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Emedoli D, Alemanno F, Iannaccone S, Houdayer E, Castellazzi P, Zangrillo F, Gasperotti F, Locatelli M, Tettamanti A. Sensory-motor training with virtual reality as a complementary intervention to manual therapy for persistent non-specific neck pain: a randomized controlled trial. Eur J Phys Rehabil Med 2024; 60:680-690. [PMID: 38922315 DOI: 10.23736/s1973-9087.24.08115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
BACKGROUND Persistent non-specific neck pain (NP) is a widespread condition described as a complex biopsychosocial disorder, characterized by physical and psychological symptoms. Virtual reality (VR) shows promise in NP treatment, potentially reducing pain, kinesiophobia, and improving range of motion (ROM) and motor control. AIM The primary aim of the study was to assess the effectiveness of VR sensorimotor training, combined with manual therapy, in reducing the level of disability in persistent non-specific NP individuals. The secondary aim was to determine if this VR-enhanced approach also contributes to improvement in overall function, pain perception and kinesiophobia. DESIGN Monocentric, single-blind, randomized controlled trial. SETTING We conducted this trial at San Raffaele Scientific Institute, Department of Rehabilitation and Functional Recovery, Milan, Italy. POPULATION Forty NP participants were enrolled in the study and randomly allocated into two groups. METHODS The study involved a 6-week rehabilitation program, comprising 12 sessions of 45 minutes each, twice weekly. Both intervention groups underwent manual therapy as a consistent component of their treatment. The Experimental Group (VRT) was additionally engaged in sensorimotor rehabilitation exercises using Virtual Reality, whereas the Control Group (CT) performed the same exercises without VR. We assessed subjects at baseline (T0) and after six weeks of rehabilitation (T1). The primary outcome was the disability (Neck Disability Index) while the secondary outcomes were: pain perception (Numeric Rating Scale, NP and Disability Scale, Central Sensitization Inventory) function (Cervical Kinematics) and kinesiophobia (Tampa Scale of Kinesiophobia). RESULTS Both groups demonstrated significant reduction in level of disability, pain perception, and kinesiophobia. Significant advancements in kinematics were observed: VRT group showed enhanced ROM during craniocervical rotation (P=0.039), lateral bending (P=0.001), flexion-extension (P=0.009), and mean velocity across movements (P<0.001), whereas CT group improved in maximal ROM during lateral bending rotation (P=0.001). Between-group analysis, after Bonferroni's correction for multiple comparisons, revealed that VRT group had significantly better outcomes in ROM during rotation (P=0.040), ratio of the primary over the secondary movement while performing rotation (P=0.021), and mean velocity during lateral bending (P=0.031). CONCLUSIONS Sensorimotor training, combined with manual therapy, could enhance kinematic outcomes for NP patients, supporting the potential of VR in rehabilitation. CLINICAL REHABILITATION IMPACT This study highlighted that both groups demonstrated significant reduction in level of disability, pain perception, and kinesiophobia after sensorimotor training combined with manual therapy. It is important to underscore that in terms of reducing the level of neck disability, both interventions proved to be equally effective. This parity in efficacy is a critical finding, reaffirming the robustness of our therapeutic approaches for this specific outcome.
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Affiliation(s)
- Daniele Emedoli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy -
- Vita-Salute San Raffaele University, Milan, Italy -
| | - Federica Alemanno
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Elise Houdayer
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Paola Castellazzi
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Federica Zangrillo
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Filippo Gasperotti
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Matteo Locatelli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
| | - Andrea Tettamanti
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Hospital, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
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Benot-López S, López-Moyano J, Ferrer-González B, Martínez Pérez Moreira R, Expósito-Tirado JA. [Tele-rehabilitation in musculoskeletal pathology of the upper and lower limb]. Rehabilitacion (Madr) 2024; 58:100860. [PMID: 38996593 DOI: 10.1016/j.rh.2024.100860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/23/2024] [Indexed: 07/14/2024]
Abstract
Chronic musculoskeletal conditions cause pain and disability and have significant impact on morbidity worldwide. Tele-rehabilitation is proposed as an alternative or complement to improve patient's muscle function, pain, and quality of life. However, the satisfaction of both patients and professionals must be assessed, together with the patient's daily life activity independence. A search of the literature was made to locate assessment reports, systematic reviews and reports from regulatory bodies with support from a documentarian from the Andalusian Health Technologies Assessment Area (AETSA). For this purpose, the following sources were used: Medline, EMBASE, INAHTA (international network of health technologies assessment) and PEDro (Physiotherapy Evidence Database) from 2014 onwards. Subsequently a secondary search was carried out on the articles selected in the initial search. A search of open clinical trials was also carried out in the database: www.ClinicalTrials.gov Initially 345 articles were identified. Duplicated articles (57) were excluded. By first analysing the title and abstract 238 articles were excluded. The full texts of the remaining 30 articles were analysed. Finally 18 articles were included.
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Affiliation(s)
- S Benot-López
- Nuevas tecnologías sanitarias, Servicio Andaluz de Salud, Sevilla, España
| | - J López-Moyano
- Unidad de Medicina Preventiva y Salud Publica Interniveles, Hospital Universitario Reina Sofía, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, España
| | | | - R Martínez Pérez Moreira
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - J A Expósito-Tirado
- Servicio de Rehabilitación, Hospital Universitario Virgen del Rocío, Sevilla, España
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Kragting M, Pool-Goudzwaard AL, Pezzica C, Voogt L, Coppieters MW. Does having an external focus in immersive virtual reality increase range of motion in people with neck pain? Musculoskelet Sci Pract 2024; 71:102940. [PMID: 38537389 DOI: 10.1016/j.msksp.2024.102940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND When instructing exercises to improve Range of Motion (ROM), clinicians often create an internal focus of attention, while motor performance may improve more when using an external focus. OBJECTIVES Using Virtual Reality (VR), we investigated the effect of tasks with an internal and external focus on maximal ROM in people with neck pain and explored whether this effect was associated with fear of movement. METHOD In this cross-over experimental design study, the cervical ROM of 54 participants was measured while performing a target-seeking exercise in a VR-environment (external focus task) and during three maximal rotation and flexion-extension movements with the VR-headset on, without signal (internal focus task). The main statistical analysis included two dependent T-tests. Pearson correlation coefficients were calculated to investigate whether the differences in ROM in both conditions were correlated to fear of movement. RESULTS Maximal neck rotation was larger in the external focus condition than in the internal focus condition (mean difference: 26.4°, 95% CI [20.6, 32.3]; p < 0.001, d = 1.24). However, there was a difference favouring the internal focus condition for flexion-extension (mean difference: 8.2°, 95% CI [-14.9, -1.5]; p = 0.018, d = 0.33). The variability in ROM was not explained by variability in fear of movement (for all correlations p ≥ 0.197). CONCLUSION An external focus resulted in a larger range of rotation, but our flexion-extension findings suggest that the task has to be specific to elicit such an effect. Further research, using a task that sufficiently elicits movement in all directions, is needed to determine the value of an external focus during exercise.
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Affiliation(s)
- Maaike Kragting
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands.
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands; Somt University of Physiotherapy, Softwareweg 5, 3821 BN, Amersfoort, the Netherlands.
| | - Carlotta Pezzica
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands.
| | - Lennard Voogt
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK, Rotterdam, the Netherlands; Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, 1081, BT, Amsterdam, the Netherlands; Menzies Health Insitute Queensland, Griffith University, Brisbane and Gold Coast, 170 Kessels Road, QLD, 4111, Nathan, Australia; School of Health Sciences and Social Work, Griffith University, Brisbane and Gold Coast, 170 Kessels Road, QLD, 4111, Nathan, Australia.
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Guo Q, Zhang L, Han LL, Gui C, Chen G, Ling C, Wang W, Gao Q. Effects of Virtual Reality Therapy Combined With Conventional Rehabilitation on Pain, Kinematic Function, and Disability in Patients With Chronic Neck Pain: Randomized Controlled Trial. JMIR Serious Games 2024; 12:e42829. [PMID: 38656775 PMCID: PMC11079768 DOI: 10.2196/42829] [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: 09/20/2022] [Revised: 10/16/2023] [Accepted: 03/17/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Neck pain is a common condition that leads to neck motor dysfunction and subsequent disability, with a significant global health care burden. As a newly emerging tool, virtual reality (VR) technology has been employed to address pain and reduce disability among patients with neck pain. However, there is still a lack of high-quality studies evaluating the efficacy of VR therapy combined with conventional rehabilitation for patients with chronic neck pain, particularly in terms of kinematic function. OBJECTIVE This study aims to investigate the effect of VR therapy combined with conventional rehabilitation on pain, kinematic function, and disability in patients with chronic neck pain. METHODS We conducted an assessor-blinded, allocation-concealed randomized controlled trial. Sixty-four participants experiencing chronic neck pain were randomly allocated into the experimental group that underwent VR rehabilitation plus conventional rehabilitation or the control group receiving the same amount of conventional rehabilitation alone for 10 sessions over 4 weeks. Pain intensity, disability, kinematic function (cervical range of motion, proprioception, and mean and peak velocity), degree of satisfaction, and relief of symptoms were evaluated at 3 timepoints (baseline, postintervention, and at 3 months follow-up). A 2*3 mixed repeated measures analysis of variance was utilized for analyzing the difference across indicators, with a significant difference level of .05. RESULTS Both groups demonstrated significant improvements in pain, disability, and kinematic functions (P<.05) at postintervention and at 3-month follow-up. The experimental group showed superior therapeutic outcomes compared to the control group in pain reduction (mean difference from the baseline: 5.50 vs 1.81 at posttreatment; 5.21 vs 1.91 at the 3-month follow-up, respectively; P<.001), disability improvement (mean difference from baseline: 3.04 vs 0.50 at posttreatment; 3.20 vs 0.85 at the 3-month follow-up, respectively; P<.001), and enhanced kinematic functions (P<.05). Moreover, participants in the experimental group reported better satisfaction and relief of symptoms than the control group (P<.05), with better initiative for exercising during the follow-up period. However, there was no between-group difference of improvement in proprioception. No adverse events were reported or observed in our research. CONCLUSIONS The findings of our study support the efficacy of combining VR therapy with conventional rehabilitation in alleviating pain, enhancing kinematic function, and reducing disability of patients with chronic neck pain. Future research should focus on refining the therapeutic protocols and dosages for VR therapy as well as on optimizing its application in clinical settings for improved convenience and effectiveness. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2000040132; http://www.chictr.org.cn/showproj.aspx?proj=64346.
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Affiliation(s)
- Qifan Guo
- West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Liming Zhang
- West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Leo Lianyi Han
- Biostatistics Group, State Key Laboratory of Genetic Engineering, Greater Bay Area Institute of Precision Medicine (Guangzhou), Fudan University, Guangzhou, China
| | - Chenfan Gui
- West China Hospital, Sichuan University, Chengdu, China
| | - Guanghui Chen
- Department of Traumatology and Orthopedics of Traditional Chinese Medicine, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Chunyan Ling
- Department of Acupuncture and Tuina, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Wei Wang
- Department of Acupuncture and Tuina, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Qiang Gao
- West China Hospital, Sichuan University, Chengdu, China
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
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Özlü A, Üstündağ S, Bulut Özkaya D, Menekşeoğlu AK. Effect of Exergame on Pain, Function, and Quality of Life in Shoulder Impingement Syndrome: A Prospective Randomized Controlled Study. Games Health J 2024; 13:109-119. [PMID: 38394299 DOI: 10.1089/g4h.2023.0108] [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: 02/25/2024] Open
Abstract
Objective: This study aimed to investigate the effect of a virtual reality (VR)-mediated gamified rehabilitation program added to a home exercise program on pain, functionality, and quality of life in shoulder impingement syndrome. Methods: Forty-eight participants with shoulder impingement syndrome were included in this prospective, randomized, single-blind study between January and July 2022. The participants were randomized into two groups: the VR group (n = 24) and the control group (n = 24). All participants were given a home exercise program for 3 weeks, with five sessions per week. The participants in the VR group received 15 sessions (45 minutes each session) of a gamified shoulder exercise program with an immersive VR headset, while those in the control group received 15 sessions (45 minutes each session) of supervised therapeutic exercises. The participants were evaluated and compared before and after treatment using the 36-item Short Form Survey (SF-36), range-of-motion (ROM) measurements, the Visual Analog Scale (VAS), and the Shoulder Pain and Disability Scale (SPADI). Results: At the baseline assessment, the two groups were homogenous regarding demographic and clinical parameters. The post-treatment shoulder extension and adduction ROM was significantly greater in the VR group and the post-treatment pain subscales for SPADI and SF-36 were significantly lower in the VR group. Conclusion: In individuals with shoulder impingement syndrome, a VR-mediated gamified exercise program added to a home exercise program increased shoulder ROM and reduced pain scores. Further clinical studies are needed to prove the long-term efficacy of the addition of VR-mediated gamified exercises to the treatment of this condition in clinical settings.
