Italy
| | - Maria Grazia Maggio
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy;
| | - Antonino Naro
- Stroke Unit, Azienda Ospedaliera Universitaria Gaetano Martino, 98123 Messina, Italy;
| | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (I.C.); (G.M.)
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (I.C.); (G.M.)
| | | | - Paolo Tonin
- S’Anna Institute, 88900 Crotone, Italy; (F.A.); (P.T.)
| | - Gennaro Tartarisco
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy; (R.B.); (G.T.); (G.P.)
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy; (R.B.); (G.T.); (G.P.)
| | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy; (R.B.); (G.T.); (G.P.)
- S’Anna Institute, 88900 Crotone, Italy; (F.A.); (P.T.)
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Rende, Italy
- Correspondence:
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Vaia S, Iavarone A, Moschiano F, Strube C, Gamboz N, De Pietro G, Gentile S, Garofalo E, Sannino M, Mazzi MC. Computer-aided cognitive training in patients with neurocognitive vascular impairment: effects on cognition, depression and behavior. JOURNAL OF GERONTOLOGY AND GERIATRICS 2022. [DOI: 10.36150/2499-6564-n357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Rangasamy SB, Raha S, Dasarathy S, Pahan K. Sodium Benzoate, a Metabolite of Cinnamon and a Food Additive, Improves Cognitive Functions in Mice after Controlled Cortical Impact Injury. Int J Mol Sci 2021; 23:192. [PMID: 35008615 PMCID: PMC8745327 DOI: 10.3390/ijms23010192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Traumatic brain injury (TBI) is a major health concern, sometimes leading to long-term neurological disability, especially in children, young adults and war veterans. Although research investigators and clinicians have applied different treatment strategies or neurosurgical procedures to solve this health issue, we are still in need of an effective therapy to halt the pathogenesis of brain injury. Earlier, we reported that sodium benzoate (NaB), a metabolite of cinnamon and a Food and Drug Administration-approved drug against urea cycle disorders and glycine encephalopathy, protects neurons in animal models of Parkinson's disease and Alzheimer's disease. This study was undertaken to examine the therapeutic efficacy of NaB in a controlled cortical impact (CCI)-induced preclinical mouse model of TBI. Oral treatment with NaB, but not sodium formate (NaFO), was found to decrease the activation of microglia and astrocytes and to inhibit the expression of inducible nitric oxide synthase (iNOS) in the hippocampus and cortex of CCI-insulted mice. Further, administration of NaB also reduced the vascular damage and decreased the size of the lesion cavity in the brain of CCI-induced mice. Importantly, NaB-treated mice showed significant improvements in memory and locomotor functions as well as displaying a substantial reduction in depression-like behaviors. These results delineate a novel neuroprotective property of NaB, highlighting its possible therapeutic importance in TBI.
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Affiliation(s)
- Suresh B. Rangasamy
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, IL 60612, USA;
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA; (S.R.); (S.D.)
| | - Sumita Raha
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA; (S.R.); (S.D.)
| | - Sridevi Dasarathy
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA; (S.R.); (S.D.)
| | - Kalipada Pahan
- Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, IL 60612, USA;
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA; (S.R.); (S.D.)
