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Cetin H, Kose N, Gurses E, Turkmen C, Aksoy S, Oge HK. Effects of Virtual Reality for Postural Control in Chronic Neck Pain: A Single-Blind, Randomized Controlled Study. J Manipulative Physiol Ther 2024:S0161-4754(24)00006-X. [PMID: 38944805 DOI: 10.1016/j.jmpt.2024.02.006] [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: 05/29/2023] [Revised: 02/15/2024] [Accepted: 02/26/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of virtual reality (VR) on postural control, posture, and kinesiophobia in patients with chronic neck pain (CNP). METHODS Forty-one participants with CNP were randomly allocated to the VR and control groups. The VR group experienced VR with glasses for 20 minutes and then performed motor control (MC) exercises for 20 minutes. The control group received only MC exercises for 40 minutes. Both groups received 18 sessions over 6 weeks. Computerized dynamic posturography outcomes, including sensory organization test (SOT), limits of stability, and unilateral stance tests, gait speed, forward head posture (FHP), shoulder protraction (SP), cervical lordosis angle, kinesiophobia, and exercise compliance were recorded. RESULTS The VR group had more effects regarding composite equilibrium (Cohen's d = 1.20) of SOT and kinesiophobia (Cohen's d = -0.96), P < .05). Also, the VR group was more effective in exercise compliance (P < .05). Contrary to these results, the control group was more effective in correcting FHP and SP (Cohen's d > 0.7, P < .05). CONCLUSION Virtual reality seemed to have an effect on postural control, posture, and kinesiophobia in patients with chronic neck pain.
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Affiliation(s)
- Hatice Cetin
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Nezire Kose
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Emre Gurses
- Department of Audiology, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ceyhun Turkmen
- Faculty of Health Sciences, Çankırı Karatekin University, Çankırı, Turkey
| | - Songül Aksoy
- Department of Audiology, Faculty of Health Sciences, Lokman Hekim University, Ankara, Turkey
| | - Halil Kamil Oge
- Department of Neurosurgery, Medical Faculty, Hacettepe University, Ankara, Turkey
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2
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He Y, Wang J, Zhao P, Wang R, Li M. Correlations of The Central Sensitization Inventory, conditioned pain modulation, cognitions and psychological factors in individuals with chronic neck pain: A cross-sectional study. Pain Ther 2024:10.1007/s40122-024-00601-w. [PMID: 38789828 DOI: 10.1007/s40122-024-00601-w] [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: 11/15/2023] [Accepted: 04/02/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Chronic neck pain (CNP) is a global public health problem, with high prevalence and absenteeism rates. Central sensitization (CS) as a basis for chronic pain may play an essential role in its development and progression. It is often comorbid with low conditioned pain modulation (CPM) effects, cognitions, and psychological problems. OBJECTIVES The purposes of this study were to (1) explore the relationship between pain-related cognitions and psychological factors, CPM effects, and the central sensitization inventory (CSI) scores; and (2) determine whether cognitions and psychological factors can predict CSI scores and CPM effects in individuals with CNP. METHODS Fifty-four individuals with CNP were recruited for this cross-sectional study. The following outcome measures were evaluated: The CSI (screening tool) was compared with the cold pressor test (CPT), which was the psychophysical test used to assess the CPM; neck pain intensity using the visual analogue scale (VAS), as well as pain-related cognitions (including kinesiophobia and pain catastrophization) and psychological states (including anxiety and depression) using self-report questionnaires. RESULTS CSI score was not associated with the CPM effect (r = 0.257, p > 0.05), and no cognitions or psychological factors were associated with CPM (p > 0.05), but CSI score was moderately positively correlated with kinesiophobia (r = 0.554, p < 0.01), lowly positively correlated with pain catastrophization (r = 0.332, p = 0.017) and anxiety (r = 0.492, p < 0.01), but not depression (r = 0.207, p = 0.132). Multiple linear regression analysis showed that kinesiophobia (B = 1.308, p < 0.01) and anxiety (B = 1.806, p = 0.02) were significant positive predictors of CSI score. CONCLUSIONS The findings confirm some of our hypotheses. Accordingly, the findings inferred that the CSI does not seem to respond to CPM effect in patients with CNP effectively. In addition, CSI score was associated with cognitions and psychological factors, of which kinesiophobia and anxiety were effective predictors. In clinical practice, pain-related cognitions and psychological factors should be fully considered to manage neck pain efficiently.
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Affiliation(s)
- Yuwei He
- College of Sports Medicine and Rehabilitation, Beijing Sport University, 48 Information Road, Haidian District, Beijing, 100084, China
| | - Jialin Wang
- China Institute of Sports Science, General Administration of Sport, 11 Gymnasium Road, Dongcheng District, Beijing, 100061, China
| | - Peng Zhao
- China Institute of Sports Science, General Administration of Sport, 11 Gymnasium Road, Dongcheng District, Beijing, 100061, China.
