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Michelle Nettleton Pearce L, Howell M, Parma Yamato T, Maria Ribeiro Bacha J, Eduardo Pompeu J, Howard K, Sherrington C, Hassett L. What attributes of digital devices are important to clinicians in rehabilitation? A cross-cultural best-worst scaling study. Int J Med Inform 2024; 191:105589. [PMID: 39137666 DOI: 10.1016/j.ijmedinf.2024.105589] [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: 04/12/2024] [Revised: 07/25/2024] [Accepted: 08/04/2024] [Indexed: 08/15/2024]
Abstract
BACKGROUND Digital interventions are becoming increasingly popular in rehabilitation. Understanding of device features which impact clinician adoption and satisfaction is limited. Research in the field should be conducted across diverse settings to ensure digital interventions do not exacerbate healthcare inequities. OBJECTIVE This study aimed to understand rehabilitation clinicians' preferences regarding device attributes and included a cross-cultural comparison. MATERIALS AND METHODS Choice experiment methodology (best-worst scaling) was used to survey rehabilitation clinicians across Australia and Brazil. Participants completed 10 best-worst questions, choosing the most and least important device attributes from subsets of 31 attributes in a partially balanced block design. Results were analysed using multinomial models by country and latent class. Attribute preference scores (PS) were scaled to 0-100 (least to most important). RESULTS A total of 122 clinicians from Brazil and 104 clinicians from Australia completed the survey. Most respondents were physiotherapists (83%) working with neurological populations (51%) in the private/self-employed sector (51%) who had experience using rehabilitation devices (87%). Despite preference heterogeneity across country and work sector (public/not-for-profit versus private/self-employed/other), clinicians consistently prioritised patient outcomes (PS 100.0, 95%CI: 86.2-100.0), patient engagement (PS 93.9, 95%CI: 80.6-94.2), usability (PS 81.3, 95%CI: 68.8-82.5), research evidence (PS 80.4, 95%CI: 68.1-81.7) and risk (PS 75.7, 95%CI: 63.8-77.3). In Australia, clinicians favoured device attributes which facilitate increased therapy dosage (PS 79.2, 95%CI: 62.6-81.1) and encourage patient independent practice (PS 66.8, 95%CI: 52.0-69.2). In Brazil, clinicians preferred attributes enabling device use for providing clinical data (PS 67.6, 95%CI: 51.8-70.9) and conducting clinical assessments (PS 65.6, 95%CI: 50.2-68.8). CONCLUSION Clinicians prioritise patients' needs and practical application over technical aspects of digital rehabilitation devices. Contextual factors shape clinician preferences rather than individual clinician characteristics. Future device design and research should consider preferences and influences, involving diverse stakeholders to account for context-driven variations across cultures and healthcare settings.
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Affiliation(s)
- Louise Michelle Nettleton Pearce
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Royal Rehab Group, Sydney, Australia.
| | - Martin Howell
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney Australia; Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia.
| | - Tiê Parma Yamato
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Universidade Cidade de Sao Paulo, Brazil.
| | | | | | - Kirsten Howard
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney Australia; Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia.
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney Australia.
| | - Leanne Hassett
- Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, Australia; Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Implementation Science Academy, Sydney Health Partners, Sydney, Australia.
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Elser A, Kopkow C, Schäfer AG. Implementation of a Virtual Reality Intervention in Outpatient Physiotherapy for Chronic Pain: Protocol for a Pilot Implementation Study. JMIR Res Protoc 2024; 13:e58089. [PMID: 39312768 DOI: 10.2196/58089] [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: 03/05/2024] [Revised: 07/11/2024] [Accepted: 07/25/2024] [Indexed: 09/25/2024] Open
Abstract
BACKGROUND Chronic pain is a global health issue that causes physical, psychological, and social disabilities for patients, as well as high costs for societies. Virtual reality (VR) is a new treatment that provides an opportunity to narrow the gap between clinical practice and recommended care in the use of patient education and behavioral interventions in the outpatient physiotherapy setting. However, there is currently no implementation strategy to integrate VR treatments into this setting. OBJECTIVE This protocol outlines a pilot implementation study that aims to (1) identify barriers and facilitators for implementing a VR intervention in outpatient physiotherapy care for people with chronic pain and (2) develop and pilot test an implementation strategy in 5 practices in Germany. METHODS The study consists of 4 phases. The first phase involves adapting the treatment protocol of the VR intervention to the local context of outpatient physiotherapy practices in Germany. The second phase includes the collection of barriers and facilitators through semistructured interviews from physiotherapists and the development of a theory-driven implementation strategy based on the Theoretical Domains framework and the Behavior Change Wheel. This strategy will be applied in the third phase, which will also include a 6-month span of using VR interventions in practices, along with a process evaluation. The fourth phase consists of semistructured interviews to evaluate the developed implementation strategy. RESULTS The recruitment process and phase 1, including the adaptation of the treatment protocol, have already been completed. We recruited 5 physiotherapy practices in Lower Saxony, Germany, where the VR intervention will be implemented. The collection of barriers and facilitators through semistructured interviews is scheduled to begin in February 2024. CONCLUSIONS This pilot implementation study aims to develop a theory-driven implementation strategy for integrating a VR intervention into outpatient physiotherapy care for people with chronic pain. The identified barriers and facilitators, along with the implementation strategy, will serve as a starting point for future randomized controlled implementation studies in different settings to refine the implementation process and integrate VR interventions into the outpatient care of people with chronic pain. TRIAL REGISTRATION German Clinical Trials Register DRKS00030862; https://tinyurl.com/3zf7uujx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/58089.
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Affiliation(s)
- Alexander Elser
- Faculty of Social Work and Health, HAWK University of Applied Sciences and Arts Hildesheim/Holzminden/Göttingen, Hildesheim, Germany
| | - Christian Kopkow
- Faculty 4 for Human Sciences, Department Therapy Science I, Brandenburg University of Technology Cottbus - Senftenberg, Cottbus - Senftenberg, Germany
| | - Axel Georg Schäfer
- Faculty of Social Work and Health, HAWK University of Applied Sciences and Arts Hildesheim/Holzminden/Göttingen, Hildesheim, Germany
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Roy I, Salles J, Neveu E, Lariviére-Bastien D, Blondin A, Levac D, Beauchamp MH. Exploring the perspectives of health care professionals on digital health technologies in pediatric care and rehabilitation. J Neuroeng Rehabil 2024; 21:156. [PMID: 39261920 PMCID: PMC11391714 DOI: 10.1186/s12984-024-01431-9] [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: 04/25/2024] [Accepted: 07/24/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND Digital health technologies are increasingly used by healthcare professionals working in pediatric hospital and rehabilitation settings. Multiple factors may affect the implementation and use of digital health technologies in these settings. However, such factors have not been identified in a multidisciplinary, pediatric context. The objective of this study was to describe actual use and to identify the factors that promote or hinder the intention to use digital health technologies (mobile learning applications, virtual/augmented reality, serious games, robotic devices, telehealth applications, computerized assessment tools, and wearables) among pediatric healthcare professionals. METHODS An online survey evaluating opinions, current use, and future intentions to use digital health technologies was completed by 108 professionals at one of Canada's largest pediatric institutes. Mann-Whitney U tests were used to compare the attitudes of healthcare professionals who intend to increase their use of digital health technologies and those who do not. Linear regression analyses were used to determine predictors of usage success. RESULTS Healthcare professionals reported mostly using mobile and tablet learning applications (n = 43, 38.1%), telehealth applications (n = 49, 43.4%), and computerized assessment tools (n = 33, 29.2%). Attitudes promoting the intention to increase the use of digital health technologies varied according to technology type. Healthcare professionals who wished to increase their use of digital health technologies reported a more positive attitude regarding benefits in clinical practice and patient care, but were also more critical of potential negative impacts on patient-professional relationships. Ease of use (β = 0.374; p = 0.020) was a significant predictor of more favorable usage success. The range of obstacles encountered was also a significant predictor (β = 0.342; p = 0.032) of less favorable evaluation of usage success. Specific factors that hinder successful usage are lack of training (β = 0.303; p = 0.033) and inadequate infrastructure (β = 0.342; p = 0.032). CONCLUSIONS When working with children, incorporating digital health technologies can be effective for motivation and adherence. However, it is crucial to ensure these tools are implemented properly. The findings of this study underscore the importance of addressing training and infrastructure needs when elaborating technology-specific strategies for multidisciplinary adoption of digital health technologies in pediatric settings.
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Affiliation(s)
| | | | | | | | | | - Danielle Levac
- Université de Montréal, Montreal, Canada
- CHU Sainte Justine Azrieli Research Center, Montreal, Canada
| | - Miriam H Beauchamp
- Université de Montréal, Montreal, Canada.
- CHU Sainte Justine Azrieli Research Center, Montreal, Canada.
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Li X, He Y, Wang D, Rezaei MJ. Stroke rehabilitation: from diagnosis to therapy. Front Neurol 2024; 15:1402729. [PMID: 39193145 PMCID: PMC11347453 DOI: 10.3389/fneur.2024.1402729] [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: 03/22/2024] [Accepted: 06/28/2024] [Indexed: 08/29/2024] Open
Abstract
Stroke remains a significant global health burden, necessitating comprehensive and innovative approaches in rehabilitation to optimize recovery outcomes. This paper provides a thorough exploration of rehabilitation strategies in stroke management, focusing on diagnostic methods, acute management, and diverse modalities encompassing physical, occupational, speech, and cognitive therapies. Emphasizing the importance of early identification of rehabilitation needs and leveraging technological advancements, including neurostimulation techniques and assistive technologies, this manuscript highlights the challenges and opportunities in stroke rehabilitation. Additionally, it discusses future directions, such as personalized rehabilitation approaches, neuroplasticity concepts, and advancements in assistive technologies, which hold promise in reshaping the landscape of stroke rehabilitation. By delineating these multifaceted aspects, this manuscript aims to provide insights and directions for optimizing stroke rehabilitation practices and enhancing the quality of life for stroke survivors.
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Affiliation(s)
- Xiaohong Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yanjin He
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dawu Wang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Curtis S, Sheehan L, Buchman E, Bhattacharjya S. Clinicians' perspectives and usage of rehabilitation technology: a survey. Disabil Rehabil Assist Technol 2024; 19:2298-2305. [PMID: 37987735 DOI: 10.1080/17483107.2023.2284365] [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: 05/16/2023] [Revised: 09/18/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE The aim of this study was to investigate clinicians' perspectives regarding their usage of rehabilitation technology in their day-to-day practice and uncover the factors that impact clinicians' use of rehabilitation technology in their daily practice. MATERIALS AND METHODS An online survey was used to gather cross-sectional data from American occupational therapists, occupational therapy assistants, physical therapists, physical therapy assistants, and speech language pathologists. This survey used Likert-scale, multiple choice, and free-response questions. RESULTS Approximately half (n = 56/105, 53.3%) of our clinicians reported using rehabilitation in their daily practice. Less than 20% (n = 18/105, 17.1%) of the respondents strongly agreed that they felt comfortable implementing new rehabilitation technology, and few reported that their workplace encouraged (n = 16/85, 18.8%) or strongly encouraged (n = 14/85, 16.5%) the use of rehabilitation technology in practice. Additionally, excluding the 2011-2020 graduate clinicians that reported that they had not learned about rehabilitation technology in school or fieldwork, few reported feeling prepared (n = 14/97, 14.4%) or very prepared (n = 4/97, 4.1%) to use rehabilitation technology after graduation. CONCLUSIONS Our findings have revealed a sizable knowledge-to-practice gap in regard to clinicians' preparedness to engage with and advocate for rehabilitation technology in their day-to-day practice.
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Affiliation(s)
- Sarah Curtis
- Department of Occupational Therapy, GA State University, Atlanta, GA, USA
| | | | - Emily Buchman
- Department of Occupational Therapy, GA State University, Atlanta, GA, USA
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Oh S, Hodson T, Kendall M, Shirota C, Kendall E. A technology-focused service within a rehabilitation setting: exploring the experiences and current technology demands of people with disabilities. Disabil Rehabil Assist Technol 2024; 19:2000-2009. [PMID: 37615165 DOI: 10.1080/17483107.2023.2244001] [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: 10/31/2022] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE To understand and combat the challenges in taking up and implementing technology in rehabilitation settings, the HabITec Lab, a clinical service focused on technology, was piloted for 12-months within a tertiary hospital. This article reports on its preliminary impacts as a clinical service and on clients, including the types of assistive technology (AT) in demand. MATERIALS AND METHODS Referral and administrative data from 25 individuals who attended the HabITec Lab were collated and analysed using descriptive statistics. For those who attended more than once (n = 12), goal attainment was assessed using the Modified Goal Attainment Measure (MGAM). Post-intervention semi-structured interviews were completed with participants to understand their experience at the HabITec Lab. Interviews were analysed using thematic analysis. RESULTS Most attendees (92%) were undergoing inpatient rehabilitation following a spinal cord injury (SCI). The majority (73%) of goals related to improving entertainment and connection. All participants who completed the MGAM showed improved goal attainment following their HabITec Lab attendance. Qualitative data highlighted appreciation for the service and suggestions for its future. CONCLUSIONS This study revealed a high level of demand for support to use AT amongst individuals with SCI, particularly consumer-grade smart devices that could assist communication. This finding may have been influenced by the impacts of the COVID-19 pandemic and frequent lockdowns during this period. This study indicated that the HabITec Lab was able to address important goals for attendees, but also illuminate a new future and trigger enthusiasm about future goals. Attendance was liberating, but resourcing barriers were frustrating.
