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Boege S, Milne-Ives M, Meinert E, Carroll C. Self-Management Systems for Patients and Clinicians in Parkinson Care: Protocol for an Integrated Scoping Review, Product Search, and Evaluation. JMIR Res Protoc 2024; 13:e58845. [PMID: 39316796 DOI: 10.2196/58845] [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: 03/26/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND Parkinson disease (PD) poses emotional and financial challenges to patients, families, caregivers, and health care systems. Self-management systems show promise in empowering people with PD and enabling more control over their treatment. The collaborative nature of PD care requires communication between patients and health care professionals. While past reviews explored self-management systems in PD diagnosis and symptom management with a focus on patient portals, there is limited research addressing the interconnectivity of systems catering to the needs of both patients and clinicians. A system's acceptability and usability for clinicians are pivotal for enabling comprehensive data collection and supporting clinical decision-making, which can enhance patient care and treatment outcomes. OBJECTIVE This review study aims to assess PD self-management systems that include a clinician portal and to determine which features enhance acceptability and usability for clinicians. The primary aim is to assess evidence of clinicians' acceptability and usability of self-management systems with a focus on the integration of systems into clinical workflows, data collection points, monitoring, clinical decision-making support, and extended education and training. METHODS The review will entail 3 separate stages: a literature review following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, a product search, and an evaluation of the level of evidence for the identified products. For the first stage, 5 databases will be searched: PubMed, CINAHL, Scopus, ACM digital library, and IEEE Xplore. Studies eligible for inclusion will be qualitative, quantitative, and mixed methods studies examining patients' and clinician's perceptions of the acceptability and usability of digital health interventions, synthesized by a narrative qualitative analysis. A web search in the iOS Apple App Store and Android Google Play Store will identify currently available tools; the level of evidence for these will then be assessed using the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS Literature search and screening began soon after submission of the protocol, and the review is expected to be completed by end of September 2024. CONCLUSIONS This review will examine currently available self-management systems in PD care, focusing on their acceptability and usability. This is significant because there is limited research addressing the integration of clinicians into these systems. The findings from this study may provide critical knowledge and insight to help inform future research and will contribute to the design of self-management systems that promote collaborative efforts in PD care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/58845.
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Affiliation(s)
- Selina Boege
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Madison Milne-Ives
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
| | - Edward Meinert
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
| | - Camille Carroll
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- Centre for Health Technology, University of Plymouth, Plymouth, United Kingdom
- University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
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Tao Y, Luo J, Tian J, Peng S, Wang H, Cao J, Wen Z, Zhang X. The role of robot-assisted training on rehabilitation outcomes in Parkinson's disease: a systematic review and meta-analysis. Disabil Rehabil 2024; 46:4049-4067. [PMID: 37818694 DOI: 10.1080/09638288.2023.2266178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/14/2023] [Accepted: 09/24/2023] [Indexed: 10/12/2023]
Abstract
PURPOSE The study aims to assess the efficacy of robot-assisted rehabilitation training on upper and lower limb motor function and fatigue in Parkinson's disease (PD), and to explore the best-acting robotic rehabilitation program. METHODS We searched studies in seven databases and the search period was from the build to 30 June 2023. Two researchers independently screened studies and assessed the quality of the studies for data extraction. RESULTS A total of 21 studies were included, 18 studies related to lower limbs rehabilitation and 3 studies related to upper limbs rehabilitation, involving a total of 787 participants. The results showed that robot-assisted rehabilitation significantly improved indicators of lower limb motor function UPDRS Part III (WMD = -3.58, 95% CI = -5.91 to -1.25, p = 0.003) and BBS (WMD = 4.24, 95% CI = 2.88 to 5.54, p < 0.001), as well as non-motor symptoms of fatigue (WMD = -13.39, 95% CI = -17.92 to -8.86, p < 0.001) in PD patients. At the level of upper limb function, there was no statistically significant difference in the outcome measures of PFS (WMD = -0.25, 95% CI = -4.44 to 3.93, p = 0.9) and BBT (WMD = 1.73, 95% CI = -2.85 to 6.33, p = 0.458). CONCLUSION Robot-assisted rehabilitation significantly improved motor function, fatigue, and balance confidence in PD patients, but current evidence doesn't show that intelligent rehabilitation systems improve upper limb function. In particular, robotics combined with virtual reality worked best.
