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Warlo LS, El Bardai S, de Vries A, van Veelen ML, Moors S, Rings EH, Legerstee JS, Dierckx B. Game-Based eHealth Interventions for the Reduction of Fatigue in People With Chronic Diseases: Systematic Review and Meta-Analysis. JMIR Serious Games 2024; 12:e55034. [PMID: 39419502 DOI: 10.2196/55034] [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: 12/14/2023] [Revised: 04/11/2024] [Accepted: 05/31/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Fatigue is a common and debilitating side effect of chronic diseases, significantly impacting patients' quality of life. While physical exercise and psychological treatments have been shown to reduce fatigue, patients often struggle with adherence to these interventions in clinical practice. Game-based eHealth interventions are believed to address adherence issues by making the intervention more accessible and engaging. OBJECTIVE This study aims to compile empirical evidence on game-based eHealth interventions for fatigue in individuals with chronic diseases and to evaluate their effectiveness in alleviating fatigue. METHODS A comprehensive literature search was performed across Embase, MEDLINE ALL, PsycINFO, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, and Google Scholar in August 2021. Study characteristics and outcomes from the included studies were extracted, and a random-effects meta-analysis was conducted. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity. RESULTS Of 1742 studies identified, 17 were included in the meta-analysis. These studies covered 5 different chronic diseases: multiple sclerosis (n=10), cancer (n=3), renal disease (n=2), stroke (n=1), and Parkinson disease (n=1). All but 1 study used exergaming interventions. The meta-analysis revealed a significant moderate effect size in reducing fatigue favoring the experimental interventions (standardized mean difference [SMD] -0.65, 95% CI -1.09 to -0.21, P=.003) compared with control conditions consisting of conventional care and no care. However, heterogeneity was high (I2=85.87%). Subgroup analyses were conducted for the 2 most prevalent diseases. The effect size for the multiple sclerosis subgroup showed a trend in favor of eHealth interventions (SMD -0.47, 95% CI -0.95 to 0.01, P=.05, I2=63.10%), but was not significant for the cancer group (SMD 0.61, 95% CI -0.36 to 1.58, P=.22). Balance exercises appeared particularly effective in reducing fatigue (SMD -1.19, 95% CI -1.95 to -0.42, P=.002). CONCLUSIONS Game-based eHealth interventions appear effective in reducing fatigue in individuals with chronic diseases. Further research is needed to reinforce these findings and explore their impact on specific diseases. Additionally, there is a lack of investigation into interventions beyond exergaming within the field of game-based learning.
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Affiliation(s)
- Leonie S Warlo
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Souraya El Bardai
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Andrica de Vries
- Department of Pediatric Oncology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Marie-Lise van Veelen
- Department of Neurosurgery, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Suzan Moors
- Department of Physiotherapy, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Edmond Hhm Rings
- Department of Pediatrics, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
- Levvel, Academic Center for Child and Adolescent Psychiatry and Specialized Youth Care, Amsterdam, Netherlands
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands
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Hsiao CC, Chou CY, Fang JT, Chang SC, Liu KC, Huang SC. Cardiopulmonary Response to Acute Exercise before Hemodialysis: A Pilot Study. Kidney Blood Press Res 2024; 49:735-744. [PMID: 39191223 DOI: 10.1159/000540767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024] Open
Abstract
INTRODUCTION Disparities in physical fitness between immediately before dialysis (pre-D) and the day following dialysis (non-D) have not been investigated despite potential adverse factors such as fluid status, uremia, and electrolyte levels in the pre-dialysis period. The effect of acute exercise immediately before hemodialysis (HD) on HD-related hypotension remains unclear. We hypothesized that cardiopulmonary performance and muscular strength would be inferior in the immediate pre-D period compared to those non-D. METHODS Twenty patients receiving chronic HD treatments underwent symptom-limited incremental cardiopulmonary exercise testing (CPET) and isokinetic testing both 1-2 h prior to dialysis (pre-D) and non-D. This investigation was a sub-study of a clinical trial assessing the efficacy of a pre-D exercise training program. Blood pressure profiles during HD post-CPET and pre-D exercise training were compared with those during usual HD sessions. RESULTS No adverse events were observed during the 80 exercise tests. Prior to dialysis, the nadir of the ventilatory equivalent of CO2 was slightly elevated, the resting heart rate was lower, and the peak systolic blood pressure was higher than those non-D. Contrary to our hypothesis, peak V˙O2 and quadriceps peak torque showed no differences. Blood pressure profiles during HD post-exercise were similar to those during sessions without prior exercise, except for a lower resting systolic blood pressure at the beginning of HD. CONCLUSION Cardiopulmonary response and muscular strength in the 1-2 h prior to HD were comparable with those on the day following HD, with only minor clinically insignificant differences. Acute exercise prior to HD did not affect the magnitude of hypotension during HD. This study suggests a potential alternative timing for exercise training or testing in patients undergoing chronic HD.