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Affiliation(s)
- Soo Oh
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Tenelle Hodson
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
- Transitional Rehabilitation Program, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Acquired Brain Injury Outreach Service, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Elizabeth Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
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Bradbury M, Tierney S. Perspectives of children with physical disabilities, parents and physiotherapists on use of walkers and their potential to increase physical activity. A qualitative exploration. J Child Health Care 2024; 28:256-276. [PMID: 35977004 DOI: 10.1177/13674935221117868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Children with physical disabilities are less physically active than children with typical development. How children's experiences of using walkers relates to their physical activity has not been studied previously. This study aimed to explore perspectives of walker use and their potential to increase physical activity. Four focus groups were conducted with children aged 7-10 (n = 3; 12.5%), aged 9-12 (n = 4; 16.7%), parents (n = 7; 29.2%) and paediatric physiotherapists (n = 10; 41.7%). Groups were audio recorded and transcribed. Data were analysed using framework analysis. An overarching concept of walkers needing flexibility to accommodate individual, interpersonal and environmental variability was underpinned by three themes: (a) contrasting drivers for use/non-use of walkers, (b) trade-offs, (c) acceptance of technology within walkers to increase physical activity. Participants were motivated by differing drivers: social for children, emotional for parents and professional for physiotherapists. These contrasting drivers create trade-offs, for example between quality of movement and independence. To maximise physical activity, walker prescribers and designers should prioritise drivers that motivate children and parents, ensuring goal setting is family-centred and participation orientated. Involving families in co-designing walkers is therefore important. Individual clinical assessment allows for identification of children's specific needs and how a child's, parent's and physiotherapist's goals may differ.
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Affiliation(s)
- Marilyn Bradbury
- Research and Innovation, Birmingham Community Healthcare NHS Foundation Trust, Birmingham, WM, UK
| | - Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX, UK
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Jarvis K, Cook J, Bavikatte G, Branscombe N, Donovan S, Haworth J, Lawrence C, Morland C, Stockley RC. A pilot exploration of staff and service-user perceptions of a novel digital health technology (Virtual Engagement Rehabilitation Assistant) in complex inpatient rehabilitation. Disabil Rehabil Assist Technol 2024:1-11. [PMID: 38743465 DOI: 10.1080/17483107.2024.2351499] [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: 10/13/2023] [Accepted: 04/30/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE Digital health technologies have the potential to advance rehabilitation. The Virtual Engagement Rehabilitation Assistant (VERA) is a digital technology, co-designed to increase service-user engagement and promote self-management. This qualitative study explored staff and service-user perceptions of implementing VERA on a UK complex inpatient rehabilitation ward. METHODS Purposively sampled service-users were allocated to VERA for up to six weeks. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework underpinned service-user post-intervention interviews and staff focus groups, and structured analysis of the data. Seven service-users were interviewed. Nine staff contributed to focus groups. RESULTS A framework analysis identified themes (and subthemes) structured by the NASSS framework domains: 1. Nature of Clinical Condition, 2. Technology (Ease of Use, Holding Information/Resources in a single Digital Location, Appointments), 3. Value Proposition (Structuring Time, Feedback, Unexpected Benefits) 4. Adopters (Confidence in using Technology, Usefulness), 5. Wider Organisation. Ease of use and storage of key information in a single location were beneficial. Reliability, and provision of accurate and timely feedback to staff and service-users, were identified as essential. CONCLUSIONS A blended approach is required to meet staff and service-user needs. The potential for VERA in a community setting was identified and requires further investigation. Learning from VERA will support development of other digital technologies and their implementation.
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Affiliation(s)
- Kathryn Jarvis
- Stroke Research Team, University of Central Lancashire (UCLan), Preston, UK
| | - Julie Cook
- Applied Health Research Hub, University of Central Lancashire (UCLan), Preston, UK
| | | | | | | | - Jo Haworth
- The Walton Centre NHS Foundation Trust, Liverpool, UK
| | | | | | - Rachel C Stockley
- Stroke Research Team, University of Central Lancashire (UCLan), Preston, UK
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Twamley J, Hamer O, Hill J, Kenyon R, Twamley H, Casey R, Zhang J, Williams A, Clegg A. Exploring the perceptions of former ICU patients and clinical staff on barriers and facilitators to the implementation of virtual reality exposure therapy: A qualitative study. Nurs Crit Care 2024; 29:313-324. [PMID: 36458458 DOI: 10.1111/nicc.12868] [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: 07/22/2022] [Revised: 10/18/2022] [Accepted: 11/21/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Virtual reality (VR) as a digital technology has developed rapidly, becoming more realistic, portable, sensory and easier to navigate. Although studies have found VR to be effective for many clinical applications, patients and clinicians have described several barriers to the successful implementation of this technology. To remove barriers for implementation of VR in health care, a greater understanding is needed of how VR can integrate into clinical environments, particularly complex settings such as an intensive care unit. AIM This study aimed to explore the perceived barriers and facilitators for the implementation of VR exposure therapy for intensive care patients and clinical staff. STUDY DESIGN A qualitative study using an Interpretative Description approach was undertaken. Semi-structured focus groups were conducted with 13 participants: nine patients and four health care professionals. Focus groups explored barriers and facilitators of using virtual reality (VR) exposure therapy in intensive care. Thematic analysis was employed to produce codes and themes. RESULTS In total, eight themes describing the perceived barriers and facilitators to implementing VR exposure therapy were identified. Four themes related to the perceived barriers of implementing VR exposure therapy in intensive care were identified: psychological, sensory, environmental and staff competency and confidence. There were a further four themes related to the perceived facilitators to the implementation of VR exposure therapy: staff training, patient capacity, orientation to technology and support during the intervention. CONCLUSIONS This study identified novel barriers and facilitators that could be expected when implementing VR exposure therapy for patients' post-intensive care unit stay. The findings suggest that psychological barriers of fear and apprehension were expected to provoke patient avoidance of exposure therapy. Perceived barriers for staff focused on preparedness to deliver the VR exposure therapy and a lack of technological competence. Both patients and staff stated that a comprehensive induction, orientation and training could facilitate VR exposure therapy, improving engagement. RELEVANCE TO CLINICAL PRACTICE This study has identified that with appropriate staff training, resources, and integration into current patient care pathways, VR exposure therapy may be a valuable intervention to support patient recovery following critical illness. Prior to undertaking VR exposure therapy, patients often need reassurance that side-effects can be managed, and that they can easily control their virtual exposure experience.
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Affiliation(s)
- Jacqueline Twamley
- Centre for Health Research and Innovation, NIHR Lancashire Clinical Research Facility, Chorley, UK
| | - Oliver Hamer
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - James Hill
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
| | - Roger Kenyon
- Critical care survivor, University of Central Lancashire, Preston, UK
| | - Huw Twamley
- Intensive Care Department, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, UK
| | - Rob Casey
- Digital Therapy Solutions to empower Stroke, Dementia, Parkinson's Rehabilitation, DancingMind Pte Ltd, London, England, United Kingdom
| | | | - Alexandra Williams
- Intensive Care Department, Lancashire Teaching Hospitals NHS Foundation Trust, Chorley, Lancashire, United Kingdom
| | - Andrew Clegg
- Synthesis, Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire, Preston, UK
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Cho HM, Kim H, Jang J, Cha S, Chang WK, Jung BK, Park DS, Jee S, Ko SH, Shin JH, Choi JS, Kim WS, Paik NJ. Attitude Toward Virtual Rehabilitation and Active Video Games Among Therapists in Korea: A Nationwide Survey. BRAIN & NEUROREHABILITATION 2024; 17:e4. [PMID: 38585030 PMCID: PMC10990844 DOI: 10.12786/bn.2024.17.e4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/08/2023] [Accepted: 12/20/2023] [Indexed: 04/09/2024] Open
Abstract
In this study, we conducted a survey targeting 191 physical therapists (PTs) and 159 occupational therapists (OTs) in South Korea to explore attitudes toward virtual rehabilitation. Utilizing the Korean version of the ADOPT VR by Glegg et al., OT exhibited significantly more experience with virtual reality (VR) and active video games (AVG) than PT. Therapists with VR/AVG experience scored significantly higher in most categories, and the scores in each category were significantly correlated with the Behavioral Intention category, reflecting the willingness to use VR/AVG. The biggest barriers identified were insufficient funds and setup assistance for the equipment. Differences in responses between the groups with and without VR/AVG experience were most prominent in terms of lack of interest and funding. Therapists' attitudes, perceptions, and intentions toward VR/AVG are crucial factors in the establishment and implementation of VR/AVG; thus, the results of this study provide valuable evidence for future policies related to VR/AVG in rehabilitation medicine.
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Affiliation(s)
- Hee-Mun Cho
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hyunji Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jihui Jang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Seungwoo Cha
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Bong-Keun Jung
- Department of Mechanical Engineering, Seoul National University College of Engineering, Seoul, Korea
| | - Dae-Sung Park
- Department of Physical Therapy, Konyang University, Daejeon, Korea
| | - Sungju Jee
- Department of Rehabilitation Medicine, Chungnam National University Hospital and Chungnam National University College of Medicine, Daejeon, Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Pusan, Korea
| | - Joon-Ho Shin
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
| | - Ji Soo Choi
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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11
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Nwosu AC, Mills M, Roughneen S, Stanley S, Chapman L, Mason SR. Virtual reality in specialist palliative care: a feasibility study to enable clinical practice adoption. BMJ Support Palliat Care 2024; 14:47-51. [PMID: 33597168 PMCID: PMC10894832 DOI: 10.1136/bmjspcare-2020-002327] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The use of virtual reality (VR) is increasing in palliative care. However, despite increasing interest in VR, there is little evidence of how this technology can be implemented into practice. AIMS This paper aims to: (1) explore the feasibility of implementing VR therapy, for patients and caregivers, in a hospital specialist inpatient palliative care unit and a hospice, and (2) to identify questions for organisations, to support VR adoption in palliative care. METHODS The Samsung Gear VR system was used in a hospital specialist palliative inpatient unit and a hospice. Patients and caregivers received VR distraction therapy and provided feedback of their experience. Staff completed a feedback questionnaire to explore their opinion of the usefulness of VR in palliative care. A public engagement event was conducted, to identify questions to support implementation of VR in palliative care settings. RESULTS Fifteen individuals (12 (80%) patients and 3 (20%) caregivers) participated. All had a positive experience. No adverse effects were reported. Ten items were identified for organisations to consider ahead of adoption of VR in palliative care. These were questions about: the purpose of VR; intended population; supporting evidence; session duration; equipment choice; infection control issues; content choice; setting of VR; person(s) responsible for delivery and the maintenance plan. CONCLUSIONS It is feasible to use VR therapy in palliative care; however, further evidence about its efficacy and effectiveness is needed. Palliative care practitioners considering VR use should carefully consider several factors, to ensure that this technology can be used safely and effectively in clinical practice.
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Affiliation(s)
- Amara Callistus Nwosu
- International Observatory on End of Life Care, Lancaster University, Faculty of Health and Medicine, Lancaster, Lancashire, UK
- Marie Curie Hospice Liverpool, Liverpool, UK
| | - Mark Mills
- Marie Curie Hospice Liverpool, Liverpool, UK
| | - Simon Roughneen
- Academic Palliative and End of Life Care Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | | | - Stephen R Mason
- Palliative Care Unit, University of Liverpool, Liverpool, UK
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Brassel S, Brunner M, Campbell A, Power E, Togher L. Exploring Discussions About Virtual Reality on Twitter to Inform Brain Injury Rehabilitation: Content and Network Analysis. J Med Internet Res 2024; 26:e45168. [PMID: 38241072 PMCID: PMC10837760 DOI: 10.2196/45168] [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: 12/19/2022] [Revised: 07/06/2023] [Accepted: 10/29/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Virtual reality (VR) use in brain injury rehabilitation is emerging. Recommendations for VR development in this field encourage end user engagement to determine the benefits and challenges of VR use; however, existing literature on this topic is limited. Data from social networking sites such as Twitter may further inform development and clinical practice related to the use of VR in brain injury rehabilitation. OBJECTIVE This study collected and analyzed VR-related tweets to (1) explore the VR tweeting community to determine topics of conversation and network connections, (2) understand user opinions and experiences of VR, and (3) identify tweets related to VR use in health care and brain injury rehabilitation. METHODS Publicly available tweets containing the hashtags #virtualreality and #VR were collected up to twice weekly during a 6-week period from July 2020 to August 2020 using NCapture (QSR International). The included tweets were analyzed using mixed methods. All tweets were coded using inductive content analysis. Relevant tweets (ie, coded as "VR in health care" or "talking about VR") were further analyzed using Dann's content coding. The biographies of users who sent relevant tweets were examined descriptively. Tweet data networks were visualized using Gephi computational analysis. RESULTS A total of 260,715 tweets were collected, and 70,051 (26.87%) were analyzed following eligibility screening. The sample comprised 33.68% (23,596/70,051) original tweets and 66.32% (46,455/70,051) retweets. Content analysis generated 10 main categories of original tweets related to VR (ie, advertising and promotion, VR content, talking about VR, VR news, general technology, VR industry, VR live streams, VR in health care, VR events, and VR community). Approximately 4.48% (1056/23,596) of original tweets were related to VR use in health care, whereas 0.19% (45/23,596) referred to VR in brain injury rehabilitation. In total, 14.86% (3506/23,596) of original tweets featured commentary on user opinions and experiences of VR applications, equipment, and software. The VR tweeting community comprised a large network of 26,001 unique Twitter users. Users that posted tweets related to "VR in health care" (2124/26,001, 8.17%) did not form an interconnected VR network, whereas many users "talking about VR" (3752/26,001, 14.43%) were connected within a central network. CONCLUSIONS This study provides valuable data on community-based experiences and opinions related to VR. Tweets showcased various VR applications, including in health care, and identified important user-based considerations that can be used to inform VR use in brain injury rehabilitation (eg, technical design, accessibility, and VR sickness). Limited discussions and small user networks related to VR in brain injury rehabilitation reflect the paucity of literature on this topic and the potential underuse of this technology. These findings emphasize that further research is required to understand the specific needs and perspectives of people with brain injuries and clinicians regarding VR use in rehabilitation.