| | - Ruirui Wang
- College of Sports Medicine and Rehabilitation, Beijing Sport University, 48 Information Road, Haidian District, Beijing, 100084, China
| | - Meng Li
- College of Sports Medicine and Rehabilitation, Beijing Sport University, 48 Information Road, Haidian District, Beijing, 100084, China
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Ho RL, Park J, Wang WE, Thomas JS, Cruz-Almeida Y, Coombes SA. Lower individual alpha frequency in individuals with chronic low back pain and fear of movement. Pain 2024; 165:1033-1043. [PMID: 38112575 PMCID: PMC11018483 DOI: 10.1097/j.pain.0000000000003098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/27/2023] [Indexed: 12/21/2023]
Abstract
ABSTRACT Significant progress has been made in linking measures of individual alpha frequency (IAF) and pain. A lower IAF has been associated with chronic neuropathic pain and with an increased sensitivity to pain in healthy young adults. However, the translation of these findings to chronic low back pain (cLBP) are sparse and inconsistent. To address this limitation, we assessed IAFs in a cohort of 70 individuals with cLBP, implemented 3 different IAF calculations, and separated cLBP subjects based on psychological variables. We hypothesized that a higher fear movement in cLBP is associated with a lower IAF at rest. A total of 10 minutes of resting data were collected from 128 electroencephalography channels. Our results offer 3 novel contributions to the literature. First, the high fear group had a significantly lower peak alpha frequency. The high fear group also reported higher pain and higher disability. Second, we calculated individual alpha frequency using 3 different but established methods; the effect of fear on individual alpha frequency was robust across all methods. Third, fear of movement, pain intensity, and disability highly correlated with each other and together significantly predicted IAF. Our findings are the first to show that individuals with cLBP and high fear have a lower peak alpha frequency.
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Affiliation(s)
- Rachel L.M. Ho
- Laboratory for Rehabilitative Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida
| | - Jinhan Park
- Laboratory for Rehabilitative Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida
| | - Wei-en Wang
- Laboratory for Rehabilitative Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida
| | - James S. Thomas
- Motor Control Lab, Department of Physical Therapy, Virginia Commonwealth University
| | - Yenisel Cruz-Almeida
- Pain Research and Intervention Center of Excellence, Department of Community Dentistry, University of Florida
| | - Stephen A. Coombes
- Laboratory for Rehabilitative Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida
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Asadzadeh A, Salahzadeh Z, Samad-Soltani T, Rezaei-Hachesu P. An affordable and immersive virtual reality-based exercise therapy in forward head posture. PLoS One 2024; 19:e0297863. [PMID: 38446782 PMCID: PMC10917330 DOI: 10.1371/journal.pone.0297863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/07/2024] [Indexed: 03/08/2024] Open
Abstract
Forward Head Posture (FHP) is one of the most commonly occurring musculoskeletal abnormalities. Despite exercise therapy being an effective approach for FHP treatment, it can be long, monotonous, and tedious. Virtual reality (VR) can be used as an innovative solution to address these challenges. We designed an affordable and immersive VR-based exercise therapy (VRET) system for FHP correction. The VRET contents (i.e., exercises and VR scenarios) were determined by physiotherapists and game designers at the focus group meetings. Hardware requirements include a VR box, smartphone, and sensors (i.e., a smartphone accelerometer and an affordable Inertial Measurement Unit (IMU)) to measure head motions and transfer them via Wi-Fi to the VRET system. The IMU was designed using the MPU6050, Arduino Nano, and ESP8266-01S. Gwet's AC1, Game Experience Questionnaires (GEQ), and System Usability Scale (SUS) were used to measure intra-rater reliability, user experience, and system usability, respectively. The determined exercises, including Capital Flexion-Extension and Chin Tuck, were designed in the form of a shooting game. A physiotherapist and twenty-one FHP individuals took part in evaluating the system. High precision was obtained for the designed IMU (i.e., pitch and roll < 0.1° and yaw < 1.3 °). Gwet's AC1 and SUS results showed very good intra-rater reliability (coefficient = 0.892) and excellent usability (score = 87.14), respectively. According to the mean scores of the GEQ, participants were confident about competence, immersion, flow, and positive affect components. The development of low-cost VRET systems for FHP correction is a step towards facilitating rehabilitation challenges by providing positive experiences for users as well as helping them perform therapeutic exercises correctly.
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Affiliation(s)
- Afsoon Asadzadeh
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Salahzadeh
- Department of Physical Therapy, Faculty of Rehabilitation Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Taha Samad-Soltani
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Peyman Rezaei-Hachesu
- Department of Health Information Technology, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Ramesh B, Konstant A, Praveena P, Senft E, Gleicher M, Mutlu B, Zinn M, Radwin RG. Manually Acquiring Targets From Multiple Viewpoints Using Video Feedback. HUMAN FACTORS 2024; 66:470-489. [PMID: 35548929 DOI: 10.1177/00187208221093829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The effect of camera viewpoint was studied when performing visually obstructed psychomotor targeting tasks. BACKGROUND Previous research in laparoscopy and robotic teleoperation found that complex perceptual-motor adaptations associated with misaligned viewpoints corresponded to degraded performance in manipulation. Because optimal camera positioning is often unavailable in restricted environments, alternative viewpoints that might mitigate performance effects are not obvious. METHODS A virtual keyboard-controlled targeting task was remotely distributed to workers of Amazon Mechanical Turk. The experiment was performed by 192 subjects for a static viewpoint with independent parameters of target direction, Fitts' law index of difficulty, viewpoint azimuthal angle (AA), and viewpoint polar angle (PA). A dynamic viewpoint experiment was also performed by 112 subjects in which the viewpoint AA changed after every trial. RESULTS AA and target direction had significant effects on performance for the static viewpoint experiment. Movement time and travel distance increased while AA increased until there was a discrete improvement in performance for 180°. Increasing AA from 225° to 315° linearly decreased movement time and distance. There were significant main effects of current AA and magnitude of transition for the dynamic viewpoint experiment. Orthogonal direction and no-change viewpoint transitions least affected performance. CONCLUSIONS Viewpoint selection should aim to minimize associated rotations within the manipulation plane when performing targeting tasks whether implementing a static or dynamic viewing solution. Because PA rotations had negligible performance effects, PA adjustments may extend the space of viable viewpoints. APPLICATIONS These results can inform viewpoint selection for visual feedback during psychomotor tasks.