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Affiliation(s)
- Yanmin Tao
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jingsong Luo
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Tian
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sihan Peng
- Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Sichuan Nursing Vocational College, Chengdu, China
| | - Jun Cao
- Sichuan Nursing Vocational College, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Skrzatek A, Nuic D, Cherif S, Beranger B, Gallea C, Bardinet E, Welter ML. Brain modulation after exergaming training in advanced forms of Parkinson's disease: a randomized controlled study. J Neuroeng Rehabil 2024; 21:133. [PMID: 39103924 DOI: 10.1186/s12984-024-01430-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 07/22/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Physical activity combined with virtual reality and exergaming has emerged as a new technique to improve engagement and provide clinical benefit for gait and balance disorders in people with Parkinson's disease (PD). OBJECTIVE To investigate the effects of a training protocol using a home-based exergaming system on brain volume and resting-state functional connectivity (rs-FC) in persons with PD. METHODS A single blind randomized controlled trial was conducted in people with PD with gait and/or balance disorders. The experimental (active) group performed 18 training sessions at home by playing a custom-designed exergame with full body movements, standing in front of a RGB-D Kinect® motion sensor, while the control group played using the computer keyboard. Both groups received the same training program. Clinical scales, gait recordings, and brain MRI were performed before and after training. We assessed the effects of both training on both the grey matter volumes (GVM) and rs-FC, within and between groups. RESULTS Twenty-three patients were enrolled and randomly assigned to either the active (n = 11) or control (n = 12) training groups. Comparing pre- to post-training, the active group showed significant improvements in gait and balance disorders, with decreased rs-FC between the sensorimotor, attentional and basal ganglia networks, but with an increase between the cerebellar and basal ganglia networks. In contrast, the control group showed no significant changes, and rs-FC significantly decreased in the mesolimbic and visuospatial cerebellar and basal ganglia networks. Post-training, the rs-FC was greater in the active relative to the control group between the basal ganglia, motor cortical and cerebellar areas, and bilaterally between the insula and the inferior temporal lobe. Conversely, rs FC was lower in the active relative to the control group between the pedunculopontine nucleus and cerebellar areas, between the temporal inferior lobes and the right thalamus, between the left putamen and dorsolateral prefrontal cortex, and within the default mode network. CONCLUSIONS Full-body movement training using a customized exergame induced brain rs-FC changes within the sensorimotor, attentional and cerebellar networks in people with PD. Further research is needed to comprehensively understand the neurophysiological effects of such training approaches. Trial registration ClinicalTrials.gov NCT03560089.
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Affiliation(s)
- Anna Skrzatek
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France
| | - Dijana Nuic
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France
| | - Saoussen Cherif
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France
- Genious Healthcare France, Paris, France
| | - Benoit Beranger
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France
- CENIR core facility, Paris Brain Institute, Paris, France
| | - Cecile Gallea
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France
- CENIR core facility, Paris Brain Institute, Paris, France
| | - Eric Bardinet
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France
- CENIR core facility, Paris Brain Institute, Paris, France
| | - Marie-Laure Welter
- Institut du Cerveau - Paris Brain Institute - ICM, Sorbonne Université, Inserm, CNRS, 47 bd de l'Hôpital, 75013, Paris, France.
- PANAM core facility, Paris Brain Institute, Paris, France.
- Neurophysiology Department, CHU Rouen, Rouen University, Rouen, France.
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Manser P, Herold F, de Bruin ED. Components of effective exergame-based training to improve cognitive functioning in middle-aged to older adults - A systematic review and meta-analysis. Ageing Res Rev 2024; 99:102385. [PMID: 38914262 DOI: 10.1016/j.arr.2024.102385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 03/19/2024] [Accepted: 06/17/2024] [Indexed: 06/26/2024]
Abstract
BACKGROUND Exergame-based training is currently considered a more promising training approach than conventional physical and/or cognitive training. OBJECTIVES This study aimed to provide quantitative evidence on dose-response relationships of specific exercise and training variables (training components) of exergame-based training on cognitive functioning in middle-aged to older adults (MOA). METHODS We conducted a systematic review with meta-analysis including randomized controlled trials comparing the effects of exergame-based training to inactive control interventions on cognitive performance in MOA. RESULTS The systematic literature search identified 22,928 records of which 31 studies were included. The effectiveness of exergame-based training was significantly moderated by the following training components: body position for global cognitive functioning, the type of motor-cognitive training, training location, and training administration for complex attention, and exercise intensity for executive functions. CONCLUSION The effectiveness of exergame-based training was moderated by several training components that have in common that they enhance the ecological validity of the training (e.g., stepping movements in a standing position). Therefore, it seems paramount that future research focuses on developing innovative novel exergame-based training concepts that incorporate these (and other) training components to enhance their ecological validity and transferability to clinical practice. We provide specific evidence-based recommendations for the application of our research findings in research and practical settings and identified and discussed several areas of interest for future research. PROSPERO REGISTRATION NUMBER CRD42023418593; prospectively registered, date of registration: 1 May 2023.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany
| | - Eling D de Bruin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland; Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Hao J, Huang B, Remis A, He Z. The application of virtual reality to home-based rehabilitation for children and adolescents with cerebral palsy: A systematic review and meta-analysis. Physiother Theory Pract 2024; 40:1588-1608. [PMID: 36847396 DOI: 10.1080/09593985.2023.2184220] [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: 11/25/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Home-based rehabilitation enables children and families to participate in therapeutic activities built into their daily routines without the barriers of arrangement and transportation to facilities. Virtual reality is an emerging technology which has shown promising outcomes in rehabilitation. PURPOSE This systematic review aims to examine the feasibility and effects of virtual reality-enhanced home rehabilitation on Body functions and structures, Activity, and Participation outcomes in children and adolescents with cerebral palsy. METHODS Interventional studies were searched across five biomedical databases on November 26, 2022. Two independent reviewers conducted study selection, data extraction, and quality assessment. The Physiotherapy Evidence Database scale and National Institutes of Health Study Quality Assessment Tools were used to evaluate the quality of included studies. Meta-analysis was performed to examine the effects of the intervention. RESULTS Eighteen studies were included in this review. Home-based virtual reality rehabilitation appears feasible with effects on upper extremity and gross motor function, strength, bone density, cognition, balance, walking, daily activity performance, and participation. Meta-analyses revealed significant improvements in hand function (SMD = 0.41, p= .003), gross motor function (SMD = 0.56, p= .0002), and walking capacity (SMD = 0.44, p= .01) following home-based virtual reality intervention. CONCLUSION Home-based virtual reality may serve as an adjunct to conventional facility-based therapy to promote participation in therapeutic exercises and maximize rehabilitation outcomes. Further properly designed randomized controlled trials using valid and reliable outcome measures with adequately powered sample sizes are warranted to enhance the current body of evidence using home-based virtual reality in cerebral palsy rehabilitation.