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Affiliation(s)
- Sophie Brassel
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Melissa Brunner
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Andrew Campbell
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Emma Power
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Leanne Togher
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Western Sydney Local Health District, Sydney, Australia
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Broderick M, Burridge J, Demain S, Johnson L, Brereton J, O'Shea R, Bentley P. Multicentre pilot randomised control trial of a self-directed exergaming intervention for poststroke upper limb rehabilitation: research protocol. BMJ Open 2024; 14:e077121. [PMID: 38245014 PMCID: PMC10806628 DOI: 10.1136/bmjopen-2023-077121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/21/2023] [Indexed: 01/22/2024] Open
Abstract
INTRODUCTION Technology-facilitated, self-directed upper limb (UL) rehabilitation, as an adjunct to conventional care, could enhance poststroke UL recovery compared with conventional care alone, without imposing additional resource burden. The proposed pilot randomised controlled trial (RCT) aims to assess whether stroke survivors will engage in self-directed UL training, explore factors associated with intervention adherence and evaluate the study design for an RCT testing the efficacy of a self-directed exer-gaming intervention for UL recovery after stroke. METHODS AND ANALYSIS This is a multicentre, internal pilot RCT; parallel design, with nested qualitative methods. The sample will consist of stroke survivors with UL paresis, presenting within the previous 30 days. Participants randomised to the intervention group will be trained to use an exergaming device and will be supported to adopt this as part of their self-directed rehabilitation (ie, without formal support/supervision) for a 3-month period. The primary outcome will be the Fugl Meyer Upper Extremity Assessment (FM-UE) at 6 months poststroke. Secondary outcomes are the Action Research Arm Test (ARAT), the Barthel Index and the Modified Rankin Scale. Assessment time points will be prior to randomisation (0-1 month poststroke), 3 months and 6 months poststroke. A power calculation to inform sample size required for a definitive RCT will be conducted using FM-UE data from the sample across 0-6 months time points. Semistructured qualitative interviews will examine factors associated with intervention adoption. Reflexive thematic analysis will be used to code qualitative interview data and generate key themes associated with intervention adoption. ETHICS AND DISSEMINATION The study protocol (V.1.9) was granted ethical approval by the Health Research Authority, Health and Care Research Wales, and the London- Harrow Research Ethics Committee (ref. 21/LO/0054) on 19 May 2021. Trial results will be submitted for publication in peer-reviewed journals, presented at national and international stroke meetings and conferences and disseminated among stakeholder communities. TRIAL REGISTRATION NUMBER NCT04475692.
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Affiliation(s)
| | - Jane Burridge
- Life Sciences, University of Southampton, Southampton, UK
| | - Sara Demain
- Life Sciences, University of Southampton, Southampton, UK
| | - Louise Johnson
- Life Sciences, University of Southampton, Southampton, UK
- University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | - Joe Brereton
- University Hospitals Dorset NHS Foundation Trust, Poole, UK
| | | | - Paul Bentley
- Brain Sciences, Imperial College London, London, UK
- Imperial College Healthcare NHS Trust, London, UK
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14
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Gomez Bergin AD, Allison AM, Hazell CM. Understanding Public Perceptions of Virtual Reality Psychological Therapy Using the Attitudes Towards Virtual Reality Therapy (AVRT) Scale: Mixed Methods Development Study. JMIR Ment Health 2024; 11:e48537. [PMID: 38214958 PMCID: PMC10818238 DOI: 10.2196/48537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/29/2023] [Accepted: 10/21/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Virtual reality (VR) psychological therapy has the potential to increase access to evidence-based mental health interventions by automating their delivery while maintaining outcomes. However, it is unclear whether these more automated therapies are acceptable to potential users of mental health services. OBJECTIVE The main aim of this study was to develop a new, validated questionnaire to measure public perceptions of VR therapy (VRT) guided by a virtual coach. We also aimed to explore these perceptions in depth and test how aspects such as familiarity with VR and mental health are associated with these perceptions, using both quantitative and qualitative approaches. METHODS We used a cross-sectional mixed methods design and conducted an exploratory factor analysis of a questionnaire that we developed, the Attitudes Towards Virtual Reality Therapy (AVRT) Scale, and a qualitative content analysis of the data collected through free-text responses during completion of the questionnaire. RESULTS We received 295 responses and identified 4 factors within the AVRT Scale, including attitudes toward VRT, expectation of presence, preference for VRT, and cost-effectiveness. We found that being more familiar with VR was correlated with more positive attitudes toward VRT (factor 1), a higher expectation of presence (factor 2), a preference for VRT over face-to-face therapy (factor 3), and a belief that VRT is cost-effective (factor 4). Qualitative data supported the factors we identified and indicated that VRT is acceptable when delivered at home and guided by a virtual coach. CONCLUSIONS This study is the first to validate a scale to explore attitudes toward VRT guided by a virtual coach. Our findings indicate that people are willing to try VRT, particularly because it offers increased access and choice, and that as VR becomes ubiquitous, they will also have positive attitudes toward VRT. Future research should further validate the AVRT Scale.
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Affiliation(s)
- Aislinn D Gomez Bergin
- National Institute of Health and Care Research MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
- National Institute of Health and Care Research Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- School of Computer Science, University of Nottingham, Nottingham, United Kingdom
| | - Aoife M Allison
- Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Cassie M Hazell
- Department of Psychological Interventions, School of Psychology, University of Surrey, Guilford, United Kingdom
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15
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Terkildsen MD, Bollerup S, Palmhøj C, Jensen LG, Lou S. How institutional logics shape the adoption of virtual reality in mental health care: A qualitative study. Digit Health 2024; 10:20552076241248914. [PMID: 38665887 PMCID: PMC11044789 DOI: 10.1177/20552076241248914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Objective To analyse institutional logics' role in adopting virtual reality in mental health care. Methods Data were collected via qualitative, semi-structured interviews with four frontline staff and seven administrative and service staff, two focus group interviews with three frontline staff and four administrative and service staff, and via participant observation in meetings between stakeholders working on virtual reality. Data were collected from May 2021 to February 2022, analysed using thematic analysis, and theoretically driven by the framework of Institutional logics. Results We identified two different forms of institutional logics being drawn upon by frontline staff and administrative and service staff, respectively, when working with the adoption of virtual reality in mental health care. Frontline staff drew mainly on a Professional logic; administrative and service staff drew on a Diffusion logic. Each logic defined a unique focal point, causal pathway, and perceptions of a meaningful adoption process for virtual reality. Conclusions By taking institutional logics as our theoretical and analytical point of departure, this study demonstrates how the meaning of virtual reality and its adoption in mental health care is grounded in multiple and sometimes conflicting institutional logics. Acknowledging the existence and influence of often multiple institutional logics in the adoption process is crucial to guide the future adoption of virtual reality in mental health care. Organising collaborative venues for stakeholders where their multiple institutional logics are made the subject of joint reflection is essential to counter frictions.
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Affiliation(s)
- Morten D Terkildsen
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Stina Bollerup
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Camilla Palmhøj
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lotte G Jensen
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
| | - Stina Lou
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Pearce L, Costa N, Sherrington C, Hassett L. Implementation of digital health interventions in rehabilitation: A scoping review. Clin Rehabil 2023; 37:1533-1551. [PMID: 37132030 DOI: 10.1177/02692155231172299] [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: 05/04/2023]
Abstract
OBJECTIVE Digital health interventions have potential to enhance rehabilitation services by increasing accessibility, affordability and scalability. However, implementation of digital interventions in rehabilitation is poorly understood. This scoping review aims to map current strategies, research designs, frameworks, outcomes and determinants used to support and evaluate the implementation of digital interventions in rehabilitation. DATA SOURCES Comprehensive searches from inception until October 2022 of MEDLINE, CINAHL, PsycINFO, PEDro, SpeechBITE, NeuroBITE, REHABDATA, WHO International Clinical Trial Registry and the Cochrane Library. METHODS Two reviewers screened studies against the eligibility criteria. Implementation science taxonomies and methods, including Powell et al.'s compilation of implementation strategies, were used to guide analysis and synthesis of findings. RESULTS The search retrieved 13,833 papers and 23 studies were included. Only 4 studies were randomised controlled trials and 9 studies (39%) were feasibility studies. Thirty-seven discrete implementation strategies were reported across studies. Strategies related to training and educating clinicians (91%), providing interactive assistance (61%), and developing stakeholder interrelationships (43%) were most frequently reported. Few studies adequately described implementation strategies and methods for selecting strategies. Almost all studies measured implementation outcomes and determinants; most commonly, acceptability, compatibility and dose delivered of digital interventions. CONCLUSION The rigour of implementation methods in the field is currently poor. Digital interventions require carefully planned and tailored implementation to facilitate successful adoption into rehabilitation practice. To keep pace with rapidly advancing technology, future rehabilitation research should prioritise using implementation science methods to explore and evaluate implementation while testing effectiveness of digital interventions.
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Affiliation(s)
- Louise Pearce
- Institute for Musculoskeletal Health, The University of Sydney/Sydney Local Health District, Sydney, Australia
- Royal Rehab LifeWorks Ryde, Royal Rehab Rehabilitation Centre, Sydney, Australia
| | - Nathalia Costa
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, The University of Sydney/Sydney Local Health District, Sydney, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Leanne Hassett
- Institute for Musculoskeletal Health, The University of Sydney/Sydney Local Health District, Sydney, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Dreesmann NJ, Buchanan D, Tang HYJ, Furness Iii T, Thompson H. Virtual Reality Meditation for Fatigue in Persons With Rheumatoid Arthritis: Mixed Methods Pilot Study. JMIR Form Res 2023; 7:e46209. [PMID: 37847542 PMCID: PMC10618887 DOI: 10.2196/46209] [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: 02/02/2023] [Revised: 09/01/2023] [Accepted: 09/08/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Effective symptom management is crucial to enhancing the quality of life for individuals with chronic diseases. Health care has changed markedly over the past decade as immersive, stand-alone, and wearable technologies including virtual reality have become available. One chronic pain population that could benefit from such an intervention is individuals with rheumatoid arthritis (RA). Recent pharmacologic advances in the management of RA have led to a decrease in inflammatory symptoms (eg, chronic pain) or even disease remission, yet up to 70% of patients with RA still suffer from fatigue. While VR-delivered behavior, meditation, and biofeedback programs show promise for pain and anxiety management, there is little information on the use of virtual reality meditation (VRM) for fatigue management among individuals with RA. OBJECTIVE This study aims to (1) examine the feasibility of implementing a study protocol that uses VRM, (2) determine the acceptability of using VRM for fatigue management in an outpatient population, and (3) identify barriers and contextual factors that might impact VRM use for fatigue management in outpatients with RA. METHODS We used a convergent, mixed methods design and enrolled adults aged 18 years or older with a clinical diagnosis of RA. Patient-Reported Outcome Measure Information System (PROMIS) measures of fatigue, depression, anxiety, pain behavior, and physical function were assessed alongside the brief mood introspection scale at baseline and weekly for 4 weeks. VRM use across the 4-week study period was automatically stored on headsets and later extracted for analysis. Semistructured interview questions focused on feedback regarding the participant's experience with RA, previous experience of fatigue, strategies participants use for fatigue management, and the participant's experience using VRM and recommendations for future use. RESULTS A total of 13 participants completed this study. Most participants completed all study surveys and measures (11/13, 84% and 13/13, 100%, respectively) and were active participants in interviews at the beginning and end of the program. Participants used VRM an average of 8.9 (SD 8.5) times over the course of the 4-week program. Most participants enjoyed VRM, found it relaxing, or recommended its use (12/13, 92%), but 8 (62%) noted barriers and conceptual factors that impacted VRM use. On average, participants saw decreases in PROMIS fatigue (-6.4, SD 5.1), depression (-5.6, SD 5.7), anxiety (-4.5, SD 6), and pain behavior (-3.9, SD 5.3), and improvements in PROMIS physical function (1.5, SD 2.7) and Brief Mood Introspection Scale mood (5.3, SD 6.7) over the course of this 4-week study. CONCLUSIONS While this study's implementation was feasible, VRM's acceptability as an adjunctive modality for symptom management in RA is contingent on effectively overcoming barriers to use and thoughtfully addressing the contextual factors of those with RA to ensure successful intervention deployment. TRIAL REGISTRATION ClinicalTrials.gov NCT04804462; https://classic.clinicaltrials.gov/ct2/show/NCT04804462.
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Affiliation(s)
- Nathan J Dreesmann
- Virtual Therapeutics, Kirkland, WA, United States
- School of Nursing, Loma Linda University, Loma Linda, CA, United States
| | - Diana Buchanan
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, United States
| | - Hsin-Yi Jean Tang
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, United States
| | - Thomas Furness Iii
- Industrial and Systems Engineering, College of Engineering, University of Washington, Seattle, WA, United States
| | - Hilaire Thompson
- Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, United States
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Ferron A, Robert MT, Fortin W, Bau O, Cardinal MC, Desgagné J, Saussez G, Bleyenheuft Y, Levac D. Virtual Reality and Active Video Game Integration within an Intensive Bimanual Therapy Program for Children with Hemiplegia. Phys Occup Ther Pediatr 2023; 44:410-426. [PMID: 37846035 DOI: 10.1080/01942638.2023.2259462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
AIMS To describe the nature of custom and non-custom virtual reality and active video game (VR/AVG) implementation within a Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) intervention program for children with hemiplegia. METHODS Six children aged 8-11 years participated in a 10-day HABIT-ILE intervention (65 h; 6.5 planned VR/AVG hours). VR/AVG implementation details were recorded daily and summarized with descriptive statistics; active motor engagement was quantified as minutes of active game participation. Post-intervention interviews with interventionists were analyzed with qualitative content analysis. RESULTS On average, participants received 79% of the planned VR/AVG dosage (314/400 planned minutes, range 214-400 min), of which the per-session active motor engagement average was 68% (27 min, SD 12 min). Participation involved equivalent amounts of custom (49%) and non-custom (51%) VR/AVG system use. Material and verbal adaptations facilitated alignment with HABIT-ILE principles. Interventionists identified type of task (gross versus fine motor), children's perceived motivation, and VR/AVG attributes as factors influencing active motor engagement and alignment with HABIT-ILE principles. CONCLUSIONS Describing individual and technological challenges of VR/AVG integration within HABIT-ILE can advance knowledge about VR/AVG use in intensive interventions and identify directions for subsequent research.