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Pallavicini F, Pepe A, Clerici M, Mantovani F. Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review (Preprint). JMIR Serious Games 2021; 10:e35000. [PMID: 36282554 PMCID: PMC9605086 DOI: 10.2196/35000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/18/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings. Objective This systematic review aimed to describe the literature on health care–targeted virtual reality applications during the COVID-19 crisis. Methods We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)].” Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. Results Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials. Conclusions Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama. Trial Registration International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/
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Affiliation(s)
- Federica Pallavicini
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Alessandro Pepe
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Fabrizia Mantovani
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
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Chen J. Clinical Effect of Virtual Reality Technology on Rehabilitation Training of Sports Injury. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1361851. [PMID: 34671447 PMCID: PMC8523234 DOI: 10.1155/2021/1361851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 09/21/2021] [Indexed: 11/17/2022]
Abstract
In order to make most patients recover most of their limb functions after rehabilitation training, virtual reality technology is an emerging human-computer interaction technology, which uses the computer and the corresponding application software to build the virtual reality environment. Completing the training tasks in the virtual environment attracts the patients to conduct repeated training in the game and task-based training mode and gradually realizes the rehabilitation training goals. For the rehabilitation population with certain exercise ability, the kinematics of human upper limbs is mainly analyzed, and the virtual reality system based on HTC VIVE is developed. The feasibility and work efficiency of the upper limb rehabilitation training system were verified by experiments. Adult volunteers who are healthy and need rehabilitation training to participate in the experiment were recruited, and experimental data were recorded. The virtual reality upper limb rehabilitation system was a questionnaire. By extracting the motion data, the system application effect is analyzed and evaluated by the simulation diagram. Follow-up results of rehabilitation training showed that the average score of healthy subjects was more than 4 points and 3.8 points per question. Therefore, it is feasible to perform upper limb rehabilitation training using the HTC VIVE virtual reality rehabilitation system.
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Affiliation(s)
- Jing Chen
- Yunnan University Dianchi College, Kunming 650228, Yunnan, China
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Han Y. A Virtual Reality Algorithm for the Study of Clinical Efficacy of Sports Injury Rehabilitation Training. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6725625. [PMID: 34630993 PMCID: PMC8500756 DOI: 10.1155/2021/6725625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/01/2021] [Indexed: 11/18/2022]
Abstract
This paper aims to explore the influence of virtual reality technology interactive rehabilitation training system and PT and OT operation therapy on the exercise function, daily life activity ability (ADL), and the quality of life in patients with a sports injury. In this context, this paper mainly designed three experiments to test the virtual rehabilitation system: two action experiments (experiment 1), two experiments with actions in 3 different positions (experiment 2), and five different actions (experiment 3), and the motion intention recognition rate, average total time, and task completion degree of the three experiments were calculated. The virtual scene and hardware equipment were kept stable, and the human-machine interaction effect was good. The effectiveness of the proposed virtual reality rehabilitation training system is demonstrated from other aspects. The results showed that the average completion time of 5 volunteers was 57.72 seconds, with an average offline accuracy of 89.03%. In experiment 2, the five volunteers averaged 54.98 seconds, with an average offline accuracy of 91.73%. The average recognition accuracy of the training system reached 90%, demonstrating the effectiveness of the virtual reality rehabilitation training system in terms of motor intention recognition rate, average total use time, and task completion.
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Affiliation(s)
- Yang Han
- College of Humanities and Art, Henan Quality Polytechnic University, Pingdingshan, Henan 467000, China
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Brassel S, Power E, Campbell A, Brunner M, Togher L. Recommendations for the Design and Implementation of Virtual Reality for Acquired Brain Injury Rehabilitation: Systematic Review. J Med Internet Res 2021; 23:e26344. [PMID: 34328434 PMCID: PMC8367177 DOI: 10.2196/26344] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/25/2021] [Accepted: 05/24/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Virtual reality (VR) is increasingly being used for the assessment and treatment of impairments arising from acquired brain injuries (ABIs) due to perceived benefits over traditional methods. However, no tailored options exist for the design and implementation of VR for ABI rehabilitation and, more specifically, traumatic brain injury (TBI) rehabilitation. In addition, the evidence base lacks systematic reviews of immersive VR use for TBI rehabilitation. Recommendations