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Affiliation(s)
- Jie Hao
- Department of Health and Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, United States
| | - Biying Huang
- Department of Health and Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, United States
| | - Andréas Remis
- Department of Physical Medicine and Rehabilitation, Gate Parkway Primary Care Center, Jacksonville
| | - Zhengting He
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore
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Hardeman LES, Geerse DJ, Hoogendoorn EM, Nonnekes J, Roerdink M. Remotely prescribed, monitored, and tailored home-based gait-and-balance exergaming using augmented reality glasses: a clinical feasibility study in people with Parkinson's disease. Front Neurol 2024; 15:1373740. [PMID: 38872812 PMCID: PMC11172158 DOI: 10.3389/fneur.2024.1373740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/04/2024] [Indexed: 06/15/2024] Open
Abstract
Background Exergaming has the potential to increase adherence to exercise through play, individually tailored training, and (online) remote monitoring. Reality Digital Therapeutics (Reality DTx®) is a digital therapeutic software platform for augmented reality (AR) glasses that enables a home-based gait-and-balance exergaming intervention specifically designed for people with Parkinson's disease (pwPD). Objective The primary objective was to evaluate the feasibility and potential efficacy of Reality DTx® AR exergaming intervention for improving gait, balance, and walking-adaptability fall-risk indicators. The secondary objective was to evaluate the potential superiority of AR glasses [Magic Leap 2 (ML2) vs. HoloLens 2 (HL2)]. Methods This waitlist-controlled clinical feasibility study comprised three laboratory visits (baseline; pre-intervention; and post-intervention), a home visit, and a 6-week AR exergaming intervention. Five complementary gait-and-balance exergames were remotely prescribed (default five sessions/week of 30 active minutes/session), monitored, and tailored. Feasibility was assessed in terms of safety, adherence, and user experience. During laboratory visits, gait-and-balance capacity was assessed using standard clinical gait-and-balance tests and advanced walking-adaptability fall-risk assessments. Results In total, 24 pwPD participated. No falls and four near falls were reported. Session adherence was 104%. The User Experience Questionnaire scores for Reality DTx® ranged from above average to excellent, with superior scores for HL2 over ML2 for Perspicuity and Dependability. Intervention effects were observed for the Timed Up and Go test (albeit small), the Five Times Sit to Stand test, and walking speed. Walking-adaptability fall-risk indicators all improved post-intervention. Conclusion Reality DTx® is a safe, adherable, usable, well-accepted, and potentially effective intervention in pwPD. These promising results warrant future randomized controlled trials on the (cost-)effectiveness of home-based AR exergaming interventions for improving gait, balance, and fall risk. Clinical trial registration ClinicalTrials.gov, identifier NCT05605249.
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Affiliation(s)
- Lotte E. S. Hardeman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Daphne J. Geerse
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Eva M. Hoogendoorn
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Jorik Nonnekes
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Rehabilitation, Centre of Expertise for Parkinson and Movement Disorders, Nijmegen, Netherlands
- Department of Rehabilitation, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Melvyn Roerdink
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
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Sedhed J, Johansson H, Andersson N, Åkesson E, Kalbe E, Franzén E, Leavy B. Feasibility of a novel eHealth intervention for Parkinson's disease targeting motor-cognitive function in the home. BMC Neurol 2024; 24:114. [PMID: 38580913 PMCID: PMC10996106 DOI: 10.1186/s12883-024-03614-2] [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: 12/15/2023] [Accepted: 03/29/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) drastically affects motor and cognitive function, but evidence shows that motor-cognitive training improves disease symptoms. Motor-cognitive training in the home is scarcely investigated and eHealth methods can provide continual support for PD self-management. Feasibility testing is however required. OBJECTIVE To assess the feasibility (i) Recruitment capability (ii) Acceptability and Suitability (iii) Demand and Safety of a home-based motor-cognitive eHealth exercise intervention in PD. METHODS The 10-week intervention was delivered using the ExorLive® application and exercises were individually adapted and systematically progressed and targeted functional strength, cardiovascular fitness, flexibility, and motor-cognitive function. People with mild-to moderate PD were assessed before and after the intervention regarding; gait performance in single and dual-task conditions; functional mobility; dual-task performance; balance performance; physical activity level; health related quality of life and perceived balance confidence and walking ability; global cognition and executive function. Feasibility outcomes were continuously measured using a home-exercise diary and contact with a physiotherapist. Changes from pre- and post-intervention are reported descriptively. RESULTS Fifteen participants (mean age 68.5 years) commenced and 14 completed the 10-week intervention. In relation to intervention Acceptability, 64% of the motor sessions and 52% of motor-cognitive sessions were rated as "enjoyable". Concerning Suitability, the average level of exertion (Borg RPE scale) was light (11-12). Adherence was high, with 86% of all (420) sessions reported as completed. No falls or other adverse events occurred in conjunction with the intervention. CONCLUSIONS This motor-cognitive eHealth home exercise intervention for PD was safe and feasible in terms of Recruitment capability, Acceptability, Safety and Demand. The intensity of physical challenge needs to be increased before testing in an efficacy trial. TRIAL REGISTRATION This trial is registered at Clinicaltrials.gov (NCT05027620).
