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Kumar P, Christodoulou A, Loizou M. Assessment approaches for hemiplegic shoulder pain in people living with stroke - A scoping review. Disabil Rehabil 2024:1-11. [PMID: 39105542 DOI: 10.1080/09638288.2024.2385736] [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: 01/11/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE Hemiplegic shoulder pain (HSP) is reported in up to 40% of people with stroke. Causes of HSP are often multifactorial. To inform appropriate treatment, reliable/valid assessments are critical. The aim of this scoping review was to collate assessment approaches used in studies where the primary outcome was HSP, and to identify how frequently each assessment approach was used. METHODS A systematic search, including studies from 2000-2023 was conducted of the MEDLINE, EMBASE, CINAHL, AMED, Biomed Central, and Cochrane Library databases, with four key terms used: "assess", "stroke", "pain" and "shoulder". All primary studies published in English language fulfilling the reviews inclusion criteria were included. Six reviewers extracted the data. RESULTS A total of 29 assessment methods for HSP were identified from 124 studies. The common assessments were: Visual Analogue Scale (n = 75, 60%), Passive Range of Movement (n = 65, 52%), Fugl-Meyer Assessment (n = 32, 26%), glenohumeral subluxation (n = 30, 24%) and Numerical Rating Scale (n = 27, 22%). CONCLUSION A wide range of assessment approaches was identified for HSP, and some are used more than others. A fully comprehensive assessment that considers different aspects of pain including severity and timing, functioning, and the psychological burden, is needed in this area of practice to be able to guide appropriate treatment.
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Affiliation(s)
- Praveen Kumar
- College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Avgi Christodoulou
- College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Michael Loizou
- Centre for Health Technology, University of Plymouth, Plymouth, UK
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2
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Banduni O, Saini M, Singh N, Nath D, Kumaran SS, Kumar N, Srivastava MVP, Mehndiratta A. Post-Stroke Rehabilitation of Distal Upper Limb with New Perspective Technologies: Virtual Reality and Repetitive Transcranial Magnetic Stimulation-A Mini Review. J Clin Med 2023; 12:jcm12082944. [PMID: 37109280 PMCID: PMC10142518 DOI: 10.3390/jcm12082944] [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: 03/16/2023] [Revised: 04/12/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Upper extremity motor impairment is the most common sequelae in patients with stroke. Moreover, its continual nature limits the optimal functioning of patients in the activities of daily living. Because of the intrinsic limitations in the conventional form of rehabilitation, the rehabilitation applications have been expanded to technology-driven solutions, such as Virtual Reality and Repetitive Transcranial Magnetic Stimulation (rTMS). The motor relearning processes are influenced by variables, such as task specificity, motivation, and feedback provision, and a VR environment in the form of interactive games could provide novel and motivating customized training solutions for better post-stroke upper limb motor improvement. rTMS being a precise non-invasive brain stimulation method with good control of stimulation parameters, has the potential to facilitate neuroplasticity and hence a good recovery. Although several studies have discussed these forms of approaches and their underlying mechanisms, only a few of them have specifically summarized the synergistic applications of these paradigms. To bridge the gaps, this mini review presents recent research and focuses precisely on the applications of VR and rTMS in distal upper limb rehabilitation. It is anticipated that this article will provide a better representation of the role of VR and rTMS in distal joint upper limb rehabilitation in patients with stroke.