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Affiliation(s)
- Aysun Özlü
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Sema Üstündağ
- Department of Internal Medicine, Faculty of Nursing, Kutahya Health Sciences University, Kutahya, Turkey
| | - Dilan Bulut Özkaya
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Ahmet Kıvanç Menekşeoğlu
- Department of Physical Medicine and Rehabilitation, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey
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Judy BF, Menta A, Pak HL, Azad TD, Witham TF. Augmented Reality and Virtual Reality in Spine Surgery: A Comprehensive Review. Neurosurg Clin N Am 2024; 35:207-216. [PMID: 38423736 DOI: 10.1016/j.nec.2023.11.010] [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: 03/02/2024]
Abstract
Augmented reality (AR) and virtual reality (VR) are powerful technologies with proven utility and tremendous potential. Spine surgery, in particular, may benefit from these developing technologies for resident training, preoperative education for patients, surgical planning and execution, and patient rehabilitation. In this review, the history, current applications, challenges, and future of AR/VR in spine surgery are examined.
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Affiliation(s)
- Brendan F Judy
- Department of Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, 6007 Zayed Tower, Baltimore, MD 21287, USA.
| | - Arjun Menta
- Department of Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, 6007 Zayed Tower, Baltimore, MD 21287, USA
| | - Ho Lim Pak
- Department of Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, 6007 Zayed Tower, Baltimore, MD 21287, USA
| | - Tej D Azad
- Department of Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, 6007 Zayed Tower, Baltimore, MD 21287, USA
| | - Timothy F Witham
- Department of Neurosurgery, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, 1800 Orleans Street, 6007 Zayed Tower, Baltimore, MD 21287, USA.
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Li R, Li Y, Kong Y, Li H, Hu D, Fu C, Wei Q. Virtual Reality-Based Training in Chronic Low Back Pain: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Med Internet Res 2024; 26:e45406. [PMID: 38407948 PMCID: PMC10928528 DOI: 10.2196/45406] [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: 12/29/2022] [Revised: 04/16/2023] [Accepted: 01/29/2024] [Indexed: 02/27/2024] Open
Abstract
BACKGROUND Low back pain is one of the most prevalent pain conditions worldwide. Virtual reality-based training has been used for low back pain as a new treatment strategy. Present evidence indicated that the effectiveness of virtual reality-based training for people with chronic low back pain is inconclusive. OBJECTIVE This study conducted a meta-analysis to evaluate the immediate- and short-term effects of virtual reality-based training on pain, pain-related fear, and disability in people with chronic low back pain. METHODS We searched the PubMed, Embase, Web of Science, PEDro, CENTRAL, and CINAHL databases from inception until January 2024. Only randomized controlled trials assessing the effects of virtual reality-based training on individuals with chronic low back pain were selected. The outcomes were focused on pain, pain-related fear measured by the Tampa Scale of Kinesiophobia, and disability measured by the Oswestry Disability Index. The immediate term was defined as the immediate period after intervention, and the short term was defined as 3 to 6 months after intervention. The Cochrane Risk of Bias tool and the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach were used to evaluate the quality of the methodology and evidence, respectively. RESULTS In total, 20 randomized controlled trials involving 1059 patients were eligible for analysis. Virtual reality-based training showed significant improvements in pain (mean difference [MD] -1.43; 95% CI -1.86 to -1.00; I2=95%; P<.001), pain-related fear using the Tampa Scale of Kinesiophobia (MD -5.46; 95% CI -9.40 to 1.52; I2=90%; P=.007), and disability using the Oswestry Disability Index (MD -11.50; 95% CI -20.00 to -3.01; I2=95%; P=.008) in individuals with chronic low back pain immediately after interventions. However, there were no significant differences observed in pain (P=.16), pain-related fear (P=.10), and disability (P=.43) in the short term. CONCLUSIONS These findings indicated that virtual reality-based training can be used effectively for individuals with chronic low back pain in the immediate term, especially to reduce pain, alleviate pain-related fear, and improve disability. However, the short-term benefits need more high-quality trials to be demonstrated. TRIAL REGISTRATION PROSPERO CRD42021292633; http://tinyurl.com/25mydxpz.
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Affiliation(s)
- Ran Li
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Yinghao Li
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China
| | - Youli Kong
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Hanbin Li
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Danrong Hu
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
| | - Chenying Fu
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, China
- Aging and Geriatric Mechanism Laboratory, West China Hospital, Sichuan University, Chengdu, China
| | - Quan Wei
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, China
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Guo L, Li S, Xie S, Bian L, Shaharudin S. The impact of digital healthcare systems on pain and body function in patients with knee joint pain: a systematic review and meta-analysis. Sci Rep 2024; 14:3310. [PMID: 38331984 PMCID: PMC10853270 DOI: 10.1038/s41598-024-53853-z] [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: 11/19/2023] [Accepted: 02/06/2024] [Indexed: 02/10/2024] Open
Abstract
The digital healthcare (DH) system has recently emerged as an advanced rehabilitation approach that promotes rehabilitation training based on virtual reality (VR) and augmented reality (AR). The purpose of this meta-analysis study is to review and assess the impact of DH systems on pain and physical function among patients diagnosed with knee joint pain. Between January 2003 and September 2023, studies that met the listed inclusion criteria were gathered from Scopus, PubMed, Web of Science, and EBSCO databases. The analysis of standardized mean difference (SMD) was carried out with 95% confidence interval (95% CI) (PROSPERO registration number: CRD42023462538). Eight research papers were selected, which collectively involved 194 males and 279 females. The meta-analysis outcomes revealed that DH intervention significantly improved balance (SMD, 0.41 [0.12, 0.69], p < 0.05) and pain level (SMD, - 1.10 [- 2.02, - 0.18], p < 0.05). The subgroup analysis of the pain level showed varied outcomes for the TKA (SMD, - 0.22 [- 0.49, 0.04], p = 0.10) or OA patients (SMD, - 2.80 [- 3.83, - 1.78], p < 0.05) Next, this study found no significant effect of DH intervention on knee joint range of motion (ROM) (SMD, 0.00 [- 0.76, 0.76], p = 1.00) and walking velocity (SMD, 0.04 [- 0.22, 0.29], p = 0.77) in patients with knee joint pain. The meta-analysis review conducted in this study revealed that DH intervention may potentially improve balance among the patients with knee joint pain. It may also alleviate the pain level particularly among OA patients.
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Affiliation(s)
- Longfei Guo
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Shuoqi Li
- School of Sports Science, Nantong University, Nantong, Jiangsu, China
| | - Shihao Xie
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Lin Bian
- School of Physical Education, Woosuk University, Jeonju, Korea
| | - Shazlin Shaharudin
- School of Health Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
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Youssef Y, De Wet D, Back DA, Scherer J. Digitalization in orthopaedics: a narrative review. Front Surg 2024; 10:1325423. [PMID: 38274350 PMCID: PMC10808497 DOI: 10.3389/fsurg.2023.1325423] [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: 10/21/2023] [Accepted: 12/27/2023] [Indexed: 01/27/2024] Open
Abstract
Advances in technology and digital tools like the Internet of Things (IoT), artificial intelligence (AI), and sensors are shaping the field of orthopaedic surgery on all levels, from patient care to research and facilitation of logistic processes. Especially the COVID-19 pandemic, with the associated contact restrictions was an accelerator for the development and introduction of telemedical applications and digital alternatives to classical in-person patient care. Digital applications already used in orthopaedic surgery include telemedical support, online video consultations, monitoring of patients using wearables, smart devices, surgical navigation, robotic-assisted surgery, and applications of artificial intelligence in forms of medical image processing, three-dimensional (3D)-modelling, and simulations. In addition to that immersive technologies like virtual, augmented, and mixed reality are increasingly used in training but also rehabilitative and surgical settings. Digital advances can therefore increase the accessibility, efficiency and capabilities of orthopaedic services and facilitate more data-driven, personalized patient care, strengthening the self-responsibility of patients and supporting interdisciplinary healthcare providers to offer for the optimal care for their patients.
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Affiliation(s)
- Yasmin Youssef
- Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Deana De Wet
- Orthopaedic Research Unit, University of Cape Town, Cape Town, South Africa
| | - David A. Back
- Center for Musculoskeletal Surgery, Charité University Medicine Berlin, Berlin, Germany
| | - Julian Scherer
- Orthopaedic Research Unit, University of Cape Town, Cape Town, South Africa
- Department of Traumatology, University Hospital of Zurich, Zurich, Switzerland
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Manes MR, Burnfield JM, Boersma K, Peoples J, Davis A, Beneciuk JM, Bialosky J, Jordan K, Osborne R. Virtual Rehabilitation and COVID-19: Varied Adoption and Satisfaction Among Patients and Providers Participating in a Multi-Site Survey Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580231222334. [PMID: 38166514 PMCID: PMC10768633 DOI: 10.1177/00469580231222334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/04/2024]
Abstract
The COVID-19 pandemic compelled rapid healthcare adaptations including increased use of telehealth (TH) and virtual care (VC) to provide rehabilitation services. This multi-site cross-sectional survey study examined rehabilitation patients' and providers' experiences with service delivery during the COVID-19 pandemic, including the use of TH/VC. Patients and providers who received or provided rehabilitation services were recruited from 1 of 3 large, post-acute rehabilitation systems located in the Southeastern and Midwestern United States during the COVID-19 pandemic. Participants rated personal satisfaction with rehabilitation services received or rendered during the pandemic and willingness to use TH/VC in the future. Questions also addressed accessibility, ease of use, and perceived barriers to TH/VC use. The adoption and personal satisfaction of TH/VC for rehabilitation care varied between patients and providers. Patients reported higher levels of satisfaction compared to providers (P < .001). Patients who did not use TH/VC had higher satisfaction than those who did (P < .05). Patients were less willing than providers to use TH/VC (P < .001). Those who used TH/VC prior to the pandemic were more willing to use post-pandemic (P < .001). Patients reported TH/VC was useful in increasing health services accessibility yet were neutral as to the ability of TH/VC to improve outcomes. Patients and providers agreed that TH/VC was easy to learn and use. Medical providers found TH/VC more useful than therapy providers. Participants who used TH/VC during the pandemic are more willing to use the service again in the future. Understanding patient and provider preferences and perspectives is key to the continued use of TH/VC in rehabilitation care.
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Affiliation(s)
- Mindi R. Manes
- Brooks Rehabilitation, Brooks Center for Research Analytics and Outcomes, Jacksonville, FL, USA
| | - Judith M. Burnfield
- Madonna Rehabilitation Hospitals, Institute for Rehabilitation Science and Engineering, Lincoln, NE, USA
| | - Kelsey Boersma
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jason Peoples
- Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Anita Davis
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
| | - Jason M. Beneciuk
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of Florida, Department of Physical Therapy, Gainesville, FL, USA
| | - Joel Bialosky
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of Florida, Department of Physical Therapy, Gainesville, FL, USA
| | - Katelyn Jordan
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
| | - Raine Osborne
- Brooks Rehabilitation, Brooks Clinical Research Center, Jacksonville, FL, USA
- University of North Florida, Department of Physical Therapy, Jacksonville, FL, USA
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11
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Ehioghae M, Montoya A, Keshav R, Vippa TK, Manuk-Hakobyan H, Hasoon J, Kaye AD, Urits I. Effectiveness of Virtual Reality-Based Rehabilitation Interventions in Improving Postoperative Outcomes for Orthopedic Surgery Patients. Curr Pain Headache Rep 2024; 28:37-45. [PMID: 38032538 DOI: 10.1007/s11916-023-01192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE OF REVIEW The surge in orthopedic surgeries strains the US healthcare system, necessitating innovative rehabilitation solutions. This review examines the potential of virtual reality (VR)-based interventions for orthopedic rehabilitation. RECENT FINDINGS The effectiveness of VR-based interventions in orthopedic surgery patients is scrutinized. While some studies suggest better patient-reported outcomes and satisfaction, mixed results emerge from others, demonstrating comparable or varied results compared to traditional rehabilitation. The underlying mechanisms of VR-based rehabilitation are elucidated, showing its positive impact on proprioception, pain management, agency, and balance. Challenges of unfamiliarity, patient engagement, and drop-out rates are identified, emphasizing the need for tailored approaches. VR technology's immersive environments and multisensory experiences offer a novel approach to addressing functional deficits and pain post-surgery. The conclusion drawn is that VR-based rehabilitation complements rather than replaces conventional methods, potentially aiding in pain reduction and functional improvement. VR-based rehabilitation holds promise for enhancing orthopedic surgery outcomes, presenting a dynamic approach to recovery. Its potential to reshape healthcare delivery and reimbursement structures underscores its significance in modern healthcare. Overall, VR-based rehabilitation offers a promising avenue for optimizing postoperative recovery in orthopedic surgery patients.