for this population are important because of the many complex and diverse impairments that individuals can experience. OBJECTIVE This study aims to conduct a two-part systematic review to identify and synthesize existing recommendations for designing and implementing therapeutic VR for ABI rehabilitation, including TBI, and to identify current evidence for using immersive VR for TBI assessment and treatment and to map the degree to which this literature includes recommendations for VR design and implementation. METHODS This review was guided by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). A comprehensive search of 11 databases and gray literature was conducted in August 2019 and repeated in June 2020. Studies were included if they met relevant search terms, were peer-reviewed, were written in English, and were published between 2009 and 2020. Studies were reviewed to determine the level of evidence and methodological quality. For the first part, qualitative data were synthesized and categorized via meta-synthesis. For the second part, findings were analyzed and synthesized descriptively owing to the heterogeneity of data extracted from the included studies. RESULTS In the first part, a total of 14 papers met the inclusion criteria. Recommendations for VR design and implementation were not specific to TBI but rather to stroke or ABI rehabilitation more broadly. The synthesis and analysis of data resulted in three key phases and nine categories of recommendations for designing and implementing VR for ABI rehabilitation. In the second part, 5 studies met the inclusion criteria. A total of 2 studies reported on VR for assessment and three for treatment. Studies were varied in terms of therapeutic targets, VR tasks, and outcome measures. VR was used to assess or treat impairments in cognition, balance, and anxiety, with positive outcomes. However, the levels of evidence, methodological quality, and inclusion of recommendations for VR design and implementation were poor. CONCLUSIONS There is limited research on the use of immersive VR for TBI rehabilitation. Few studies have been conducted, and there is limited inclusion of recommendations for therapeutic VR design and implementation. Future research in ABI rehabilitation should consider a stepwise approach to VR development, from early co-design studies with end users to larger controlled trials. A list of recommendations is offered to provide guidance and a more consistent model to advance clinical research in this area.
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Affiliation(s)
- Sophie Brassel
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Andrew Campbell
- Cyberpsychology Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melissa Brunner
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Henry JD. Prospective memory impairment in neurological disorders: implications and management. Nat Rev Neurol 2021; 17:297-307. [PMID: 33686303 DOI: 10.1038/s41582-021-00472-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 01/31/2023]
Abstract
Prospective memory is a core neurocognitive ability that refers to memory for future intentions, such as remembering to take medications and to switch off appliances. Any breakdown in prospective memory, therefore, has serious implications for the ability to function independently in everyday life. In many neurological disorders, including Parkinson disease and dementia, prospective memory deficits are common even in the earliest stages and typically become more severe with disease progression. Consequently, clinical assessment of prospective memory is of critical importance. This article provides an overview of the various manifestations and neural bases of prospective memory deficits. To facilitate clinical decision-making, validated measures of this construct are identified and their suitability for clinical practice is discussed, focusing in particular on clinical sensitivity and psychometric properties. The article concludes by reviewing the approaches that can be used to rehabilitate different types of prospective memory impairment, and algorithms to guide the evaluation and treatment of these impairments are provided.
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Affiliation(s)
- Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
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Alashram AR, Annino G, Aldajah S, Raju M, Padua E. Rehabilitation of limb apraxia in patients following stroke: a systematic review. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1658-1668. [PMID: 33851895 DOI: 10.1080/23279095.2021.1900188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Apraxia is widely used to describe one of the more disabling deficits following left strokes. The role of rehabilitation in treating apraxic stroke patients remains unclear. This systematic review was conducted to study the impacts of various rehabilitation interventions on the limb apraxia post-stroke. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched for the experimental studies that investigated the effects of the rehabilitation interventions on apraxia in patients with stroke. The methodological quality was rated using the Physiotherapy Evidence Database scale (PEDro). Six studies met our inclusion criteria in this systematic review. Four were randomized controlled trials, pilot (n = 1), and case study (n = 1). The scores on the PEDro scale ranged from two to eight, with a median of seven. The results showed some evidence for the effects of strategy training and gesture training interventions on the cognitive functions, motor activities, and activities of daily livings outcomes poststroke. The preliminary findings showed that the effects of the strategy training and the gesture training on apraxia in patients with stroke are promising. Further randomized controlled trials with long-term follow-ups are strongly needed.