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Affiliation(s)
- Onika Banduni
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Megha Saini
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Neha Singh
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - Debasish Nath
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
| | - S Senthil Kumaran
- Department of Nuclear Medicine and Resonance, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - M V Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - Amit Mehndiratta
- Centre for Biomedical Engineering, Indian Institute of Technology Delhi (IITD), New Delhi 110016, India
- Department of Biomedical Engineering, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
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3
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Mugisha S, Job M, Zoppi M, Testa M, Molfino R. Computer-Mediated Therapies for Stroke Rehabilitation: A Systematic Review and Meta-Analysis. J Stroke Cerebrovasc Dis 2022; 31:106454. [DOI: 10.1016/j.jstrokecerebrovasdis.2022.106454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 03/11/2022] [Accepted: 03/13/2022] [Indexed: 12/29/2022] Open
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4
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Lu L, Wang H, Liu P, Liu R, Zhang J, Xie Y, Liu S, Huo T, Xie M, Wu X, Ye Z. Applications of Mixed Reality Technology in Orthopedics Surgery: A Pilot Study. Front Bioeng Biotechnol 2022; 10:740507. [PMID: 35273954 PMCID: PMC8902164 DOI: 10.3389/fbioe.2022.740507] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/21/2022] [Indexed: 12/28/2022] Open
Abstract
Objective: The aim of this study is to explore the potential of mixed reality (MR) technology in the visualization of orthopedic surgery. Methods: The visualization system with MR technology is widely used in orthopedic surgery. The system is composed of a 3D imaging workstation, a cloud platform, and an MR space station. An intelligent segmentation algorithm is adopted on the 3D imaging workstation to create a 3D anatomical model with zooming and rotation effects. This model is then exploited for efficient 3D reconstruction of data for computerized tomography (CT) and magnetic resonance imaging (MRI). Additionally, the model can be uploaded to the cloud platform for physical parameter tuning, model positioning, rendering and high-dimensional display. Using Microsoft’s HoloLens glasses in combination with the MR system, we project and view 3D holograms in real time under different clinical scenarios. After each procedure, nine surgeons completed a Likert-scale questionnaire on communication and understanding, spatial awareness and effectiveness of MR technology use. In addition to that, the National Aeronautics and Space Administration Task Load Index (NASA-TLX) is also used to evaluate the workload of MR hologram support. Results: 1) MR holograms can clearly show the 3D structures of bone fractures, which improves the understanding of different fracture types and the design of treatment plans; 2) Holograms with three-dimensional lifelike dynamic features provide an intuitive communication tool among doctors and also between doctors and patients; 3) During surgeries, a full lesion hologram can be obtained and blended in real time with a patient’s virtual 3D digital model in order to give surgeons superior visual guidance through novel high-dimensional “perspectives” of the surgical area; 4) Hologram-based magnetic navigation improves the accuracy and safety of the screw placement in orthopaedics surgeries; 5) The combination of mixed reality cloud platform and telemedicine system based on 5G provides a new technology platform for telesurgery collaboration. Results of qualitative study encourage the usage of MR technology for orthopaedics surgery. Analysis of the Likert-scale questionnaire shows that MR adds significant value to understanding and communication, spatial awareness, learning and effectiveness. Based on the NASA TLX-scale questionnaire results, mixed reality scored significantly lower under the “mental,” “temporal,” “performance,” and “frustration” categories compared to usual 2D. Conclusion: The integration of MR technology in orthopaedic surgery reduces the dependence on surgeons’ experience and provides personalized 3D visualization models for accurate diagnosis and treatment of orthopaedic abnormalities. This integration is clearly one of the prominent future development directions in medical surgery.
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Affiliation(s)
- Lin Lu
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Honglin Wang
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Pengran Liu
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Rong Liu
- Department of Orthopaedic Surgery, Puren Hospital of Wuhan, Wuhan University of Science and Technology, Wuhan, China
| | - Jiayao Zhang
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Xie
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Songxiang Liu
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tongtong Huo
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mao Xie
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinghuo Wu
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xinghuo Wu, ; Zhewei Ye,
| | - Zhewei Ye
- Department of Orthopaedics Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Intelligent Medical Laboratory, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xinghuo Wu, ; Zhewei Ye,
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Abd El-Kafy EM, Alshehri MA, El-Fiky AAR, Guermazi MA, Mahmoud HM. The Effect of Robot-Mediated Virtual Reality Gaming on Upper Limb Spasticity Poststroke: A Randomized-Controlled Trial. Games Health J 2022; 11:93-103. [PMID: 35100025 DOI: 10.1089/g4h.2021.0197] [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] [Indexed: 11/13/2022] Open
Abstract
Objective: Stroke is a common reason for motor disability and is often associated with spasticity and poor motor function of the upper limbs involved. Spasticity management is important to accelerate motor recovery. The objective of this study was to investigate the effects of training with robot-mediated virtual reality gaming on upper limb spasticity and motor functions in individuals with chronic stroke. Materials and Methods: A total of 40 Saudi individuals with chronic stroke were involved in this study. Participants were randomly assigned to two groups. The experimental group received conventional physiotherapy and training with robot-mediated virtual reality gaming, and the control group received only conventional physiotherapy. Outcomes were measured by the Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), WMFT-Time, Modified Ashworth Scale (MAS), Active Range of Motion (AROM) of multiple joints of the upper limb, and Handgrip Strength (HGS). The scores of all the outcome measures were recorded at baseline and after the completion of the treatment. Results: Individuals with stroke in the experimental group had a better improvement in most measured variables (AROM of shoulder abduction, elbow supination and wrist extension, WMFT-Time, HGS, ARAT, WMFT, and MAS) compared with the control group after the completion of the treatment. Both groups showed significant improvement in all the measured variables after completion of the treatment, except in MAS for wrist flexors in the control group. Conclusion: Training with robot-mediated virtual reality gaming was effective in modulating spasticity and improving the motor functions of the affected upper limbs in individuals with chronic stroke. This study was registered in ClinicalTrial.gov (NCT05069480).