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Affiliation(s)
- Audrey Ferron
- Centre Hospitalier Universitaire Sainte-Justine - Research Center, Montreal, Canada
| | | | - William Fortin
- Centre Hospitalier Universitaire Sainte-Justine - Research Center, Montreal, Canada
| | - Odette Bau
- Centre Hospitalier Universitaire Sainte-Justine - Marie Enfant Rehabilitation Center, Montreal, Canada
| | - Marie-Claude Cardinal
- Centre Hospitalier Universitaire Sainte-Justine - Marie Enfant Rehabilitation Center, Montreal, Canada
| | - Julie Desgagné
- Centre Hospitalier Universitaire Sainte-Justine - Marie Enfant Rehabilitation Center, Montreal, Canada
| | - Geoffroy Saussez
- Institute of Neuroscience, Université catholique de Louvain, Louvain, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université catholique de Louvain, Louvain, Belgium
| | - Danielle Levac
- Centre Hospitalier Universitaire Sainte-Justine - Research Center, Montreal, Canada
- Faculty of Medicine, University of Montreal, Montreal, Canada
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Broderick M, O'Shea R, Burridge J, Demain S, Johnson L, Bentley P. Examining Usability, Acceptability, and Adoption of a Self-Directed, Technology-Based Intervention for Upper Limb Rehabilitation After Stroke: Cohort Study. JMIR Rehabil Assist Technol 2023; 10:e45993. [PMID: 37603405 PMCID: PMC10477927 DOI: 10.2196/45993] [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: 01/27/2023] [Revised: 06/25/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Upper limb (UL) recovery after stroke is strongly dependent upon rehabilitation dose. Rehabilitation technologies present pragmatic solutions to dose enhancement, complementing therapeutic activity within conventional rehabilitation, connecting clinicians with patients remotely, and empowering patients to drive their own recovery. To date, rehabilitation technologies have been poorly adopted. Understanding the barriers to adoption may shape strategies to enhance technology use and therefore increase rehabilitation dose, thus optimizing recovery potential. OBJECTIVE We examined the usability, acceptability, and adoption of a self-directed, exercise-gaming technology within a heterogeneous stroke survivor cohort and investigated how stroke survivor characteristics, technology usability, and attitudes toward technology influenced adoption. METHODS A feasibility study of a novel exercise-gaming technology for self-directed UL rehabilitation in early subacute stroke survivors (N=30) was conducted in an inpatient, acute hospital setting. Demographic and clinical characteristics were recorded; participants' performance in using the system (usability) was assessed using a 4-point performance rating scale (adapted from the Barthel index), and adherence with the system was electronically logged throughout the trial. The technology acceptance model was used to formulate a survey examining the acceptability of the system. Spearman rank correlations were used to examine associations between participant characteristics, user performance (usability), end-point technology acceptance, and intervention adherence (adoption). RESULTS The technology was usable for 87% (n=26) of participants, and the overall technology acceptance rating was 68% (95% CI 56%-79%). Participants trained with the device for a median of 26 (IQR 16-31) minutes daily over an enrollment period of 8 (IQR 5-14) days. Technology adoption positively correlated with user performance (usability) (ρ=0.55; 95% CI 0.23-0.75; P=.007) and acceptability as well as domains of perceived usefulness (ρ=0.42; 95% CI 0.09-0.68; P=.03) and perceived ease of use (ρ=0.46; 95% CI 0.10-0.74; P=.02). Technology acceptance decreased with increased global stroke severity (ρ=-0.56; 95% CI -0.79 to -0.22; P=.007). CONCLUSIONS This technology was usable and acceptable for the majority of the cohort, who achieved an intervention dose with technology-facilitated, self-directed UL training that exceeded conventional care norms. Technology usability and acceptability were determinants of adoption and appear to be mediated by stroke severity. The results demonstrate the importance of selecting technologies for stroke survivors on the basis of individual needs and abilities, as well as optimizing the accessibility of technologies for the target user group. Facilitating changes in stroke survivors' beliefs and attitudes toward rehabilitation technologies may enhance adoption. Further work is needed to understand how technology can be optimized to benefit those with more severe stroke.
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Affiliation(s)
- Michelle Broderick
- Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Robert O'Shea
- Department of Cancer Imaging, Kings College London, London, United Kingdom
| | - Jane Burridge
- School of Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Sara Demain
- School of Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Louise Johnson
- School of Life Sciences, University of Southampton, Southampton, United Kingdom
- University Hospitals Dorset NHS Foundation Trust, Bournemouth, United Kingdom
| | - Paul Bentley
- Department of Brain Sciences, Imperial College London, London, United Kingdom
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20
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Saussez G, Bailly R, Araneda R, Paradis J, Ebner-Karestinos D, Klöcker A, Sogbossi ES, Riquelme I, Brochard S, Bleyenheuft Y. Efficacy of integrating a semi-immersive virtual device in the HABIT-ILE intervention for children with unilateral cerebral palsy: a non-inferiority randomized controlled trial. J Neuroeng Rehabil 2023; 20:98. [PMID: 37516873 PMCID: PMC10385889 DOI: 10.1186/s12984-023-01218-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 07/13/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND The implementation of virtual devices can facilitate the role of therapists (e.g., patient motivation, intensity of practice) to improve the effectiveness of treatment for children with cerebral palsy. Among existing therapeutic devices, none has been specifically designed to promote the application of principles underlying evidence-based motor skill learning interventions. Consequently, evidence is lacking regarding the effectiveness of virtual-based sessions in motor function rehabilitation with respect to promoting the transfer of motor improvements into daily life activities. We tested the effectiveness of implementing a recently developed virtual device (REAtouch®), specifically designed to enable the application of therapeutic motor skill learning principles, during a Hand Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) intervention. METHODS Forty children with unilateral cerebral palsy (5-18 years; MACS I-III; GMFCS I-II) were randomly assigned to a control group or a "REAtouch®" experimental group for a 90-h HABIT-ILE day-camp intervention (two weeks). Children in the REAtouch® group spent nearly half of their one-on-one therapeutic time using the REAtouch®. Participants underwent three testing sessions: the week before (T1), after intervention (T2), and at three months follow-up (T3). The primary outcome was the Assisting Hand Assessment (T3-T1; blinded). Secondary outcomes measured uni-bimanual hand function, stereognosis, gait endurance, daily life abilities, and functional goals. Accelerometers and a manual report of daily activities served to document therapeutic dosage and treatment characteristics. We used one-way RMANOVA to compare the efficacies of the two interventions, and non-inferiority analyses to contrast changes in the "REAtouch®" group versus the "HABIT-ILE" control group. RESULTS We found significant improvements in both groups for most of the outcome measures (p < 0.05). There was significant non-inferiority of changes in the REAtouch® group for upper extremities motor function, functional goals attainment, and abilities in daily life activities (p < 0.05). CONCLUSIONS Use of the REAtouch® device during HABIT-ILE showed non-inferior efficacy compared to the conventional evidence-based HABIT-ILE intervention in children with unilateral cerebral palsy. This study demonstrates the feasibility of using this virtual device in a high dosage camp model, and establishes the possibility of applying the therapeutic principles of motor skill learning during specifically designed virtual-based sessions. TRIAL REGISTRATION Trial registration number: NCT03930836-Registration date on the International Clinical Trials Registry Platform (ICTRP): June 21th, 2018; Registration date on NIH Clinical Trials Registry: April 29th, 2019. First patient enrollment: July 3rd, 2018.
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Affiliation(s)
- G Saussez
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium.
- Motor Sciences department, FfH Lab, CeREF Santé, HELHa, Rue Trieu Kaisin, 136, 6061, Montignies-Sur-Sambre, Belgium.
| | - R Bailly
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - R Araneda
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - J Paradis
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - D Ebner-Karestinos
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- Exercise and Rehabilitation Science Institute, School of Physical Therapy, Faculty of Rehabilitation Science, Universidad Andres Bello, Santiago, Chile
| | - A Klöcker
- Haute Ecole Leonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - E S Sogbossi
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - I Riquelme
- Research Institute of Health Sciences (IUNICS-IdISBa), University of the Balearic Islands, Palma, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma, Spain
| | - S Brochard
- Fondation Ildys, Brest, France
- Laboratoire de Traitement de l'information Médicale (LaTIM), Inserm U1101, Université Bretagne Occidentale, Brest, France
| | - Y Bleyenheuft
- UCLouvain, Institute of Neuroscience, COSY Pole, MSL-IN Lab, Brussels, Belgium
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21
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Kovanur Sampath K, Arumugam A, Yaghi E, Fairs E, Andersen P. Perception and knowledge of learners about the use of 3D technologies in manual therapy education - a qualitative study. BMC MEDICAL EDUCATION 2023; 23:509. [PMID: 37461000 DOI: 10.1186/s12909-023-04497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES Manual therapy is a specific hands-on approach used and taught by various professions such as physiotherapy and osteopathy. The current paradigm of teaching manual therapy incorporates the traditional 'See one, do one, teach one' approach. However, this 'teacher centred' approach may not enable learners to develop the complex clinical skills of manual therapy. In this context, 3D technologies such as virtual reality may facilitate the teaching and learning of manual therapy. Hence the aim of the current study was to investigate the perception, knowledge and attitude of manual therapy learners about the use of 3D technologies in manual therapy education. METHODS An exploratory qualitative research design using semi-structured interviews was used in this study. A total of ten manual therapy (5 physiotherapy and 5 osteopathic) students (mean age = 32; 80% female) enrolled in an appropriate physiotherapy or osteopathic degree provided by a New Zealand recognized institution (e.g., university or polytechnic) participated in this study. Data saturation was achieved after 10 interviews (average duration: 35 min) that provided thick data. A thematic analysis was used for data analysis. RESULTS Six factors were identified which appeared to influence participants' perception of role of technology in manual therapy education. These were (1) the sufficiency of current teaching method; (2) evolution as a learner (a novice to an expert); (3) need for objectivity; (4) tutor feedback; (5) knowledge and (6) barriers and enablers. These six factors influenced the participants' perception about the role of 3D technologies in manual therapy education with participants evidently taking two distinct/polarized positions ('no role' (techstatic) versus a 'complete role' (techsavvy)). CONCLUSION Although 3D technology may not replace face-to-face teaching, it may be used to complement the traditional approach of learning/teaching to facilitate the learning of complex skills according to the perceptions of manual therapy learners in our study. The advantage of such an approach is an area of future research.
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Affiliation(s)
- Kesava Kovanur Sampath
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand.
| | - Ashokan Arumugam
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, P.O.Box 27272, Sharjah, United Arab Emirates
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS-Research Institute of Medical and Health Sciences, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
- Sustainable Engineering Asset Management Research Group, RISE-Research Institute of Sciences and Engineering, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
- Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Esra Yaghi
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand
| | - Emma Fairs
- Ara Institute of Canterbury, Christchurch, New Zealand
| | - Patrea Andersen
- Centre for Health and Social Practice, Waikato Institute of Technology, 51, Akoranga Road, Hamilton, New Zealand
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Dow, QLD, 4556, Australia
- School of Nursing, Midwifery and Social Science, CQ University, Queensland, 4702, Australia
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Mitchell J, Shirota C, Clanchy K. Factors that influence the adoption of rehabilitation technologies: a multi-disciplinary qualitative exploration. J Neuroeng Rehabil 2023; 20:80. [PMID: 37340496 DOI: 10.1186/s12984-023-01194-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/23/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Technological innovation is recognised as having the potential to enhance rehabilitation for people with disability. Yet, resistance to, and abandonment of, rehabilitation technology is prevalent and the successful translation of technology into rehabilitation settings remains limited. Therefore, the aim of this work was to develop an in-depth, multi-stakeholder perspective on what influences the adoption of rehabilitation technologies. METHODS Semi-structured focus groups were conducted as part of a larger research project aiming to facilitate the co-design of a novel neurorestorative technology. Focus group data were analysed using a five-phase hybrid deductive-inductive approach to qualitative data analysis. RESULTS Focus groups were attended by 43 stakeholders with expertise in one or more of the following fields: people with disability, allied health, human movement science, computer science, design, engineering, ethics, funding, marketing, business, product development, and research development. Six main themes influencing the adoption of technology in rehabilitation were identified: cost beyond the purchase price, benefits to all stakeholders, trust to be earned in technology, ease of technology operation, ability to access technology, and the 'co' in co-design. All six themes were found to be interrelated; in particular, the importance of direct stakeholder engagement in the development of rehabilitation technologies (the 'co' in co-design) was prevalent in all themes. CONCLUSIONS A range of complex and interrelated factors influence the adoption of rehabilitation technologies. Importantly, many of the issues that have the potential to negatively impact rehabilitation technology adoption may be addressed during development by utilising the experience and expertise of stakeholders who influence its supply and demand. Our findings state that a wider cohort of stakeholders needs to be actively engaged in the development of rehabilitation technologies to better address the factors that contribute to technology underutilisation and abandonment and facilitate better outcomes for people with disability.