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Affiliation(s)
- Anas Radi Alashram
- Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Roma, Italy.,Department of Physiotherapy, Isra University, Amman, Jordan
| | - Giuseppe Annino
- Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Roma, Italy
| | | | - Manikandan Raju
- Department of Neuroscience, University of Rome La Sapienza, Roma, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, Telematic University San Raffaele Rome Srl, Roma, Italy
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Kulshrestha S, Agrawal M, Singh AK, Kulshreshtha D. Post Stroke Rehabilitation Using Computer-based Cognitive Intervention (CBCI): A Systematic Review. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2020. [DOI: 10.2174/2666082216999200622135105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Cognitive impairment as a consequence of stroke is a major cause affecting
the patient’s functional independence, activity participation, daily living skills, and occupation. Almost
75% of post-stroke patients are diagnosed with significant cognitive impairment, which includes
problems with attention, orientation, memory, language, and perception. Along with effective
pharmaceutical cures, cognitive intervention as a part of rehabilitation approaches that may prevent,
delay, or treat cognitive impairment is becoming increasingly important. Many studies have reported
improvement in cognitive functions of post-stroke patients after using computer-based cognitive
intervention (CBCI). CBCI can be an effective add-on to available rehabilitation programs.
Objective:
This article provides reviews related to relevant literature and, represents a structure to
specify the efficacy of CBCI for the rehabilitation of post-stroke patients for future research.
Methods:
We searched many search engines namely MEDLINE, Web of Science, clinical key and
The Cochrane Library, for studies investigating the effect of cognitive intervention based on a computer
program for post-stroke patients. The results of selected studies were summarized. Total 19
publications from January 2007 to January 2019 are included in this review. The search terms entered
were a combination of these search areas that defined (1) the population as adults who had suffered
a stroke and cognitive dysfunction, (2) intervention search term included cognitive abilities, cognitive
training, and computer-based training; computer-based cognitive intervention for rehabilitation.
Results:
The results after computer-based training showed improvement in various cognitive functions
such as; memory, attention and executive functions of post-stroke patients. However, a significant
difference between the study groups has not been observed in all the studies. Most studies analyzed
in this research project indicated that such interventions might contribute to the improvement
of cognitive function, especially attention concentration and memory. Of the 19 kinds of research
that discussed CBCI outcomes 18 found significant improvements for one or more cognitive functions.
When the effect size for CBCI was reported, effects were large in comparison to other traditional
cognitive interventions of post-stroke patients.
Conclusion:
Studies related to cognitive functions strongly support CBCI except few have reported
a significant difference. The review of all the studies suggests that CBCI may help to change the
functional aspect of post-stroke patients by improving their cognitive functions. In this field, it is a
challenge to conduct well designed and sufficiently powered studies due to low budgets availability,
the limited number of available patients, heterogeneity of the population, and ethical considerations.
Future studies should examine all the challenges, limitations, and valuable insights into the study
and emphasize the need for a carefully designed computer-based cognitive intervention program for
the future. Future studies should target to compare CBCI with active and passive control conditions
and include a larger sample size.
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Affiliation(s)
- Sudhi Kulshrestha
- Amity Institute of Behavioral and Allied Sciences, Amity University, Lucknow, India
| | - Manju Agrawal
- Amity Institute of Behavioral and Allied Sciences, Amity University, Lucknow, India
| | - Ajai K. Singh
- Department of Neurology, Dr. Ram ManoharLohia Institute of Medical Sciences, Lucknow, India
| | - Dinkar Kulshreshtha
- Department of Neurology, Dr. Ram ManoharLohia Institute of Medical Sciences, Lucknow, India
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d’Arma A, Isernia S, Di Tella S, Rovaris M, Valle A, Baglio F, Marchetti A. Social Cognition Training for Enhancing Affective and Cognitive Theory of Mind in Schizophrenia: A Systematic Review and a Meta-Analysis. THE JOURNAL OF PSYCHOLOGY 2020; 155:26-58. [DOI: 10.1080/00223980.2020.1818671] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Alessia d’Arma
- IRCCS Fondazione Don Carlo Gnocchi
- Università Cattolica del Sacro Cuore
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Polanowska KE. Neuropsychological rehabilitation of acquired, non-progressive cognitive-behavioral disorders in evidence-based clinical recommendations. REHABILITACJA MEDYCZNA 2020. [DOI: 10.5604/01.3001.0014.4134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: Neuropsychological rehabilitation is an important area of neurological rehabilitation. Its techniques are studied in terms of effectiveness and subjected to collective analyses in order to identify the best interventions.