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Affiliation(s)
- Jenny Sedhed
- Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden.
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 83, Sweden.
| | - Hanna Johansson
- Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 83, Sweden
- Theme Women's Health and Allied Health Professionals, Medical unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Nina Andersson
- Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden
| | - Elisabet Åkesson
- Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden
- Department of Neurobiology, Care sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Elke Kalbe
- Medical Psychology | Neuropsychology and Gender Studies and Center for Neuropsychological Diagnostics and Intervention (CeNDI), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Erika Franzén
- Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 83, Sweden
- Theme Women's Health and Allied Health Professionals, Medical unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Breiffni Leavy
- Stockholm Sjukhem Foundation, R&D unit, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 83, Sweden
- Theme Women's Health and Allied Health Professionals, Medical unit Occupational Therapy & Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
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Ayenigbara IO. Active video game (AVG); a viable option for the promotion of physical activity. J Public Health (Oxf) 2024; 46:e189. [PMID: 37632392 DOI: 10.1093/pubmed/fdad166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/16/2023] [Indexed: 08/28/2023] Open
Affiliation(s)
- Israel Oluwasegun Ayenigbara
- Department of Health Education, School and Community Health Education Unit, University of Ibadan, Ibadan 200284, Nigeria
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Seinsche J, de Bruin ED, Hinrichs T, Giannouli E. Effects of home-based interventions using exergames on physical and cognitive functions in community-dwelling older adults: a PRISMA-P-compliant protocol for a systematic review. Front Public Health 2024; 11:1291120. [PMID: 38274539 PMCID: PMC10808653 DOI: 10.3389/fpubh.2023.1291120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/20/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Physical activity and exercise are crucial to counteract physical and cognitive decline in old age. Home-based exergame training can be a solution to overcome physical inactivity. This systematic review aims to provide a comprehensive overview of home-based exergame interventions and evaluate their effectiveness in improving cognitive and physical functions through physical activity enhancement in older adults. Methods and analysis We are conducting a systematic literature search including studies examining (1) community-dwelling older adults aged 60 years and older without any specific disease, (2) exergame-based exercise programs that take place at least partially in a home setting, and (3) intervention-related physical and/or cognitive outcomes. We will include randomized controlled trials and any other type of pre-post study published in English. There are no restrictions in terms of control group type and publication date. A search string was created and used in PubMed, Web of Science, Embase, Scopus and CINAHL. In addition, a hand search is carried out. This involves checking the references of the included studies and searching Google Scholar for further studies. The included studies will be summarized and, if homogeneity is sufficient, a random-effects meta-analysis will be performed. We will assess the risk of bias using RoB 2.0 and ROBINS-I. Conclusion The findings of this systematic review will help to define the most suitable exergame programs to counteract cognitive and physical decline in older adults. Additionally, they will inform the development of effective home-based exergame systems and point to future pathways of digital rehabilitation in older adults. Registration Prospero (ID: CRD42023374234).
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Affiliation(s)
- Julia Seinsche
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
| | - Eling D. de Bruin
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
- Department of Health, OST—Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Eleftheria Giannouli
- Movement Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zürich, Zürich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Feldmann LK, Roudini J, Kühn AA, Habets JGV. Improving naturalistic neuroscience with patient engagement strategies. Front Hum Neurosci 2024; 17:1325154. [PMID: 38259336 PMCID: PMC10800538 DOI: 10.3389/fnhum.2023.1325154] [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: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The clinical implementation of chronic electrophysiology-driven adaptive deep brain stimulation (DBS) algorithms in movement disorders requires reliable representation of motor and non-motor symptoms in electrophysiological biomarkers, throughout normal life (naturalistic). To achieve this, there is the need for high-resolution and -quality chronic objective and subjective symptom monitoring in parallel to biomarker recordings. To realize these recordings, an active participation and engagement of the investigated patients is necessary. To date, there has been little research into patient engagement strategies for DBS patients or chronic electrophysiological recordings. Concepts and results We here present our concept and the first results of a patient engagement strategy for a chronic DBS study. After discussing the current state of literature, we present objectives, methodology and consequences of the patient engagement regarding study design, data acquisition, and study infrastructure. Nine patients with Parkinson's disease and their caregivers participated in the meeting, and their input led to changes to our study design. Especially, the patient input helped us designing study-set-up meetings and support structures. Conclusion We believe that patient engagement increases compliance and study motivation through scientific empowerment of patients. While considering patient opinion on sensors or questionnaire questions may lead to more precise and reliable data acquisition, there was also a high demand for study support and engagement structures. Hence, we recommend the implementation of patient engagement in planning of chronic studies with complex designs, long recording durations or high demand for individual active study participation.
