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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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Liu Y, Du Q, Jiang Y. The effect of virtual reality technology in exercise and lung function of patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2024; 21:307-317. [PMID: 38297408 DOI: 10.1111/wvn.12698] [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: 05/31/2023] [Revised: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a serious chronic disease worldwide, with significant negative impacts on the quality of life, family economic burden, and social healthcare burden of patients. AIMS The aim of this study was to explore the effects of virtual reality technology on exercise function and lung function in COPD patients. METHODS A meta-analysis of randomized controlled trials was utilized. PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CINAHL, Medline, Scopus, China National Knowledge Infrastructure (CNKI), Wanfang Database, Weipu Database (VIP), and Chinese Biomedical Database (CBM) were systematically searched. We included randomized controlled trials published from the establishment of the database to August 10, 2022, on virtual reality technology in COPD patients. Literature retrieval and screening was carried out independently by two reviewers to obtain literature that met our inclusion and exclusion criteria and to extract relevant data. Two reviewers assessed the risk of bias in the included literature. A meta-analysis was performed using Revman 5.4 Software. RESULTS A total of 10 randomized controlled trials with 539 participants were included. The results showed that virtual reality technology significantly improved the lung function of COPD patients, such as forced expiratory volume (FEV1; MD = 7.29, 95% CI [4.34, 10.24], p < .01) and forced expiratory volume/forced vital capacity (FEV1/FVC; MD = 6.71, 95% CI [4.72, 8.71], p < .01). The combined intervention with different virtual reality technology had different effects on motor function. Compared with endurance training (ET) alone, virtual reality technology combined with ET had no significant effect on the 6-minute walk test (6WMT) in COPD patients (p > .05). Compared with pulmonary rehabilitation (PR) alone, virtual reality technology combined with PR was more effective in increasing 6WMT in COPD patients (MD = 30.80, 95% CI [10.85, 50.74], p < .01). LINKING EVIDENCE TO ACTION Virtual reality technology can help to improve lung function in COPD patients, and virtual reality combined with PR can improve exercise tolerance in COPD patients. However, due to the limited number of included studies, large-sample, multicenter, high-quality randomized controlled trial studies are needed to provide clear evidence.
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Affiliation(s)
- Yaxin Liu
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qiufeng Du
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yunlan Jiang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Chen IW, Wang WT, Hung KC. Comment on effect of virtual reality technology as intervention for people with kinesiophobia. J Clin Nurs 2024; 33:1588-1589. [PMID: 38243681 DOI: 10.1111/jocn.16991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Affiliation(s)
- I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan City, Taiwan
| | - Wei-Ting Wang
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan
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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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Hu Y, Yuan X, Ye P, Chang C, Hu YH, Zhang W, Li K. Virtual Reality in Clinical Nursing Practice Over the Past 10 Years: Umbrella Review of Meta-Analyses. JMIR Serious Games 2023; 11:e52022. [PMID: 37997773 PMCID: PMC10690102 DOI: 10.2196/52022] [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: 08/21/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 11/25/2023] Open
Abstract
Background Virtual reality (VR) has shown promising levels of effectiveness in nursing education, pain management, and rehabilitation. However, meta-analyses have discussed the effects of VR usage in nursing unilaterally and inconsistently, and the evidence base is diffuse and varied. Objective We aimed to synthesize the combined evidence from meta-analyses that assessed the effects of nurses using VR technology on nursing education or patient health outcomes. Methods We conducted an umbrella review by searching for meta-analyses about VR intervention in clinical nursing practice on Web of Science, Embase, Cochrane, and PubMed, and in reference lists. Eligible studies were published in English between December 1, 2012, and September 20, 2023. Meta-analyses of ≤2 intervention studies and meta-analyses without 95% CI or heterogeneity data were excluded. Characteristic indicators, population information, VR intervention information, and 95% CIs were extracted. A descriptive analysis of research results was conducted to discern relationships between VR interventions and outcomes. I2 and P values were used to evaluate publication bias. AMSTAR (A Measurement Tool to Assess Systematic Reviews) 2 and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) checklist were used to appraise literature quality. Results In total, 768 records were identified; 74 meta-analyses were included for review. The most reported VR study conditions were neuronursing (25/74, 34%), pediatric nursing (13/74, 18%), surgical and wound care (11/74, 15%), oncological nursing (11/74, 15%), and older adult nursing (10/74, 14%). Further, 30% (22/74) of meta-analyses reported publication bias, and 15% (11/74) and 8% (6/74) were rated as "high" based on AMSTAR 2 and the GRADE checklist, respectively. The main outcome indicators among all included meta-analyses were pain (37/214, 17.3%), anxiety (36/214, 16.8%), cognitive function (17/214, 7.9%), balance (16/214, 7.5%), depression (16/214, 7.5%), motor function (12/214, 5.6%), and participation in life (12/214, 5.6%). VR treatment for cognition, pain, anxiety, and depression was effective (all P values were <.05), while the utility of VR for improving motor function, balance, memory, and attention was controversial. Adverse effects included nausea, vomiting, and dizziness (incidence: range 4.76%-50%). The most common VR platforms were Pico VR glasses, head-mounted displays, the Nintendo Wii, and the Xbox Kinect. VR intervention duration ranged from 2 weeks to 12 months (typically ≥4 wk). VR session length and frequency ranged from 5 to 100 minutes and from 1 to 10 times per week, respectively. Conclusions VR in nursing has positive effects-relieving patients' pain, anxiety, and depression and improving cognitive function-despite the included studies' limited quality. However, applying VR in nursing to improve patients' motor function, balance, memory, and attention remains controversial. Nursing researchers need to further explore the effects and standard operation protocols of VR in clinical practice, and more high-quality research on VR in nursing is needed.
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Affiliation(s)
- Yanjie Hu
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xingzhu Yuan
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Peiling Ye
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Chengting Chang
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Yue Han Hu
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
| | - Weihua Zhang
- School of Computer Science, Sichuan University, Chengdu, China
| | - Ka Li
- West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China
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Percy D, Phillips T, Torres F, Chaleunphonh M, Sung P. Effectiveness of virtual reality-based balance and gait in older adults with fear of movement: A systematic review and meta-analysis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e2037. [PMID: 37427539 DOI: 10.1002/pri.2037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/31/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE To summarize the current evidence from randomized controlled trials (RCTs) regarding the effectiveness of Virtual Reality (VR) training and functional mobility in older adults with fear of movement. TYPE: Systematic review and meta-analysis of randomized clinical trials. METHODOLOGY An electronic search was performed using PubMed, Embase, Medline, SPORTDiscus, Scopus, and CINAHL. A data search from January 2015 to December 2022 and a manual electronic literature search were conducted to identify published RCTs. The effectiveness of VR-based balance training for balance and gait was evaluated in older adults with a fear of movement, which was measured by the Timed Up and Go (TUG) test and the Falls Efficacy Scale (FES). Three reviewers independently performed the study selection, and the quality assessment of the included studies was performed using the Physiotherapy Evidence Database (PEDro) scale. The reporting was based on the new Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. SYNTHESIS The search product produced 345 results, from which 23 full text articles were studied. Seven RCTs of good methodological quality, including 265 participants, were included in the review. Overall, the studies reported that VR had a significant improvement on the TUG (Cohen's d = -0.91 [-1.38; -0.44], p = 0.001), while the FES was not significantly different (Cohen's d = -0.54 [-1.80; 0.71] p = 0.40). The average for PEDro scores (6.14) was good, and the risk of bias revealed that more than one-third of the studies correctly described the random sequence generation and allocation concealment procedures. CONCLUSION VR-based training is effective on balance or gait training based on the TUG; however, there were mixed results to improve FES scores following VR intervention. These inconsistent results might be limited due to variations in the studies, including heterogeneous training paradigms, sensitive outcome measures, small sample sizes, and short intervention durations, which limit the validity of our findings. Future investigations should compare different VR protocols to help establish better guidelines for clinicians.
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Affiliation(s)
- David Percy
- Department of Physical Therapy, School of Nursing and Health Sciences, Indiana Wesleyan University, Marion, Indiana, USA
| | - Tyler Phillips
- Department of Physical Therapy, School of Nursing and Health Sciences, Indiana Wesleyan University, Marion, Indiana, USA
| | - Fabian Torres
- Department of Physical Therapy, School of Nursing and Health Sciences, Indiana Wesleyan University, Marion, Indiana, USA
| | - Michele Chaleunphonh
- Department of Occupational Therapy, School of Nursing and Health Sciences, Indiana Wesleyan University, Marion, Indiana, USA
| | - Paul Sung
- Department of Physical Therapy, School of Nursing and Health Sciences, Indiana Wesleyan University, Marion, Indiana, USA
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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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