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Affiliation(s)
- Mark Ehioghae
- Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA.
| | - Alexis Montoya
- , Eastern Virginia Medical School 825 Fairfax Ave, Norfolk, VA, 23507, USA
| | - Ritwik Keshav
- , Eastern Virginia Medical School 825 Fairfax Ave, Norfolk, VA, 23507, USA
| | - Tarun K Vippa
- University of Arizona College of Medicine-Phoenix, 475 N 5th St, Phoenix, AZ, 85004, USA
| | - Hayk Manuk-Hakobyan
- Cedars Sinai Medical Center, 8700 Beverly Blvd #5725, Los Angeles, CA, 90048, USA
| | - Jamal Hasoon
- McGovern Medical School, The University of Texas Health Science Center at Houston, 7000 Fannin Street, Houston, TX, 77030, USA
| | - Alan D Kaye
- Louisiana State University Health Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Ivan Urits
- Southcoast Health Pain Management, 100 Rosebrook Way, Wareham, 02571, USA
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12
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Dejaco B, Brady N, Tankink A, Lewis J, van Goor H, Staal JB, Stolwijk N. Experiences of physiotherapists considering virtual reality for shoulder rehabilitation: A focus group study. Digit Health 2024; 10:20552076241234738. [PMID: 38414562 PMCID: PMC10898295 DOI: 10.1177/20552076241234738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/07/2024] [Indexed: 02/29/2024] Open
Abstract
Introduction Shoulder pain is common and associated with substantial morbidity. Different treatment strategies are being prescribed with equivocal results. Virtual reality (VR) is a novel technology and emerging research suggests that VR may be a promising alternative to current treatments. Prior to effectiveness research or any large-scale introduction, VR-applications require appropriate scrutiny including feasibility- and acceptability of clinicians and patients. Therefore, the aim of this study was to collect experiences of physiotherapists after using immersive VR. Methods A qualitative interpretive design was used to explore physiotherapists' experiences related to the use of VR for people with shoulder symptoms. 17 physiotherapists were asked to use VR at home for five days prior to a focus group interview. Data from the focus group interviews were analyzed using a six-phase process of thematic analysis. Results Three main themes were identified, each divided into subthemes. The main themes were: 1. VR as an extension of contemporary physiotherapy care: physiotherapists were positive about the potential of VR and its applicability in daily care. 2. Physiotherapist uncertainties of future care using VR: participants expressed concerns about their professional identity, particularly as patients engage in independent home exercises. 3. Physiotherapist's requirements for implementation of VR: participants shared their needs for evidence regarding the effectiveness and parameters such as frequency, dosage and intensity of the VR intervention. Conclusion Physiotherapists were positive about VR as an intervention tool. However, they felt more knowledge is needed about parameters of VR. The findings of this study inform researchers and technology developers about optimal design of interventions and applications using VR.
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Affiliation(s)
- Beate Dejaco
- Radboud Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Department of Physiotherapy, Sports Medical Centre Papendal, Arnhem, The Netherlands
| | - Niamh Brady
- Discipline of Physiotherapy, University College Cork, Cork, Ireland
- Evolve Health, Cork, Ireland
| | - Anne Tankink
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Jeremy Lewis
- Therapy Department, Central London Community Healthcare National Health Service Trust, London, UK
- Musculoskeletal Research, Clinical Therapies, University of Limerick, Limerick, Ireland
| | - Harry van Goor
- Radboud Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Bart Staal
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Niki Stolwijk
- Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences, Nijmegen, The Netherlands
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13
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Yalfani A, Abedi M, Raeisi Z, Asgarpour A. The effects of virtual reality training on postural sway and physical function performance on older women with chronic low back pain: A double-blind randomized clinical trial. J Back Musculoskelet Rehabil 2024; 37:761-770. [PMID: 38217579 DOI: 10.3233/bmr-230260] [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: 01/15/2024]
Abstract
BACKGROUND Chronic low back pain (CLBP) is known as an important debilitating health condition among older women. OBJECTIVE This study aimed to evaluate the effects of eight-week virtual reality training (VRT) exercises on postural sway and physical function performance (PFP) among older women suffering from CLBP. METHODS Twenty-seven older women presenting with CLBP were randomized into experimental and control groups. The experimental group was instructed to perform 30-minute VRT exercises three times a week for eight weeks. Plantar pressure variables [sway velocity (SV) and anterior-posterior (AP) and medial-lateral (ML) fluctuations of the center of pressure (CoP)], 30-second chair stand test (30CST), and timed up and go (TUG) test were recorded. RESULTS The VRT group exhibited significant decreases in SV (p= 0.002), AP (p= 0.008), and ML (p= 0.02) fluctuations. Also, the performance of the VRT group in the 30CST and TUG tests significantly improved after the exercises (P< 0.001). CONCLUSION According to the results, VRT and the program used in this study should be used to enhance balance and PFP in older women with CLBP who mostly prefer activities that are accessible and feasible in low-risk environments.
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Affiliation(s)
- Ali Yalfani
- Department of Sports Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Mitra Abedi
- Department of Sports Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
| | - Zahra Raeisi
- Department of Sports Rehabilitation, Faculty of Sport Sciences, Arak University, Arak, Iran
| | - Azadeh Asgarpour
- Department of Sports Rehabilitation, Faculty of Sport Sciences, Bu-Ali Sina University, Hamedan, Iran
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14
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Chaplin E, Karatzios C, Benaim C. Clinical Applications of Virtual Reality in Musculoskeletal Rehabilitation: A Scoping Review. Healthcare (Basel) 2023; 11:3178. [PMID: 38132067 PMCID: PMC10742848 DOI: 10.3390/healthcare11243178] [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: 10/31/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023] Open
Abstract
(1) Background: VR is based on a virtual world that creates sounds effects and videos that replace the real environment. Arising literature shows VR efficacy in the field of neurological rehabilitation (NR) and that its use is also taking a place in musculoskeletal rehabilitation (MSR), as a treatment of various disorders that cause disability and chronic pain. (2) Aim: We discuss the role of VR in MSR, presenting its use and development on acute and chronic musculoskeletal disorders, based on the most recent literature. (3) Design and Methods: Literature searches were conducted in the databases Pubmed and Medline up to 30 September 2023. The PRISMA-Scr Checklist was followed. (4) Results: A total of 51 records were included. The analysed studies were conducted within a variety of populations, musculoskeletal disorders, settings, and VR technologies. Only a few studies could statistically affirm the efficacy of VR in MSR, as mentioned for the rehabilitation of the upper limb. Nevertheless, the observed trend is an improvement of the global perceived effect compared to traditional rehabilitation. (5) Conclusion: VR allows for the personalisation of treatment with an adaptable treatment platform, which may improve the participation of the patient and increase acceptability and adherence to long-term rehabilitation programs. We provide recommendations and suggestions for future research and use of VR in musculoskeletal rehabilitation.
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Affiliation(s)
- Elizabeth Chaplin
- Division of Physical Medicine and Rehabilitation, Orthopaedic Hospital, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (C.K.); (C.B.)
| | - Christos Karatzios
- Division of Physical Medicine and Rehabilitation, Orthopaedic Hospital, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (C.K.); (C.B.)
| | - Charles Benaim
- Division of Physical Medicine and Rehabilitation, Orthopaedic Hospital, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (C.K.); (C.B.)
- Department of Medical Research, Clinique Romande de Réadaptation, Suvacare, 1950 Sion, Switzerland
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15
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Mazurek J, Cieślik B, Wrzeciono A, Gajda R, Szczepańska-Gieracha J. Immersive Virtual Reality Therapy Is Supportive for Orthopedic Rehabilitation among the Elderly: A Randomized Controlled Trial. J Clin Med 2023; 12:7681. [PMID: 38137750 PMCID: PMC10743561 DOI: 10.3390/jcm12247681] [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: 11/14/2023] [Revised: 12/02/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
OBJECTIVE This research aimed to determine the efficacy of VR therapy in mitigating symptoms of depression, anxiety, and stress among older adults following arthroplasty surgery and to comprehend the influence of psychological improvement on changes in functional outcomes. METHODS Utilizing a parallel-group randomized controlled trial design, the study involved 68 osteoarthritis patients who had recently undergone either total hip or knee arthroplasty. Subjects were split into two groups. The experimental group underwent eight VR therapy sessions during their rehabilitation, while the control group was given standard care. Assessments encompassed both psychological and functional outcomes, with tools like the Hospital Anxiety and Depression Scale, Perceived Stress Scale, and the Barthel Index, among others. The experimental group showcased notable enhancements in both psychological and functional areas compared to the control group. RESULTS A significant (p value of < 0.001) relationship was found between psychological progress and functional recovery, indicating that psychological factors can serve as predictors for functional outcomes. CONCLUSIONS The findings emphasize the promising role of VR therapy as a beneficial addition to the rehabilitation process for older adults' post-hip and knee arthroplasty. The integration of psychological interventions in standard rehabilitation practices appears valuable, but further studies are needed to ascertain the long-term advantages of such an approach.
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Affiliation(s)
- Justyna Mazurek
- University Rehabilitation Centre, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Błażej Cieślik
- Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy
| | - Adam Wrzeciono
- Faculty of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
| | - Robert Gajda
- Department of Kinesiology and Health Prevention, Jan Dlugosz University in Częstochowa, 42-200 Częstochowa, Poland
- Center for Sports Cardiology, Gajda-Med Medical Center in Pułtusk, 06-100 Pułtusk, Poland
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16
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Gavish L, Weissberger O, Barzilay Y. Gamification of Cervical Spine Physiotherapy by Virtual Reality Software: Is This Real Rehabilitation? Games Health J 2023; 12:468-471. [PMID: 37486726 DOI: 10.1089/g4h.2023.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Objective: Physical rehabilitation by virtual reality (VR) gamification is gaining acceptance. This study was designed to verify whether neck movements invoked by a fully immersive VR game environment may be physiotherapist-prescribed rehabilitation exercise. Methods: This was a single-visit prospective clinical trial (NCT03104647). Healthy participants put on VR headsets and entered a fully immersive game environment (VRPhysio, XRHealth, Tel Aviv, Israel) that prompted neck movement (flexion, extension, rotation, lateral bend, and combinations repeated twice in random order) accompanied by feedback encouraging correct performance. Four board-certified physiotherapists independently viewed videotapes recorded during the session, identified movements, and determined whether they were recommended as neck rehabilitation exercises. Results: Twenty (n = 20) participants (male-female ratio = 13:7; age = 38 ± 14 years old) completed the training session (16 movements per participant). All movements were identified correctly and determined to be appropriate for neck rehabilitation. No adverse events were reported. Conclusions: The VRPhysio software invoked movements identified by board-certified physiotherapists as appropriate for neck rehabilitation. The potential advantage of home-based VR gamification of cervical spine rehabilitation programs over common practice in motivating patient adherence warrants evaluation by randomized controlled trials.
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Affiliation(s)
- Lilach Gavish
- Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, Jerusalem, Israel
| | | | - Yair Barzilay
- Department of Orthopedic Surgery, Shaare Zedek Medical Center, Jerusalem, Israel
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17
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Carnevale A, Mannocchi I, Schena E, Carli M, Sassi MSH, Marino M, Longo UG. Performance Evaluation of an Immersive Virtual Reality Application for Rehabilitation after Arthroscopic Rotator Cuff Repair. Bioengineering (Basel) 2023; 10:1305. [PMID: 38002429 PMCID: PMC10668954 DOI: 10.3390/bioengineering10111305] [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: 09/18/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Few studies have evaluated the effectiveness of shoulder rehabilitation in virtual environments. The objective of this study was to investigate the performance of a custom virtual reality application (VR app) with a stereophotogrammetric system considered the gold standard. A custom VR app was designed considering the recommended rehabilitation exercises following arthroscopic rotator cuff repair. Following the setting of the play space, the user's arm length, and height, five healthy volunteers performed four levels of rehabilitative exercises. Results for the first and second rounds of flexion and abduction displayed low total mean absolute error values and low numbers of unmet conditions. In internal and external rotation, the number of times conditions were not met was slightly higher; this was attributed to a lack of isolated shoulder movement. Data is promising, and volunteers were able to reach goal conditions more often than not. Despite positive results, more literature comparing VR applications with gold-standard clinical parameters is necessary. Nevertheless, results contribute to a body of literature that continues to encourage the application of VR to shoulder rehabilitation programs.
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Affiliation(s)
- Arianna Carnevale
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (A.C.); (M.M.)
| | - Ilaria Mannocchi
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, Via Vito Volterra, 62, 00146 Roma, Italy; (I.M.); (M.C.); (M.S.H.S.)
| | - Emiliano Schena
- Unit of Measurement and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy;
| | - Marco Carli
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, Via Vito Volterra, 62, 00146 Roma, Italy; (I.M.); (M.C.); (M.S.H.S.)
| | - Mohamed Saifeddine Hadj Sassi
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, Via Vito Volterra, 62, 00146 Roma, Italy; (I.M.); (M.C.); (M.S.H.S.)
| | - Martina Marino
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (A.C.); (M.M.)
| | - Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, 200, 00128 Roma, Italy; (A.C.); (M.M.)