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Affiliation(s)
- Ching-Chung Hsiao
- Department of Nephrology, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei, Taiwan,
- College of Medicine, Chang Gung University, Taoyuan, Taiwan,
| | - Chuan-Yi Chou
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ji-Tseng Fang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shih-Chieh Chang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuo-Cheng Liu
- Department of Physical Medicine and Rehabilitation, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei, Taiwan
| | - Shu-Chun Huang
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Physical Medicine and Rehabilitation, New Taipei Municipal Tucheng Hospital, Chang Gung Memorial Hospital, New Taipei, Taiwan
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Watanabe G, Tanaka K, Saito H, Kimura H, Tani Y, Asai J, Suzuki H, Sato K, Nakayama M, Kazama JJ. Post-dialysis fatigue predicts all-cause mortality in patients on chronic hemodialysis. Ther Apher Dial 2024. [PMID: 39013552 DOI: 10.1111/1744-9987.14186] [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: 04/30/2024] [Revised: 06/11/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
INTRODUCTION Fatigue is reportedly associated with a poor prognosis in dialysis patients. The aim of the present study was to investigate whether fatigue on dialysis days or non-dialysis days is associated with mortality in patients on chronic hemodialysis. METHODS This was a prospective study of 134 hemodialysis patients. The level of fatigue was evaluated using a visual analog scale (VAS). The association between high fatigue evaluated by the highest quartile of the VAS value and all-cause death was investigated. RESULTS The fatigue scale score was significantly higher on dialysis than on non-dialysis days. During the follow-up period (median 6.8 years), 42 patients died. Patients with high post-dialysis fatigue in the higher quartiles died more frequently compared to those with in the lower quartiles (p = 0.012). Multivariate Cox regression analysis showed that high post-dialysis fatigue was an independent predictor of all-cause death (adjusted hazard ratio 2.12, 95% confidence interval 1.10-4.07). CONCLUSION Higher post-dialysis fatigue is related to increased mortality.
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Affiliation(s)
- Guy Watanabe
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
| | - Kenichi Tanaka
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
- Division of Advanced Community Based Care for Lifestyle Related Diseases, Fukushima Medical University, Fukushima, Japan
| | - Hirotaka Saito
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
| | - Hiroshi Kimura
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
- Division of Advanced Community Based Care for Lifestyle Related Diseases, Fukushima Medical University, Fukushima, Japan
| | | | - Jun Asai
- Fujita General Hospital, Kunimi, Japan
| | | | | | - Masaaki Nakayama
- Department of Research Management, St Luke's International University, Tokyo, Japan
- Head Office for Open Innovation Business Development Strategy, Tohoku University, Sendai, Japan
| | - Junichiro James Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University, Fukushima, Japan
- Division of Advanced Community Based Care for Lifestyle Related Diseases, Fukushima Medical University, Fukushima, Japan
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Romeu-Perales M, Segura-Ortí E, Cana-Poyatos A, Toquero-Correa M, Benavent-Caballer V, Pans-Alcaina D, García-Maset R, García-Testal A. The Effect of Intradialytic Exercise Using Virtual Reality on the Body Composition of Patients with Chronic Kidney Disease. Nutrients 2024; 16:1968. [PMID: 38931320 PMCID: PMC11206238 DOI: 10.3390/nu16121968] [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: 05/15/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Individuals with chronic kidney disease (CKD) often experience reduced muscle strength and diminished health-related quality of life (HRQoL), and engaging in regular exercise may improve them. The aim of this study was to assess the effect of intradialytic exercise using non-immersive virtual reality (VR) on body composition of patients with CKD on hemodialysis (HD). METHODS This was a substudy in a clinical trial of intradialytic exercise intervention using a non-immersive VR game in which the patient interacted by moving the lower limbs. Body composition was determined by BCM Fresenius multifrequency stereoscopic bioimpedance. Body mass index (BMI), fat tissue index (FTI), lean tissue index (LTI), extracellular/intracellular water (EIW), and phase angle (PA) were recorded in 52 patients, 24 in the control group (CG) and 28 in the exercise group (EG). RESULTS Statistically significant differences were observed between both groups. The LTI increased in the EG while it decreased in the CG. The FTI and the EIW decreased in the EG compared to the increase observed in the CG. CONCLUSIONS Intradialytic exercise using non-immersive VR was associated with an increase in LTI and a decrease in FTI of CKD patients on HD.
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Affiliation(s)
- Marta Romeu-Perales
- Department of Biotechnology, Universidad de Valencia, 46010 Valencia, Spain;
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (M.T.-C.)
| | - Alicia Cana-Poyatos
- Research Unit, Nephrology Service, Hospital de Manises, 46940 Valencia, Spain;
| | - Marina Toquero-Correa
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (M.T.-C.)
| | - Vicent Benavent-Caballer
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain; (M.T.-C.)
| | - Delia Pans-Alcaina
- Hemodialysis Unit Nursing, Nephrology Service, Hospital de Manises, 46940 Valencia, Spain
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Turoń-Skrzypińska A, Mińko A, Rył A, Mańkowska K, Ciechanowski K, Bereda Z, Rotter I, Dutkiewicz G. Impact of Effectiveness of Physical Activity in a Virtual Environment on the Regulation of Sclerostin and Interleukin 6 Levels in Haemodialysis Patients. J Clin Med 2024; 13:2321. [PMID: 38673595 PMCID: PMC11051331 DOI: 10.3390/jcm13082321] [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: 03/20/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Chronic kidney disease is a significant public health issue associated with reduced physical activity. This can lead to mineral and bone disorders and increased levels of inflammatory markers. One innovative solution that can significantly contribute to increasing patient motivation is the combination of physical training with virtual reality technology during haemodialysis sessions. The aim of this study is to comprehensively assess the impact of regular virtual reality-based physical activity on plasma sclerostin and interleukin 6 levels, as well as on physical performance and the level of physical activity in patients undergoing renal replacement therapy through haemodialysis. Methods: This study is a prospective cohort study. Patients included in the study were randomly assigned to two groups: the study group and the control group. The study group consisted of patients who were entrusted with the task of conducting training using the prototype of the NefroVR system. The duration of the study period for both the study and control groups was 3 months. Results: One hundred and two (102) patients with stage 5 chronic kidney disease who underwent haemodialysis as a renal replacement therapy participated in the study. Patients from the study group were characterized by higher physical activity compared to the control group. There was a significant difference in the level of IL-6 and SOST between the study and control groups in the second measurement. Conclusions: Regular physical activity, especially using approaches such as virtual reality, contributes to improving physical fitness and overall activity levels in patients undergoing haemodialysis. The study demonstrated that regular exercise may be associated with a reduction in inflammatory parameters and positive effects on bone metabolism in patients undergoing haemodialysis.