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Gür O, Başar S. The effect of virtual reality on pain, kinesiophobia and function in total knee arthroplasty patients: A randomized controlled trial. Knee 2023; 45:187-197. [PMID: 37931366 DOI: 10.1016/j.knee.2023.09.012] [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] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Virtual reality (VR) has emerged as a promising new therapeutic approach, showing promise in the treatment of patients with a variety of diseases. This study aimed to investigate the effect of VR on pain, kinesiophobia, and function in patients undergoing total knee arthroplasty (TKA). METHODS This randomized controlled trial was performed on patients who had TKA due to osteoarthritis at Gazi University Hospital from October 2019 to August 2021. For this study, 21 female TKA patients were divided into two groups by the blocked randomization method: VR (n = 10) and exercise (n = 11). The exercise group was given a home exercise program. The VR group received immersive VR application in addition to the exercise. Pain, kinesiophobia, pain catastrophizing, knee range of motion, functional status, and quality of life were assessed. The Wilcoxon Test and Mann-Whitney U Test were used for comparison of the results. RESULTS The VR group had a statistically significant difference in the intensity of pain at rest, at night, and during the Timed Up and Go Test (TUG), kinesiophobia, pain catastrophizing, active knee flexion, the TUG, and the stair-climb test scores (P = 0.005 (95% confidence interval (CI) (-5.000, -1.000)), P = 0.005 (95% CI (-7.000, -2.000)), P = 0.023 (95% CI (-4.000, 0)), P = 0.006 (95% CI (-15.000, -3.000)), P = 0.012 (95% CI (-19.000, -3.000)), P = 0.010 (95% CI (4.000, 17.333)), P = 0.017 (95% CI (-14.700, -0.850)), P = 0.011 (95% CI (-23.100, -1.000)), respectively). CONCLUSION In the early period following total knee arthroplasty, using virtual reality integrated with exercise helps to reduce pain, kinesiophobia and pain catastrophizing, and to improve functional outcomes in female patients.
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Affiliation(s)
- Ozan Gür
- Physical Therapy and Rehabilitation Department, Kırklareli University, Kırklareli, Turkey.
| | - Selda Başar
- Physical Therapy and Rehabilitation Department, Gazi University, Ankara, Turkey
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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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Hilger K, Häge AS, Zedler C, Jost M, Pauli P. Virtual reality to understand pain-associated approach behaviour: a proof-of-concept study. Sci Rep 2023; 13:13799. [PMID: 37612345 PMCID: PMC10447531 DOI: 10.1038/s41598-023-40789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
Pain-associated approach and avoidance behaviours are critically involved in the development and maintenance of chronic pain. Empirical research suggests a key role of operant learning mechanisms, and first experimental paradigms were developed for their investigation within a controlled laboratory setting. We introduce a new Virtual Reality paradigm to the study of pain-related behaviour and investigate pain experiences on multiple dimensions. The paradigm evaluates the effects of three-tiered heat-pain stimuli applied contingent versus non-contingent with three types of arm movements in naturalistic virtual sceneries. Behaviour, self-reported pain-related fear, pain expectancy and electrodermal activity were assessed in 42 healthy participants during an acquisition phase (contingent movement-pain association) and a modification phase (no contingent movement-pain association). Pain-associated approach behaviour, as measured by arm movements followed by a severe heat stimulus, quickly decreased in-line with the arm movement-pain contingency. Slower effects were observed in fear of movement-related pain and pain expectancy ratings. During the subsequent modification phase, the removal of the pain contingencies modified all three indices. In both phases, skin conductance responses resemble the pattern observed for approach behaviour, while skin conductance levels equal the pattern observed for the self-ratings. Our findings highlight a fast reduction in approach behaviour in the face of acute pain and inform about accompanying psychological and physiological processes. We discuss strength and limitations of our paradigm for future investigations with the ultimate goal of gaining a comprehensive understanding of the mechanisms involved in chronic pain development, maintenance, and its therapy.