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, 21, 00128 Roma, Italy
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18
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Longo UG, Carnevale A, Andreoli F, Mannocchi I, Bravi M, Sassi MSH, Santacaterina F, Carli M, Schena E, Papalia R. Immersive virtual reality for shoulder rehabilitation: evaluation of a physical therapy program executed with oculus quest 2. BMC Musculoskelet Disord 2023; 24:859. [PMID: 37919702 PMCID: PMC10621204 DOI: 10.1186/s12891-023-06861-5] [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: 05/29/2023] [Accepted: 09/07/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Virtual Reality (VR) systems have been increasingly used across several medical fields. A crucial preliminary step for developing optimized VR-based applications for rehabilitation purposes is identifying potential interventions to meet the requirements necessary to satisfy end-users' needs. This study aims to assess the acceptability, usability, and appropriateness of a VR physical therapy program executed with Oculus Quest 2 by expert physiotherapists of shoulder musculoskeletal rehabilitation. METHODS Eleven physiotherapists were enrolled to test a VR program for shoulder musculoskeletal rehabilitation. At the end of each session, physiotherapists completed three questionnaires about the acceptability, usability, and appropriateness of the VR system and application, investigating aspects such as wearability, safety, stability, ease of control, comfort, size, utility, playability, and use mode. RESULTS The acceptability questionnaire revealed that all the physiotherapists found the VR system easy to wear and control, very confident, and safe. The usability questionnaire showed that most physiotherapists (73%) found the VR application entertaining, although only 45% said the system could be used independently by patients without the support of a therapist. Many physiotherapists found the use of the VR application appropriate for patients with rotator cuff tears treated conservatively (63.6%) or surgically (54.5%), for patients with shoulder osteoarthritis treated conservatively (72.7%), for patients with shoulder osteoarthritis after surgical treatment (63.6%). 91% of physiotherapists think it would be best for patients to use the VR system under the supervision of a therapist and not independently in a home setting. CONCLUSIONS The use of VR in orthopaedic rehabilitation is encouraging, although further efforts are needed to increase the independent use of patients without the supervision of a physiotherapist. Moreover, future studies should strive to ensure the clinical effectiveness of VR rehabilitation in reaching therapeutic goal settings.
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Affiliation(s)
- Umile Giuseppe Longo
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, Roma, 200, 00128, Italy.
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit? Campus Bio-Medico di Roma, Via Álvaro del Portillo, Roma, 21, 00128, Italy.
| | - Arianna Carnevale
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, Roma, 200, 00128, Italy
| | - Flavia Andreoli
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, Roma, 200, 00128, Italy
| | - Ilaria Mannocchi
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, Via Vito Volterra, Roma, 62, 00146, Italy
| | - Marco Bravi
- Research Unit of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, Roma, 200, 00128, Italy
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Roma, 00135, Italy
| | - Mohamed Saifeddine Hadj Sassi
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, Via Vito Volterra, Roma, 62, 00146, Italy
| | - Fabio Santacaterina
- Research Unit of Physical and Rehabilitation Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, Roma, 200, 00128, Italy
| | - Marco Carli
- Department of Industrial, Electronic and Mechanical Engineering, University of Roma Tre, Via Vito Volterra, Roma, 62, 00146, Italy
| | - Emiliano Schena
- Laboratory of Measurement and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo, Roma, 21, 00128, Italy
| | - Rocco Papalia
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo, Roma, 200, 00128, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit? Campus Bio-Medico di Roma, Via Álvaro del Portillo, Roma, 21, 00128, Italy
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19
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Chen D, Liu X, Liu Y, Wang X, Zheng J, Wu L. Virtual reality used in undergraduate orthodontic education. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023. [PMID: 37908172 DOI: 10.1111/eje.12968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023]
Abstract
INTRODUCTION Undergraduate dental students frequently have reduced clinical experience which presents a challenge for their dental education. Previously, we developed a virtual reality (VR) simulating the whole clinical treatment process of a patient with angle Class II division 1 malocclusion, and the VR also helped to explain some important orthodontic concepts. As a novel teaching tool, this study aims to compare the effects of VR versus traditional case analysis by Power Point (PPT) in inspiring student learning motivation and evaluating learning experience. MATERIALS AND METHODS A randomized, cross-over, stratified sampling method was taken to divide the fourth-year undergraduate dental students equally into two groups. The two groups were crossed over to use VR and PPT. RESULTS For the whole study, results indicated that students in the VR group showed higher learning motivation (including attention, relevance, confidence and satisfaction) than in the PPT group, but the differences between VR and PPT groups were not very big, and the median of the differences located at 0. For learning experience, students thought VR to be more useful, more enjoyable and more engaging, but the median of differences also located at 0. Notably, the majority of students had higher recommendations for VR than PPT, and the median difference located at 1. However, when the two phases were analysed separately, some items showed no significant differences between VR and PPT learning. CONCLUSION VR is a very useful adjunct to education compared to traditional case analysis by PPT, but we cannot exaggerate its benefits. Educators should make good use of VR to solve the difficult problems in education.
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Affiliation(s)
- Dongru Chen
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xiangqi Liu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Yuanbo Liu
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Xi Wang
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Jinxuan Zheng
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
| | - Liping Wu
- Department of Orthodontics, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University. Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, China
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Richlan F, Weiß M, Kastner P, Braid J. Virtual training, real effects: a narrative review on sports performance enhancement through interventions in virtual reality. Front Psychol 2023; 14:1240790. [PMID: 37928573 PMCID: PMC10622803 DOI: 10.3389/fpsyg.2023.1240790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 10/04/2023] [Indexed: 11/07/2023] Open
Abstract
The present article reports a narrative review of intervention (i.e., training) studies using Virtual Reality (VR) in sports contexts. It provides a qualitative overview and narrative summary of such studies to clarify the potential benefits of VR technology for sports performance enhancement, to extract the main characteristics of the existing studies, and to inform and guide future research. Our literature search and review eventually resulted in 12 intervention studies with a pre vs. post design focused on different sports, including target and precision sports (archery, bowling, curling, darts, golf), bat/racquet and ball sports (baseball, table tennis), goal sports (football/soccer, basketball), martial arts (karate), and sport-unspecific processes such as bodily sensations and balancing. The samples investigated in the primary studies included novice, amateur, and expert athletes (total aggregated sample size N = 493). Many studies found statistically significant effects in relevant target skills following interventions in VR, often outperforming training effects in passive or active control conditions (e.g., using conventional training protocols). Therefore, interventions in VR (or extended reality) have the potential to elicit real effects in sports performance enhancement through training of motor and psychological skills and capabilities in athletes, including perception-action skills, strategic, tactical and decision-making, responding to unexpected events, and enhancing psychological resilience and mental performance under pressure. The neurocognitive mechanisms (e.g., visual search behavior, imagery), methodological aspects (e.g., adaptive training difficulty), and the issues of real-world transfer and generalizability via which these potential sports-performance-related improvements may occur are discussed. Finally, limitations of the present review, the included studies, the current state of the field in general as well as an outlook and future perspectives for research designs and directions are taken into consideration.
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LaMarca A, Tse I, Keysor J. Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim? Healthcare (Basel) 2023; 11:2751. [PMID: 37893825 PMCID: PMC10606667 DOI: 10.3390/healthcare11202751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Chronic conditions such as stroke, Parkinson's disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care-i.e., exoskeletons, virtual/augmented reality, and remote monitoring-offer the opportunity to bring evidence-based rehabilitation into homes. Successful integration of rehabilitation techniques at home could help recovery and access and foster long term self-management. However, widespread uptake of technology in rehabilitation is still limited, leaving many technologies developed but not adopted. METHODS In this narrative review, clinical need, efficacy, and obstacles and suggestions for implementation are discussed. The use of three technologies is reviewed in the management of the most prevalent chronic diseases that utilize rehabilitation services, including common neurological, musculoskeletal, metabolic, pulmonary, and cardiac conditions. The technologies are (i) exoskeletons, (ii) virtual and augmented reality, and (iii) remote monitoring. RESULTS Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes. CONCLUSION While rehabilitation technologies bring opportunities to bridge the gap between clinics and homes, there are many challenges with adoption. Hybrid effectiveness and implementation trials are a possible path to successful technology development and adoption.
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Affiliation(s)
- Amber LaMarca
- Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA 02129, USA;
| | - Ivy Tse
- Doctor of Physical Therapy Program, MGH Institute of Health Professions, Boston, MA 02129, USA
| | - Julie Keysor
- School of Health Care Leadership, MGH Institute of Health Professions, Boston, MA 02129, USA
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Thoomes E, Cleland JA, Falla D, de Pauw R, Maissan F, de Graaf M. Measurement properties of a computer adaptive device, the Senscoordination 3D Cervical Trainer, to assess cervical range of motion in people with neck pain. Musculoskelet Sci Pract 2023; 67:102861. [PMID: 37757582 DOI: 10.1016/j.msksp.2023.102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Clinicians commonly assess cervical range of motion (ROM) in patients with neck pain. Recently, a new instrument has been developed, the Senscoordination 3D Cervical Trainer (SCT), designed to measure neck ROM in addition to joint position error, static and dynamic balance performance, and performance on a 'neuro muscular control test'. This study aims to assess the interrater reliability, concurrent validity, and responsiveness of the SCT using the CROM device as a comparator. METHODS One hundred patients with non-specific neck pain were included and their active cervical ROM was measured in a random order by two raters in succession using both devices simultaneously at baseline and after personalised physiotherapy management, at 12 week follow up. Convergent validity and responsiveness were quantified by a Pearson correlation coefficient. The intraclass correlation coefficient (ICC) was used to calculate the test-retest reliability of the SCT. The smallest detectable change (SDC) was calculated per movement direction and for the total range of motion. RESULTS The correlation between the measures obtained with the CROM device and the SCT was high (0.97 or 0.98 depending on direction of movement). Interrater reliability was high for all directions (ICC ranging from 0.81 to 0.97). The SDC ranged from 6.9 for left cervical rotation to 12.2 for right cervical rotation. At the follow up, correlation between the change score on the CROM device and the SCT was high (0.86-0.94 depending on the direction of movement). CONCLUSION The SCT is a valid, reliable and responsive instrument for measuring cervical ROM.
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Affiliation(s)
- Erik Thoomes
- Fysio-Experts, Research Department, Hazerswoude, the Netherlands; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom.
| | - Joshua A Cleland
- Department of Physical Therapy, Tufts University School of Medicine, Boston, MA, USA
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom
| | - Robby de Pauw
- Department of Manual Therapy, Breederode University of Applied Science, Rotterdam, the Netherlands; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Francois Maissan
- Research Group Lifestyle and Health, HU University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Marloes de Graaf
- Fysio-Experts, Research Department, Hazerswoude, the Netherlands; Department of Manual Therapy, Breederode University of Applied Science, Rotterdam, the Netherlands
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Afzal MW, Ahmad A, Hanif HMB, Chaudhary N, Gilani SA. Effects of Virtual Reality Exercises on Chronic Low Back Pain: Quasi-Experimental Study. JMIR Rehabil Assist Technol 2023; 10:e43985. [PMID: 37713252 PMCID: PMC10541639 DOI: 10.2196/43985] [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: 11/01/2022] [Revised: 04/15/2023] [Accepted: 08/15/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Low back pain is a common health problem globally. Based on the duration of pain, it is classified as acute, subacute, or chronic low back pain. Different treatment strategies are available to reduce chronic low back pain. Virtual reality (VR) is a novel approach in back pain rehabilitation. OBJECTIVE This study aimed to compare the effects of VR games on chronic low back pain. METHODS This quasi-experimental study was conducted among 40 patients with chronic low back pain. The data were collected using a nonprobability, convenient sampling technique. Patients visiting the Department of Physiotherapy, Government Services Hospital, Lahore, Pakistan, were recruited and equally divided into 4 groups. Group A received the Reflex Ridge game; group B received the Body Ball game; group C combined the 2 games without back-strengthening exercises; and group D combined the 2 games with back-strengthening exercises. The participants received 8 treatment sessions, with 3 sessions/wk. The outcomes were pre- and posttest measurements of pain intensity, low back disability, and lumbar range of motion. The repeated measurement ANOVA was used for inter- and intragroup comparison, with significance at P≤.05. RESULTS The study comprised a sample of 40 patients with low back pain; 12 (40%) were female and 28 (60%) were male, with a mean age of 37.85 (SD 12.15) years. The pre- and posttest mean pain scores were 7.60 (SD 1.84) and 4.20 (SD 1.62) in group A, 6.60 (SD 1.776) and 5.90 (SD 1.73) in group B, 6.90 (SD 1.73) and 5.40 (SD 1.07) in group C, and 7.10 (SD 1.53) and 3.60 (SD 0.97) in group D, respectively. The mean pain score differences of group D (combining the Reflex Ridge and Body Ball games with back-strengthening exercises) compared to groups A, B, and C were -.60 (P=.76), -2.30 (P<.001), and -1.80 (P=.03), respectively. Regarding the range of motion, the forward lumbar flexion mean differences of group D compared to groups A, B, and C were 3.80 (P=.21), 4.80 (P=.07), and 7.40 (P<.001), respectively. Similarly, the right lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P=.04), 5.20 (P<.001), and 4.80 (P<.001), respectively. The left lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P<.001), 4.80 (P=.02), and 2.20 (P<.001). respectively, showing significant pre- and posttreatment effects. CONCLUSIONS VR exercises had statistically significant effects on improving pain, low back disability, and range of motion in all groups, but the combination of Reflex Ridge and Body Ball games with back-strengthening exercises had dominant effects compared to the other groups. TRIAL REGISTRATION Iranian Registry of Clinical Trial IRCT20200330046895N1; https://en.irct.ir/trial/46916.