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Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Alicja Mińko
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Katarzyna Mańkowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.C.); (G.D.)
| | - Zuzanna Bereda
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (A.R.); (Z.B.); (I.R.)
| | - Grażyna Dutkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.C.); (G.D.)
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Lu X, Yang J, Bai D, Wu C, Cai M, Wang W, He J, Gong X, Gao J, Hou C. Effect of Exercise on Fatigue in Patients Receiving Maintenance Hemodialysis Treatment: A Systematic Review and Network Meta-analysis. Am J Phys Med Rehabil 2024; 103:293-301. [PMID: 37816191 DOI: 10.1097/phm.0000000000002348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
OBJECTIVE This study aimed to evaluate the effect of different exercises for improving fatigue in maintenance hemodialysis patients. DESIGN PubMed, Embase, Web of Science, Cochrane, PEDro, CNKI, VIP, Wanfang data, CBM, and CINAHL were conducted from the establishment of the database to July 2023. We independently screened the literature, evaluated the quality, analyzed the data using Stata 15.0, and performed subgroup analysis on intervention time and exercise intervention adherence. RESULTS Twenty-three studies were analyzed, with 1867 patients and nine interventions. Based on the surface under cumulative ranking curves and pairwise comparisons effects, overall long-term, short-term, and exercise intervention adherence >90% effects have all presented that during dialysis aerobic-resistance combined exercise was ranked as the most effective compared with routine care (surface under cumulative ranking curves = 83.9%, standardized mean difference = -1.45, 95% CI = -2.23 to -0.67; surface under cumulative ranking curves = 85.9%, standardized mean difference = -1.38, 95% CI = -2.24 to -0.52; surface under cumulative ranking curves = 86.6%, standardized mean difference = -1.54, 95% CI = -2.58 to -0.49; surface under cumulative ranking curves = 83.6%, standardized mean difference = -1.45, 95% CI = -2.25 to -0.66, respectively), followed by interdialytic period muscle relaxation exercise, interdialytic period aerobic-resistance combined exercise, interdialytic period aerobic exercise, and interdialytic period Baduanjin. CONCLUSIONS Dialysis aerobic-resistance combined exercise may be considered in practice when resources allow. However, high-quality, multicenter, and large-sample randomized control trials must further verify this conclusion.
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Affiliation(s)
- Xianying Lu
- From the School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Akdağ MA, Menekşeoğlu AK, Seğmen H, Gözek B, Korkmaz MD, Güçlü B. Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics. Front Neurosci 2024; 18:1319965. [PMID: 38312930 PMCID: PMC10835795 DOI: 10.3389/fnins.2024.1319965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/05/2024] [Indexed: 02/06/2024] Open
Abstract
Introduction Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study applied a novel ultrasonic stimulation method to test tactile sensitivity in CTS and also a mixed-reality-assisted (MR-assisted) exercise program which measured hand movements and provided haptic feedback for rehabilitation. Methods Twenty patients with mild unilateral CTS took part in the experiments. A mid-air haptics device (Ultrahaptics STRATOS Explore) was used to apply amplitude-modulated ultrasound waves (carrier frequency: 40 kHz) onto the skin to create tactile stimulation mechanically. Participants performed a two-alternative forced-choice task for measuring tactile thresholds at 250-Hz modulation frequency. They were tested at the index fingers and the thenar eminences of both hands. Additionally, 15 CTS patients used an MR-assisted program to do hand exercises with haptic feedback. Exercise performance was assessed by calculating errors between target and actual hand configurations. System Usability Scale (SUS) was adopted to verify the practical usability of the program. Results Thresholds at the thenar eminences of the affected and healthy hands were not significantly different. While the thresholds at the healthy index fingers could be measured, those of the affected fingers were all higher than the stimulation level produced by the maximum output from the ultrasound device. In the exercise program, a significant positive correlation (ρ = 0.89, p < 0.001) was found between the performance scores and the SUS scores, which were above the criterion value established in the literature. Discussion The results show that thenar tactile sensitivity is not affected in mild CTS as expected from the palmar cutaneous branch of the median nerve (PCBm), but index finger threshold is likely to be higher. Overall, this study suggests that mid-air haptics, with certain improvements, may be used as a preliminary test in the clinical setting. Moreover, the device is promising to develop gamified rehabilitation programs and for the treatment follow-up of CTS.