Objective: The purpose of the article is to present current clinical recommendations for neuropsychological rehabilitation among adult patients with acquired, non-progressive brain damage usually caused by a stroke or head injury.
Data sources: The recommendations are based on the latest scientific papers containing systematic reviews and meta-analysis of studies on the rehabilitation of patients with cognitive dysfunctions and/or behavioral abnormalities.
Conclusions: To date, the highest recommendation and the status of practice standards in neuropsychological rehabilitation have been achieved by therapeutic techniques of 5 post-stroke disorders (attention deficits, mild memory deficits, left-sided visual neglect, aphasia, global decline in cognitive-behavioral functioning) and 5 post-traumatic disorders (attention deficits, mild memory deficits, mild and moderate executive dysfunctions, abnormalities in social functioning and interpersonal communication, global decline in cognitive-behavioral functioning). These techniques may be used independently or introduced in combination with interventions of a lower recommendation level, classified as practice guidelines or practice options. The use of lower grade recommendations should also be considered in situations where there are no standard techniques for specific forms of disorders. In the case of deficits for which no recommendations have yet been made, further research is necessary. This applies to agnosia, profound memory disorders and amnesia, as well as profound executive dysfunctions.
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Affiliation(s)
- Katarzyna Ewa Polanowska
- Clinical Neuropsychology Laboratory, 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland / Pracownia Neuropsychologii Klinicznej, II Klinika Neurologiczna, Instytut Psychiatrii i Neurologii w Warszawie
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Cavedoni S, Chirico A, Pedroli E, Cipresso P, Riva G. Digital Biomarkers for the Early Detection of Mild Cognitive Impairment: Artificial Intelligence Meets Virtual Reality. Front Hum Neurosci 2020; 14:245. [PMID: 32848660 PMCID: PMC7396670 DOI: 10.3389/fnhum.2020.00245] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/02/2020] [Indexed: 01/16/2023] Open
Abstract
Elderly people affected by Mild Cognitive Impairment (MCI) usually report a perceived decline in cognitive functions that deeply impacts their quality of life. This subtle waning, although it cannot be diagnosable as dementia, is noted by caregivers on the basis of their relative’s behaviors. Crucially, if this condition is also not detected in time by clinicians, it can easily turn into dementia. Thus, early detection of MCI is strongly needed. Classical neuropsychological measures – underlying a categorical model of diagnosis - could be integrated with a dimensional assessment approach involving Virtual Reality (VR) and Artificial Intelligence (AI). VR can be used to create highly ecologically controlled simulations resembling the daily life contexts in which patients’ daily instrumental activities (IADL) usually take place. Clinicians can record patients’ kinematics, particularly gait, while performing IADL (Digital Biomarkers). Then, Artificial Intelligence employs Machine Learning (ML) to analyze them in combination with clinical and neuropsychological data. This integrated computational approach would enable the creation of a predictive model to identify specific patterns of cognitive and motor impairment in MCI. Therefore, this new dimensional cognitive-behavioral assessment would reveal elderly people’s neural alterations and impaired cognitive functions, typical of MCI and dementia, even in early stages for more time-sensitive interventions.