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Affiliation(s)
- Lucia K. Feldmann
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Juliet Roudini
- QUEST Center for Responsible Research, Berlin Institute of Health at Charité, Berlin, Germany
- Patient and Stakeholder Engagement, Cluster of Excellence, NeuroCure, Berlin, Germany
| | - Andrea A. Kühn
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Charité University Medicine, Berlin, Germany
- NeuroCure Clinical Research Center, Charité University Medicine, Berlin, Germany
- DZNE, German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Jeroen G. V. Habets
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité – Universitätsmedizin Berlin, Berlin, Germany
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Herold F, Theobald P, Gronwald T, Kaushal N, Zou L, de Bruin ED, Bherer L, Müller NG. Alexa, let's train now! - A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:30-46. [PMID: 36736727 PMCID: PMC10818117 DOI: 10.1016/j.jshs.2023.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/07/2022] [Accepted: 12/08/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging. Consequently, the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions. In this context, digital and home-based physical training interventions might be a promising alternative to center-based intervention programs. Thus, this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance. METHODS In this pre-registered systematic review (PROSPERO; ID: CRD42022320031), 5 electronic databases (PubMed, Web of Science, PsycInfo, SPORTDiscus, and Cochrane Library) were searched by 2 independent researchers (FH and PT) to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults. The systematic literature search yielded 8258 records (extra 17 records from other sources), of which 27 controlled trials were considered relevant. Two reviewers (FH and PT) independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale). RESULTS Of the 27 reviewed studies, 15 reported positive effects on cognitive and motor-cognitive outcomes (i.e., performance improvements in measures of executive functions, working memory, and choice stepping reaction test), and a considerable heterogeneity concerning study-related, population-related, and intervention-related characteristics was noticed. A more detailed analysis suggests that, in particular, interventions using online classes and technology-based exercise devices (i.e., step-based exergames) can improve cognitive performance in healthy older adults. Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence (≤85%) and monitoring of the level of regular physical activity in the control group. CONCLUSION The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall, though there is limited evidence that specific types of digital and home-based physical training interventions (e.g., online classes and step-based exergames) can be an effective strategy for improving cognitive performance in older adults. However, due to the limited number of available studies, future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.
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Affiliation(s)
- Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany; Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen 518060, China.
| | - Paula Theobald
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg 20457, Germany
| | - Navin Kaushal
- Department of Health Sciences, School of Health & Human Sciences, Indiana University, Indianapolis, IN 46202, USA
| | - Liye Zou
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany; Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen 518060, China
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich 8093, Switzerland; Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm 17177, Sweden; Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen 9001, Switzerland
| | - Louis Bherer
- Montreal Heart Institute, Montreal, QC H1T 1C8, Canada; Department of Medicine, Universite de Montreal, Montreal, QC H3T 1J4, Canada; Centre de Recherche de l'Institut Universitaire de Geriatrie de Montreal, Montreal, QC H3W 1W5, Canada
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam 14476, Germany; Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen 518060, China
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Seinsche J, de Bruin ED, Saibene E, Rizzo F, Carpinella I, Ferrarin M, Ifanger S, Moza S, Giannouli E. Feasibility and Effectiveness of a Personalized Home-Based Motor-Cognitive Training Program in Community-Dwelling Older Adults: Protocol for a Pragmatic Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e49377. [PMID: 37943591 PMCID: PMC10667977 DOI: 10.2196/49377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/23/2023] [Accepted: 09/18/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Exergame-based motor-cognitive training in older adults has been associated with improvements in physical, cognitive, and psychological functioning. The novel Cocare system (Dividat GmbH), developed through a user-centered design process, allows motor-cognitive training in a telerehabilitation setting. It includes (1) a stationary stepping platform for supervised exergame training (Dividat Senso; Dividat GmbH), (2) a home-based version (Dividat Senso Flex, which is a rollable pressure-sensitive mat; Dividat GmbH), (3) an assessment system (including motor-cognitive tests), and (4) a rehabilitation cockpit for remote training supervision and management. OBJECTIVE The aim of this study is to test the feasibility and effectiveness of this novel training system. METHODS A total of 180 older adults from Switzerland, Italy, and Cyprus aged ≥60 years with a prescription for rehabilitation are randomly allocated to an intervention group or a control group. Both groups continue with their usual care, whereas participants in the intervention group additionally perform a 2-week supervised exergame training program at rehabilitation centers, followed by a 10-week home training program under remote supervision. The assessment system is used to indicate the start level of each participant, and, in both intervention periods, standardized progression rules are applied. The measures of feasibility include adherence, attrition, exergame enjoyment, willingness to perform such a training program, and the number and types of help requests. Effectiveness is assessed in terms of cognitive and physical functioning, balance confidence, and quality of life. RESULTS Data collection started in February 2023 and is ongoing. Final measurements are expected to be performed in January 2024. CONCLUSIONS Owing to the user-centered design approach, the Cocare system is expected to be user-friendly and offers several novel features to cover the whole continuum of care. This pragmatic trial will provide valuable information regarding final necessary adaptations and subsequent implementation efforts. TRIAL REGISTRATION ClinicalTrials.gov NCT05751551; https://www.clinicaltrials.gov/study/NCT05751551. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/49377.