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Affiliation(s)
- Kirsten Hilger
- Department of Psychology I, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany.
| | - Anne-Sophie Häge
- Department of Psychology I, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Christina Zedler
- Department of Psychology I, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Michael Jost
- Department of Psychology I, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology I, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
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Tresser S, Kuflik T, Levin I, Weiss PL. Personalisation of a virtual gaming system for children with motor impairments: performance and usability. Disabil Rehabil Assist Technol 2023; 18:876-882. [PMID: 34270909 DOI: 10.1080/17483107.2021.1936222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To demonstrate the potential role of virtual game personalisation for use as a therapeutic modality to improve upper extremity function in children with cerebral palsy (CP). METHODS The study tested a convenience sample of 60 typically developing children (TD) aged 6-10 years and 20 children with CP aged 7-11 years. Children participated in a single 30-min session when they played the game in accuracy mode (virtual targets are hit as they become progressively larger or smaller) or dwell mode (virtual targets are hit when the users remains on them for progressively shorter or longer durations). These two modes can be played in conventional (non-personalised), personalised and with and without arm weights conditions; weights were used for the TD group in order to ensure that game play would be sufficiently challenging as to require personalisation. We measured performance variables (frequency of changes in game level difficulty and accuracy as measured by percent success of hitting the virtual targets) in each condition and usability variables (self-reported perceived effort and enjoyment). RESULTS Comparisons between the usability of the conventional and personalised conditions among typically developing children showed that although children self-reported significantly more effort while playing the personalised game, the level of enjoyment remained high (no significant differences between conventional and personalised game play conditions). In addition, comparisons between playing the personalised game with and without weights by typically developing children, indicated that percent success was significantly higher for the game played without weights, suggesting that the system is sensitive to dynamic changes in performance. Comparisons between the TD and CP groups showed that when the game was played in personalised dwell mode (hovering over the target for several seconds) children with CP progressed significantly less quickly through different difficulty levels compared to typically developing children. In contrast, no significant differences were found in accuracy mode (immediate response on target hit), between the TD and CP groups in any of the experimental conditions. DISCUSSION The personalised game approach was shown to be enjoyable for both groups of users and able to change the level of difficulty in real time. The results suggest that this approach to gaming can provide motor challenges while preserving a high level of enjoyment. CONCLUSION Personalised virtual therapy shows promise as a tool for upper extremity therapy for children with motor impairment.Implications for RehabiliationIn recent years, there has been an increase in the use of assistive technologies including virtual gaming in the general area of health care and clinical practice.Virtual gaming provides an interactive, real-time experiences that are flexible and ecologically valid ways to improve specific cognitive and motor abilities.Personalisation of virtual games entails dynamic adaptation of the parameters in real time according to the user's functional level).The results have demonstrated that personalised virtual gaming is enjoyable and feasible for typically developing children and children with cerebral palsy.The results suggest that this approach to gaming can provide motor challenges while preserving a high level of enjoyment.
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Affiliation(s)
- Sarit Tresser
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
| | - Tsvi Kuflik
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Irina Levin
- Department of Information Systems, University of Haifa, Haifa, Israel
| | - Patrice L Weiss
- Department of Occupational Therapy, University of Haifa, Haifa, Israel
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Kragting M, Voogt L, Coppieters MW, Pool-Goudzwaard AL. Visual feedback manipulation in virtual reality to influence pain-free range of motion. Are people with non-specific neck pain who are fearful of movement more susceptible? PLoS One 2023; 18:e0287907. [PMID: 37406021 DOI: 10.1371/journal.pone.0287907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 06/15/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Movement-evoked pain may have a protective or learned component, influenced by visual cues which suggest that the person is moving towards a position that may be perceived as threatening. We investigated whether visual feedback manipulation in virtual reality (VR) had a different effect on cervical pain-free range of motion (ROM) in people with fear of movement. METHOD In this cross-sectional study, seventy-five people with non-specific neck pain (i.e., neck pain without a specific underlying pathology) rotated their head until the onset of pain, while wearing a VR-headset. Visual feedback about the amount of movement was equal, 30% smaller or 30% larger than their actual rotation. ROM was measured using the VR-headset sensors. The effect of VR manipulation in fearful (N = 19 using the Tampa Scale for Kinesiophobia (TSK) and N = 18 using the Fear Avoidance Beliefs Questionnaire-physical activity (FABQpa)) and non-fearful (N = 46; non-fearful on both scales) people was compared using mixed-design ANOVAs. RESULTS Fear of movement, influenced the effect of visual feedback manipulation on cervical pain-free ROM (TSK: p = 0.036, ղp2 = 0.060; FABQpa: p = 0.020, ղp2 = 0.077); a greater amplitude of pain-free movement was found when visual feedback reduced the perceived rotation angle compared to the control condition (TSK: p = 0.090, ղp2 = 0.104; FABQpa: p = 0.030, ղp2 = 0.073). Independent of the presence of fear, visual feedback manipulation reduced the cervical pain-free ROM in the overstated condition (TSK: p< 0.001, ղp2 = 0.195; FABQpa: p<0.001, ղp2 = 0.329). DISCUSSION Cervical pain-free ROM can be influenced by visual perception of the amount of rotation and people with fear of movement seem to be more susceptible to this effect. Further research in people with moderate/severe fear is needed to determine whether manipulating visual feedback may have clinical applicability to make patients aware that ROM may be influenced more by fear than tissue pathology.