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Affiliation(s)
- Mehmet Akif Akdağ
- Institute of Biomedical Engineering, Boğaziçi University, İstanbul, Türkiye
| | - Ahmet Kıvanç Menekşeoğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
| | - Hatice Seğmen
- Department of Neurology, University of Health Sciences, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
| | - Berk Gözek
- Institute of Biomedical Engineering, Boğaziçi University, İstanbul, Türkiye
| | - Merve Damla Korkmaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Türkiye
| | - Burak Güçlü
- Institute of Biomedical Engineering, Boğaziçi University, İstanbul, Türkiye
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Gurz D, Coimbatore Dada K, Naga Nyshita V, Aderibigbe FD, Singh M, Yadav KP, Shah SK, Pumbhadia B, Abbas K, Khan W, Kumaran V. The Impact of Virtual Reality (VR) Gaming and Casual/Social Gaming on the Quality of Life, Depression, and Dialysis Tolerance in Patients With Chronic Kidney Disease: A Narrative Review. Cureus 2023; 15:e44904. [PMID: 37814762 PMCID: PMC10560511 DOI: 10.7759/cureus.44904] [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: 07/28/2023] [Accepted: 09/07/2023] [Indexed: 10/11/2023] Open
Abstract
This comprehensive narrative review aims to investigate the impact of virtual reality (VR) and social gaming on the quality of life, depression, and dialysis tolerance in patients with chronic kidney disease (CKD), a growing global health concern affecting the quality of life and increasing mortality rates. Through a combination of exercise and video games, exergaming, and digital game therapy (DGT), sedentary risks can be mitigated and therapy adherence enhanced. Despite potential side effects such as exhaustion and nausea, research indicates that virtual therapeutic games improve motivation and dialysis tolerance, and even reduce brain activity in pain-associated regions during procedures. These methods are superior to traditional distraction techniques like music, movies, and toys. Exergaming, social gaming, and VR gaming can improve various health factors including depressive symptoms, functional capacity, muscle strength, fatigue, physical activity, mental health, motivation, engagement, cognition, and overall quality of life for CKD patients. Representing a novel approach to CKD management, these interventions promote physical activity, cognitive stimulation, and social interaction. Continued research and innovation will facilitate the integration of VR-based therapies into routine CKD care.
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Affiliation(s)
- Danyel Gurz
- Department of Internal Medicine, Combined Military Hospital Lahore, Lahore, PAK
| | | | | | | | - Mankaranvir Singh
- Department of Medicine and Surgery, Government Medical College, Patiala, IND
| | - Kameshwar P Yadav
- Department of Internal Medicine, Universal College of Medical Sciences, Bhairahawa, NPL
| | - Sanjay K Shah
- Department of Internal Medicine, Janaki Medical College, Janakpurdham, NPL
| | - Binali Pumbhadia
- Department of Internal Medicine, Government Medical College, Surat, IND
| | - Kiran Abbas
- Department of Community Health Sciences, Aga Khan University, Karachi, PAK
| | - Wajiha Khan
- Department of Oncology, Ziauddin University, Karachi, PAK
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Turoń-Skrzypińska A, Rotter I, Przybyciński J, Szylińska A, Mińko A, Ciechanowski K, Dutkiewicz G. Does Exercising with the Use of Virtual Reality during Haemodialysis Have an Impact on Plasma Levels of Interleukin 1β, Interleukin 6, and Interleukin 8? J Clin Med 2023; 12:5358. [PMID: 37629400 PMCID: PMC10456086 DOI: 10.3390/jcm12165358] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/11/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Cytokines are a group of fine proteins which play a key role in the regulation of various biological processes, including inflammatory reactions. Proinflammatory cytokines, such as interleukin 1β (IL-1β), interleukin 6 (IL-6), and interleukin 8 (IL-8), are produced in response to various stimuli, including infections, tissue damage, and oxidative stress. Virtual reality (VR) use during intradialytic exercises improves physical activity. The purpose of the study was to evaluate the relationship between exercising regularly with the use of virtual reality during haemodialysis and the levels of selected cytokines (Il-1, Il-6, Il-8). The study and the control groups consisted of end-stage renal disease patients who underwent haemodialysis as a renal replacement treatment. The study group comprised patients subject to haemodialysis as a renal replacement therapy who were to work out with the use of a prototype of the NefroVR system for 20 min when undergoing haemodialysis (HD). Statistical analyses utilised Statistica 13. The conducted research demonstrated that regular exercises with the use of virtual reality might be related to a decrease in inflammation in patients included in the chronic haemodialysis programme. It is key to encourage patients with end-stage renal disease treated with haemodialysis to exercise regularly because of the possibility of their proinflammatory parameters becoming reduced.
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Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (I.R.); (A.S.)
| | - Iwona Rotter
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (I.R.); (A.S.)
| | - Jarosław Przybyciński
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.P.); (K.C.); (G.D.)
| | - Aleksandra Szylińska
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (I.R.); (A.S.)
| | - Alicja Mińko
- Department and Unit of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.T.-S.); (I.R.); (A.S.)
| | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.P.); (K.C.); (G.D.)
| | - Grażyna Dutkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.P.); (K.C.); (G.D.)
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Takahashi R, Yabe H, Hibino T, Morishita S, Watanabe M, Nishioka K, Ishikawa H. The study of exercise therapy using a virtual reality system on healthy subjects assuming hospital use and intradialytic exercise. NAGOYA JOURNAL OF MEDICAL SCIENCE 2023; 85:490-503. [PMID: 37829487 PMCID: PMC10565589 DOI: 10.18999/nagjms.85.3.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/15/2022] [Indexed: 10/14/2023]
Abstract
This study aimed to investigate the basic data on the effectiveness and safety of the system in healthy subjects using an immersive virtual reality (VR) exercise system specialized for therapeutic exercise therapy during dialysis or hospital use. A total of 15 healthy adult subjects performed four exercises, namely lifting and rowing exercises using VR and each movement exercise without VR (control). The simulator sickness questionnaire (SSQ) was administered pre- and post-operatively to assess for VR sickness. Blood pressure, heart rate (HR), rating of perceived exhaustion, Profile of Mood States 2nd Edition Japanese version, and muscle activity (iEMG) were measured using electromyography. The correlation between changes in mood states and HR or iEMG results was examined. The SSQ measured post-VR exercise was 11.2 (18.7-7.5) and 11.2 (7.5-29.9) points in the lifting and rowing VR, respectively. The HR in lifting (VR, 82.5 ± 12.7 vs control, 71.6 ± 10.6 bpm, P<0.05) and rowing (VR, 94.2 ± 13.1 vs control, 83.5 ± 12.0, P<0.05) with VR exercise was significantly higher than in control. No significant differences were observed between the other variables. There was a positive correlation between HR and negative mood in the lifting VR condition (r=0.64, P<0.05), but not in the control group. Contrastingly, there was a positive correlation between iEMG and negative mood in rowing control (r=0.56), but not VR. Safety was confirmed, with no VR sickness or discontinuation of the system. Exercise therapy using VR resulted in a higher exercise load. This VR system has the potential for additional effective intradialytic exercises and hospital use.