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Affiliation(s)
- Julia Seinsche
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Enrico Saibene
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Francesco Rizzo
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Ilaria Carpinella
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Maurizio Ferrarin
- Istituto di Ricovero e Cura a Carattere Scientifico, Fondazione Don Carlo Gnocchi Onlus, Milan, Italy
| | - Sarina Ifanger
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
| | | | - Eleftheria Giannouli
- Motor Control and Learning Group, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, Eidgenössische Technische Hochschule Zurich, Zurich, Switzerland
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Gallou-Guyot M, Mandigout S, Marie R, Robin L, Daviet JC, Perrochon A. Feasibility and potential cognitive impact of a cognitive-motor dual-task training program using a custom exergame in older adults: A pilot study. Front Aging Neurosci 2023; 15:1046676. [PMID: 36819724 PMCID: PMC9932982 DOI: 10.3389/fnagi.2023.1046676] [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: 09/16/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Dual-task training may be relevant and efficient in the context of active aging. An issue in training programs lies in enhancing the adherence of participants. This can potentially be improved using games as support. We designed and developed a custom interactive exergame in this way. The objective of this pilot study was to explore the potential use of this exergame and the feasibility of our intervention, including the level of safety and adherence. The result's trends on cognitive and motor capacities, as well as on the level of motivation for physical activity, fear of falling, and quality of life of participants, were also explored. Methods Older adults aged 65 years or older were recruited and realized 30 min of supervised training in groups of 4, 2-3 times a week for 12 weeks. Exercises consisted of incorporated cognitive and motor dual tasks, with an increased difficulty over the weeks. Our program's safety, engagement, attendance, and completion levels were evaluated. Participants' postural control in single-task and dual-task conditions, as well as their performances in mental inhibition, flexibility, working memory, mobility, and postural control, and their levels of motivation for physical activity, fear of falling, and quality of life were also assessed. We realized a per protocol statistical analysis with a p-value set at 0.05. Results Thirty-nine participants (aged 84.6 ± 8.5 years) were recruited. No adverse events, and 89% adherence, 88% attendance, and 87% completion rates were observed. A potentially significant effect of our exergame on working memory in single-task conditions and on the cognitive aspect of dual-task conditions was also observed. We observed no differences in other parameters. Discussion Our exergame seemed feasible and safe and was enjoyed by participants, mainly due to the gamification of our training program. Moreover, our exergame may be efficient for cognitive training in older adults, as well as for the maintenance of motor functions, motivation for physical activity, fear of falling, and quality of life levels. This constitutes the first step for our solution with interesting results that need to be further studied.
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Affiliation(s)
- Matthieu Gallou-Guyot
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,*Correspondence: Matthieu Gallou-Guyot,
| | | | - Romain Marie
- Institut d’Ingénierie Informatique de Limoges, Limoges, France,3iL Ingénieurs, Limoges, France
| | - Louise Robin
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Québec City, QC, Canada
| | - Jean-Christophe Daviet
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France,Pôle Neurosciences Tête et Cou, Service de Médecine Physique et de Réadaptation, Hôpital Jean Rebeyrol, CHU Limoges, Limoges, France
| | - Anaick Perrochon
- Laboratoire HAVAE (UR20217), Université de Limoges, Limoges, France
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Marotta N, Calafiore D, Curci C, Lippi L, Ammendolia V, Ferraro F, Invernizzi M, de Sire A. Integrating virtual reality and exergaming in cognitive rehabilitation of patients with Parkinson disease: a systematic review of randomized controlled trials. Eur J Phys Rehabil Med 2022; 58:818-826. [PMID: 36169933 PMCID: PMC10081485 DOI: 10.23736/s1973-9087.22.07643-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION In recent years, growing attention is rising to virtual reality (VR) tools and exergaming in rehabilitation management of patients with Parkinson disease (PD). However, no strong evidence supports the effectiveness of these cutting-edge technologies on cognitive function and the integration of these promising tool in the rehabilitation framework of PD patients is still challenging. Therefore, the present systematic review of randomized controlled trials (RCTs) aimed at assessing the effects of VR and exergames/telerehabilitation in the cognitive rehabilitation management of patients with PD. EVIDENCE ACQUISITION PubMed, Scopus and Web of Science databases were systematically searched up to February 14th, 2022, to identify RCTs assessing patients with PD undergoing cognitive rehabilitation including VR or exergames/telerehabilitation. The intervention was compared to conventional rehabilitation protocols. The primary outcome was cognitive function. The quality assessment was performed following the Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). PROSPERO registration code: CRD42022319788. EVIDENCE SYNTHESIS Out of 1419 identified studies, 66 articles were assessed for eligibility, and, at the end of the screening process, 10 studies were included in the present systematic review. Five RCTs (50%) assessed the exergaming devices, reporting significant positive results on cognitive outcomes scales (Trail Making test scale, Digit Span backward, MoCA, and MyCQ score). The other 5 RTCs (50%) assessed VR approaches, reporting significant improvement in executive functions. The RoB 2 showed an overall high risk of bias for the 40% of studies included. CONCLUSIONS Exergaming and VR might be considered promising rehabilitation interventions in the cognitive rehabilitation framework of PD patients. Further high-quality studies are needed to define the role of exergames and VR in a comprehensive rehabilitation approach aiming at improving the multilevel cognitive impairment characterizing patients with PD.