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Affiliation(s)
- Maaike Kragting
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lennard Voogt
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Menzies Health Insitute Queensland, Griffith University, Brisbane, Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Brisbane, Gold Coast, Australia
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Program Musculoskeletal Health, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Somt University of Physiotherapy, Amersfoort, The Netherlands
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Chen K, Chen KB. Task-Oriented and Imitation-Oriented Movements in Virtual Reality Exercise Performance and Design. HUMAN FACTORS 2023; 65:125-136. [PMID: 33874773 DOI: 10.1177/00187208211010100] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
OBJECTIVE This study investigated the influence of game features and practice type on human kinematic and muscular performance in a virtual reality exercise (VRE). Participants demonstrated changes in shoulder flexion angle and muscle activation under different virtual scenarios. BACKGROUND Conventional VRE studies often compared the outcomes between an experimental group that underwent exercise in VR and a real-world exercise control group, whereas comparisons between VRE programs are lacking. Besides, the attributes of VREs received little attention. METHOD Thirteen able-bodied participants performed upper extremity exercise movements in immersive VR using a head-mounted display. Participants performed task-oriented and imitation-oriented movements with different game features. Shoulder muscle activity (the deltoid, supraspinatus, and infraspinatus) and shoulder motion were collected. RESULTS Practice type (task-oriented, imitation-oriented) significantly influenced the flexion angle of the shoulder complex (F(1,11) = 9.53, p = .01), and the muscle activity of the supraspinatus (F(1,9) = 12.61, p = .006) and the infraspinatus (F(1,9) = 12.71, p = .006). Game features did not have a statistically significant effect on shoulder flexion angle or shoulder muscles' activations. CONCLUSIONS Compared to imitation-oriented practice, task-oriented practice elicited more intensive shoulder movements and muscular efforts but also induced greater movement variations. Substantial differences across game features levels should be further investigated to have significant effects. APPLICATIONS This research may help guide the design of future VREs. For strength training or rehabilitation where intensive practice is required, task-oriented practice should be considered; for movement learning where movement consistency is required, imitation oriented practice should be adopted.
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Affiliation(s)
- Ken Chen
- 6798 North Carolina State University, Raleigh, USA
| | - Karen B Chen
- 6798 North Carolina State University, Raleigh, USA
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Wang S, Sun J, Yin X, Li H. Effect of virtual reality technology as intervention for people with kinesiophobia: A meta-analysis of randomised controlled trials. J Clin Nurs 2022. [PMID: 35692077 DOI: 10.1111/jocn.16397] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVE To explore the effectiveness of Virtual Reality Technology in reducing kinesiophobia in people. BACKGROUND Kinesiophobia is an important psychosocial factor affecting the pain experience and has a significant negative impact on rehabilitation. Virtual reality technology has been widely used in the treatment of phobias, mental disorders and anxiety disorders. However, the effect of virtual reality technology on people with kinesiophobia has been reported with inconsistent results. DESIGN A meta-analysis of randomised controlled trials. METHODS This study systematically searched PubMed, Web of Science, PsycINFO, CINAHL, Embase, Cochrane Library, Medline, Scopus and four Chinese databases. The standardised mean difference (SMD) was calculated using random-effects models, and the Cochrane Collaboration's tool was used to assess the risk of bias in each study. The PRISMA 2020 checklist provided by the EQUATOR network was used. RESULTS Eleven randomised controlled trials involving a total of 488 subjects were included. Meta-analysis showed the effect sizes of virtual reality intervention on kinesiophobia (SMD = -0.53, 95% CI [-0.90, -0.17], p = .004). Virtual reality intervention was more effective in reducing kinesiophobia in people with chronic low back pain (SMD = -1.00, 95% CI [-1.71, -0.29], p = .006). Compared with fully immersive virtual reality (SMD = -0.29, 95% CI [-0.62, 0.05], p = 0.09), non-immersive virtual reality was more effective in reducing kinesiophobia (SMD = -0.66, 95% CI [-1.24, -0.09], p = 0.02). Compared with virtual reality intervention alone (SMD = -0.35, 95% CI [-1.40, 0.71], p = 0.52), virtual reality combined with exercise was more effective in reducing kinesiophobia (SMD = -0.59, 95% CI [-0.95, -0.22], p = 0.002). CONCLUSIONS Virtual reality technology has the potential to reduce the degree of kinesiophobia in people. In addition, virtual reality technology was more effective in people with chronic low back pain; non-immersive virtual reality was more effective in reducing kinesiophobia; and virtual reality technology combined with exercise was more effective in reducing kinesiophobia than virtual reality intervention alone. Clinical nursing staff should be encouraged to use virtual reality to speed up patient recovery. However, to achieve immersion and apply this technology to different diseases, more studies are required to provide clearer suggestions. RELEVANCE TO CLINICAL PRACTICE This study suggests that healthcare staff should pay attention to kinesiophobia, and early identification and intervention of kinesiophobia can help patients recover their health and improve the quality of nursing.