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Affiliation(s)
- Jessie Mitchell
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kelly Clanchy
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
- School of Health Sciences and Social Work, Griffith University, Southport, Australia.
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Brassel S, Brunner M, Power E, Campbell A, Togher L. Speech-Language Pathologists' Views of Using Virtual Reality for Managing Cognitive-Communication Disorders Following Traumatic Brain Injury. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:907-923. [PMID: 36580534 DOI: 10.1044/2022_ajslp-22-00077] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Using virtual reality (VR) to support rehabilitation is an emerging area of research that may offer people with communication disorders a stable and safe communication environment to practice their communication skills. There are currently no VR applications that have been designed to assess or treat cognitive-communication disorders (CCDs) following traumatic brain injury (TBI). Therefore, this study aimed to explore the views of speech-language pathologists (SLPs) who work with people who have a TBI to generate ideas and considerations for using VR in rehabilitation for CCDs. VR researchers were included to provide expert advice about VR technology. METHOD A total of 14 SLPs and three VR specialists participated in an online interview or focus group. Semistructured discussions explored participants' perspectives related to potential ideas for VR use and any perceived barriers and facilitators to VR implementation for managing CCDs following TBI. Data were video- and audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. RESULTS Three main themes were generated from thematic analysis: VR is a tool that could enhance clinical practice, the need to consider and navigate potential red flags, and solutions to pave the way forward. Suggestions to overcome perceived barriers to VR use were also provided. DISCUSSION Participants expressed interest in using VR for rehabilitation of CCDs following TBI. However, potential barriers and risks to use should be considered prior to implementation. The findings offer guidance to support future research and development of VR in this field. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21669647.
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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, New South Wales, Australia
| | - Melissa Brunner
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Andrew Campbell
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Using the Theoretical Domains Framework to Inform the Implementation of Therapeutic Virtual Reality into Mental Healthcare. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2023; 50:237-268. [PMID: 36512145 DOI: 10.1007/s10488-022-01235-w] [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] [Accepted: 10/26/2022] [Indexed: 12/15/2022]
Abstract
Evidence supporting the efficacy of therapeutic virtual reality (VR) for mental health conditions is rapidly growing. However, little is known about how best to implement VR, or the challenges perceived by treatment providers. This study aimed to (1) synthesis perspectives of staff working in private mental healthcare and (2) use the Theoretical Domains Framework (TDF) and Behaviour Change Wheel (BCW) to identify mechanisms of change targets and intervention functions to facilitate its clinical implementation. Semi-structured interviews were conducted with clinicians (n = 14) and service managers (n = 5) working in a major private mental health hospital in Victoria, Australia. Transcripts were coded using framework analysis to identify relevant TDF domains. Specific belief statements were generated and coded as a barrier and/or facilitator and thematically organised within domains. Domains were ranked for importance based on frequency, elaboration, and evidence of conflicting beliefs. Using the BCW, domains were mapped to their respective COM-B components and indicated intervention functions. A total of 11 TDF domains were identified as relevant to early-stage implementation of therapeutic VR. Three domains were judged as highly important (beliefs about consequences; environmental context and resources; knowledge), while seven domains were judged as moderately important (social/professional role and identity; emotions; skills; memory, attention, and decision processes; intentions; beliefs about capabilities; social influences). Based on current data, we propose a theory-informed roadmap to promote VR uptake in mental healthcare services. A priority for intervention development should be addressing knowledge gaps and attitudinal barriers (e.g., safety concerns) with education and training.
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Kiani S, Rezaei I, Abasi S, Zakerabasali S, Yazdani A. Technical aspects of virtual augmented reality-based rehabilitation systems for musculoskeletal disorders of the lower limbs: a systematic review. BMC Musculoskelet Disord 2023; 24:4. [PMID: 36597077 PMCID: PMC9808732 DOI: 10.1186/s12891-022-06062-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 12/06/2022] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION Musculoskeletal disorders are one of the most common causes of physical disability. The rehabilitation process after musculoskeletal disorders is long and tedious, and patients are not motivated to follow rehabilitation protocols. Therefore, new systems must be used to increase patient motivation. Virtual reality (VR) and augmented reality (AR) technologies can be used in this regard. In developing such systems, various technologies and methods of movement recognition are used; therefore, this study aims to summarize the technical aspects of using VR/AR in rehabilitation and evaluate and discuss efficient methods of investigating studies using the Statement of Standards for Reporting Implementation Studies (StaRI). METHODS Search in four scientific databases was done systematically based on PRISMA through online search engines from inception to June 2021. These databases include Medline (PubMed), Scopus, IEEE, and Web of Science. An updated search was also conducted on 17 December 2021. The research used keywords and MeSH terms associated with VR/AR, musculoskeletal disorder, and rehabilitation. Selected articles were evaluated qualitatively using the Standards for Reporting Implementation Studies (StaRI) statement. RESULTS A total of 2343 articles were found, and 20 studies were included. We found that 11 (55%) studies used Kinect technology as input tools, and 15 (75%) studies have described the techniques used to analyze human movements, such as dynamic time warping (DTW) and support vector machines (SVM). In 10 (50%) studies, the Unity game engine was used for visualization. In 8 studies (40%), usability was assessed, and high usability was reported. Similarly, the results of the review of studies according to the StaRI checklist showed poor reporting in the title and discussion of the studies. CONCLUSIONS We found that academic studies did not describe the technical aspects of rehabilitation systems. Therefore, a good description of the technical aspects of the system in such studies should be considered to provide repeatability and generalizability of these systems for investigations by other researchers.
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Affiliation(s)
- Shamim Kiani
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Rezaei
- grid.412571.40000 0000 8819 4698Physical Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Abasi
- grid.412571.40000 0000 8819 4698Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayyeh Zakerabasali
- grid.412571.40000 0000 8819 4698Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Health Information Management Department, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Yazdani
- grid.412571.40000 0000 8819 4698Health Human Resources Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698Health Information Management Department, Shiraz University of Medical Sciences, Shiraz, Iran ,grid.412571.40000 0000 8819 4698 Clinical Education Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Deliv C, Devane D, Putnam E, Healy P, Hall A, Rosenbaum S, Toomey E. Development of a video-based evidence synthesis knowledge translation resource: Drawing on a user-centred design approach. Digit Health 2023; 9:20552076231170696. [PMID: 37152241 PMCID: PMC10159242 DOI: 10.1177/20552076231170696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Objectives We aimed to develop a video animation knowledge translation (KT) resource to explain the purpose, use and importance of evidence synthesis to the public regarding healthcare decision-making. Methods We drew on a user-centred design approach to develop a spoken animated video (SAV) by conducting two cycles of idea generation, prototyping, user testing, analysis, and refinement. Six researchers identified the initial key messages of the SAV and informed the first draft of the storyboard and script. Seven members of the public provided input on this draft and the key messages through think-aloud interviews, which we used to develop an SAV prototype. Seven additional members of the public participated in think-aloud interviews while watching the video prototype. All members of the public also completed a questionnaire on perceived usefulness, desirability, clarity and credibility. We subsequently synthesised all data to develop the final SAV. Results Researchers identified the initial key messages as 1) the importance of evidence synthesis, 2) what an evidence synthesis is and 3) how evidence synthesis can impact healthcare decision-making. Members of the public rated the initial video prototype as 9/10 for usefulness, 8/10 for desirability, 8/10 for clarity and 9/10 for credibility. Using their guidance and feedback, we produced a three-and-a-half-minute video animation. The video was uploaded on YouTube, has since been translated into two languages, and viewed over 12,000 times to date. Conclusions Drawing on user-centred design methods provided a structured and transparent approach to the development of our SAV. Involving members of the public enhanced the credibility and usefulness of the resource. Future work could explore involving the public from the outset to identify key messages in developing KT resources explaining methodological topics. This study describes the systematic development of a KT resource with limited resources and provides transferrable learnings for others wishing to do similar.
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Affiliation(s)
- Cristian Deliv
- School of Medicine, University of Galway, Galway, Ireland
| | - Declan Devane
- Cochrane Ireland and Evidence Synthesis
Ireland, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - El Putnam
- School of English and Creative Arts, University of Galway, Galway, Ireland
| | - Patricia Healy
- Cochrane Ireland and Evidence Synthesis
Ireland, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| | - Amanda Hall
- Primary Healthcare Research Unit,
Faculty of Medicine, Memorial University,
Newfoundland, Canada
| | - Sarah Rosenbaum
- Centre for Informed Health Choices, Norwegian Institute of Public
Health, Oslo, Norway
| | - Elaine Toomey
- Cochrane Ireland and Evidence Synthesis
Ireland, University of Galway, Galway, Ireland
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
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Hurtubise K, Gaboury I, Berbari J, Battista MC, Schuster T, Phoenix M, Rosenbaum P, Kraus De Camargo O, Lovo S, Pritchard-Wiart L, Zwicker JG, Beaudoin AJ, Morin M, Poder T, Gagnon MP, Roch G, Levac D, Tousignant M, Colquhoun H, Miller K, Churchill J, Robeson P, Ruegg A, Nault M, Camden C. Training Intervention and Program of Support for Fostering the Adoption of Family-Centered Telehealth in Pediatric Rehabilitation: Protocol for a Multimethod, Prospective, Hybrid Type 3 Implementation-Effectiveness Study. JMIR Res Protoc 2022; 11:e40218. [PMID: 36306158 PMCID: PMC9652740 DOI: 10.2196/40218] [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: 07/09/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Children with disability face long wait times for rehabilitation services. Before the COVID-19 pandemic, telehealth adoption was low across pediatric rehabilitation. Owing to the COVID-19 pandemic restrictions, pediatric therapists were asked to rapidly shift to telehealth, often with minimal training. To facilitate the behavior changes necessary for telehealth adoption, provision of appropriate evidence-based training and support is required. However, evidence to support the effective implementation of such training is lacking. The successful real-world implementation of a training intervention and program of support (TIPS) targeting pediatric therapists to enhance the adoption of family-centered telerehabilitation (FCT) requires the evaluation of both implementation and effectiveness. OBJECTIVE This study aimed to evaluate TIPS implementation in different pediatric rehabilitation settings and assess TIPS effectiveness, as it relates to therapists' adoption, service wait times, families' perception of service quality, and costs. METHODS This 4-year, pan-Canadian study involves managers, pediatric occupational therapists, physiotherapists, speech-language pathologists, and families from 20 sites in 8 provincial jurisdictions. It will use a multimethod, prospective, hybrid type 3 implementation-effectiveness design. An interrupted time series will assess TIPS implementation. TIPS will comprise a 1-month training intervention with self-paced learning modules and a webinar, followed by an 11-month support program, including monthly site meetings and access to a virtual community of practice. Longitudinal mixed modeling will be used to analyze indicators of therapists' adoption of and fidelity to FCT collected at 10 time points. To identify barriers and facilitators to adoption and fidelity, qualitative data will be collected during implementation and analyzed using a deductive-inductive thematic approach. To evaluate effectiveness, a quasi-experimental pretest-posttest design will use questionnaires to evaluate TIPS effectiveness at service, therapist, and family levels. Generalized linear mixed effects models will be used in data analysis. Manager, therapist, and family interviews will be conducted after implementation and analyzed using reflective thematic analysis. Finally, cost data will be gathered to calculate public system and societal costs. RESULTS Ethics approval has been obtained from 2 jurisdictions (February 2022 and July 2022); approval is pending in the others. In total, 20 sites have been recruited, and data collection is anticipated to start in September 2022 and is projected to be completed by September 2024. Data analysis will occur concurrently with data collection, with results disseminated throughout the study period. CONCLUSIONS This study will generate knowledge about the effectiveness of TIPS targeting pediatric therapists to enhance FCT adoption in pediatric rehabilitation settings, identify facilitators for and barriers to adoption, and document the impact of telehealth adoption on therapists, services, and families. The study knowledge gained will refine the training intervention, enhance intervention uptake, and support the integration of telehealth as a consistent pediatric rehabilitation service option for families of children with disabilities. TRIAL REGISTRATION ClinicalTrials.gov NCT05312827; https://clinicaltrials.gov/ct2/show/NCT05312827. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/40218.
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Affiliation(s)
- Karen Hurtubise
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster Univeristy, Hamilton, ON, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Jade Berbari
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Claude Battista
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill Univeristy, Montreal, QC, Canada
| | - Michelle Phoenix
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster Univeristy, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olaf Kraus De Camargo
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Stacey Lovo
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Jill G Zwicker
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Audrée Jeanne Beaudoin
- Institut Universitaire de Première Ligne en Santé et Services Sociaux, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Morin
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas Poder
- School of Public Health, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est de l'Île de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier de Québec-Univeristé Laval Research Centre, Québec, QC, Canada
- Faculty of Nursing, Univeristé Laval, Québec, QC, Canada
| | - Geneviève Roch
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier de Québec-Univeristé Laval Research Centre, Québec, QC, Canada
- Faculty of Nursing, Univeristé Laval, Québec, QC, Canada
| | - Danielle Levac
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Faculty of Medicine, Univeristé de Montréal, Montréal, QC, Canada
| | - Michel Tousignant
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Heather Colquhoun
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, ON, Canada
| | - Kimberly Miller
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Physical Therapy, Univeristy of British Columbia, Vancouver, BC, Canada
| | | | | | - Andréa Ruegg
- Training Intervention and Program of Support Study Team, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martine Nault
- Training Intervention and Program of Support Study Team, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Chantal Camden
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
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The role of 3D digital applications in Manual therapy education – A scoping review. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.10.007] [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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Okurame JC, Cannon L, Carter E, Thomas S, Elliott EJ, Rice LJ. Fetal alcohol spectrum disorder resources for health professionals: a scoping review protocol. BMJ Open 2022; 12:e065327. [PMID: 36100303 PMCID: PMC9472138 DOI: 10.1136/bmjopen-2022-065327] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION People with fetal alcohol spectrum disorder (FASD) encounter a range of health and allied health providers and require specialised support to ensure health services are provided safely and effectively. Not all health professionals possess the knowledge or expertise required for the identification, assessment, referral and management of FASD. Accessible resources for understanding and managing FASD can help create awareness in health professionals and ensure patients receive the correct diagnosis and timely access to the necessary supports and services. The aim of this scoping review is to identify and analyse FASD resources for health professionals. METHODS AND ANALYSIS A comprehensive search of eight databases (MEDLINE, Scopus, PsycINFO, CINAHL, PubMED, EMBASE, Web of Science and Trip Medical Database) and nine grey literature databases (FASD Hub, NOFASD Australia, National Organisation for FASD, FASD United, HealthInfoNet, Proof Alliance, Child Family Community Australia, Foundation for Alcohol Research & Education and the Australian Department of Health websites) will be conducted using three search engines including PubMed, Ovid and Google advanced search (search dates: October 2021 to May 2022). Consultations will also be carried out with international and national experts in the diagnosis/management of FASD to obtain any additional relevant published or unpublished resources. Inclusion criteria were developed to guide the selection of resources that are publicly available, primarily focused on FASD and curated for health professionals for the identification, management or referral of FASD. Critical appraisal process will be executed using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE II) tool to assess the quality of selected resources. ETHICS AND DISSEMINATION Ethical approval is not required for the scoping review. Scoping review results will be presented at relevant national and international conferences and published in peer-reviewed journals. Search results will be made available to ensure reproducibility and transparency.