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Affiliation(s)
| | - Mansour Abdullah Alshehri
- Department of Physical Therapy, Umm Al-Qura University, Makkah, Saudi Arabia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | | | | | - Hayam Mohamed Mahmoud
- Department of Physical Therapy, Umm Al-Qura University, Makkah, Saudi Arabia.,Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Mennella C, Alloisio S, Novellino A, Viti F. Characteristics and Applications of Technology-Aided Hand Functional Assessment: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2021; 22:199. [PMID: 35009742 PMCID: PMC8749695 DOI: 10.3390/s22010199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 01/08/2023]
Abstract
Technology-aided hand functional assessment has received considerable attention in recent years. Its applications are required to obtain objective, reliable, and sensitive methods for clinical decision making. This systematic review aims to investigate and discuss characteristics of technology-aided hand functional assessment and their applications, in terms of the adopted sensing technology, evaluation methods and purposes. Based on the shortcomings of current applications, and opportunities offered by emerging systems, this review aims to support the design and the translation to clinical practice of technology-aided hand functional assessment. To this end, a systematic literature search was led, according to recommended PRISMA guidelines, in PubMed and IEEE Xplore databases. The search yielded 208 records, resulting into 23 articles included in the study. Glove-based systems, instrumented objects and body-networked sensor systems appeared from the search, together with vision-based motion capture systems, end-effector, and exoskeleton systems. Inertial measurement unit (IMU) and force sensing resistor (FSR) resulted the sensing technologies most used for kinematic and kinetic analysis. A lack of standardization in system metrics and assessment methods emerged. Future studies that pertinently discuss the pathophysiological content and clinimetrics properties of new systems are required for leading technologies to clinical acceptance.
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Affiliation(s)
- Ciro Mennella
- Institute of Biophysics, National Research Council, Via De Marini 6, 16149 Genova, Italy; (S.A.); (F.V.)
| | - Susanna Alloisio
- Institute of Biophysics, National Research Council, Via De Marini 6, 16149 Genova, Italy; (S.A.); (F.V.)
- ETT Spa, Via Sestri 37, 16154 Genova, Italy;
| | | | - Federica Viti
- Institute of Biophysics, National Research Council, Via De Marini 6, 16149 Genova, Italy; (S.A.); (F.V.)
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7
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Fonseca D, Cavalcanti J, Peña E, Valls V, Sanchez-Sepúlveda M, Moreira F, Navarro I, Redondo E. Mixed Assessment of Virtual Serious Games Applied in Architectural and Urban Design Education. SENSORS (BASEL, SWITZERLAND) 2021; 21:3102. [PMID: 33946868 PMCID: PMC8125721 DOI: 10.3390/s21093102] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 02/06/2023]
Abstract
The creation and usage of serious games on virtual reality (VR) and/or interactive platforms for the teaching of architecture, construction, urban planning, and other derived areas, such as security and risk prevention, require design processes, studies, and research that lead to further consolidation expansion. In that sense, this paper presents two main aims developed: the improvement of a virtual navigation system through the results of previous user studies and mixed research (quantitative and qualitative) improved based on the user perception for educational and professional uses. The VR system used is based on Unreal Engine programming of the HTC Vive sensor. This study is related to the GAME4City 3.0 and a broader project focused on gamified visualization and its educational uses in architectural and urban projects. The results reflect great interest, good usability, and high motivation for further usage for all types of users. However, an apparent resistance to deepen its use continues to be perceived in academia. Based on the research results, weak points of educational gamified systems have been identified, and the main differences and needs in user profiles' function. With these data, progress regarding implementing this kind of system at the teaching and professional levels must be pursued.