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Affiliation(s)
- Shanshan Wang
- The First Hospital of Jilin University, Changchun, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, China
| | - Xin Yin
- The First Hospital of Jilin University, Changchun, China
| | - Hongyan Li
- The First Hospital of Jilin University, Changchun, China
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Conventional Cervical Exercises Compared with a Mixed-Reality-Based Game in Asymptomatic Subjects: An Exploratory Crossover Pilot Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12073657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mixed reality presents itself as a potential technological tool for the management of people with musculoskeletal disorders, without having as many adverse side effects as immersive virtual reality. The objective of this study was to explore the possibilities of a mixed-reality game, performing task-oriented cervical exercises compared to conventional therapeutic exercises in sensorimotor outcome measures in asymptomatic subjects. A randomized crossover pilot study was performed with two intervention groups: a mixed-reality group (MRG) and a conventional exercise group (CEG). The cervical joint position error test (CJPET) and deep cervical flexor endurance test (DCFET) were measured as sensorimotor outcomes. Statistically significant differences were found in the pre–post comparison in the DCFET for both groups (MRG: t = −3.87, p < 0.01; CEG: t = −4.01, p < 0.01) and in the extension of the CJPET for the MRG (t = 3.50, p < 0.01). The rest of the measurements showed no significant differences comparing both groups pre- and postintervention (p > 0.05). Mixed reality has apparently the same positive effects as conventional exercises in sensorimotor outcomes in asymptomatic subjects. These results could help in future studies with mixed virtual reality in the management of people with musculoskeletal disorders.
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Sarig Bahat H, Levy A, Yona T. The association between forward head posture and non-specific neck pain: A cross-sectional study. Physiother Theory Pract 2022:1-10. [PMID: 35196950 DOI: 10.1080/09593985.2022.2044420] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Poor posture is traditionally associated with various musculoskeletal disorders. Consequently, educators in the musculoskeletal field have been teaching postural observation as part of the physical assessment. Forward head posture (FHP) is hypothesized to be associated with neck pain; however, evidence in this topic remains inconclusive. PURPOSE To investigate the association between FHP and neck pain intensity, disability, and cervical kinematics in individuals with neck pain compared to asymptomatic individuals. A secondary aim of this study was to explore the possible effect of a head-mounted display (HMD) used in a virtual reality (VR) assessment on FHP. METHODS The study was conducted with 43 volunteers (20 asymptomatic individuals, 23 individuals with neck pain) aged 19 to 62. FHP was assessed by measuring craniovertebral angle on profile photographs. Secondary outcome measures included pain intensity, the neck disability index (NDI) questionnaire, and neck kinematics using specialized VR software. RESULTS There were no significant differences between individuals with neck pain and asymptomatic individuals in FHP (craniovertebral angle = 48.24°±7.29; 48.90°±5.89, respectively, p > .05). The neck pain group demonstrated a restricted range of motion and slower neck movements (p < .05). We found no significant correlation between FHP and visual analog scale, NDI, and most neck kinematic measures. CONCLUSIONS Our findings cannot support a clinically applicable association between FHP and neck pain. Additionally, individuals with neck pain had a lower range of motion and slower neck movements.
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Affiliation(s)
| | - Andrei Levy
- Department of Physical Therapy, University of Haifa, Haifa, Israel
| | - Tomer Yona
- Department of Physical Therapy, University of Haifa, Haifa, Israel
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15
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Hayre CM, Kilgour A. Diagnostic radiography education amidst the COVID-19 pandemic: Current and future use of virtual reality (VR). J Med Imaging Radiat Sci 2021; 52:S20-S23. [PMID: 34600846 PMCID: PMC8450271 DOI: 10.1016/j.jmir.2021.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022]
Affiliation(s)
- Christopher M Hayre
- School of Dentistry & Medical Sciences, Faculty of Science, Charles Sturt University, NSW, Australia; School of Health and Sport Sciences, University of Suffolk, Ipswich United Kingdom.
| | - Andrew Kilgour
- School of Dentistry & Medical Sciences, Faculty of Science, Charles Sturt University, NSW, Australia
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16
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Tao G, Garrett B, Taverner T, Cordingley E, Sun C. Immersive virtual reality health games: a narrative review of game design. J Neuroeng Rehabil 2021; 18:31. [PMID: 33573684 PMCID: PMC7879508 DOI: 10.1186/s12984-020-00801-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High quality head-mounted display based virtual reality (HMD-VR) has become widely available, spurring greater development of HMD-VR health games. As a behavior change approach, these applications use HMD-VR and game-based formats to support long-term engagement with therapeutic interventions. While the bulk of research to date has primarily focused on the therapeutic efficacy of particular HMD-VR health games, how developers and researchers incorporate best-practices in game design to achieve engaging experiences remains underexplored. This paper presents the findings of a narrative review exploring the trends and future directions of game design for HMD-VR health games. METHODS We searched the literature on the intersection between HMD-VR, games, and health in databases including MEDLINE, Embase, CINAHL, PsycINFO, and Compendex. We identified articles describing HMD-VR games designed specifically as health applications from 2015 onwards in English. HMD-VR health games were charted and tabulated according to technology, health context, outcomes, and user engagement in game design. FINDINGS We identified 29 HMD-VR health games from 2015 to 2020, with the majority addressing health contexts related to physical exercise, motor rehabilitation, and pain. These games typically involved obstacle-based challenges and extrinsic reward systems to engage clients in interventions related to physical functioning and pain. Less common were games emphasizing narrative experiences and non-physical exercise interventions. However, discourse regarding game design was diverse and often lacked sufficient detail. Game experience was evaluated using primarily ad-hoc questionnaires. User engagement in the development of HMD-VR health games primarily manifested as user studies. CONCLUSION HMD-VR health games are promising tools for engaging clients in highly immersive experiences designed to address diverse health contexts. However, more in-depth and structured attention to how HMD-VR health games are designed as game experiences is needed. Future development of HMD-VR health games may also benefit from greater involvement of end-users in participatory approaches.