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Affiliation(s)
| | - Lisa Cannon
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Emily Carter
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Kimberley, Australia
| | - Sue Thomas
- Marulu Unit, Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Kimberley, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Kids Research, The Sydney Children's Hospitals Network, Westmead, New South Wales, Australia
| | - Lauren J Rice
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Lukacs MJ, Salim S, Katchabaw MJ, Yeung E, Walton DM. Virtual reality in physical rehabilitation: a narrative review and critical reflection. PHYSICAL THERAPY REVIEWS 2022. [DOI: 10.1080/10833196.2022.2105077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Michael J. Lukacs
- Health and Rehabilitation Sciences, Western University, Canada
- Bone and Joint Institute, Western University, Canada
| | - Shahan Salim
- Public Health and Health Systems, University of Waterloo, Canada
| | | | - Euson Yeung
- Physical Therapy, University of Toronto, Canada
| | - David M. Walton
- Bone and Joint Institute, Western University, Canada
- School of Physical Therapy, Western University, Canada
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Wray TB, Emery NN. Feasibility, Appropriateness, and Willingness to Use Virtual Reality as an Adjunct to Counseling among Addictions Counselors. Subst Use Misuse 2022; 57:1470-1477. [PMID: 35754378 DOI: 10.1080/10826084.2022.2092148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Research suggests that virtual reality (VR) experiences can be helpful as adjunctive tools in psychotherapy for some mental health conditions. VR is a computer-generated experience that produces a feeling of being immersed in a different environment. VR experiences could be useful in the treatment of substance use disorders, and several are currently being tested. However, few psychotherapists report using VR experiences in their practices, even when doing so is well-supported. Understanding key barriers and concerns about using VR among drug/alcohol counselors is important to ultimately encouraging adoption. METHODS Licensed counselors (N = 101) who provide treatment to clients with substance use disorders were recruited via email Listservs, professional organizations, and social media. Participants viewed a 15-minute educational video about VR and then completed a survey of their views about using it with their clients. RESULTS Most clinicians (82%) believed they would be likely to use a VR experience in drug/alcohol counseling, and 81% believed it would be appropriate for most of their clients. A minority (19%) noted important concerns, including that their clients may be skeptical of it (15%), cost (14%), and space (10%). Those who had cost and space concerns were less likely to report high use intentions (OR = 0.29 and OR = 031, both p < .05, respectively). CONCLUSIONS Findings suggest that addictions counselors are eager to use VR, but key barriers should be addressed. VR developers should incorporate features to encourage trust among users, design experiences for small spaces, and explore ways of supporting the purchase of VR systems for counselors.
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Affiliation(s)
- Tyler B Wray
- Center for Alcohol and Addictions Studies, Brown University, Providence, Rhode Island, USA
| | - Noah N Emery
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
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Stockley RC, Christian DL. A focus group study of therapists' views on using a novel neuroanimation virtual reality game to deliver intensive upper-limb rehabilitation early after stroke. Arch Physiother 2022; 12:15. [PMID: 35701828 PMCID: PMC9199178 DOI: 10.1186/s40945-022-00139-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intensive training can significantly reduce upper-limb impairments after stroke but delivering interventions of sufficiently high intensity is extremely difficult in routine practice. The MindPod Dolphin® system is a novel neuroanimation experience which provides motivating and intensive virtual reality based training for the upper-limb. However several studies report that health professionals have reservations about using technology in rehabilitation. Therefore, this study sought to explore the views of therapists who had used this novel neuroanimation therapy (NAT) in a clinical centre to deliver intensive for the upper-limb of people after stroke in a phase 2 trial (SMARTS2). METHODS Four therapists (three female, two physical and two occupational therapists) who delivered NAT participated in a focus group conducted by two independent researchers. The theoretical domains framework and COM-B behaviour change models informed the discussion schedule for the focus group. An inductive approach to content analysis was used. Recordings were transcribed, coded and thematically analysed. Generated key themes were cross-checked with participants. RESULTS Whilst therapists had some initial concerns about using NAT, these were reduced by training, reference materials and face-to-face technical support. Therapists noted several significant benefits to using NAT including multi-system involvement, carry-over to functional tasks and high levels of patient engagement. CONCLUSIONS These findings illuminate key areas that clinicians, technology developers and researchers should consider when designing, developing and implementing NAT. Specifically, they highlight the importance of planning the implementation of rehabilitation technologies, ensuring technologies are robust and suggest a range of benefits that might be conferred to patients when using intensive NAT as part of rehabilitation for the upper-limb after stroke.
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Affiliation(s)
- Rachel C Stockley
- Stroke Research Team, Faculty of Health and Wellbeing, University of Central Lancashire, PrestonPreston, PR1 2HE, UK.
| | - Danielle L Christian
- Stroke Research Team, Faculty of Health and Wellbeing, University of Central Lancashire, PrestonPreston, PR1 2HE, UK
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Gaballa A, Cavalcante RS, Lamounier E, Soares A, Cabibihan JJ. Extended Reality "X-Reality" for Prosthesis Training of Upper-Limb Amputees: A Review on Current and Future Clinical Potential. IEEE Trans Neural Syst Rehabil Eng 2022; 30:1652-1663. [PMID: 35635835 DOI: 10.1109/tnsre.2022.3179327] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The rejection rates of upper-limb prosthetic devices in adults are high, currently averaging 26% and 23% for body-powered and electric devices, respectively. While many factors influence acceptance, prosthesis training methods relying on novel virtual reality systems have been cited as a critical factor capable of increasing the likelihood of long-term, full-time use. Despite that, these implementations have not yet garnered widespread traction in the clinical setting, and their use remains immaterial. This review aims to explore the reasons behind this situation by identifying trends in existing research that seek to advance Extended Reality "X-Reality" systems for the sake of upper-limb prosthesis rehabilitation and, secondly, analyzing barriers and presenting potential pathways to deployment for successful adoption in the future. The search yielded 42 research papers that were divided into two categories. The first category included articles that focused on the technical aspect of virtual prosthesis training. Articles in the second category utilize user evaluation procedures to ensure applicability in a clinical environment. The review showed that 75% of articles that conducted whole system testing experimented with non-immersive virtual systems. Furthermore, there is a shortage of experiments performed with amputee subjects. From the large-scale studies analyzed, 71% of those recruited solely able-bodied participants. This paper shows that X-Reality technologies for prosthesis rehabilitation of upper-limb amputees carry significant benefits. Nevertheless, much still must be done so that the technology reaches widespread clinical use.
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Gamified Neurorehabilitation Strategies for Post-stroke Motor Recovery: Challenges and Advantages. Curr Neurol Neurosci Rep 2022; 22:183-195. [PMID: 35278172 PMCID: PMC8917333 DOI: 10.1007/s11910-022-01181-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 11/23/2022]
Abstract
Abstract Purpose of Review Stroke is the leading cause of permanent motor disability in the United States (US), but there has been little progress in developing novel, effective strategies for treating post-stroke motor deficits. The past decade has seen the rapid development of many promising, gamified neurorehabilitation technologies; however, clinical adoption remains limited. The purpose of this review is to evaluate the recent literature surrounding the adoption and use of gamification in neurorehabilitation after stroke. Recent Findings Gamification of neurorehabilitation protocols is both feasible and effective. Deployment strategies and scalability need to be addressed with more rigor. Relationship between engaged time on task and rehabilitation outcomes should be explored further as it may create benefits beyond repetitive movement. Summary As gamification becomes a more common and feasible way of delivering exercise-based therapies, additional benefits of gamification are emerging. In spite of this, questions still exist about scalability and widespread clinical adoption.
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Implementation of virtual reality for patient distraction during diagnostic cardiac catheterisation. Cardiol Young 2022; 32:323-327. [PMID: 34304747 DOI: 10.1017/s1047951121002845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Until now, the application of virtual reality as a distraction model has been widely described in the medical field, showing different benefits offered on patient's perception, particularly related to pain and anxiety. Previous clinical experience of virtual reality applications on surgical intervention has shown how during procedures with local anaesthesia, this modality improves patients' experience without changing times, costs, and clinical outcomes. Herein, we report our experience with three patients during diagnostic cardiac catheterisation, showing the effect of this technology on patients' perception and metrics during the procedure.
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Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031525. [PMID: 35162546 PMCID: PMC8834834 DOI: 10.3390/ijerph19031525] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/22/2022] [Accepted: 01/25/2022] [Indexed: 12/12/2022]
Abstract
Health 4.0 aligns with Industry 4.0 and encourages the application of the latest technologies to healthcare. Virtual reality (VR) is a potentially significant component of the Health 4.0 vision. Though VR in health care is a popular topic, there is little knowledge of VR-aided therapy from a macro perspective. Therefore, this paper was aimed to explore the research of VR in aiding therapy, thus providing a potential guideline for futures application of therapeutic VR in healthcare towards Health 4.0. A mixed research method was adopted for this research, which comprised the use of a bibliometric analysis (a quantitative method) to conduct a macro overview of VR-aided therapy, the identification of significant research structures and topics, and a qualitative review of the literature to reveal deeper insights. Four major research areas of VR-aided therapy were identified and investigated, i.e., post-traumatic stress disorder (PTSD), anxiety and fear related disorder (A&F), diseases of the nervous system (DNS), and pain management, including related medical conditions, therapies, methods, and outcomes. This study is the first to use VOSviewer, a commonly used software tool for constructing and visualizing bibliometric networks and developed by Center for Science and Technology Studies, Leiden University, the Netherlands, to conduct bibliometric analyses on VR-aided therapy from the perspective of Web of Science core collection (WoSc), which objectively and visually shows research structures and topics, therefore offering instructive insights for health care stakeholders (particularly researchers and service providers) such as including integrating more innovative therapies, emphasizing psychological benefits, using game elements, and introducing design research. The results of this paper facilitate with achieving the vision of Health 4.0 and illustrating a two-decade (2000 to year 2020) map of pre-life of the Health Metaverse.
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Bovim LPV, Valved L, Bleikli B, Geitung AB, Soleim H, Bogen B. Theoretical Rationale for Design of Tasks in a Virtual Reality-Based Exergame for Rehabilitation Purposes. Front Aging Neurosci 2021; 13:734223. [PMID: 34795575 PMCID: PMC8593199 DOI: 10.3389/fnagi.2021.734223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/05/2021] [Indexed: 11/13/2022] Open
Abstract
Virtual reality games are playing a greater role in rehabilitation settings. Previously, commercial games have dominated, but increasingly, bespoke games for specific rehabilitation contexts are emerging. Choice and design of tasks for VR-games are still not always clear, however; some games are designed to motivate and engage players, not necessarily with the facilitation of specific movements as a goal. Other games are designed specifically for the facilitation of specific movements. A theoretical background for the choice of tasks seems warranted. As an example, we use a game that was designed in our lab: VR Walk. Here, the player walks on a treadmill while wearing a head-mounted display showing a custom-made virtual environment. Tasks include walking on a glass bridge across a drop, obstacle avoidance, narrowing path, walking in virtual footsteps, memory, and selection tasks, and throwing and catching objects. Each task is designed according to research and theory from movement science, exercise science, and cognitive science. In this article, we discuss how for example walking across a glass bridge gives perceptual challenges that may be suitable for certain medical conditions, such as hearing loss, when perceptual abilities are strained to compensate for the hearing loss. In another example, walking in virtual footsteps may be seen as a motor and biomechanical constraint, where the double support phase and base of support can be manipulated, making the task beneficial for falls prevention. In a third example, memory and selection tasks may challenge individuals that have cognitive impairments. We posit that these theoretical considerations may be helpful for the choice of tasks and for the design of virtual reality games.