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Affiliation(s)
- M Waqar Afzal
- Department of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Ashfaq Ahmad
- Department of Physical Therapy, University of Lahore, Lahore, Pakistan
| | | | - Nauman Chaudhary
- Department of Public Health, Institute of Social & Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Syed Amir Gilani
- Faculty of Allied Health Sciences, University of Lahore, Lahore, Pakistan
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García-López FJ, Pastora-Bernal JM, Moreno-Morales N, Estebanez-Pérez MJ, Liñán-González A, Martín-Valero R. Virtual reality to improve low-back pain and pelvic pain during pregnancy: a pilot RCT for a multicenter randomized controlled trial. Front Med (Lausanne) 2023; 10:1206799. [PMID: 37731709 PMCID: PMC10507341 DOI: 10.3389/fmed.2023.1206799] [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: 04/16/2023] [Accepted: 08/14/2023] [Indexed: 09/22/2023] Open
Abstract
A significant proportion of women experience low back and pelvic pain during and after pregnancy, which can negatively impact their daily lives. Various factors are attributed to these complaints, and many affected women do not receive adequate healthcare. However, there is evidence to support the use of different physiotherapeutic interventions to alleviate these conditions. Virtual reality is a promising complementary treatment to physiotherapy, particularly in improving pain perception and avoidance. The primary objective of this study is to evaluate the efficacy of a four-week program combining VR and physiotherapy compared to standard physiotherapy in pregnant women with low back and pelvic pain, in terms of improving pain avoidance, intensity, disability, and functional level. The study also aims to investigate patient satisfaction with the VR intervention. This research will be conducted through a multi-center randomized controlled clinical trial involving pregnant patients residing in the provinces of Seville and Malaga with a diagnosis of low back and pelvic pain during pregnancy. The alternative hypothesis is that the implementation of a Virtual Reality program in combination with standard physiotherapy will result in better clinical outcomes compared to the current standard intervention, which could lead to the development of new policies and interventions for these pathologies and their consequences. Clinical trial registration: clinicaltrials.gov, identifier NCT05571358.
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Affiliation(s)
| | | | - Noelia Moreno-Morales
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
| | - María-José Estebanez-Pérez
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
- Department of Physiotherapy, Faculty of Health Science, Campus of Melilla, University of Granada, Melilla, Spain
| | - Antonio Liñán-González
- Department of Nursing, Faculty of Health Science, Campus of Melilla, University of Granada, Melilla, Spain
| | - Rocío Martín-Valero
- Department of Physiotherapy, Faculty of Health Science, University of Malaga, Malaga, Spain
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Luca A, Giorgino R. Augmented and virtual reality in spine surgery. J Orthop 2023; 43:30-35. [PMID: 37555206 PMCID: PMC10405158 DOI: 10.1016/j.jor.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 08/10/2023] Open
Abstract
Augmented Reality (AR) and Virtual Reality (VR) have developed unprecedentedly in recent years, providing interesting opportunities for medical applications. Their integration into clinical assessment, surgical workflow, and training has shown tremendous potential to improve daily life activity in spine surgery. The paper explores the utilization of VR and AR in spine surgery, with their applications, benefits, challenges, and forthcoming prospects.
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Affiliation(s)
- Andrea Luca
- Spine Unit III, IRCSS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Riccardo Giorgino
- Residency Program in Orthopaedics and Traumatology, University of Milan, 20141, Milan, Italy
- IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy
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Bilika P, Karampatsou N, Stavrakakis G, Paliouras A, Theodorakis Y, Strimpakos N, Kapreli E. Virtual Reality-Based Exercise Therapy for Patients with Chronic Musculoskeletal Pain: A Scoping Review. Healthcare (Basel) 2023; 11:2412. [PMID: 37685446 PMCID: PMC10487144 DOI: 10.3390/healthcare11172412] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/10/2023] Open
Abstract
This scoping review aimed to identify interventions utilizing virtual-reality-based exercise therapy in patients with chronic musculoskeletal pain. Searches were conducted in four databases using descriptors related to virtual reality, exercise, and chronic musculoskeletal pain. Two reviewers screened the titles and abstracts of the studies to assess eligibility, with a third author resolving any discrepancies. Data were extracted and summarized in a narrative format by three independent raters. Clinical trials were evaluated using the PEDro scale to assess the effectiveness of virtual-reality-based exercise therapy in chronic musculoskeletal pain patients. A total of 162 articles were identified from the databases. After applying the inclusion criteria, nine articles were considered suitable for analysis, including six randomized clinical trials. The selected articles were categorized based on study characteristics, virtual-reality-based exercise therapy interventions (including technologies and equipment used), exercise interventions, outcome measures, and effectiveness. The findings indicate that virtual-reality-based exercise therapy shows promising results in reducing pain, improving disability, enhancing range of motion, and increasing treatment satisfaction in patients with chronic musculoskeletal pain. However, it is not possible to conclude that virtual-reality-based exercise therapy is superior to other treatments due to the limited number of available studies, heterogeneity in application protocols, and varying methodological quality. Further research is needed to draw more definitive conclusions.
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Affiliation(s)
- Paraskevi Bilika
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece (G.S.); (A.P.); (E.K.)
| | - Natalia Karampatsou
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece (G.S.); (A.P.); (E.K.)
| | - Giorgos Stavrakakis
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece (G.S.); (A.P.); (E.K.)
| | - Achilleas Paliouras
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece (G.S.); (A.P.); (E.K.)
| | - Yannis Theodorakis
- Exercise Psychology & Quality of Life Research Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Nikolaos Strimpakos
- Health Assessment and Quality of Life Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece
- Division of Musculoskeletal & Dermatological Sciences, Honorary Research Associate, University of Manchester, Manchester M13 9PL, UK
| | - Eleni Kapreli
- Clinical Exercise Physiology and Rehabilitation Research Laboratory, Physiotherapy Department, Faculty of Health Sciences, University of Thessaly, 35100 Lamia, Greece (G.S.); (A.P.); (E.K.)
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Favre J, Cantaloube A, Jolles BM. Rehabilitation for Musculoskeletal Disorders: The Emergence of Serious Games and the Promise of Personalized Versions Using Artificial Intelligence. J Clin Med 2023; 12:5310. [PMID: 37629350 PMCID: PMC10455669 DOI: 10.3390/jcm12165310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
According to the World Health Organization (WHO), musculoskeletal conditions are among the most common health problems, affecting approximately 1 [...].
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Affiliation(s)
- Julien Favre
- Swiss BioMotion Lab, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland
- The Sense Innovation and Research Center, CH-1007 Lausanne, Switzerland
| | - Alexis Cantaloube
- Swiss BioMotion Lab, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland
| | - Brigitte M. Jolles
- Swiss BioMotion Lab, Lausanne University Hospital, University of Lausanne (CHUV-UNIL), CH-1011 Lausanne, Switzerland
- Institute of Electrical and Micro Engineering, Ecole Polytechnique Fédérale Lausanne (EPFL), CH-1015 Lausanne, Switzerland
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28
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Kato N, Iuchi T, Murabayashi K, Tanaka T. Comparison of Smoothness, Movement Speed and Trajectory during Reaching Movements in Real and Virtual Spaces Using a Head-Mounted Display. Life (Basel) 2023; 13:1618. [PMID: 37629476 PMCID: PMC10456102 DOI: 10.3390/life13081618] [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: 06/21/2023] [Revised: 07/11/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
Virtual reality is used in rehabilitation and training simulators. However, whether movements in real and virtual spaces are similar is yet to be elucidated. The study aimed to examine the smoothness, trajectory, and velocity of participants' movements during task performance in real and virtual space. Ten participants performed the same motor task in these two spaces, reaching for targets placed at six distinct positions. A head-mounted display (HMD) presented the virtual space, which simulated the real space environment. The smoothness of movements during the task was quantified and analysed using normalised jerk cost. Trajectories were analysed using the actual trajectory length normalised by the shortest distance to the target, and velocity was analysed using the time of peak velocity. The analysis results showed no significant differences in smoothness and peak velocity time between the two spaces. No significant differences were found in the placement of the six targets between the two spaces. Conversely, significant differences were observed in trajectory length ratio and peak velocity time, albeit with small effect sizes. This outcome can potentially be attributed to the fact that the virtual space was presented from a first-person perspective using an HMD capable of presenting stereoscopic images through binocular parallax. Participants were able to obtain physiological depth information and directly perceive the distance between the target and the effector, such as a hand or a controller, in virtual space, similar to real space. The results suggest that training in virtual space using HMDs with binocular disparity may be a useful tool, as it allows the simulation of a variety of different environments.
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Affiliation(s)
- Norio Kato
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Sapporo 006-8585, Japan
| | - Tomoya Iuchi
- Shin-Sapporo Orthopaedic Hospital, Sapporo 004-0051, Japan;
| | - Katsunobu Murabayashi
- Division of Rehabilitation Sciences, Graduate School of Health Sciences, Hokkaido University of Science, Sapporo 006-8585, Japan;
- Sapporo Keijinkai Rehabilitation Hospital, Sapporo 060-0010, Japan
| | - Toshiaki Tanaka
- Department of Physical Therapy, Faculty of Health Sciences, Hokkaido University of Science, Sapporo 006-8585, Japan
- The Research Center for Advanced Science and Technology, Institute of Gerontology, The University of Tokyo, Tokyo 113-8656, Japan;
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29
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Willwacher S, Robbin J, Eßer T, Mai P. [Motion analysis systems in research and for practicing orthopedists]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04404-3. [PMID: 37391676 DOI: 10.1007/s00132-023-04404-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Complex biomechanical motion analysis can provide relevant information for a variety of orthopedic problems. When purchasing motion analysis systems, in addition to the classical measurement quality criteria (validity, reliability, objectivity), spatial and temporal conditions, as well as the requirements for the qualification of the measuring personnel should be considered. APPLICATION In complex movement analysis, systems are used to determine kinematics, kinetics and muscle activity (electromyography). This article gives an overview of methods of complex biomechanical motion analysis for use in orthopaedic research or for individual patient care. In addition to the use for pure movement analysis, the use of movement analysis methods in the field of biofeedback training is discussed. ACQUISITION For the specific acquisition of motion analysis systems, it is recommended to contact professional societies (e.g., the German Society for Biomechanics),universities with existing motion analysis facilities or distributors in the field of biomechanics.
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Affiliation(s)
- Steffen Willwacher
- Institute for Advanced Biomechanics and Motion Studies, Hochschule Offenburg, Max-Planck-Str. 1, 77656, Offenburg, Deutschland.
| | - Johanna Robbin
- Institute for Advanced Biomechanics and Motion Studies, Hochschule Offenburg, Max-Planck-Str. 1, 77656, Offenburg, Deutschland
| | - Tanja Eßer
- Institut für Funktionelle Diagnostik, Köln, Deutschland, Im Mediapark 2, 50670
| | - Patrick Mai
- Institute for Advanced Biomechanics and Motion Studies, Hochschule Offenburg, Max-Planck-Str. 1, 77656, Offenburg, Deutschland
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Hernandez R, Wilund K, Solai K, Tamayo D, Fast D, Venkatesan P, Lash JP, Lora CM, Martinez L, Martin Alemañy G, Martinez A, Kwon S, Romero D, Browning MHEM, Moskowitz JT. Positive Psychological Intervention Delivered Using Virtual Reality in Patients on Hemodialysis With Comorbid Depression: Protocol and Design for the Joviality Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e45100. [PMID: 37327026 DOI: 10.2196/45100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Depression is highly prevalent in individuals on hemodialysis, but it is infrequently identified and remains undertreated. In this paper, we present details of the methodology of a randomized controlled trial (RCT) aimed at testing the feasibility and preliminary efficacy of a 5-week positive psychological intervention in individuals on hemodialysis with comorbid depression delivered using immersive virtual reality (VR) technology. OBJECTIVE We aim to describe the protocol and design of the Joviality trial whose main objectives are 2-fold: determine the feasibility of the Joviality VR software through metrics capturing rates of recruitment, refusal, retention, noncompliance, and adherence, as well as end-user feedback; and assess preliminary efficacy for outcomes measures of depressive symptoms, psychological well-being and distress, quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalizations. METHODS This 2-arm RCT is scheduled to enroll 84 individuals on hemodialysis with comorbid depression from multiple outpatient centers in Chicago, Illinois, United States. Enrollees will be randomized to the following groups: VR-based Joviality positive psychological intervention or sham VR (2D wildlife footage and nature-based settings with inert music presented using a head-mounted display). To be eligible, individuals must be on hemodialysis for at least 3 months, have Beck Depression Inventory-II scores of ≥11 (ie, indicative of mild-to-severe depressive symptoms), be aged ≥21 years, and be fluent in English or Spanish. The Joviality VR software was built using agile design principles and incorporates fully immersive content, digital avatars, and multiplex features of interactability. Targeted skills of the intervention include noticing positive events, positive reappraisal, gratitude, acts of kindness, and mindful or nonjudgmental awareness. The primary outcomes include metrics of feasibility and acceptability, along with preliminary efficacy focused on decreasing symptoms of depression. The secondary and tertiary outcomes include quality of life, treatment adherence, clinical biomarkers, and all-cause hospitalization rates. There are 4 assessment time points: baseline, immediately after the intervention, 3 months after the intervention, and 6 months after the intervention. We hypothesize that depressive symptoms and hemodialysis-related markers of disease will substantially improve in participants randomized to the VR-based Joviality positive psychology treatment arm compared with those in the attention control condition. RESULTS This RCT is funded by the National Institute of Diabetes and Digestive and Kidney Diseases and is scheduled to commence participant recruitment in June 2023. CONCLUSIONS This trial will be the first to test custom-built VR software to deliver a positive psychological intervention, chairside, in individuals on hemodialysis to reduce symptoms of depression. Within the context of an RCT using an active control arm, if proven effective, VR technology may become a potent tool to deliver mental health programming in clinical populations during their outpatient treatment sessions. TRIAL REGISTRATION ClinicalTrials.gov NCT05642364; https://clinicaltrials.gov/ct2/show/NCT05642364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/45100.