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Affiliation(s)
- Silvia Cavedoni
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Alice Chirico
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Faculty of Psychology, eCampus University, Novedrate, Italy
| | - Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy.,Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Cieślik B, Mazurek J, Rutkowski S, Kiper P, Turolla A, Szczepańska-Gieracha J. Virtual reality in psychiatric disorders: A systematic review of reviews. Complement Ther Med 2020; 52:102480. [PMID: 32951730 DOI: 10.1016/j.ctim.2020.102480] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Virtual reality (VR) is being used more and more often as a therapeutic tool in psychology or psychiatry. In recent years, VR interventions appear more extensively also in disorders such as depression, anxiety and phobia. However, there has yet to be a comprehensive synthesis and critical review of the literature to identify future directions to advance the field in this area. OBJECTIVES To broadly characterize the literature to date on the application of VR in psychiatric disorders by conducting a systematic review of reviews, describe the limitations of existing research, suggest avenues for future research to address gaps in the current literature and provide practical recommendations for incorporating VR into various treatments for psychiatric disorders. METHODS PubMed and Web of Science databases were searched for reviews on VR use in psychiatric disorders (e.g. various pain perceptions, post-traumatic stress disorder, phobias, attention deficit hyperactivity disorder, psychosis, depression). The methodological quality of each literature review was assessed using AMSTAR. RESULTS The original search identified 848 reviews, of which 70 were included in the systematic review of reviews. Broadly, the literature indicates that various VR interventions could be useful in different psychiatric disorders. CONCLUSION This study provides evidence supporting the positive impact of VR therapy in psychiatric disorders. However, the impact is defined differently according to the studied area. Nevertheless, due to the continuous development of VR hardware and software, it is essential to conduct further research in the area of psychiatric disorders, especially as no review has concluded that VR does not work.
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Affiliation(s)
- Błażej Cieślik
- Faculty of Health Sciences, Jan Dlugosz University in Czestochowa, Czestochowa, Poland.
| | - Justyna Mazurek
- Department and Division of Medical Rehabilitation, Wroclaw Medical University, Wroclaw, Poland.
| | - Sebastian Rutkowski
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.
| | - Paweł Kiper
- Laboratory of Neurorehabilitation Technologies, San Camillo IRCCS S.r.l., Venice, Italy.
| | - Andrea Turolla
- Laboratory of Neurorehabilitation Technologies, San Camillo IRCCS S.r.l., Venice, Italy.
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Alashram AR, Padua E, Hammash AK, Lombardo M, Annino G. Effectiveness of virtual reality on balance ability in individuals with incomplete spinal cord injury: A systematic review. J Clin Neurosci 2020; 72:322-327. [DOI: 10.1016/j.jocn.2020.01.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
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Coco-Martin MB, Piñero DP, Leal-Vega L, Hernández-Rodríguez CJ, Adiego J, Molina-Martín A, de Fez D, Arenillas JF. The Potential of Virtual Reality for Inducing Neuroplasticity in Children with Amblyopia. J Ophthalmol 2020; 2020:7067846. [PMID: 32676202 PMCID: PMC7341422 DOI: 10.1155/2020/7067846] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, virtual reality (VR) has emerged as a new safe and effective tool for neurorehabilitation of different childhood and adulthood conditions. VR-based therapies can induce cortical reorganization and promote the activation of different neuronal connections over a wide range of ages, leading to contrasted improvements in motor and functional skills. The use of VR for the visual rehabilitation in amblyopia has been investigated in the last years, with the potential of using serious games combining perceptual learning and dichoptic stimulation. This combination of technologies allows the clinician to measure, treat, and control changes in interocular suppression, which is one of the factors leading to cortical alterations in amblyopia. Several clinical researches on this issue have been conducted, showing the potential of promoting visual acuity, contrast sensitivity, and stereopsis improvement. Indeed, several systems have been evaluated for amblyopia treatment including the use of different commercially available types of head mounted displays (HMDs). These HMDs are mostly well tolerated by patients during short exposures and do not cause significant long-term side effects, although their use has been occasionally associated with some visual discomfort and other complications in certain types of subjects. More studies are needed to confirm these promising therapies in controlled randomized clinical trials, with special emphasis on the definition of the most adequate planning for obtaining an effective recovery of the visual and binocular function.