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Affiliation(s)
- Lars Peder Vatshelle Bovim
- SimArena Rehabilitation Lab, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway.,The Vitality Centre for Children and Youth, Haukeland University Hospital, Bergen, Norway
| | - Lauritz Valved
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Bendik Bleikli
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Atle Birger Geitung
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Harald Soleim
- Department of Computer Science, Electrical Engineering and Mathematical Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Bård Bogen
- SimArena Rehabilitation Lab, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
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Bernaerts S, De Witte NAJ, Van der Auwera V, Bonroy B, Muraru L, Bamidis P, Frantzidis C, Kourtidou-Papadeli C, Azevedo N, Garatea J, Muñoz I, Almeida R, Losada R, Fung J, Kehayia E, Lamontagne A, de Guise E, Duclos C, Higgins J, Nadeau S, Beaudry L, Konstantinidis E. Rehabilitation supported by technology: Protocol for an international co-creation and user experience study (Preprint). JMIR Res Protoc 2021; 11:e34537. [PMID: 35266874 PMCID: PMC8949709 DOI: 10.2196/34537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background Living labs in the health and well-being domain have become increasingly common over the past decade but vary in available infrastructure, implemented study designs, and outcome measures. The Horizon 2020 Project Virtual Health and Wellbeing Living Lab Infrastructure aims to harmonize living lab procedures and open living lab infrastructures to facilitate and promote research activities in the health and well-being domain in Europe and beyond. This protocol will describe the design of a joint research activity, focusing on the use of innovative technology for both rehabilitation interventions and data collection in a rehabilitation context. Objective With this joint research activity, this study primarily aims to gain insight into each living lab’s infrastructure and procedures to harmonize health and well-being living lab procedures and infrastructures in Europe and beyond, particularly in the context of rehabilitation. Secondarily, this study aims to investigate the potential of innovative technologies for rehabilitation through living lab methodologies. Methods This study has a mixed methods design comprising multiple phases. There are two main phases of data collection: cocreation (phase 1) and small-scale pilot studies (phase 2), which are preceded by a preliminary harmonization of procedures among the different international living labs. An intermediate phase further allows the implementation of minor adjustments to the intervention or protocol depending on the input that was obtained in the cocreation phase. A total of 6 small-scale pilot studies using innovative technologies for intervention or data collection will be performed across 4 countries. The target study sample comprises patients with stroke and older adults with mild cognitive impairment. The third and final phases involve Delphi procedures to reach a consensus on harmonized procedures and protocols. Results Phase 1 data collection will begin in March 2022, and phase 2 data collection will begin in June 2022. Results will include the output of the cocreation sessions, small-scale pilot studies, and advice on harmonizing procedures and protocols for health and well-being living labs focusing on rehabilitation. Conclusions The knowledge gained by the execution of this research will lead to harmonized procedures and protocols in a rehabilitation context for health and well-being living labs in Europe and beyond. In addition to the harmonized procedures and protocols in rehabilitation, we will also be able to provide new insights for improving the implementation of innovative technologies in rehabilitation. International Registered Report Identifier (IRRID) PRR1-10.2196/34537
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Affiliation(s)
- Sylvie Bernaerts
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerpen, Belgium
| | - Nele A J De Witte
- LiCalab, Thomas More University of Applied Sciences, Geel, Belgium
- Expertise Unit Psychology, Technology & Society, Thomas More University of Applied Sciences, Antwerpen, Belgium
| | | | - Bert Bonroy
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Luiza Muraru
- Mobilab & Care, Thomas More University of Applied Sciences, Geel, Belgium
| | - Panagiotis Bamidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Christos Frantzidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Chrysoula Kourtidou-Papadeli
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Aerospace Medical Association and Space Research, Thessaloniki, Greece
| | - Nancy Azevedo
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
| | - Jokin Garatea
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, San Sebastian, Spain
| | - Idoia Muñoz
- GAIA, Asociación de Industrias de Conocimiento y Tecnologías Aplicadas, San Sebastian, Spain
| | - Rosa Almeida
- Fundación INTRAS, Research, Development and Innovation Department, Valladolid, Spain
| | - Raquel Losada
- Fundación INTRAS, Research, Development and Innovation Department, Valladolid, Spain
| | - Joyce Fung
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Eva Kehayia
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Anouk Lamontagne
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Elaine de Guise
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Cyril Duclos
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Johanne Higgins
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Sylvie Nadeau
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Université de Montreal, Montreal, QC, Canada
| | - Lucie Beaudry
- Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Institut Universitaire sur la réadaptation en déficience physique de Montréal, Montreal, QC, Canada
- Dance Department, Université du Québec à Montréal, Montreal, QC, Canada
| | - Evdokimos Konstantinidis
- Medical Physics and Digital Innovation Laboratory, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
- European Network of Living Labs, Brussels, Belgium
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Broderick M, Almedom L, Burdet E, Burridge J, Bentley P. Self-Directed Exergaming for Stroke Upper Limb Impairment Increases Exercise Dose Compared to Standard Care. Neurorehabil Neural Repair 2021; 35:974-985. [PMID: 34449290 PMCID: PMC8593287 DOI: 10.1177/15459683211041313] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background. One of the strongest modifiable determinants of rehabilitation outcome is exercise dose. Technologies enabling self-directed exercise offer a pragmatic means to increase dose, but the extent to which they achieve this in unselected cohorts, under real-world constraints, is poorly understood. Objective. Here we quantify the exercise dose achieved by inpatient stroke survivors using an adapted upper limb (UL) exercise gaming (exergaming) device and compare this with conventional (supervised) therapy. Methods. Over 4 months, patients presenting with acute stroke and associated UL impairment were screened at a single stroke centre. Participants were trained in a single session and provided with the device for unsupervised use during their inpatient admission. Results. From 75 patients referred for inpatient UL therapy, we recruited 30 (40%), of whom 26 (35%) were able to use the device meaningfully with their affected UL. Over a median enrolment time of 8 days (IQR: 5–14), self-directed UL exercise duration using the device was 26 minutes per day (median; IQR: 16–31), in addition to 25 minutes daily conventional UL therapy (IQR: 12–34; same cohort plus standard care audit; joint n = 50); thereby doubling total exercise duration (51 minutes; IQR: 32–64) relative to standard care (Z = 4.0, P <.001). The device enabled 104 UL repetitions per day (IQR: 38–393), whereas conventional therapy achieved 15 UL repetitions per day (IQR: 11–23; Z = 4.3, P <.001). Conclusion. Self-directed adapted exergaming enabled participants in our stroke inpatient cohort to increase exercise duration 2-fold, and repetitions 8-fold, compared to standard care, without requiring additional professional supervision.
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Affiliation(s)
- Michelle Broderick
- Department of Brain Sciences, 4615Imperial College London, Charing Cross Hospital Campus, London, UK
| | - Leeza Almedom
- Department of Brain Sciences, 4615Imperial College London, Charing Cross Hospital Campus, London, UK
| | - Etienne Burdet
- Department. of Bioengineering, Human Robotics Group, Imperial College, South Kensington Campus, London, UK
| | - Jane Burridge
- Department of Restorative Neuroscience, University of Southampton, Southampton, UK
| | - Paul Bentley
- Department of Brain Sciences, 4615Imperial College London, Charing Cross Hospital Campus, London, UK
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Abstract
OBJECTIVE The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). INTRODUCTION Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. METHODS Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. RESULTS The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. CONCLUSIONS The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned.
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Xie M, Zhou K, Patro N, Chan T, Levin M, Gupta MK, Archibald J. Virtual Reality for Vestibular Rehabilitation: A Systematic Review. Otol Neurotol 2021; 42:967-977. [PMID: 33782257 DOI: 10.1097/mao.0000000000003155] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Vertigo is a debilitating symptom, leading to increased healthcare utilization and lost patient productivity. Vestibular rehabilitation is used to manage the symptomatic manifestations of vestibular disease. However, vestibular rehabilitation is limited by accessibility and time commitment. Recently, virtual reality has been described as a vestibular rehabilitation tool that may circumvent these barriers to treatment. Despite this, the efficacy of virtual reality for vestibular rehabilitation remains unclear. This study aims to review and summarize the current literature on the effectiveness of virtual reality-based vestibular rehabilitation. METHODS A systematic review of the MEDLINE, EMBASE, and Alternative and Complementary Medicine databases was conducted for prospective studies describing virtual reality-based vestibular rehabilitation. RESULTS Our search identified 382 unique articles. Six randomized controlled trials and four other studies were ultimately included. Study sample sizes ranged from 13 to 70 participants and varied in diagnoses from any unilateral peripheral vertigo to specific pathologies. Different virtual reality interventions were used. Comparator groups ranged from supervised vestibular rehabilitation to independent Cawthorne-Cooksey exercises. Outcomes consisted of validated questionnaires, objective clinical tests, and measurements of balance or reflexes. CONCLUSION The studies reviewed in this study are preliminary evidence to suggest the benefit of virtual reality-based vestibular rehabilitation. However, these studies are limited by their inclusion criteria, heterogeneity, comparator design, and evidence-based clinical outcomes. Further research should address these limitations.
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Affiliation(s)
- Michael Xie
- Division of Otolaryngology-Head and Neck Surgery
| | - Kelvin Zhou
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Nivedh Patro
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Teffran Chan
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marc Levin
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
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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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Ong T, Wilczewski H, Paige SR, Soni H, Welch BM, Bunnell BE. Extended Reality for Enhanced Telehealth During and Beyond COVID-19: Viewpoint. JMIR Serious Games 2021; 9:e26520. [PMID: 34227992 PMCID: PMC8315161 DOI: 10.2196/26520] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/07/2021] [Accepted: 06/15/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic caused widespread challenges and revealed vulnerabilities across global health care systems. In response, many health care providers turned to telehealth solutions, which have been widely embraced and are likely to become standard for modern care. Immersive extended reality (XR) technologies have the potential to enhance telehealth with greater acceptability, engagement, and presence. However, numerous technical, logistic, and clinical barriers remain to the incorporation of XR technology into telehealth practice. COVID-19 may accelerate the union of XR and telehealth as researchers explore novel solutions to close social distances. In this viewpoint, we highlight research demonstrations of XR telehealth during the COVID-19 pandemic and discuss future directions to make XR the next evolution of remote health care.
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Affiliation(s)
- Triton Ong
- Doxy.me, LLC, Rochester, NY, United States
| | | | | | - Hiral Soni
- Doxy.me, LLC, Rochester, NY, United States
| | - Brandon M Welch
- Doxy.me, LLC, Rochester, NY, United States
- Biomedical Informatics Center, Medical University of South Carolina, Charleston, SC, United States
| | - Brian E Bunnell
- Doxy.me, LLC, Rochester, NY, United States
- Department of Psychiatry, University of South Florida, Tampa, FL, United States
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Rimer E, Husby LV, Solem S. Virtual Reality Exposure Therapy for Fear of Heights: Clinicians' Attitudes Become More Positive After Trying VRET. Front Psychol 2021; 12:671871. [PMID: 34335386 PMCID: PMC8319686 DOI: 10.3389/fpsyg.2021.671871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/23/2021] [Indexed: 12/24/2022] Open
Abstract
Background Virtual reality exposure therapy (VRET) has the potential to solve logistic challenges when treating specific phobias. However, VRET has yet to see a large-scale implementation in clinical settings despite positive findings in treatment trials. This may partly be due to attitudes and lack of experience among clinicians, but also because of expensive and stationary VR solutions. Objective This study tested whether modern, wireless, commercially available VR equipment with controller-free hand tracking could induce and reduce discomfort using scenarios designed for fear of heights. Also, the study tested if clinicians’ attitudes toward using VR in therapy changed after trying it themselves. Method Attitudes to using VR in therapy and discomfort ratings were assessed for 74 clinicians before and after completing two VR scenarios. In addition, 54 non-clinicians completed the same scenarios. Participants were not diagnosed with acrophobia. Results The VR scenarios induced discomfort comparable to participants’ reported fear of heights in real life. Repeated training reduced discomfort. Positive attitudes toward use of VR in therapy was predicted by previous experience with VR, as well as positive attitudes toward novel technology and exposure therapy. Clinicians’ attitudes became more favorable after trying VRET themselves. Clinicians reported a range of possible advantages and disadvantages of using VR in therapy. Conclusion VRET for fear of heights was able to induce and reduce discomfort in clinicians and non-clinicians, and clinicians’ attitudes toward using VRET become more positive after trying VRET for themselves. The latest generation of VR solutions has potential to improve clinical availability and treatment options. Future research should explore how VRET can be implemented in clinical settings.
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Affiliation(s)
- Elise Rimer
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Vågsholm Husby
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Solem
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Considerations and practical protocols for using virtual reality in psychological research and practice, as evidenced through exposure-based therapy. Behav Res Methods 2021; 53:2725-2742. [PMID: 34080173 DOI: 10.3758/s13428-021-01543-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 12/12/2022]
Abstract
Everyday client stressors are often challenging to replicate in clinical and research environments, which hinders the ability to reliably reproduce clinical outcomes. To overcome this obstacle, tools that can bridge the inherent disconnect between these settings and the real-world experiences of clients are urgently needed. Virtual reality (VR) promises to provide immersive experiences within controlled laboratory or clinical settings. While the potential opportunities and challenges of VR applications have been scientifically reviewed, clinical adoptions into psychology are hampered by a paucity of practical and methodological publications. This paper intends to address that gap, by providing a four-step process for decision-making considerations, including practical recommendations and an applied case study of developing an exposure-based system for obsessive-compulsive disorder. We provide a framework to make VR accessible for clinician-researchers to create similar systems that realise the promise while encouraging ongoing scientific rigour.