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Affiliation(s)
- Nicola Marotta
- Unit of Physical Medicine and Rehabilitation, Department of Medical and Surgical Sciences, Magna Grecia University, Catanzaro, Italy
| | - Dario Calafiore
- Unit Physical Medicine and Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantua, Italy
| | - Claudio Curci
- Unit Physical Medicine and Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantua, Italy
| | - Lorenzo Lippi
- Unit of Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Unit of Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Valerio Ammendolia
- Unit of Physical Medicine and Rehabilitation, Department of Medical and Surgical Sciences, Magna Grecia University, Catanzaro, Italy
| | - Francesco Ferraro
- Unit Physical Medicine and Rehabilitation, Department of Neurosciences, ASST Carlo Poma, Mantua, Italy
| | - Marco Invernizzi
- Unit of Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.,Unit of Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Alessandro de Sire
- Unit of Physical Medicine and Rehabilitation, Department of Medical and Surgical Sciences, Magna Grecia University, Catanzaro, Italy -
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Amprimo G, Masi G, Priano L, Azzaro C, Galli F, Pettiti G, Mauro A, Ferraris C. Assessment Tasks and Virtual Exergames for Remote Monitoring of Parkinson's Disease: An Integrated Approach Based on Azure Kinect. SENSORS (BASEL, SWITZERLAND) 2022; 22:8173. [PMID: 36365870 PMCID: PMC9654712 DOI: 10.3390/s22218173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/17/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
Motor impairments are among the most relevant, evident, and disabling symptoms of Parkinson’s disease that adversely affect quality of life, resulting in limited autonomy, independence, and safety. Recent studies have demonstrated the benefits of physiotherapy and rehabilitation programs specifically targeted to the needs of Parkinsonian patients in supporting drug treatments and improving motor control and coordination. However, due to the expected increase in patients in the coming years, traditional rehabilitation pathways in healthcare facilities could become unsustainable. Consequently, new strategies are needed, in which technologies play a key role in enabling more frequent, comprehensive, and out-of-hospital follow-up. The paper proposes a vision-based solution using the new Azure Kinect DK sensor to implement an integrated approach for remote assessment, monitoring, and rehabilitation of Parkinsonian patients, exploiting non-invasive 3D tracking of body movements to objectively and automatically characterize both standard evaluative motor tasks and virtual exergames. An experimental test involving 20 parkinsonian subjects and 15 healthy controls was organized. Preliminary results show the system’s ability to quantify specific and statistically significant (p < 0.05) features of motor performance, easily monitor changes as the disease progresses over time, and at the same time permit the use of exergames in virtual reality both for training and as a support for motor condition assessment (for example, detecting an average reduction in arm swing asymmetry of about 14% after arm training). The main innovation relies precisely on the integration of evaluative and rehabilitative aspects, which could be used as a closed loop to design new protocols for remote management of patients tailored to their actual conditions.
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Affiliation(s)
- Gianluca Amprimo
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
- Department of Control and Computer Engineering, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Giulia Masi
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
| | - Lorenzo Priano
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Corrado Azzaro
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Federica Galli
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Giuseppe Pettiti
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
| | - Alessandro Mauro
- Department of Neurosciences, University of Turin, Via Cherasco 15, 10100 Torino, Italy
- Istituto Auxologico Italiano, IRCCS, S. Giuseppe Hospital, Strada Luigi Cadorna 90, 28824 Piancavallo, Italy
| | - Claudia Ferraris
- Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, Corso Duca degli Abruzzi 24, 10129 Torino, Italy
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Niranjan V, Tarantino G, Kumar J, Stokes D, O’Connor R, O’Regan A. The Impact of Dance Interventions on Patients with Noninfectious Pulmonary Diseases: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11115. [PMID: 36078841 PMCID: PMC9518039 DOI: 10.3390/ijerph191711115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/29/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Dance has been highlighted as one of the most enjoyable, safe, and feasible forms of physical activity, improving physical health, mental health, and general well-being, among various patients. Little is known about the effect and impact of dance interventions to improve health among patients with pulmonary diseases, and research lacks a robust synthesis of evidence. Therefore, this systematic review aimed to investigate the impact of dance intervention on patients with noninfectious pulmonary diseases. Following the PRISMA guidelines, six electronic databases were searched in May 2022. Of the 1308 unique records identified, seven studies (five quantitative, two qualitative) across four countries were included in this systematic review. Six studies investigated adult populations, and one study explored the effect of dance on children. The dance interventions lasted between 1 and 10 weeks. Overall, dance was perceived to have a broad range of physical/mental/social benefits, including quality of life, social cohesion, dyspnoea levels, balance, exercise tolerance, general well-being, and adherence to nutrition regimens. Furthermore, the dance session was the most enjoyable activity among children and adolescents with asthma. With available evidence, dance interventions are promising and may effectively improve health and well-being among patients with noninfectious pulmonary diseases. More organised and continuous long-term dance interventions in future may reveal a detailed impact on health outcomes.