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Affiliation(s)
- David Fonseca
- Architecture La Salle, Universitat Ramon Llull, 08022 Barcelona, Spain; (E.P.); (V.V.); (M.S.-S.)
| | - Janaina Cavalcanti
- Instituto de Investigación e Innovación en Bioingeniería (I3B), Universitat Politècnica de Valencia, 46022 Valencia, Spain;
| | - Enric Peña
- Architecture La Salle, Universitat Ramon Llull, 08022 Barcelona, Spain; (E.P.); (V.V.); (M.S.-S.)
| | - Victor Valls
- Architecture La Salle, Universitat Ramon Llull, 08022 Barcelona, Spain; (E.P.); (V.V.); (M.S.-S.)
| | - Mónica Sanchez-Sepúlveda
- Architecture La Salle, Universitat Ramon Llull, 08022 Barcelona, Spain; (E.P.); (V.V.); (M.S.-S.)
| | - Fernando Moreira
- REMIT, IJP, Universidade Portucalense, 4200-072 Porto, Portugal;
- IEETA, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Isidro Navarro
- Escola Tècnica Superior d’Arquitectura de Barcelona, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (I.N.); (E.R.)
| | - Ernesto Redondo
- Escola Tècnica Superior d’Arquitectura de Barcelona, Universitat Politècnica de Catalunya, 08028 Barcelona, Spain; (I.N.); (E.R.)
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Lehmann I, Baer G, Schuster-Amft C. Experience of an upper limb training program with a non-immersive virtual reality system in patients after stroke: a qualitative study. Physiotherapy 2020; 107:317-326. [DOI: 10.1016/j.physio.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/10/2017] [Indexed: 10/20/2022]
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Efficacy of Virtual Reality Combined With Real Instrument Training for Patients With Stroke: A Randomized Controlled Trial. Arch Phys Med Rehabil 2019; 100:1400-1408. [PMID: 31002812 DOI: 10.1016/j.apmr.2019.03.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 03/02/2019] [Accepted: 03/06/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To investigate the efficacy of real instrument training in virtual reality (VR) environment for improving upper-extremity and cognitive function after stroke. DESIGN Single-blind, randomized trial. SETTING Medical center. PARTICIPANTS Enrolled subjects (N=31) were first-episode stroke, assessed for a period of 6 months after stroke onset; age between 20 and 85 years; patients with unilateral paralysis and a Fugl-Meyer assessment upper-extremity scale score >18. INTERVENTIONS Both groups were trained 30 minutes per day, 3 days a week, for 6 weeks, with the experimental group performing the VR combined real instrument training and the control group performing conventional occupational therapy. MAIN OUTCOME MEASURES Manual Muscle Test, modified Ashworth scale, Fugl-Meyer upper motor scale, hand grip, Box and Block, 9-Hole Peg Test (9-HPT), Korean Mini-Mental State Examination, and Korean-Montreal Cognitive Assessment. RESULTS The experimental group showed greater therapeutic effects in a time-dependent manner than the control group, especially on the motor power of wrist extension, spasticity of elbow flexion and wrist extension, and Box and Block Tests. Patients in the experimental group, but not the control group, also showed significant improvements on the lateral, palmar, and tip pinch power, Box and Block, and 9-HPTs from before to immediately after training. Significantly greater improvements in the tip pinch power immediately after training and spasticity of elbow flexion 4 weeks after training completion were noted in the experimental group. CONCLUSIONS VR combined real instrument training was effective at promoting recovery of patients' upper-extremity and cognitive function, and thus may be an innovative translational neurorehabilitation strategy after stroke.