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Affiliation(s)
- Ren Takahashi
- Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Japan
| | - Hiroki Yabe
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
| | - Takashi Hibino
- Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Japan
| | - Sayumi Morishita
- Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Japan
| | - Mina Watanabe
- Long-term care health facilities Ohfuji Goko Home, Iwata, Japan
| | | | - Hideaki Ishikawa
- Department of Internal Medicine, Kaikoukai Josai Hospital, Nagoya, Japan
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Jesus LADSD, Pinheiro BV, Lucinda LMF, de Oliveira GBGR, Haddad MFPD, Vidigal ABR, Maciel JM, Watanabe LD, Oliveira CC, Reboredo MM. Factors associated with postural balance in patients with end-stage renal disease on hemodialysis. Clin Biomech (Bristol, Avon) 2023; 107:106033. [PMID: 37352608 DOI: 10.1016/j.clinbiomech.2023.106033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/18/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND Patients with end-stage renal disease on hemodialysis have postural balance impairments due to uremic syndrome and hemodialysis complications. This study evaluated the factors associated with postural balance in patients on hemodialysis. METHODS This cross-sectional study included patients on hemodialysis [n = 93, 62.0 (16.0) years]. Postural balance was evaluated using a force plate in a static position with eyes opened and eyes closed on a firm surface and with eyes opened on a foam surface to register the center of pressure path length. Physical function was assessed by isometric handgrip force, the 5-repetition sit-to-stand test, and gait speed. The level of physical activity and quality of life were evaluated by accelerometry and the 36-Item Short Form Health Survey, respectively. FINDINGS After adjustment for potential confounders, the multiple linear regression analysis showed that the presence of diabetes mellitus and neurological disease and gait speed were significantly associated with the center of pressure path length in the eyes opened test (R2 = 0.263; p < 0.001). The center of pressure path length in the eyes closed test was significantly associated with the presence of neurological disease (R2 = 0.177; p = 0.002). The center of pressure path length in the eyes opened on a foam surface test was significantly associated with the presence of diabetes mellitus (R2 = 0.223; p < 0.001). INTERPRETATION Poor postural balance was associated with the presence of diabetes mellitus and neurological disease and a slower gait speed in patients on hemodialysis.
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Affiliation(s)
| | - Bruno Valle Pinheiro
- Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil; School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Leda Marília Fonseca Lucinda
- Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil; Barbacena School of Medicine, Barbacena, Minas Gerais, Brazil; Department of Morphology, Institute of Biological Sciences, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | | | | | | | | | - Cristino Carneiro Oliveira
- Department of Physiotherapy, Federal University of Juiz de Fora - Governador Valadares, Governador Valadares, Minas Gerais, Brazil; School of Physical Education, Physical Therapy, and Occupational Therapy. Department of Physical Therapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maycon Moura Reboredo
- Pulmonary and Critical Care Division, University Hospital of Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil; School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
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12
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Comparison of effectiveness of Nintendo Wii-based exergaming and home-based fun video exercises in pediatric patients with chronic kidney disease. Int J Rehabil Res 2023; 46:26-34. [PMID: 36416089 DOI: 10.1097/mrr.0000000000000554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Functional capacity and quality of life (QoL) are reduced in children and adults with chronic kidney disease (CKD). Aerobic, strengthening exercises, and exergames are reported as effective in the treatment of symptoms associated with CKD. Unlike adult patients, there are insufficient studies investigating the effects of exercise on disease-related symptoms in pediatric CKD. This study aimed to compare the effects of Nintendo Wii-based exergaming and home-based fun video exercises on functional capacity, muscle strength, physical activity (PA), depression, fatigue, and QoL in pediatric patients with CKD. Twenty-three pediatric patients with CKD were included in the study and randomized to group I (Nintendo Wii Fit) and group II (home-based fun video exercises). Patients in both groups underwent exercise programs twice per week for 6 weeks. Functional capacity, muscle strength, PA, QoL, fatigue, and depression of the patients were evaluated before and after the treatments. Sixteen patients completed the study. After treatment, significant differences were observed in both groups on 6MWT, muscle strength, average daily steps, PedsQoL Child Self-Report PHSS, and the Visual Fatigue Scale. Left knee flexor muscle strength and average step counts were found to be superior in group I. Both exergaming and home-based fun video exercises provide positive effects on functional capacity, muscle strength, fatigue, PA, depression, and QoL in pediatric patients with CKD. We think that these exercise methods can help to protect physical and mental health of patients and should be included in treatment from the early stages of the disease.