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Affiliation(s)
- Vikram Niranjan
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Giampiero Tarantino
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Jaspal Kumar
- NUS Centre for Cancer Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 169857, Singapore
| | - Diarmuid Stokes
- UCD Library, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Ray O’Connor
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
| | - Andrew O’Regan
- School of Medicine, University of Limerick, V94 T9PX Limerick, Ireland
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Gelineau A, Perrochon A, Robin L, Daviet JC, Mandigout S. Measured and Perceived Effects of Upper Limb Home-Based Exergaming Interventions on Activity after Stroke: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9112. [PMID: 35897472 PMCID: PMC9329711 DOI: 10.3390/ijerph19159112] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/20/2022] [Accepted: 07/24/2022] [Indexed: 01/25/2023]
Abstract
After discharge from the hospital to home, stroke patients may experience weakness and reduced movement in their hemiparetic arms that limits their ability to perform daily activities. Therapists can use exercise games (exergames) to maintain functional abilities and daily use of the arm at home. A systematic review and meta-analysis was conducted to determine the efficiency of upper limb home-based rehabilitation, using exergaming on activity abilities in stroke. Randomized controlled trials were reviewed in the CENTRAL, MEDLINE, CINAHL, EMBASE, and SCOPUS online databases. Clinical measures of observation and self-reporting were studied in post-intervention and follow-up. Nine studies were included in this systematic review (535 participants). The Physiotherapy Evidence Database (PEDro) score was 6.6/10 (SD 1.0, range 5-8), indicating good quality. This systematic review and meta-analysis showed that upper limb home-based exergaming interventions were no more effective in terms of activity than conventional therapy after stroke, according to the observational and subjective assessments in post-intervention and follow-up. Using this same approach, future studies should focus on evaluating home-based exergames through subgroup analysis to be able to propose recommendations.
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Affiliation(s)
- Axelle Gelineau
- HAVAE Laboratory UR 20217, University of Limoges, 87000 Limoges, France; (A.P.); (L.R.); (J.-C.D.); (S.M.)
| | - Anaick Perrochon
- HAVAE Laboratory UR 20217, University of Limoges, 87000 Limoges, France; (A.P.); (L.R.); (J.-C.D.); (S.M.)
| | - Louise Robin
- HAVAE Laboratory UR 20217, University of Limoges, 87000 Limoges, France; (A.P.); (L.R.); (J.-C.D.); (S.M.)
| | - Jean-Christophe Daviet
- HAVAE Laboratory UR 20217, University of Limoges, 87000 Limoges, France; (A.P.); (L.R.); (J.-C.D.); (S.M.)
- Department of Physical Medicine and Rehabilitation, University Hospital Center, 87000 Limoges, France
| | - Stéphane Mandigout
- HAVAE Laboratory UR 20217, University of Limoges, 87000 Limoges, France; (A.P.); (L.R.); (J.-C.D.); (S.M.)
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Mahboobeh DJ, Dias SB, Khandoker AH, Hadjileontiadis LJ. Machine Learning-Based Analysis of Digital Movement Assessment and ExerGame Scores for Parkinson's Disease Severity Estimation. Front Psychol 2022; 13:857249. [PMID: 35369199 PMCID: PMC8974120 DOI: 10.3389/fpsyg.2022.857249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 02/03/2022] [Indexed: 01/06/2023] Open
Abstract
Neurodegenerative Parkinson's Disease (PD) is one of the common incurable diseases among the elderly. Clinical assessments are characterized as standardized means for PD diagnosis. However, relying on medical evaluation of a patient's status can be subjective to physicians' experience, making the assessment process susceptible to human errors. The use of ICT-based tools for capturing the status of patients with PD can provide more objective and quantitative metrics. In this vein, the Personalized Serious Game Suite (PGS) and intelligent Motor Assessment Tests (iMAT), produced within the i-PROGNOSIS European project (www.i-prognosis.eu), are explored in the current study. More specifically, data from 27 patients with PD at Stage 1 (9) and Stage 3 (18) produced from their interaction with PGS/iMAT are analyzed. Five feature vector (FV) scenarios are set, including features from PGS or iMAT scores or their combination, after also taking into consideration the age of patients with PD. These FVs are fed into three machine learning classifiers, i.e., K-Nearest Neighbor (KNN), Support Vector Machines (SVM), and Random Forest (RF), to infer the stage of each patient with PD. A Leave-One-Out Cross-Validation (LOOCV) method is adopted for testing the classification performance. The experimental results show that a high (>90%) classification accuracy is achieved from both data sources (PGS/iMAT), justifying the effectiveness of PGS/iMAT to efficiently reflect the motor skill status of patients with PD and further potentiating PGS/iMAT enhancement with a machine learning a part to infer for the stage of patients with PD. Clearly, this integrated approach provides new opportunities for remote monitoring of the stage of patients with PD, contributing to a more efficient organization and set up of personalized interventions.
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Affiliation(s)
- Dunia J. Mahboobeh
- Department of Electrical Engineering and Computer Science, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Sofia B. Dias
- CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Ahsan H. Khandoker
- Department of Biomedical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
- Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi, United Arab Emirates
| | - Leontios J. Hadjileontiadis
- Department of Biomedical Engineering, Khalifa University, Abu Dhabi, United Arab Emirates
- Healthcare Engineering Innovation Center (HEIC), Khalifa University, Abu Dhabi, United Arab Emirates
- Department of Electrical and Computer Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
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