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Affiliation(s)
- Rosalba Hernandez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Ken Wilund
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Killivalavan Solai
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - David Tamayo
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Drew Fast
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - Prasakthi Venkatesan
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana Champaign, Urbana, IL, United States
| | - James P Lash
- Division of Nephrology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Claudia M Lora
- Division of Nephrology, College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Lizet Martinez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Geovana Martin Alemañy
- Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Angela Martinez
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Soonhyung Kwon
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Dana Romero
- Department of Population Health Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Matthew H E M Browning
- Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Wolf MA, Kosmalla F, Landgraeber S. [Digital tools in musculoskeletal rehabilitation]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04392-4. [PMID: 37289215 DOI: 10.1007/s00132-023-04392-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/09/2023]
Abstract
The demographic transition in combination with the increasing demands of society and a growing shortage of skilled workers are leading to a shortage of care in musculoskeletal rehabilitation, especially in times of the pandemic. Digital interventions represent an opportunity to reintegrate patients with musculoskeletal dysfunctions into everyday life. The changes to the legal basis enable physicians and therapists to support the rehabilitation of their patients with reimbursable apps and digital applications and to permanently integrate learned skills into their daily lives. Telerehabilitation technologies, apps, telerobotics and mixed reality offer the opportunity to complement and optimize existing care structures and to redesign specialized therapeutic home visits with modern technology in a new and contemporary way.
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Affiliation(s)
- Milan Anton Wolf
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str. 100, Homburg, Deutschland.
| | - Felix Kosmalla
- Saarland Informatics Campus, Deutsches Forschungszentrum für Künstliche Intelligenz (DFKI), Saarbrücken, Deutschland
| | - Stefan Landgraeber
- Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsklinikum des Saarlandes, Kirrberger Str. 100, Homburg, Deutschland
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Jang S, Lee B, Lee E, Kim J, Lee JI, Lim JY, Hwang JH, Jang S. A Systematic Review and Meta-Analysis of the Effects of Rehabilitation Using Digital Healthcare on Musculoskeletal Pain and Quality of Life. J Pain Res 2023; 16:1877-1894. [PMID: 37284324 PMCID: PMC10239626 DOI: 10.2147/jpr.s388757] [Citation(s) in RCA: 1] [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: 09/05/2022] [Accepted: 05/05/2023] [Indexed: 06/08/2023] Open
Abstract
Rehabilitation using digital healthcare (DHC) has the potential to enhance the effectiveness of treatment for musculoskeletal disorders (MSDs) and associated pain by improving patient outcomes, while being cost-effective, safe, and measurable. This systematic review and meta-analysis aimed to evaluate the effectiveness of musculoskeletal rehabilitation using DHC. We searched PubMed, Ovid-Embase, Cochrane Library, and PEDro Physiotherapy Evidence Database from inception to October 28, 2022 for controlled clinical trials comparing DHC to conventional rehabilitation. We used a random-effects model for the meta-analysis, pooling the effects of DHC on pain and quality of life (QoL) by calculating standardized mean differences (SMDs) with 95% confidence intervals (CIs) between DHC rehabilitation and conventional rehabilitation (control). Fifty-four studies with 6240 participants met the inclusion criteria. The sample size ranged from 26 to 461, and the average age of the participants ranged from 21.9 to 71.8 years. The majority of the included studies focused on knee or hip joint MSD (n = 23), and the most frequently utilized DHC interventions were mobile applications (n = 26) and virtual or augmented reality (n = 16). Our meta-analysis of pain (n = 45) revealed that pain reduction was greater in DHC rehabilitation than in conventional rehabilitation (SMD: -0.55, 95% CI: -0.74, -0.36), indicating that rehabilitation using DHC has the potential to ameliorate MSD pain. Furthermore, DHC significantly improved health-related QoL and disease-specific QoL (SMD: 0.66, 95% CI: 0.29, 1.03; SMD: -0.44, 95% CI: -0.87, -0.01) compared to conventional rehabilitation. Our findings suggest that DHC offers a practical and flexible rehabilitation alternative for both patients with MSD and healthcare professionals. Nevertheless, further researches are needed to elucidate the underlying mechanisms by which DHC affects patient-reported outcomes, which may vary depending on the type and design of the DHC intervention.
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Affiliation(s)
- Suhyun Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea
| | - Boram Lee
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Eunji Lee
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea
| | - Jungbin Kim
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea
| | - Jong In Lee
- Department of Rehabilitation Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Republic of Korea
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Arroyo-Cruz G, Orozco-Varo A, Domínguez-Cardoso P, Árbol-Carrero AB, Jiménez-Castellanos E. FitJaw Mobile, a virtual reality device applied to dentistry: An analysis based on two patient treatments. J Prosthet Dent 2023:S0022-3913(23)00274-3. [PMID: 37236885 DOI: 10.1016/j.prosdent.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023]
Abstract
STATEMENT OF PROBLEM Virtual reality (VR) has improved significantly in the last decade and has been applied to different fields, including medicine, dentistry, and physiotherapy. VR has been used for the innovative treatment of painful conditions, especially when traditional exercise therapies were unsuccessful because of patient noncompliance. PURPOSE The purpose of this study was to analyze the use of VR as an aid when using exercises to manage temporomandibular disorders (TMDs). MATERIAL AND METHODS Two White women diagnosed with TMDs of muscular origin (one with muscular pain and the other with reduced mouth opening) were referred to the Department of Prosthodontics of the University of Seville, where they were enrolled in an exercise program using the VR software program FitJaw Mobile. Both had been treated the previous year with an occlusal device for TMD of muscular origin, but their symptoms had not improved. RESULTS For both patients, the functional movement limitation and the chronic pain improved noticeably. CONCLUSIONS The use of VR when doing jaw exercises can improve outcomes and compliance.
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Affiliation(s)
- Gema Arroyo-Cruz
- Assistant Professor, Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain
| | - Ana Orozco-Varo
- Assistant Professor, Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain.
| | - Pablo Domínguez-Cardoso
- Assistant Professor, Department of Stomatology, School of Dentistry, University of Seville, Seville, Spain
| | - Ana Belén Árbol-Carrero
- Graduate student, Graduate Physiotherapy, School of Physiotherapy, University of Seville, Seville, Spain; Private practice, Seville, Spain
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Hao J, Chen Z, Remis A, He Z. Virtual Reality-Based Rehabilitation to Restore Motor Function in People With Amputation: A Systematic Literature Review. Am J Phys Med Rehabil 2023; 102:468-474. [PMID: 36730652 DOI: 10.1097/phm.0000000000002150] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Virtual reality is an emerging technology with accumulating research and clinical evidence in the field of physical rehabilitation. This study aimed to systematically identify and examine the effects of virtual reality on motor function outcomes in patients with amputation to inform clinical decision making on amputation rehabilitation and inform further research endeavors. Five databases were searched, including PubMed, CINAHL, PsycINFO, Embase, and Scopus. After screening for 1052 records, 10 clinical studies were included in this review: four randomized controlled trials, three pre-post single-arm studies, and three case studies; all studies had fair to good methodological quality. Seven studies were for lower extremity amputation, and three were for upper extremity amputation. Results reveal the positive effects of virtual reality on improving motor function in prosthesis training, including balance, gait, and upper extremity outcomes. Participants also report enjoyment during virtual reality intervention as measured by subjective experience. However, it is unclear whether virtual reality can induce better therapeutic outcomes than conventional rehabilitation, given the limited number of controlled studies and conflicting results reported in the included studies. More properly designed randomized controlled trials with adequately powered sample sizes are warranted to elucidate the benefits of virtual reality-based rehabilitation in the amputation population.
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Affiliation(s)
- Jie Hao
- From the College of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska (JH); School of Basic Medical Sciences, Capital Medical University, Beijing, China (ZC); Gate Parkway Primary Care Center, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Jacksonville, Florida (AR); and Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland (ZH)
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Guerra-Armas J, Flores-Cortes M, Pineda-Galan C, Luque-Suarez A, La Touche R. Role of Immersive Virtual Reality in Motor Behaviour Decision-Making in Chronic Pain Patients. Brain Sci 2023; 13:brainsci13040617. [PMID: 37190582 DOI: 10.3390/brainsci13040617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/31/2023] [Accepted: 04/03/2023] [Indexed: 05/17/2023] Open
Abstract
Primary chronic pain is a major contributor to disability worldwide, with an estimated prevalence of 20-33% of the world's population. The high socio-economic impact of musculoskeletal pain justifies seeking an appropriate therapeutic strategy. Immersive virtual reality (VR) has been proposed as a first-line intervention for chronic musculoskeletal pain. However, the growing literature has not been accompanied by substantial progress in understanding how VR exerts its impact on the pain experience and what neurophysiological mechanisms might be involved in the clinical effectiveness of virtual reality interventions in chronic pain patients. The aim of this review is: (i) to establish the state of the art on the effects of VR on patients with chronic pain; (ii) to identify neuroplastic changes associated with chronic pain that may be targeted by VR intervention; and (iii) to propose a hypothesis on how immersive virtual reality could modify motor behavioral decision-making through an interactive experience in patients with chronic pain.
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Affiliation(s)
- Javier Guerra-Armas
- Faculty of Health Sciences, Universidad Las Palmas de Gran Canaria (ULPGC), 35016 Las Palmas, Spain
| | - Mar Flores-Cortes
- Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
| | | | - Alejandro Luque-Suarez
- Faculty of Health Sciences, Universidad de Malaga, 29071 Malaga, Spain
- Instituto de la Investigacion Biomedica de Malaga (IBIMA), 29071 Malaga, Spain
| | - Roy La Touche
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Sciences of the Movement (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, 28023 Madrid, Spain
- Instituto de Dolor Craneofacial y Neuromusculoesquelético (INDCRAN), 28008 Madrid, Spain
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Lier EJ, de Vries M, Steggink EM, Ten Broek RPG, van Goor H. Effect modifiers of virtual reality in pain management: a systematic review and meta-regression analysis. Pain 2023:00006396-990000000-00268. [PMID: 36943251 DOI: 10.1097/j.pain.0000000000002883] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 01/10/2023] [Indexed: 03/23/2023]
Abstract
ABSTRACT There is a rapidly growing body of evidence for the application of virtual reality (VR) in pain management, however, with varying effectiveness. Little is known about patient-related and VR-related factors affecting efficacy of VR. A systematic review and meta-analysis was performed including 122 randomised controlled trials (9138 patients), reporting on subjectively reported pain scores comparing an immersive VR intervention to a non-VR control group. Virtual reality significantly reduced pain in the pooled analysis (standardized mean difference = -0.65, 95% CI -0.76 to -0.54, P < 0.001). Subgroup analyses showed no significant differences between type of pain, ie, VR effects were similar in acute, chronic, and procedural pain conditions. Univariate and multivariate meta-regression analyses were performed to investigate the effect of intervention, patient, and pain characteristics on VR. Virtual reality effectively reduced pain, especially in patients reporting moderate to severe pain and in younger subjects. Studies comparing VR with a control group receiving no distraction methods were associated with higher effect sizes. The effect of VR was not related to a specific frequency or duration of use. Type of software and interaction level were related to VR effects in the univariable, but not in the multivariable, meta-regression analysis. Heterogeneity was considerable for all meta-analyses, and risk of bias was moderate to high in most included studies. Studies on mechanisms behind VR analgesia in younger patients and patients reporting moderate to severe pain are recommended to confirm our hypotheses while taking into account risk of bias and the comparator. Optimal application of VR using treatment modules for long-term pain conditions are an important issue for future research.