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13
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Meléndez-Oliva E, Sánchez-Romero EA, Segura-Ortí E, Gil-Gómez JA, Soto-Goñi XA, Poveda-Pagán EJ. Effect of a Virtual Reality Exercise on Patients Undergoing Haemodialysis: A Randomised Controlled Clinical Trial Research Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4116. [PMID: 36901125 PMCID: PMC10002015 DOI: 10.3390/ijerph20054116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
High levels of inflammatory markers have been associated with a greater deterioration of renal function and cardiovascular morbidity and mortality. For its part, physical exercise has been shown to be beneficial in improving the functional, psychological, and inflammatory states of patients with chronic kidney failure (CKF) undergoing haemodialysis (HD) treatment, improving their health-related quality of life. In recent years, virtual reality (VR) has been studied and described as an effective and safe tool that improves patients' adherence to exercise programs. For these reasons, we propose to analyse the effect of VR exercise on the functional, psychological, and inflammatory states of patients on HD, as well as their levels of adherence to exercise, and compare them with static pedalling exercises. We will randomise 80 patients with CKF into two blind groups: an experimental group, which will carry out an intradialytic exercise program with non-immersive VR (n = 40), and a control group, which will exercise with a static pedal (n = 40). Functional capacity, inflammatory and phycological status, and exercise adherence will be analysed. Higher levels of adherence to exercise are expected in the VR group, which will have greater effects on the patients' functional capacity and psychological and inflammatory status.
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Affiliation(s)
- Erika Meléndez-Oliva
- Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan, 03550 Alicante, Spain
| | - Eleuterio A. Sánchez-Romero
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, European University of Madrid, 28670 Madrid, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Xabier A. Soto-Goñi
- Department of Psychobiology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Emilio J. Poveda-Pagán
- Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan, 03550 Alicante, Spain
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Seo EY, Kim YS, Lee YJ, Hur MH. Virtual Reality Exercise Program Effects on Body Mass Index, Depression, Exercise Fun and Exercise Immersion in Overweight Middle-Aged Women: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:900. [PMID: 36673656 PMCID: PMC9859405 DOI: 10.3390/ijerph20020900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 06/17/2023]
Abstract
Background: This study explored the effects of a virtual reality exercise program on overweight middle-aged women. Methods: This randomized controlled trial included women 40−65 years of age with a body mass index (BMI) of 23 kg/m2 or more living in Daejeon City. The virtual reality environment was set up by attaching an IoT sensor to an indoor bicycle and linking it with a smartphone, enabling exercise in an immersive virtual reality through a head-mounted display. Results: In the virtual reality exercise group, the BMI was significantly decreased after the 8-week intervention compared with the baseline value (F = 59.491, p < 0.001). The depression scores were significantly different among the three groups, with the intervention effect being more significant in the virtual reality exercise group than in the indoor bicycle exercise and control groups (F = 3.462, p < 0.001). Furthermore, the levels of exercise fun (F = 12.373, p < 0.001) and exercise immersion (F = 14.629, p < 0.001) were significantly higher in the virtual reality exercise group than in the indoor bicycle exercise and control groups. Conclusions: The virtual reality exercise program positively affected the BMI and the levels of depression, exercise fun, and exercise immersion in overweight middle-aged women. It is an effective home exercise program for obesity management in this population.
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Affiliation(s)
- Eun-Young Seo
- Department of Nursing, Gyeongbuk College of Health, Gimcheon 39525, Republic of Korea
| | - Yeon-Suk Kim
- Department of Nursing, Chung Cheong University, Cheongju 28171, Republic of Korea
| | - Yu-Jin Lee
- College of Nursing, Eulji University, Uijeongbu 11759, Republic of Korea
| | - Myung-Haeng Hur
- College of Nursing, Eulji University, Uijeongbu 11759, Republic of Korea
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15
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Hemodynamic Tolerance of Virtual Reality Intradialysis Exercise Performed during the Last 30 Minutes versus the Beginning of the Hemodialysis Session. Healthcare (Basel) 2022; 11:healthcare11010079. [PMID: 36611539 PMCID: PMC9818851 DOI: 10.3390/healthcare11010079] [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: 12/02/2022] [Revised: 12/19/2022] [Accepted: 12/22/2022] [Indexed: 12/29/2022] Open
Abstract
Background: Exercise improves the physical function of people suffering from chronic kidney disease on hemodialysis (HD). Virtual reality is a new type of intradialysis exercise that has a positive impact on physical function. Intradialysis exercise is recommended during the first 2 h, but its safety in the last part of the dialysis session is unknown. Methods: This was a pilot sub-study of a clinical trial. Several hemodynamic control variables were recorded, including blood pressure, heart rate, and intradialytic hypotensive events. These variables were recorded during three different HD sessions, one HD session at rest, another HD session with exercise during the first two hours, and one HD session with exercise during the last 30 min of dialysis. The intradialysis virtual reality exercise was performed for a maximum of 30 min. Results: During exercise sessions, there was a significant increase in heart rate (6.65 (4.92, 8.39) bpm; p < 0.001) and systolic blood pressure (6.25 (0.04,12.47) mmHg; p < 0.05). There was no difference in hemodynamic control between the sessions with exercise during the first two hours and the sessions with exercise during the last 30 min. There was no association between intra-dialytic hypotensive events at rest (five events) or exercise at any point (two vs. one event(s), respectively). Conclusion: performing exercise with virtual reality at the end of a hemodialysis session is not associated with hemodynamic instability.
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Kroon R, Neumann DL, Piatkowski TM, Moffitt RL. How the physical appearance of companions affects females with high or low social physique anxiety: a virtual reality exercise study. VIRTUAL REALITY 2022; 27:541-551. [PMID: 35910716 PMCID: PMC9309447 DOI: 10.1007/s10055-022-00676-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/27/2022] [Indexed: 06/05/2023]
Abstract
Technologies such as virtual reality (VR), an immersive computer-based environment that induces a feeling of mental and physical presence, are becoming increasingly popular for promoting participation in exercise. The purpose of this study was to explore changes in motivation and other psychological states when the physique of an exercise companion was altered during a VR-based exercise task, and whether trait social physique anxiety (SPA) altered these effects. Using a mixed experimental design, female participants (N = 43) categorised as high or low in SPA participated in two counterbalanced 10-min running tasks within a VR environment where the exercise companion was either overweight or in-shape. Across both running tasks, individuals with high SPA reported higher negative affect, pressure and tension, and lower perceived competencies, than those with low SPA. Pressure and tension were also higher when exercising with an in-shape companion than with an overweight companion for all participants. In addition, participants with high SPA reported a stronger preference to exercise with an overweight companion than those with low SPA in a real exercise setting, but not in a VR setting. The findings suggest that the physique of an exercise companion and the SPA of an exerciser have important, but independent, psychosocial effects during exercise. That an in-shape physique of a virtual exercise companion was not a deterrent among those with high SPA has provided preliminary evidence that VR-based exercise may be helpful among females who worry about their appearance or feel self-conscious while exercising.