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Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey CM, Khalil H. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth 2021; 18:2119-2126. [PMID: 33038124 DOI: 10.11124/jbies-20-00167] [Citation(s) in RCA: 1560] [Impact Index Per Article: 520.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR). INTRODUCTION Scoping reviews are an increasingly common approach to informing decision-making and research based on the identification and examination of the literature on a given topic or issue. Scoping reviews draw on evidence from any research methodology and may also include evidence from non-research sources, such as policy. In this manner, scoping reviews provide a comprehensive overview to address broader review questions than traditionally more specific systematic reviews of effectiveness or qualitative evidence. The increasing popularity of scoping reviews has been accompanied by the development of a reporting guideline: the PRISMA-ScR. In 2014, the JBI Scoping Review Methodology Group developed guidance for scoping reviews that received minor updates in 2017 and was most recently updated in 2020. The updates reflect ongoing and substantial developments in approaches to scoping review conduct and reporting. As such, the JBI Scoping Review Methodology Group recognized the need to revise the guidance to align with the current state of knowledge and reporting standards in evidence synthesis. METHODS Between 2015 and 2020, the JBI Scoping Review Methodology Group expanded its membership; extensively reviewed the literature; engaged via annual face-to-face meetings, regular teleconferences, and email correspondence; sought advice from methodological experts; facilitated workshops; and presented at scientific conferences. This process led to updated guidance for scoping reviews published in the JBI Manual for Evidence Synthesis. The updated chapter was endorsed by JBI's International Scientific Committee in 2020. RESULTS The updated JBI guidance for scoping reviews includes additional guidance on several methodological issues, such as when a scoping review is (or is not) appropriate, and how to extract, analyze, and present results, and provides clarification for implications for practice and research. Furthermore, it is aligned with the PRISMA-ScR to ensure consistent reporting. CONCLUSIONS The latest JBI guidance for scoping reviews provides up-to-date guidance that can be used by authors when conducting a scoping review. Furthermore, it aligns with the PRISMA-ScR, which can be used to report the conduct of a scoping review. A series of ongoing and future methodological projects identified by the JBI Scoping Review Methodology Group to further refine the methodology are planned.
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Affiliation(s)
- Micah D J Peters
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia.,School of Nursing, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.,The Centre for Evidence-based Practice South Australia (CEPSA): A JBI Centre of Excellence Adelaide, SA, Australia
| | - Casey Marnie
- Rosemary Bryant AO Research Centre, UniSA Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andrea C Tricco
- Li Ka Shing Knowledge Institute of St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada.,Epidemiology Division and Institute of Health Management, Policy, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence Kingston, ON, Canada
| | - Danielle Pollock
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Lyndsay Alexander
- School of Health Sciences, Robert Gordon University, Aberdeen, UK.,The Scottish Centre for Evidence-based Multi-professional Practice: A JBI Centre of Excellence Aberdeen, Scotland
| | - Patricia McInerney
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, GT, South Africa.,The Wits-JBI Centre for Evidence-Based Practice: A JBI Affiliated Group Johannesburg, GT, South Africa
| | - Christina M Godfrey
- Queen's Collaboration for Health Care Quality: A JBI Centre of Excellence Kingston, ON, Canada.,School of Nursing, Queen's University, Kingston, ON, Canada
| | - Hanan Khalil
- School of Psychology and Public Health, Department of Public Health, La Trobe University, Melbourne, Vic, Australia.,The Queensland Centre of Evidence Based Nursing and Midwifery: A JBI Centre of Excellence, Brisbane, QLD, Australia
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Tran JE, Fowler CA, Delikat J, Kaplan H, Merzier MM, Schlesinger MR, Litzenberger S, Marszalek JM, Scott S, Winkler SL. Immersive Virtual Reality to Improve Outcomes in Veterans With Stroke: Protocol for a Single-Arm Pilot Study. JMIR Res Protoc 2021; 10:e26133. [PMID: 33970110 PMCID: PMC8145080 DOI: 10.2196/26133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Over the last decade, virtual reality (VR) has emerged as a cutting-edge technology in stroke rehabilitation. VR is defined as a type of computer-user interface that implements real-time simulation of an activity or environment allowing user interaction via multiple sensory modalities. In a stroke population, VR interventions have been shown to enhance motor, cognitive, and psychological recovery when utilized as a rehabilitation adjunct. VR has also demonstrated noninferiority to usual care therapies for stroke rehabilitation. OBJECTIVE The proposed pilot study aims to (1) determine the feasibility and tolerability of using a therapeutic VR platform in an inpatient comprehensive stroke rehabilitation program and (2) estimate the initial clinical efficacy (effect size) associated with the VR platform using apps for pain distraction and upper extremity exercise for poststroke neurologic recovery. METHODS This study will be conducted in the Comprehensive Integrated Inpatient Rehabilitation Program at the James A Haley Veterans' Hospital. Qualitative interviews will be conducted with 10 clinical staff members to assess the feasibility of the VR platform from the clinician perspective. A prospective within-subject pretest-posttest pilot design will be used to examine the tolerability of the VR platform and the clinical outcomes (ie, upper extremity neurologic recovery, hand dexterity, pain severity) in 10 veteran inpatients. A VR platform consisting of commercially available pain distraction and upper extremity apps will be available at the participants' bedside for daily use during their inpatient stay (approximately 4-6 weeks). Clinician interviews will be analyzed using qualitative descriptive analysis. Cohen d effect sizes with corresponding 95% CIs will be calculated for upper extremity neurologic recovery, hand dexterity, and pain. The proportion of participants who achieve minimal clinically important difference after using the VR platform will be calculated for each clinical outcome. RESULTS This study was selected for funding in August 2020. Institutional review board approval was received in October 2020. The project start date was December 2020. The United States Department has issued a moratorium on in-person research activities secondary to COVID-19. Data collection will commence once this moratorium is lifted. CONCLUSIONS Our next step is to conduct a large multi-site clinical trial that will incorporate the lessons learned from this pilot feasibility study to test the efficacy of a VR intervention in inpatient rehabilitation and transition to home environments. When VR is used in patients' rooms, it serves to provide additional therapy and may reduce clinician burden. VR also presents an opportunity similar to home-based practice exercises. VR can be implemented in both clinical settings and people's own homes, where engagement in ongoing self-management approaches is often most challenging. This unique experience offers the potential for seamless transition from inpatient rehabilitation to the home. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/26133.
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Affiliation(s)
- Johanna E Tran
- Physical Medicine and Rehabilitation Service, James A Haley Veterans' Hospital, Tampa, FL, United States
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Christopher A Fowler
- Research and Development Service, James A Haley Veterans' Hospital, Tampa, FL, United States
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Jemy Delikat
- Research and Development Service, James A Haley Veterans' Hospital, Tampa, FL, United States
| | - Howard Kaplan
- Advanced Visualization Center, Information Technology and Research Computing, University of South Florida, Tampa, FL, United States
| | - Marie M Merzier
- Research and Development Service, James A Haley Veterans' Hospital, Tampa, FL, United States
| | - Michelle R Schlesinger
- Physical Medicine and Rehabilitation Service, James A Haley Veterans' Hospital, Tampa, FL, United States
| | - Stefan Litzenberger
- Physical Medicine and Rehabilitation Service, James A Haley Veterans' Hospital, Tampa, FL, United States
- Department of Physical Medicine and Rehabilitation, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Jacob M Marszalek
- Research and Development Service, James A Haley Veterans' Hospital, Tampa, FL, United States
- Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Steven Scott
- Polytrauma Rehabilitation Center, James A Haley Veterans' Hospital, Tampa, FL, United States
- Department of Neurology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Sandra L Winkler
- Research and Development Service, James A Haley Veterans' Hospital, Tampa, FL, United States
- Department of Occupational Therapy, Nova Southeastern University, Fort Lauderdale, FL, United States
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Anwar N, Karimi H, Ahmad A, Gilani SA, Khalid K, Aslam AS, Hanif A. VIRTUAL REALITY TRAINING THROUGH NINTENDO WII GAMES IN STROKE PATIENTS: A RANDOMISED CLINICAL TRIAL (Preprint). JMIR Serious Games 2021; 10:e29830. [PMID: 35699989 PMCID: PMC9237768 DOI: 10.2196/29830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/30/2021] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Stroke is a leading cause of disability. It is difficult to devise an optimal rehabilitation plan once stroke survivors are back home. Conventional rehabilitative therapies are extensively used in patients with stroke to recover motor functioning and disability, but these are arduous and expensive. Virtual reality (VR) video games inspire patients to get involved in their therapeutic exercise routine in a fun way. VR in the form of games provides a fruitful, secure, and challenging learning environment for motor control and neural plasticity development in rehabilitation. The effects of upper limb sensorimotor functioning and balance are the main focus of this trial. Objective The aim of this study is to compare the effects of VR training and routine physical therapy on balance and upper extremity sensorimotor function in patients with stroke. Methods It was a single assessor-blinded randomized clinical trial. A total of 74 participants with their first chronic stroke were included and rehabilitated in a clinical setting. The lottery method was used to randomly assign patients to either the VR group (n=37) or the routine physical therapy group (n=37). The VR group received a 1-hour session of VR training for 3 weekdays over 6 weeks, and the routine physical therapy group received different stretching and strengthening exercises. The outcome measuring tools were the Berg Balance Scale for balance and the Fugl-Meyer Assessment (upper extremity) scale for sensorimotor, joint pain, and range assessment. The assessment was done at the start of treatment and after the 6 weeks of intervention. Data analysis was done using SPSS 22. Results The trial was completed by 68 patients. A significant difference between the two groups was found in the Berg Balance Scale score (P<.001), Fugl-Meyer Assessment for motor function (P=.03), and Fugl-Meyer Assessment for joint pain and joint range (P<.001); however, no significant difference (P=.19) in the Fugl-Meyer Assessment for upper extremity sensation was noted. Conclusions VR training is helpful for improving balance and function of the upper extremities in the routine life of patients with stroke; although, it was not found to be better than conventional training in improving upper limb sensation. VR training can be a better option in a rehabilitation plan designed to increase functional capability. Trial Registration Iranian Registry of Clinical Trials RCT20190715044216N1; https://www.irct.ir/user/trial/40898/view
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Affiliation(s)
- Naveed Anwar
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
- Department of Physical Therapy, Nur International University, Lahore, Pakistan
| | - Hossein Karimi
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Ashfaq Ahmad
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Syed Amir Gilani
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Kehkshan Khalid
- Department of Physical Therapy, Avicenna Medical College, Lahore, Pakistan
| | - Ahmed Sohaib Aslam
- Department of Physical Therapy, Kanaan Healthcare Center, Lahore, Pakistan
| | - Asif Hanif
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
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Integration of BIM and Immersive Technologies for AEC: A Scientometric-SWOT Analysis and Critical Content Review. BUILDINGS 2021. [DOI: 10.3390/buildings11030126] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
With the outset of Industrial Revolution 4.0 (IR 4.0), every sector is escalating to get enrichment out of it, whether they are research- or industry-oriented. The Architecture Engineering and Construction (AEC) industry lags a bit in adopting it because of its multi-faceted dependencies and unique nature of work. Despite this, a trend has been seen recently to hone the IR 4.0 multitudes in the AEC industry. The upsurge has been seen in the usage of Immersive Technologies (ImTs) as one of the disruptive techniques. This paper studies the literature based on ImTs, which are Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) integrating with Building Information Modelling (BIM) in the AEC sector. A total number of 444 articles were selected from Scopus following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol of reviewing the literature. Among the selected database, 64 papers are identified as the result of following the protocol, and the articles are divided into eight domains relevant to the AEC industry, namely client/stakeholder, design exploration, design analysis, construction planning, construction monitoring, construction health/safety, facility/management, and education/training. This study adopts both a scientometric analysis for bibliometrics visualization and a critical review using Strength Weakness Opportunity Threat (SWOT) analysis for finding gaps and state of play. The novelty of this paper lies in the analysis techniques used in the literature to provide an insight into the literature, and it provides directions for the future with an emphasis on developing sustainable development goals (SDGs). In addition, research directions for the future growth on the adoption of ImTs are identified and presented based on categorization in immersive devices, graphical/non-graphical data and, responsive/integrative processes. In addition, five subcategories for each direction are listed, citing the limitations and future/needs. This study presents the roadmap for the successful adoption of ImTs for industry practitioners and stakeholders in the AEC industry for various domains. The paper shows that there are studies on ImTs with or without BIM; however, future studies should focus on the usage of ImTs in various sectors such as modular integrated construction (MiC) or emerging needs such as SDGs.
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Finley JM, Gotsis M, Lympouridis V, Jain S, Kim A, Fisher BE. Design and Development of a Virtual Reality-Based Mobility Training Game for People With Parkinson's Disease. Front Neurol 2021; 11:577713. [PMID: 33519665 PMCID: PMC7843522 DOI: 10.3389/fneur.2020.577713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/20/2020] [Indexed: 12/25/2022] Open
Abstract
People with Parkinson's disease (PD) commonly have gait impairments that reduce their ability to walk safely in the community. These impairments are characterized, in part, by a compromised ability to turn and negotiate both predictable and unpredictable environments. Here, we describe the development and usability assessment of a virtual reality training application, Wordplay VR, that allows people with PD to practice skills such as turning, obstacle avoidance, and problem-solving during over-ground walking in a game-based setting. Nine people with PD completed three sessions with Wordplay VR, and each session was directed by their personal physical therapist. Our outcome measures included perceived sense of presence measured using the International Test Commission–Sense of Presence Inventory (ITC-SOPI), levels of motivation using the Intrinsic Motivation Inventory (IMI), overall system usability using the System Usability Scale (SUS), and setup time by the physical therapists. Both the people with PD and the physical therapists rated their sense of presence in the training system positively. The system received high ratings on the interest and value subscales of the IMI, and the system was also rated highly on usability, from the perspective of both the patient during gameplay and the therapist while controlling the experience. These preliminary results suggest that the application and task design yielded an experience that was motivating and user-friendly for both groups. Lastly, with repeated practice over multiple sessions, therapists were able to reduce the time required to help their patients don the headset and sensors and begin the training experience.
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Affiliation(s)
- James M Finley
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States.,Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, United States
| | - Marientina Gotsis
- School of Cinematic Arts, University of Southern California, Los Angeles, CA, United States
| | - Vangelis Lympouridis
- Department of Computer Science, University of Southern California, Los Angeles, CA, United States
| | - Shreya Jain
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Aram Kim
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
| | - Beth E Fisher
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, United States
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