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Affiliation(s)
- Elisabeth J Lier
- Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
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Cioeta M, Pournajaf S, Goffredo M, Giovannico G, Franceschini M. Improving Adherence to a Home Rehabilitation Plan for Chronic Neck Pain through Immersive Virtual Reality: A Case Report. J Clin Med 2023; 12:jcm12051926. [PMID: 36902713 PMCID: PMC10003452 DOI: 10.3390/jcm12051926] [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: 01/20/2023] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Idiopathic chronic neck pain is a highly disabling musculoskeletal condition. Immersive virtual reality shows a promising efficacy in the treatment of chronic cervical pain through the mechanism of distraction from the pain. This case report describes the management of C.F., a fifty-seven-year-old woman, who suffered from neck pain for fifteen months. She had already undergone a cycle of physiotherapy treatments including education, manual therapy, and exercises, following international guidelines. The patient's poor compliance did not allow adherence to the exercise's prescription. Home exercise training through virtual reality was therefore proposed to the patient to improve her adherence to the treatment plan. The personalization of the treatment allowed the patient to resolve in a short time period her problem and return to live with her family peacefully.
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Affiliation(s)
- Matteo Cioeta
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Sanaz Pournajaf
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Correspondence: (S.P.); (M.G.)
| | - Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Correspondence: (S.P.); (M.G.)
| | - Giuseppe Giovannico
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Marco Franceschini
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, 000163 Rome, Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, 00166 Rome, Italy
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Choi T, Heo S, Choi W, Lee S. A Systematic Review and Meta-Analysis of the Effectiveness of Virtual Reality-Based Rehabilitation Therapy on Reducing the Degree of Pain Experienced by Individuals with Low Back Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3502. [PMID: 36834197 PMCID: PMC9958662 DOI: 10.3390/ijerph20043502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND The concept of virtual reality (VR)-based rehabilitation therapy for treating people with low back pain is of growing research interest. However, the effectiveness of such therapy for pain reduction in clinical settings remains controversial. METHODS The present study was conducted according to the reporting guidelines presented in the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. We searched the PubMed, Embase, CENTRAL, and ProQuest databases for both published and unpublished papers. The Cochrane risk of bias tool (version 2) was used to evaluate the quality of the selected studies. GRADEprofiler software (version 3.6.4) was used to evaluate the level of evidence. We analyzed the included research results using RevMan software (version 5.4.1). RESULTS We included a total of 11 articles in the systematic review and meta-analysis, with a total of 1761 subjects. Having assessed the quality of these studies, the risk of bias was generally low with high heterogeneity. The results revealed a small to medium effect (standardized mean difference = ±0.37, 95% confidence interval: 0.75 to 0) based on evidence of moderate overall quality. CONCLUSION There is evidence that treatment using VR improves patients' pain. The effect size was small to medium, with the studies presenting evidence of moderate overall quality. VR-based treatment can reduce pain; therefore, it may help in rehabilitation therapy.
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Affiliation(s)
- Taeseok Choi
- Department of Physical Therapy, Howon University, Gunsan 54058, Republic of Korea
| | - Seoyoon Heo
- Department of Occupational Therapy, Kyungbok University, Namyangju 11138, Republic of Korea
| | - Wansuk Choi
- Department of Physical Therapy, International University of Korea, Jinju 17731, Republic of Korea
| | - Sangbin Lee
- Department of Physical Therapy, Namseoul University, Cheonan 31020, Republic of Korea
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Kantha P, Lin JJ, Hsu WL. The Effects of Interactive Virtual Reality in Patients with Chronic Musculoskeletal Disorders: A Systematic Review and Meta-Analysis. Games Health J 2023; 12:1-12. [PMID: 36706260 DOI: 10.1089/g4h.2022.0088] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Objective: Interactive virtual reality (iVR) has been widely used for treatment purposes in patients with chronic musculoskeletal disorders. However, no consensus has been reached on the effects of iVR on pain, psychological distress, and functional disability. Therefore, this study aims to investigate the effects of iVR on pain, psychological distress, and functional disability in patients with chronic musculoskeletal disorders compared with no rehabilitation and conventional rehabilitation. Methods: Five electronic databases (PubMed, Cochrane CENTRAL, Scopus, EMBASE, and Web of Science) were searched from January 2016 to December 2021. All randomized controlled trials using iVR for treating pain, psychological distress, and functional disability in patients with chronic musculoskeletal disorders were included. A subgroup analysis was conducted to compare the effects of nonimmersive and immersive types of iVR on the outcomes of interest. Results: Our study provides good quality evidence that iVR reduced overall pain by 9.28 points as compared with no rehabilitation and by 8.09 points as compared with conventional rehabilitation. In the subgroup analysis, nonimmersive iVR showed a reduction in psychological distress (standardized mean differences = -0.35) as compared with no rehabilitation. However, no statistically significant difference in the outcomes existed between nonimmersive and immersive iVR. Furthermore, there were no statistically significant differences in the outcomes of functional disability. Conclusions: iVR is recommended for reducing pain intensity more than no rehabilitation or conventional rehabilitation. Meanwhile, nonimmersive iVR has been proposed for psychological distress improvement, with effects similar to those of conventional rehabilitation. However, iVR may not be an effective intervention in the case of functional disability.
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Affiliation(s)
- Phunsuk Kantha
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jiu-Jenq Lin
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Wei-Li Hsu
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Physical Therapy Center, National Taiwan University Hospital, Taipei, Taiwan
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Hao J, Li Y, Swanson R, Chen Z, Siu KC. Effects of virtual reality on physical, cognitive, and psychological outcomes in cancer rehabilitation: a systematic review and meta-analysis. Support Care Cancer 2023; 31:112. [PMID: 36633695 DOI: 10.1007/s00520-022-07568-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE To systematically examine and summarize the current evidence regarding the effects of virtual reality (VR) on physical, cognitive, and psychological outcomes in cancer rehabilitation. METHODS Six bioscience and engineering databases were searched. Two independent reviewers screened the titles and abstracts of 2397 records and retrieved 25 full-text articles. Inclusion criteria included patients with a current or previous diagnosis of cancer; VR was used as an intervention for physical, cognitive, or psychological impairments and functional limitations; and clinical trials with at least two arms and with both pre- and post-intervention assessments. Reviewers assessed methodological quality using the Physiotherapy Evidence Database scale. RESULTS Seventeen studies including 799 patients with cancer were identified. Within-group pooled analysis indicated that patients demonstrated significant improvement in pain (P < 0.001), fatigue (P < 0.001), anxiety (P < 0.001), upper extremity function (P < 0.001), and quality of life (P = 0.008) after VR intervention. Between-group pooled analysis indicated significant improvements with VR in pain (P = 0.004), anxiety (P < 0.001), and upper extremity function (P < 0.001) compared with the control. Three studies reported the positive effects of VR on cognition. CONCLUSIONS VR demonstrates promising effects in physical, cognitive, and psychological aspects of patients with cancer. VR can be incorporated into a comprehensive cancer rehabilitation program to alleviate impairments and functional limitations.
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Affiliation(s)
- Jie Hao
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA
| | - Yanfei Li
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA
| | - Rebecca Swanson
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, College of Medicine, University of Nebraska Medical Center, Omaha, NE, 68198-6878, USA
| | - Zhen Chen
- Department of Neurorehabilitation, The First Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Ka-Chun Siu
- Division of Physical Therapy Education, Department of Health & Rehabilitation Sciences, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, 68198-4420, USA.
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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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Soon B, Lee N, Lau J, Tan N, Cai C. Potential of the omnidirectional walking platform with virtual reality as a rehabilitation tool. J Rehabil Assist Technol Eng 2023; 10:20556683231161574. [PMID: 36910687 PMCID: PMC9996727 DOI: 10.1177/20556683231161574] [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: 06/08/2022] [Accepted: 02/17/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction The combination of virtual reality (VR) with an omnidirectional walking platform (ODWP) may have potential in rehabilitation settings. However, its use, acceptance, safety, and effectiveness are unclear. This preliminary study aims to understand the feasibility, safety, and user experience (including investigating the onset of cybersickness) while walking on the ODWP with fully immersive VR. Methods Participants engaged with eight immersive VR walking scenarios. The scenarios were created using 360-degree videos and were programmed to run with the ODWP. Safety modifications for the ODWP were made, with the addition of parallel bars. Quantitative feedback on the perceived safety and acceptance of using VR with an ODWP for rehabilitation was collected. Cybersickness was evaluated using the Simulation Symptoms Questionnaire (SSQ). Results Thirty-five participants (n = 8 physiotherapists, n = 27 healthy adults) were recruited for this study. The mean perceived safety score was 78.9/100 and acceptance was 64.5/100. Seventy-one percent of participants experienced mild to moderate symptoms of cybersickness as reported on the SSQ. The SSQ scores were not correlated to participant age or simulation exposure time. Conclusion VR while using ODWP has the potential for rehabilitation, however, more consideration is needed to address acceptance and cybersickness.
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Elaraby AER, Shahien M, Jahan AM, Etoom M, Bekhet AH. The Efficacy of Virtual Reality Training in the Rehabilitation of Orthopedic Ankle Injuries: A Systematic Review and Meta-analysis. ADVANCES IN REHABILITATION SCIENCE AND PRACTICE 2023; 12:11795727231151636. [PMID: 36891135 PMCID: PMC9933927 DOI: 10.1177/11795727231151636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/02/2023] [Indexed: 02/11/2023]
Abstract
Introduction Orthopedic ankle injuries are considered among the most common musculoskeletal injuries. A wide variety of modalities and techniques have been used for the management of these injuries, and virtual reality (VR) is one modality that has been examined in ankle injuries rehabilitation. Purpose This study aims to systemically review previous studies evaluating the effect of virtual reality in rehabilitating orthopedic ankle injuries. Methods We searched six online databases: PubMed, Web of Science (WOS), Scopus, the Physiotherapy Evidence Database (PEDro), Virtual Health Library (VHL), and Cochrane Central Register of Controlled Trials (CENTRAL). Results Ten randomized clinical trials met the inclusion criteria. Our results showed that VR had a significant effect on overall balance compared to conventional physiotherapy (SMD = 0.359, 0.009-0.710 P = 0.04), [I 2= 17%, P = 0.30]. Compared with conventional physiotherapy, VR programs significantly improved gait parameters such as speed and cadence, muscle power, and perceived ankle instability; however, no significant difference was detected in the foot and ankle ability measure (FAAM). Additionally, significant improvements in static balance and perceived ankle instability were reported after the use of VR balance and strengthening programs. Finally, only two articles were deemed to have good quality, and the other studies' quality ranged from poor to fair. Conclusion VR rehabilitation programs can be used to rehabilitate ankle injuries, as they are regarded as safe interventions and have promising effects. However, there is a need for studies with high quality since most included studies' quality varied from poor to fair.
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Affiliation(s)
- Abd El Rahman Elaraby
- Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Impact Research Group, Cairo, Egypt
| | - Mostafa Shahien
- Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Impact Research Group, Cairo, Egypt
| | - Alhadi M Jahan
- Impact Research Group, Cairo, Egypt.,School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada.,Department of Physiotherapy, College of Medical Technology, Misrata, Libya
| | - Mohammad Etoom
- Division of physical therapy, allied medical sciences department, Aqaba University of Technology, Aqaba, Jordan
| | - Amira Hassan Bekhet
- Faculty of Physical Therapy, Cairo University, Giza, Egypt.,Impact Research Group, Cairo, Egypt.,Medical Research Group of Egypt (MRGE), Cairo, Egypt
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Gupta A, Ambade R. From Diagnosis to Therapy: The Role of Virtual and Augmented Reality in Orthopaedic Trauma Surgery. Cureus 2022; 14:e29099. [PMID: 36249662 PMCID: PMC9557249 DOI: 10.7759/cureus.29099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/12/2022] [Indexed: 11/28/2022] Open
Abstract
By reducing procedure-related problems, advancements in computer-assisted surgery (CAS) and surgical training aim to boost operative precision and enhance patient safety. Orthopaedic training and practice have started to change as a result of the incorporation of reality technologies like virtual reality (VR), augmented reality (AR), and mixed reality (MR) into CAS. Today's trainees can engage in realistic and highly involved operational simulations without supervision. With the coronavirus disease 2019 (COVID-19) pandemic, there is a greater need for breakthrough technology adoption. VR is an interactive technology that enables personalised care and could support successful patient-centered rehabilitation. It is a valid and trustworthy evaluation method for determining joint range of motion, function, and balance in physical rehabilitation. It may make it possible to customise care, encourage patients, boost compliance, and track their advancement. AR supplementation in orthopaedic surgery has shown promising results in pre-clinical settings, with improvements in surgical accuracy and reproducibility, decreased operating times, and less radiation exposure. As little patient observation is needed, this may lessen the workload clinicians must bear. The ability to use it for home-based therapy is often available commercially as well. The objectives of this review are to evaluate the technology available, comprehend the available evidence regarding the benefit, and take into account implementation problems in clinical practice. The use of this technology, its practical and moral ramifications, and how it will affect orthopaedic doctors and their patients are also covered. This review offers a current and thorough analysis of the reality technologies and their uses in orthopaedic surgery.