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Affiliation(s)
- Gordon Tao
- Graduate Programs in Rehabilitation Science, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Bernie Garrett
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Tarnia Taverner
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Elliott Cordingley
- Faculty of Science, University of British Columbia, Vancouver, BC, Canada
| | - Crystal Sun
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
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Asadzadeh A, Samad-Soltani T, Salahzadeh Z, Rezaei-Hachesu P. Effectiveness of virtual reality-based exercise therapy in rehabilitation: A scoping review. INFORMATICS IN MEDICINE UNLOCKED 2021. [DOI: 10.1016/j.imu.2021.100562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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18
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Kragting M, Schuiling SF, Voogt L, Pool-Goudzwaard AL, Coppieters MW. Using Visual Feedback Manipulation in Virtual Reality to Influence Pain-Free Range of Motion in People with Nonspecific Neck Pain. Pain Pract 2020; 21:428-437. [PMID: 33251721 PMCID: PMC8048536 DOI: 10.1111/papr.12971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/04/2020] [Accepted: 11/23/2020] [Indexed: 11/29/2022]
Abstract
Background Based on associative learning theories it is hypothesized that pain might be a conditioned response. In people with musculoskeletal pain, the occurrence of movement‐induced pain might be a protective response, influenced by visual cues suggesting that the person is approaching a painful position. This study aimed to determine (1) whether the pain‐free range of motion (ROM) increased and decreased when visual feedback understated or overstated true rotation in people with neck pain and (2) whether this effect was more pronounced if pain was chronic. Method People with subacute and chronic nonspecific neck pain wore a VR‐headset and rotated their head to the left and right until the onset of pain. Visual feedback about the amount of movement was either equal, 20% less, or 20% greater than their actual rotation. Maximal pain‐free ROM was measured using the VR‐headset sensors. Data were analyzed using a mixed‐design ANOVA. Results There was no effect of visual feedback manipulation on pain‐free ROM (P = 0.13) and no interaction effect between the visual feedback condition and duration of pain (P = 0.86). Discussion The inability to influence pain‐free ROM by manipulating visual feedback in people with subacute or chronic neck pain does not support associative learning theories for the perception of neck pain.
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Affiliation(s)
- Maaike Kragting
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stefan F Schuiling
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lennard Voogt
- Department of Physical Therapy, Research Centre for Health Care Innovations, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.,Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Annelies L Pool-Goudzwaard
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michel W Coppieters
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Menzies Health Institute Queensland, Griffith University, Brisbane and Gold Coast, Queensland, Australia
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Wang WE, Ho RLM, Gatto B, Der Veen SMV, Underation MK, Thomas JS, Antony AB, Coombes SA. A Novel Method to Understand Neural Oscillations During Full-Body Reaching: A Combined EEG and 3D Virtual Reality Study. IEEE Trans Neural Syst Rehabil Eng 2020; 28:3074-3082. [PMID: 33232238 DOI: 10.1109/tnsre.2020.3039829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Virtual reality (VR) can be used to create environments that are not possible in the real-world. Producing movements in VR holds enormous promise for rehabilitation and offers a platform from which to understand the neural control of movement. However, no study has examined the impact of a 3D fully immersive head-mounted display (HMD) VR system on the integrity of neural data. We assessed the quality of 64-channel EEG data with and without HMD VR during rest and during a full-body reaching task. We compared resting EEG while subjects completed three conditions: No HMD (EEG-only), HMD powered off (VR-off), and HMD powered on (VR-on). Within the same session, EEG were collected while subjects completed full-body reaching movements in two conditions (EEG-only, VR-on). During rest, no significant differences in data quality and power spectrum were observed between EEG-only, VR-off, and VR-on conditions. During reaching movements, the proportion of components attributed to the brain was greater in the EEG-only condition compared to the VR-on condition. Despite this difference, neural oscillations in source space were not significantly different between conditions, with both conditions associated with decreases in alpha and beta power in sensorimotor cortex during movements. Our findings demonstrate that the integrity of EEG data can be maintained while individuals execute full-body reaching movements within an immersive 3D VR environment. Clinical impact: Integrating VR and EEG is a viable approach to understanding the cortical processes of movement. Simultaneously recording movement and brain activity in combination with VR provides the foundation for neurobiologically informed rehabilitation therapies.
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20
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Yan C, Wu T, Huang K, He J, Liu H, Hong Y, Wang B. The Application of Virtual Reality in Cervical Spinal Surgery: A Review. World Neurosurg 2020; 145:108-113. [PMID: 32931993 DOI: 10.1016/j.wneu.2020.09.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023]
Abstract
In recent years, clinicians have used virtual reality (VR) to simulate real-world environments for medical purposes. The use of VR systems in the field of cervical spine surgery can lead to effective surgical training programs without causing harm to patients. Moreover, both imaging and VR can be used before surgery to assist preoperative surgical planning. VR devices have a variety of built-in motion sensors, therefore kinematic data can be recorded while users are wearing VR devices and performing some actions for the evaluation of cervical spine activity and exercise ability. Therapists have also applied VR to cervical spine rehabilitation and showed good results. At present, the application of VR systems in cervical spine surgery has great potential, but current research is insufficient. Here, we review the latest advancements in VR technology used in cervical spine surgery and discuss potential directions for future work.