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Ho TH, Yang FC, Lin RC, Chien WC, Chung CH, Chiang SL, Chou CH, Tsai CK, Tsai CL, Lin YK, Lee JT. Impact of virtual reality-based rehabilitation on functional outcomes in patients with acute stroke: a retrospective case-matched study. J Neurol 2019; 266:589-597. [PMID: 30610428 DOI: 10.1007/s00415-018-09171-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/22/2018] [Accepted: 12/25/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVES To date, the efficacy of the virtual reality (VR) application for acute stroke compared with conventional therapy (CT) remains unclear. This retrospective study aims to assess the impact of adjuvant VR technology on multidimensional therapy for patients with acute-stage stroke. METHODS 100 acute ischemic stroke patients with onset within 7 days who underwent combined adjuvant VR-based rehabilitation program and CT (intervention group-VR + CT) were compared to an equal number of cross-matched patients who received CT alone. While the intervention group received 40-min CT plus 20-min VR program (seven times for 1 week), the comparison group received time-matched CT alone. The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), medical cost-effectiveness, and shortening of hospital stay were used as outcome measures. RESULTS Posttreatment, the VR + CT group revealed significantly improved NIHSS and mRS (P < 0.001), whereas only the mRS improvement was remarkable in the CT group. In between-group comparisons, the intervention group had better improvements of symptom severity (NIHSS percentage improvement from the baseline; 20.18% vs. 4.59%, P < 0.005), functional outcomes (mRS improvement from the baseline; - 0.58 vs. - 0.23, P < 0.001), and reduced medical cost (Taiwan dollar; 49474 vs. 66306, P < 0.005). Furthermore, the VR + CT group reached markedly higher proportion of functional independence in activities of daily living (mRS, 0-2) at discharge compared with the CT group (68% vs. 60%, P < 0.001). CONCLUSIONS This study suggests that the combination of VR-based rehabilitation and traditional therapy could be more effective for neurorehabilitation than CT alone in the early improvement of symptom severity, functional outcomes, and lower medical expenditure in acute stroke patients.
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Affiliation(s)
- Tsung-Han Ho
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Ruei-Ching Lin
- Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Shang-Lin Chiang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan. .,Graduate Institute of Medical Sciences, National Defense Medical Center, No. 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan.
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11
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Schuster-Amft C, Eng K, Suica Z, Thaler I, Signer S, Lehmann I, Schmid L, McCaskey MA, Hawkins M, Verra ML, Kiper D. Effect of a four-week virtual reality-based training versus conventional therapy on upper limb motor function after stroke: A multicenter parallel group randomized trial. PLoS One 2018; 13:e0204455. [PMID: 30356229 PMCID: PMC6200191 DOI: 10.1371/journal.pone.0204455] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 08/20/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Virtual reality-based training has found increasing use in neurorehabilitation to improve upper limb training and facilitate motor recovery. OBJECTIVE The aim of this study was to directly compare virtual reality-based training with conventional therapy. METHODS In a multi-center, parallel-group randomized controlled trial, patients at least 6 months after stroke onset were allocated either to an experimental group (virtual reality-based training) or a control group receiving conventional therapy (16x45 minutes within 4 weeks). The virtual reality-based training system replicated patients´ upper limb movements in real-time to manipulate virtual objects. Blinded assessors tested patients twice before, once during, and twice after the intervention up to 2-month follow-up for dexterity (primary outcome: Box and Block Test), bimanual upper limb function (Chedoke-McMaster Arm and Hand Activity Inventory), and subjective perceived changes (Stroke Impact Scale). RESULTS 54 eligible patients (70 screened) participated (15 females, mean age 61.3 years, range 20-81 years, time since stroke 3.0±SD 3 years). 22 patients were allocated to the experimental group and 32 to the control group (3 drop-outs). Patients in the experimental and control group improved: Box and Block Test mean 21.5±SD 16 baseline to mean 24.1±SD 17 follow-up; Chedoke-McMaster Arm and Hand Activity Inventory mean 66.0±SD 21 baseline to mean 70.2±SD 19 follow-up. An intention-to-treat analysis found no between-group differences. CONCLUSIONS Patients in the experimental and control group showed similar effects, with most improvements occurring in the first two weeks and persisting until the end of the two-month follow-up period. The study population had moderate to severely impaired motor function at entry (Box and Block Test mean 21.5±SD 16). Patients, who were less impaired (Box and Block Test range 18 to 72) showed higher improvements in favor of the experimental group. This result could suggest that virtual reality-based training might be more applicable for such patients than for more severely impaired patients. TRIAL REGISTRATION ClinicalTrials.gov NCT01774669.