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Affiliation(s)
- Rianca Kroon
- School of Applied Psychology, Griffith University, Brisbane, QLD 4222 Australia
| | - David L. Neumann
- School of Applied Psychology, Griffith University, Brisbane, QLD 4222 Australia
| | - Timothy M. Piatkowski
- School of Applied Psychology, Griffith University, Brisbane, QLD 4222 Australia
- College of Health and Human Sciences, Charles Darwin University, Casuarina, NT Australia
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Melillo A, Chirico A, De Pietro G, Gallo L, Caggianese G, Barone D, De Laurentiis M, Giordano A. Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature. Cancers (Basel) 2022; 14:3163. [PMID: 35804933 PMCID: PMC9264833 DOI: 10.3390/cancers14133163] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Rehabilitation plays a crucial role in cancer care, as the functioning of cancer survivors is frequently compromised by impairments that can result from the disease itself but also from the long-term sequelae of the treatment. Nevertheless, the current literature shows that only a minority of patients receive physical and/or cognitive rehabilitation. This lack of rehabilitative care is a consequence of many factors, one of which includes the transportation issues linked to disability that limit the patient's access to rehabilitation facilities. The recent COVID-19 pandemic has further shown the benefits of improving telemedicine and home-based rehabilitative interventions to facilitate the delivery of rehabilitation programs when attendance at healthcare facilities is an obstacle. In recent years, researchers have been investigating the benefits of the application of virtual reality to rehabilitation. Virtual reality is shown to improve adherence and training intensity through gamification, allow the replication of real-life scenarios, and stimulate patients in a multimodal manner. In our present work, we offer an overview of the present literature on virtual reality-implemented cancer rehabilitation. The existence of wide margins for technological development allows us to expect further improvements, but more randomized controlled trials are needed to confirm the hypothesis that VRR may improve adherence rates and facilitate telerehabilitation.
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Affiliation(s)
- Antonio Melillo
- Department of Mental and Physical Health and Preventive Medicine, “Luigi Vanvitelli” University of Campania, 80129 Naples, Italy;
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
| | - Andrea Chirico
- Department of Social and Developmental Psychology, “Sapienza” University of Rome, 00185 Rome, Italy;
| | - Giuseppe De Pietro
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), 80131 Naples, Italy; (G.D.P.); (L.G.); (G.C.)
| | - Luigi Gallo
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), 80131 Naples, Italy; (G.D.P.); (L.G.); (G.C.)
| | - Giuseppe Caggianese
- Institute for High Performance Computing and Networking, National Research Council of Italy (ICAR-CNR), 80131 Naples, Italy; (G.D.P.); (L.G.); (G.C.)
| | - Daniela Barone
- Cell Biology and Biotherapy Unit, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, 80131 Naples, Italy;
| | - Michelino De Laurentiis
- Department of Breast and Thoracic Oncology, National Cancer Institute “Fondazione Pascale”, 80131 Naples, Italy
| | - Antonio Giordano
- Department of Biology, Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA 19122, USA;
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Virtual reality-based distraction on pain, performance, and anxiety during and after moderate-vigorous intensity cycling. Physiol Behav 2022; 250:113779. [PMID: 35283175 DOI: 10.1016/j.physbeh.2022.113779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To determine whether increased visual perceptual load (PL) within an immersive virtual environment may help explain previously shown pain-relieving effects of virtual reality (VR) during high intensity cycling. METHODS Using a within-subjects design, participants cycled at a perceptually "hard" intensity for 10 min on three separate occasions. The first session did not use VR (i.e., no perceptual load - NPL). Subsequent sessions employed VR during cycling with either a low or high perceptual load (LPL or HPL). Quadriceps pain intensity (PI) was reported by participants throughout cycling. RESULTS Data were analyzed for 43 healthy participants (20 females, mean age 21 [SD 1.4]). For PI, ANOVA showed there were significant main effects of condition (F = 13.458, df =1.579, 66.334, p<0.001) and time (F = 113.045, df =1.618, 227.683, p<0.001). At every time point, t-tests revealed mean PI was significantly lower in the NPL than in the LPL condition (t(42)=4.737, p<0.001, d = 0.472) and HPL condition (t(42)=3.380, p = 0.002, d = 0.391). Dependent t-tests showed that more work (kilojoules) was performed during the LPL condition than the NPL (t(42)=2.992, p = 0.005) and HPL (t(42)=5.810, p<0.001) conditions. CONCLUSIONS Compared to a traditional 10-minute bout of cycle ergometry (NPL), individuals who cycled in the LPL condition chose to exercise at a higher intensity despite greater PI. Those who cycled in the HPL condition did not change their exercise intensity, but did report higher PI, possibly, because of the greater mental effort/energy requirement.