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Affiliation(s)
- Chunyi Yan
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tingkui Wu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Kangkang Huang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Junbo He
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao Liu
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Hong
- Department of Anesthesia and Operation Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China; West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Beiyu Wang
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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21
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Harper HE, Hirt PA, Lev-Tov H. The use of virtual reality in non-burn dermatological care - a review of the literature. J DERMATOL TREAT 2020; 33:48-53. [PMID: 32174192 DOI: 10.1080/09546634.2020.1743812] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: Virtual Reality (VR) is the artificial depiction of a three-dimensional (3D) environment using computer-generated technology which allows users to interact with a simulated setting. VR has been used in a variety of clinical scenarios due to its efficacy as a distraction intervention, reducing anxiety and pain associated with medical procedures. The aim of this review is to provide clinicians with an overview of VR use in clinical dermatology.Methods: A search on VR use in clinical dermatology was conducted using PubMed Medline, Embase, Cochrane, Google Scholar and ClinicalTrials.Gov in July 2019. Results related to burn care were excluded.Results: This review identifies studies that utilized VR in the management of skin diseases and discusses considerations for its future use.Conclusion: The findings of these studies indicate that VR has beneficial effects as a complementary tool in the treatment of dermatological conditions.
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Affiliation(s)
| | - Penelope A Hirt
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hadar Lev-Tov
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Abstract
AIM Chronic low back pain (CLBP) is a highly prevalent and significant cause of disability which is often resistant to pharmacological management. Virtual reality (VR) is an emerging technology with the potential to influence CLBP, and has been suggested as an alternative to opioids for pain management. VR is a goalfocused, computer-simulated reality allowing modification of the user's experience of their perceived world. MATERIALS/METHODS A narrative review of peer-reviewed literature using a systematic search strategy, and sole reviewer for data extraction. CONCLUSIONS VR has demonstrated effectiveness in reducing acute, experimental and chronic pain. This review describes the theoretical basis of the therapeutic effects of VR on CLBP via three distinct mechanisms: distraction, neuromodulation and graded exposure therapy. Furthermore, clinical application will be considered, including discussion of ethical issues associated with the technology.Implications for rehabilitationVirtual reality (VR) is suggested as an alternative for opioids in the management of acute and chronic pain.The therapeutic mechanisms of VR in chronic low back pain (CLBP) are equivocal but include distraction, neuromodulation of body perception and graded exposure therapy.VR may show greater efficacy in patients with CLBP with associated kinesiophobia.VR may show greater effect with increased immersion.
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Won AS, Bailey J, Bailenson J, Tataru C, Yoon IA, Golianu B. Immersive Virtual Reality for Pediatric Pain. CHILDREN (BASEL, SWITZERLAND) 2017; 4:E52. [PMID: 28644422 PMCID: PMC5532544 DOI: 10.3390/children4070052] [Citation(s) in RCA: 108] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 05/24/2017] [Accepted: 06/16/2017] [Indexed: 12/29/2022]
Abstract
Children must often endure painful procedures as part of their treatment for various medical conditions. Those with chronic pain endure frequent or constant discomfort in their daily lives, sometimes severely limiting their physical capacities. With the advent of affordable consumer-grade equipment, clinicians have access to a promising and engaging intervention for pediatric pain, both acute and chronic. In addition to providing relief from acute and procedural pain, virtual reality (VR) may also help to provide a corrective psychological and physiological environment to facilitate rehabilitation for pediatric patients suffering from chronic pain. The special qualities of VR such as presence, interactivity, customization, social interaction, and embodiment allow it to be accepted by children and adolescents and incorporated successfully into their existing medical therapies. However, the powerful and transformative nature of many VR experiences may also pose some risks and should be utilized with caution. In this paper, we review recent literature in pediatric virtual reality for procedural pain and anxiety, acute and chronic pain, and some rehabilitation applications. We also discuss the practical considerations of using VR in pediatric care, and offer specific suggestions and information for clinicians wishing to adopt these engaging therapies into their daily clinical practice.
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Affiliation(s)
- Andrea Stevenson Won
- Department of Communication, Cornell University, 417 Mann Library Building, Ithaca, NY 14853, USA.
| | - Jakki Bailey
- Department of Anesthesiology and Perioperative Medicine, Stanford University, 300 Pasteur Dr. H3580A, Stanford, CA 94305, USA.
| | - Jeremy Bailenson
- Department of Anesthesiology and Perioperative Medicine, Stanford University, 300 Pasteur Dr. H3580A, Stanford, CA 94305, USA.
| | - Christine Tataru
- Department of Anesthesiology and Perioperative Medicine, Stanford University, 300 Pasteur Dr. H3580A, Stanford, CA 94305, USA.
| | - Isabel A Yoon
- Department of Anesthesiology and Perioperative Medicine, Stanford University, 300 Pasteur Dr. H3580A, Stanford, CA 94305, USA.
| | - Brenda Golianu
- Department of Anesthesiology and Perioperative Medicine, Stanford University, 300 Pasteur Dr. H3580A, Stanford, CA 94305, USA.
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