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Affiliation(s)
- Corina Schuster-Amft
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland
| | - Kynan Eng
- Institute of Neuroinformatics, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Zorica Suica
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
| | - Irene Thaler
- Department of Physiotherapy, Insel Group, Bern University Hospital, Berne, Switzerland
| | - Sandra Signer
- Physiotherapy Department, Buergerspital Solothurn, Solothurn, Switzerland
| | - Isabelle Lehmann
- Department of Physiotherapy, Insel Group, Bern University Hospital, Berne, Switzerland
| | - Ludwig Schmid
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- Physiotherapy Department, Zurcher RehaZentrum Lengg, Zurich, Switzerland
| | - Michael A. McCaskey
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- Institute of Human Movement Sciences, ETH Zurich, Zurich, Switzerland
| | - Miura Hawkins
- Institute of Neuroinformatics, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Martin L. Verra
- Department of Physiotherapy, Insel Group, Bern University Hospital, Berne, Switzerland
| | - Daniel Kiper
- Institute of Neuroinformatics, University of Zurich and ETH Zurich, Zurich, Switzerland
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Feng Z, Tang Q, Lin J, He Q, Peng C. Application of animated cartoons in reducing the pain of dressing changes in children with burn injuries. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2018; 8:106-113. [PMID: 30515348 PMCID: PMC6261918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/08/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Nonpharmacological management remains one of the central pain interventional therapies in the burn unit. VR and other distraction treatments for adults have achieved great advantages in pain relief. METHODS A within-subject study was conducted to evaluate 54 participants aged from 3 to 7. In the control group, a standard analgesic, ibuprofen, was used over the period of dressing change, whereas animated cartoons were played simultaneously in the intervention-group condition. We adopted the Wong-Baker faces pain rating scale, COMFORT scale, FLACC scale and POCIS to assess the pain rating 5 min before, during and 5 min after dressing changes, respectively. RESULTS Compared with the control group, FLACC scale and POCIS scores in the intervention group were not significantly different (P>0.05) throughout the observation period; outcomes measured using the Wong-Baker faces pain rating scale and COMFORT scale 5 min before and during dressing changes were also not different between the groups (P>0.05). Nevertheless, 5 min after that period, subjects in the intervention group had reduced pain behavior according to scores on the Wong-Baker faces pain rating scale (control-group scores: 7.231±0.403; intervention-group scores: 6.026±0.501, P<0.05) and COMFORT scale (control-group scores: 21.602±1.316; intervention-group scores: 19.040±1.204, P<0.05). CONCLUSION This study supports that watching animated cartoons appears to be a practical way to ease the pain behavior of children in the burn unit after replacing wound dressings, although its effectiveness remains insufficient before and during the dressing change procedure. SIGNIFICANCE Conducting a thorough study and exploring the efficacy of animated cartoons in reducing the pain of dressing changes for pediatric patients may surely result in practical value, especially in developing countries.
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Affiliation(s)
- Zhicai Feng
- Department of Burns and Plastic Surgery of The 3rd Xiangya Hospital, Central South UniversityChangsha 410013, Hunan, China
| | - Qiyu Tang
- Xiangya Medical School of Central South UniversityChangsha 410013, Hunan, China
| | - Junqing Lin
- Xiangya Medical School of Central South UniversityChangsha 410013, Hunan, China
| | - Quanyong He
- Department of Burns and Plastic Surgery of The 3rd Xiangya Hospital, Central South UniversityChangsha 410013, Hunan, China
| | - Cheng Peng
- Department of Burns and Plastic Surgery of The 3rd Xiangya Hospital, Central South UniversityChangsha 410013, Hunan, China
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Behrendt F, Schuster-Amft C. Using an interactive virtual environment to integrate a digital Action Research Arm Test, motor imagery and action observation to assess and improve upper limb motor function in patients with neuromuscular impairments: a usability and feasibility study protocol. BMJ Open 2018; 8:e019646. [PMID: 30012780 PMCID: PMC6082472 DOI: 10.1136/bmjopen-2017-019646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 04/24/2018] [Accepted: 05/15/2018] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION In the recent past, training systems using an interactive virtual environment have been introduced to neurorehabilitation. Such systems can be applied to encourage purposeful limb movements and will increasingly be used at home by the individual patient. Therefore, an integrated valid and reliable assessment tool on the basis of such a system to monitor the recovery process would be an essential asset. OBJECTIVES The aim of the study is to evaluate usability, feasibility and validity of the digital version of the Action Research Arm Test using the Bi-Manu-Trainer system as a platform. Additionally, the feasibility and usability of the implementation of action observation and motor imagery tasks into the Bi-Manu-Trainer software will be evaluated. PATIENTS AND METHODS This observational study is planned as a single-arm trial for testing the new assessment and the action observation and motor imagery training module. Therefore, 75 patients with Parkinson's disease, multiple sclerosis, stroke, traumatic brain injury or Guillain-Barré syndrome will be included. 30 out of the 75 patients will additionally take part in a 4-week training on the enhanced Bi-Manu-Trainer system. Primary outcomes will be the score on the System Usability Scale and the correlation between the conventional and digital Action Research Arm Test scores. Secondary outcomes will be hand dexterity, upper limb activities of daily living and quality of life. HYPOTHESIS We hypothesise that the digital Action Research Arm Test assessment is a valid and essential tool and that it is feasible to incorporate action observation and motor imagery into Bi-Manu-Trainer practice. The results are expected to give recommendations for necessary modifications and might also contribute knowledge concerning the application of action observation and motor imagery tasks using a training system such as the Bi-Manu-Trainer. TRIAL REGISTRATION NUMBER NCT03268304; Pre-results.