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Affiliation(s)
- María B. Coco-Martin
- 1Group of Applied Clinical Neurosciences and Advanced Data Analysis, Neurology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - David P. Piñero
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- 3Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Luis Leal-Vega
- 1Group of Applied Clinical Neurosciences and Advanced Data Analysis, Neurology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
| | - Carlos J. Hernández-Rodríguez
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- 3Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
| | - Joaquin Adiego
- 4Group of Applied Clinical Neurosciences and Advanced Data Analysis, Computer Science Department, School of Computing, University of Valladolid, Valladolid, Spain
| | - Ainhoa Molina-Martín
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Dolores de Fez
- 2Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Juan F. Arenillas
- 1Group of Applied Clinical Neurosciences and Advanced Data Analysis, Neurology Department, Faculty of Medicine, University of Valladolid, Valladolid, Spain
- 5Department of Neurology, Stroke Unit and Stroke Program, University Hospital, University of Valladolid, Valladolid, Spain
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Bevilacqua R, Maranesi E, Riccardi GR, Di Donna V, Pelliccioni P, Luzi R, Lattanzio F, Pelliccioni G. Non-Immersive Virtual Reality for Rehabilitation of the Older People: A Systematic Review into Efficacy and Effectiveness. J Clin Med 2019; 8:E1882. [PMID: 31694337 PMCID: PMC6912349 DOI: 10.3390/jcm8111882] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/25/2019] [Accepted: 11/01/2019] [Indexed: 01/17/2023] Open
Abstract
: Objective: the objective of this review is to analyze the advances in the field of rehabilitation through virtual reality, while taking into account non-immersive systems, as evidence have them shown to be highly accepted by older people, due to the lowest "cibersikness" symptomatology. DATA SOURCES a systematic review of the literature was conducted in June 2019. The data were collected from Cochrane, Embase, Scopus, and PubMed databases, analyzing manuscripts and articles of the last 10 years. STUDY SELECTION we only included randomized controlled trials written in English aimed to study the use of the virtual reality in rehabilitation. We selected 10 studies, which were characterized by clinical heterogeneity. DATA EXTRACTION quality evaluation was performed based on the Physioterapy Evidence Database (PEDro) scale, suggested for evidence based review of stroke rehabilitation. Of 10 studies considered, eight were randomized controlled trials and the PEDro score ranged from four to a maximum of nine. DATA SYNTHESIS VR (Virtual Reality) creates artificial environments with the possibility of a patient interaction. This kind of experience leads to the development of cognitive and motor abilities, which usually positively affect the emotional state of the patient, increasing collaboration and compliance. Some recent studies have suggested that rehabilitation treatment interventions might be useful and effective in treating motor and cognitive symptoms in different neurological disorders, including traumatic brain injury, multiple sclerosis, and progressive supranuclear palsy. CONCLUSIONS as it is shown by the numerous studies in the field, the application of VR has a positive impact on the rehabilitation of the most predominant geriatric syndromes. The level of realism of the virtual stimuli seems to have a crucial role in the training of cognitive abilities. Future research needs to improve study design by including larger samples, longitudinal designs, long term follow-ups, and different outcome measures, including functional and quality of life indexes, to better evaluate the clinical impact of this promising technology in healthy old subjects and in neurological patients.
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Affiliation(s)
| | - Elvira Maranesi
- Scientific Direction, IRCCS INRCA, 60129 Ancona, Italy; (R.B.); (F.L.)
| | | | - Valentina Di Donna
- Clinical Unit of Physical Rehabilitation, IRCCS INRCA, 60100 Ancona, Italy; (G.R.R.); (V.D.D.)
| | | | - Riccardo Luzi
- Medical Direction, IRCCS INRCA, 60100 Ancona, Italy;
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