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Jachak S, Phansopkar P, Chitale N. Occulus-Guided Rehabilitation Approach in a Patient With Osteoarthritis Knee: A Case Report. Cureus 2022; 14:e29021. [PMID: 36237738 PMCID: PMC9552510 DOI: 10.7759/cureus.29021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
Abstract
Osteoarthritis (OA) is the most frequent musculoskeletal condition affecting the elderly's quality of life. Wear and tear, as well as the progressive deterioration of articular cartilage, are the causes of OA, also known as degenerative joint disease. There are two types of OA: primary and secondary. The condition can be treated both conservatively and surgically. Medication and physical therapy might be used to treat it conservatively. Physical rehabilitation can include advanced management through the use of virtual reality (VR). The other option for treatment is surgical management. We are presenting a case of a 52-year-old female who presented to musculoskeletal physiotherapy out patient department with complaints of left-sided knee pain, stiffness, and difficulty in sitting with crossed legs on the floor. On examination, crepitations were present. Knee range of motion and strength were significantly reduced. Physiotherapy treatment was planned for the same. In physiotherapy rehabilitation, Occulus-guided physiotherapy exercises were given to improve the strength and range of motion of the joint.
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Hadamus A, Błażkiewicz M, Wydra KT, Kowalska AJ, Łukowicz M, Białoszewski D, Marczyński W. Effectiveness of Early Rehabilitation with Exergaming in Virtual Reality on Gait in Patients after Total Knee Replacement. J Clin Med 2022; 11:jcm11174950. [PMID: 36078879 PMCID: PMC9456315 DOI: 10.3390/jcm11174950] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 11/16/2022] Open
Abstract
Total knee replacement (TKR) is the treatment of choice for advanced stages of osteoarthritis but it requires good postoperative rehabilitation. This study aimed to assess the effectiveness of exercises using virtual reality to improve gait parameters in patients after TKR. Fifty-nine patients 7−14 days after TKR surgery were divided into a study group (VRG, n = 38) and a control group (CG, n = 21). Both groups underwent the same 4-week rehabilitation protocol. The VRG group had 12 additional nonimmersive virtual reality game sessions on the Virtual Balance Clinic prototype system at 30 min each, focusing on gait and balance improvement. Spatiotemporal, force and foot plantar pressure parameters were collected on an instrumented treadmill during a 30 s walk. The most significant improvement was in the symmetry indices of forefoot force, maximum forefoot force, loading response time, and preswing time (p < 0.05) in both groups. Gait speed increased by 31.25% and 44% in the VRG and CG groups, respectively (p < 0.005). However, the extra exergaming sessions did not significantly improve rehabilitation outcomes. Therefore, additional VR training does not improve gait better than standard rehabilitation alone, but the improvement of gait, especially its symmetry, is significant within the first six weeks after surgery.
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Affiliation(s)
- Anna Hadamus
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
- Correspondence:
| | - Michalina Błażkiewicz
- Faculty of Rehabilitation, The Józef Piłsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland
| | - Kamil T. Wydra
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland
| | - Aleksandra J. Kowalska
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland
| | - Małgorzata Łukowicz
- Professor Adam Gruca Independent Public Teaching Hospital in Otwock, Rehabilitation Clinic, 05-400 Otwock, Poland
| | - Dariusz Białoszewski
- Department of Rehabilitation, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
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Chang WK, Lee JI, Hwang JH, Lim JY. Post-operative rehabilitation using a digital healthcare system in patients who had undergone rotator cuff repair: protocol for a single-center randomized controlled trial. Trials 2022; 23:667. [PMID: 35978437 PMCID: PMC9386934 DOI: 10.1186/s13063-022-06648-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/07/2022] [Indexed: 11/14/2022] Open
Abstract
Background Operative repair of a rotator cuff tear requires up to 12 weeks of post-operative (post-op) home-based rehabilitation. Maintaining patients’ compliance in the post-op rehabilitation program is a pivotal component for generating successful outcomes. By developing a post-op rehabilitation-oriented digital healthcare system and applying it in patients who had undergone rotator cuff repair, we aim to increase the efficacy of the rehabilitation program and raise patients’ compliance levels. Here, we present a protocol developed for comparing the efficacy of rehabilitation using a newly developed augmented reality (AR)-based digital healthcare system with that of conventional rehabilitation for post-op rehabilitation of rotator cuff repair. Methods This study will recruit a total of 115 patients who had undergone rotator cuff repair within 3 days after surgery. Patients will be randomly allocated to rehabilitation using an AR-based digital healthcare system (digital group) or conventional rehabilitation (conventional group). Patients in both groups will perform brochure-based exercises from the immediate post-op period to post-op 6 weeks. From post-op 6 weeks to 12 weeks, patients in the digital group will use the AR-based system for post-op exercises, whereas patients in the conventional group will continue brochure-based rehabilitation exercises. The primary outcome will be scores on the Simple Shoulder Test at post-op 12 weeks. Secondary outcomes include numeric rating scale scores for pain, measures of range of motion and muscle strength of the affected shoulder, grip strength of the affected arm, scores on the Disabilities of the Arm, Shoulder and Hand test, the Shoulder Pain and Disability Index, and the EuroQoL-5D-5L quality-of-life measure. Analyses will be conducted using an intention-to-treat approach. Discussion This study will examine the effectiveness of an AR-based digital healthcare system for post-op rehabilitation in the patients after rotator cuff repair. The study will add evidence for the application of digital healthcare systems in post-op rehabilitation. Trial registration ClinicalTrials.gov NCT04511377. Registered on 10 August 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06648-4.
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Affiliation(s)
- Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - Jong In Lee
- Department of Rehabilitation Medicine, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea
| | - Ji Hye Hwang
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Jae-Young Lim
- Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Republic of Korea. .,Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Rodrigues KA, Moreira JVDS, Pinheiro DJLL, Dantas RLM, Santos TC, Nepomuceno JLV, Nogueira MARJ, Cavalheiro EA, Faber J. Embodiment of a virtual prosthesis through training using an EMG-based human-machine interface: Case series. Front Hum Neurosci 2022; 16:870103. [PMID: 35992955 PMCID: PMC9387771 DOI: 10.3389/fnhum.2022.870103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 07/06/2022] [Indexed: 12/03/2022] Open
Abstract
Therapeutic strategies capable of inducing and enhancing prosthesis embodiment are a key point for better adaptation to and acceptance of prosthetic limbs. In this study, we developed a training protocol using an EMG-based human-machine interface (HMI) that was applied in the preprosthetic rehabilitation phase of people with amputation. This is a case series with the objective of evaluating the induction and enhancement of the embodiment of a virtual prosthesis. Six men and a woman with unilateral transfemoral traumatic amputation without previous use of prostheses participated in the study. Participants performed a training protocol with the EMG-based HMI, composed of six sessions held twice a week, each lasting 30 mins. This system consisted of myoelectric control of the movements of a virtual prosthesis immersed in a 3D virtual environment. Additionally, vibrotactile stimuli were provided on the participant’s back corresponding to the movements performed. Embodiment was investigated from the following set of measurements: skin conductance response (affective measurement), crossmodal congruency effect (spatial perception measurement), ability to control the virtual prosthesis (motor measurement), and reports before and after the training. The increase in the skin conductance response in conditions where the virtual prosthesis was threatened, recalibration of the peripersonal space perception identified by the crossmodal congruency effect, ability to control the virtual prosthesis, and participant reports consistently showed the induction and enhancement of virtual prosthesis embodiment. Therefore, this protocol using EMG-based HMI was shown to be a viable option to achieve and enhance the embodiment of a virtual prosthetic limb.
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Affiliation(s)
- Karina Aparecida Rodrigues
- Neuroengineering and Neurocognition Laboratory, Paulista School of Medicine, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
- *Correspondence: Karina Aparecida Rodrigues,
| | - João Vitor da Silva Moreira
- Neuroengineering and Neurocognition Laboratory, Paulista School of Medicine, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Daniel José Lins Leal Pinheiro
- Neuroengineering and Neurocognition Laboratory, Paulista School of Medicine, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Rodrigo Lantyer Marques Dantas
- Neuroengineering and Neurocognition Laboratory, Paulista School of Medicine, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Thaís Cardoso Santos
- Neuroengineering Laboratory, Department of Biomedical Engineering, Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
| | - João Luiz Vieira Nepomuceno
- Neuroengineering Laboratory, Department of Biomedical Engineering, Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
| | | | - Esper Abrão Cavalheiro
- Neuroengineering and Neurocognition Laboratory, Paulista School of Medicine, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
| | - Jean Faber
- Neuroengineering and Neurocognition Laboratory, Paulista School of Medicine, Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil
- Neuroengineering Laboratory, Department of Biomedical Engineering, Institute of Science and Technology, Federal University of São Paulo, São José dos Campos, Brazil
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Su Z, Liu Y, Zhao W, Bai Y, Jiang N, Zhu S. Digital technology for orthognathic surgery training promotion: a randomized comparative study. PeerJ 2022; 10:e13810. [PMID: 35935255 PMCID: PMC9354792 DOI: 10.7717/peerj.13810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/07/2022] [Indexed: 02/05/2023] Open
Abstract
Background This study aims to investigate whether a systematic digital training system can improve the learning efficiency of residents in the first-year orthognathic surgery training course and evaluate its effectiveness in teaching orthognathic surgery. Methods A digital training system was applied, and a comparative research approach was adopted. 24 first-year orthognathic surgery residents participated in the experiment as part of their professional skill training. The Experimental group was required to use a digital training system, and the Control group was trained in lectures without digital technologies. Three indicators, including theoretical knowledge and clinical operation, were assessed in tests, and evaluations from instructors were analyzed to evaluate learning efficiency. Results The results showed that the scores in theoretical tests, practical operations, and teacher evaluations, the Experimental groups were all higher than the Control group (P = 0.002 for anatomy, P = 0.000 for operation theory) after using digital technology, except for the understanding of complications (P = 0.771). In addition, the questionnaire survey results showed that the study interest (P = 0.001), self-confidence (P = 0.001), satisfaction (P = 0.002), and academic performance (P = 0.001) of the residents of the Experimental group were higher than those of the Control group. Conclusions The outcomes indicated that the digital training system could benefit orthognathic residents' learning efficiency, and learning interest and teaching satisfaction will also improve.
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Affiliation(s)
- Zhan Su
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yao Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Zhao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuanyan Bai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral & Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Tokgöz P, Stampa S, Wähnert D, Vordemvenne T, Dockweiler C. Virtual Reality in the Rehabilitation of Patients with Injuries and Diseases of Upper Extremities. Healthcare (Basel) 2022; 10:healthcare10061124. [PMID: 35742176 PMCID: PMC9222955 DOI: 10.3390/healthcare10061124] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/13/2022] [Accepted: 06/15/2022] [Indexed: 11/30/2022] Open
Abstract
Upper-extremity injuries and diseases rarely have life-threatening consequences, but failure to manage them properly can result in severe dysfunction. This article presents the current state of using virtual reality to support the rehabilitation process of patients with injuries and diseases of the upper extremities and points out their effects on upper-extremity functions. A scoping review was conducted to provide a comprehensive overview of the field of virtual reality for upper-extremity rehabilitation. PubMed, Web of Science, and the Cochrane Library were searched by two independent researchers between April and May 2021 to identify relevant publications and were examined according to inclusion and exclusion criteria. As a result of the literature review, 11 studies of various target groups were identified. Virtual-reality technologies were categorized into multisensory high-end systems and game-based systems. With respect to functional recovery, technologies based on virtual reality were not inferior to traditional rehabilitation. In addition, the users were highly motivated and satisfied. The results emphasize the need for stronger evidence-based virtual-reality technologies for rehabilitation of injuries and diseases of upper extremities.
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Affiliation(s)
- Pinar Tokgöz
- School of Public Health, Bielefeld University, 33615 Bielefeld, Germany
- Department of Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, 57068 Siegen, Germany; (S.S.); (C.D.)
- Correspondence:
| | - Susanne Stampa
- Department of Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, 57068 Siegen, Germany; (S.S.); (C.D.)
| | - Dirk Wähnert
- Department for Trauma Surgery and Orthopedics, Protestant Hospital of Bethel Foundation, 33617 Bielefeld, Germany; (D.W.); (T.V.)
| | - Thomas Vordemvenne
- Department for Trauma Surgery and Orthopedics, Protestant Hospital of Bethel Foundation, 33617 Bielefeld, Germany; (D.W.); (T.V.)
| | - Christoph Dockweiler
- Department of Digital Health Sciences and Biomedicine, School of Life Sciences, University of Siegen, 57068 Siegen, Germany; (S.S.); (C.D.)
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