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Affiliation(s)
- Frank Behrendt
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- University Children’s Hospital Basel, Basel, Switzerland
| | - Corina Schuster-Amft
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
- Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Keller MS, Park HJ, Cunningham ME, Fouladian JE, Chen M, Spiegel BMR. Public Perceptions Regarding Use of Virtual Reality in Health Care: A Social Media Content Analysis Using Facebook. J Med Internet Res 2017; 19:e419. [PMID: 29258975 PMCID: PMC5750416 DOI: 10.2196/jmir.7467] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/29/2017] [Accepted: 09/27/2017] [Indexed: 11/13/2022] Open
Abstract
Background Virtual reality (VR) technology provides an immersive environment that enables users to have modified experiences of reality. VR is increasingly used to manage patients with pain, disability, obesity, neurologic dysfunction, anxiety, and depression. However, public opinion regarding the use of VR in health care has not been explored. Understanding public opinion of VR is critical to ensuring effective implementation of this emerging technology. Objective This study aimed to examine public opinion about health care VR using social listening, a method that allows for the exploration of unfiltered views of topics discussed on social media and online forums. Methods In March 2016, NBC News produced a video depicting the use of VR for patient care. The video was repackaged by NowThis, a social media news website, and distributed on Facebook by Upworthy, a news aggregator, yielding 4.3 million views and 2401 comments. We used Microsoft Excel Power Query and ATLAS.ti software (version 7.5, Scientific Software Development) to analyze the comments using content analysis and categorized the comments around first-, second-, and third-order concepts. We determined self-identified gender from the user’s Facebook page and performed sentiment analysis of the language to analyze whether the perception of VR differed by gender using a Pearson’s chi-square test. Results Out of the 1614 analyzable comments, 1021 (63.26%) were attributed to female Facebook users, 572 (35.44%) to male users, and 21 (1.30%) to users of unknown gender. There were 1197 comments coded as expressing a positive perception about VR (74.16%), 251 coded as expressing a negative perception and/or concern (15.56%), and 560 coded as neutral (34.70%). Informants identified 20 use cases for VR in health care, including the use of VR for pain and stress reduction; bed-bound individuals; women during labor; and patients undergoing chemotherapy, dialysis, radiation, or imaging procedures. Negative comments expressed concerns about radiation, infection risk, motion sickness, and the ubiquity of and overall dependence on technology. There was a statistically significant association between the language valence of the Facebook post and the gender of the Facebook user; men were more likely to post negative perceptions about the use of VR for health care, whereas women were more likely to post positive perceptions (P<.001). Conclusions Most informants expressed positive perceptions about the use of VR in a wide range of health care settings. However, many expressed concerns that should be acknowledged and addressed as health care VR continues to evolve. Our results provide guidance in determining where further research on the use of VR in patient care is needed, and offer a formal opportunity for public opinion to shape the VR research agenda.
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Affiliation(s)
- Michelle Sophie Keller
- Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, United States.,Division of Informatics, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States.,Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA, United States
| | - Hannah J Park
- Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Maria Elena Cunningham
- Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Joshua Eleazar Fouladian
- Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Michelle Chen
- Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Brennan Mason Ross Spiegel
- Cedars-Sinai Center for Outcomes Research and Education, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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