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The effect of a 6-month intradialytic exercise program on hemodialysis adequacy and body composition: a randomized controlled trial. Int Urol Nephrol 2022; 54:2983-2993. [DOI: 10.1007/s11255-022-03238-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 05/04/2022] [Indexed: 12/25/2022]
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Martínez-Olmos FJ, Gómez-Conesa AA, García-Testal A, Ortega-Pérez-de-Villar L, Valtueña-Gimeno N, Gil-Gómez JA, Garcia-Maset R, Segura-Ortí E. An intradialytic non-immersive virtual reality exercise program: a crossover randomized controlled trial. Nephrol Dial Transplant 2021; 37:1366-1374. [PMID: 34245292 DOI: 10.1093/ndt/gfab213] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Chronic kidney disease is closely related to a high risk of death and disability, poor physical performance, and frailty. The main objective of this research was to analyse how intradialytic administration of a non-immersive virtual reality (VR) exercise program would affect physical function and adherence to exercise in these patients. METHODS A total of 56 individuals participated in two 12-week periods in a crossover randomised controlled trial. Each patient underwent a functional capacity evaluation before and after each study period. The functional tests administered included the 4-metre gait speed test, Short Physical Performance Battery (SPPB), timed up-and-go (TUG) test, one-legged stance test (OLST) for balance, sit-to-stand 10 (STS-10) and sit-to-stand 60 (STS-60) tests, and 6-minute walking test (6MWT). Adherence to the exercise program was also recorded. To assess the effect of VR exercise on the functional test outcomes over time, the patients were analysed using a 2-way repeated-measures ANOVA with time and treatment as the within-participant factors. RESULTS By the end of the 12 weeks of exercise, compared to the control period, 33 participants showed significant change in physical function as measured through the 4-metre gait speed (0.14 m/s), SPPB (1.2 points), TUG (-1.7 seconds), OLST (7.1 seconds), STS-10 (-5.8 seconds), STS-60 (5.0 repetitions), and 6MWT (85.2 metres) with adherence rates exceeding 70%. There were no changes in the biochemical data or in the medications in the period of the study. CONCLUSION An intradialytic non-immersive VR exercise program improves patient physical function.
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Affiliation(s)
| | | | | | | | - Noemí Valtueña-Gimeno
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - José A Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Valencia, Spain
| | | | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Viana RB, de Oliveira VN, Dankel SJ, Loenneke JP, Abe T, da Silva WF, Morais NS, Vancini RL, Andrade MS, de Lira CAB. The effects of exergames on muscle strength: A systematic review and meta-analysis. Scand J Med Sci Sports 2021; 31:1592-1611. [PMID: 33797115 DOI: 10.1111/sms.13964] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/24/2021] [Accepted: 03/30/2021] [Indexed: 12/17/2022]
Abstract
This systematic review and meta-analysis examined studies on the chronic effects of exergames on muscle strength in humans. PubMed, Scopus, CENTRAL, Web of Science, SciELO, Biblioteca Virtual em Saúde, and Google Scholar were searched, and manual searches of the reference lists of included studies and hand-searches on Physiotherapy Evidence Database and ResearchGate were conducted from inception to August 10, 2020. Randomized and non-randomized exergame intervention studies with or without a non-exercise group and/or a "usual care intervention group" (any other intervention that did not incorporate exergames), which evaluated muscle strength through direct measurements, were included. Forty-seven and 25 studies were included in the qualitative review and meta-analysis, respectively. The between-groups meta-analyses showed no significant differences between exergames and non-exercise control groups for handgrip strength in heathy/unhealthy middle-aged/older adults or knee extension maximum voluntary isometric contraction (MVIC) in healthy older adults. However, exergames provided a greater increase in handgrip strength, knee flexion MVIC, and elbow extension MVIC, but not knee extension MVIC or elbow flexion MVIC, in individuals with different health statuses when compared to usual care interventions. Also, there was a greater increase in handgrip strength in children with hemiplegic cerebral palsy favouring usual care plus exergames compared to usual care interventions. These results suggest that exergames may improve upper and lower limb muscle strength in individuals with different heath statuses compared to usual care interventions, but not muscle strength in middle age/older adults after accounting for random error. Also, exergames appear to be a useful tool for improving handgrip strength in children with hemiplegic cerebral palsy when added to usual care. However, as the exergame interventions were applied in different populations and there currently are many different approaches to perform exergames, future randomized controlled trials with high methodological quality and large sample sizes are needed to provide more compelling evidence in favour of a specific exergame protocol, or to elucidate exergame protocol design principles that appear to strongly influence outcomes.
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Affiliation(s)
- Ricardo Borges Viana
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | | | - Scott J Dankel
- Department of Health and Exercise Science, Rowan University, Glassboro, NJ, USA
| | - Jeremy P Loenneke
- Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS, USA
| | - Takashi Abe
- Kevser Ermin Applied Physiology Laboratory, University of Mississippi, University, MS, USA
| | | | - Naiane Silva Morais
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil
| | - Rodrigo Luiz Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Brazil
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Omonaiye O, Smyth W, Nagle C. Impact of virtual reality interventions on haemodialysis patients: A scoping review. J Ren Care 2021; 47:193-207. [PMID: 33491276 DOI: 10.1111/jorc.12362] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/29/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND An understanding of the potential of virtual reality to affect the level of engagement in self-care and health-related quality of life is required for patients receiving haemodialysis. OBJECTIVE This scoping review aimed to collate, summarise, and report on related study findings to identify evidence gaps and draw conclusions from the existing literature. METHODS The methodological steps outlined in the Arksey and O'Malley framework combined with modifications of Levac and colleagues guided this systematic scoping review. MEDLINEComplete, Embase, CINAHLComplete and PsychINFO databases were searched. Additionally, hand searches of key articles and journals were performed. RESULTS From the database searches, 610 studies were identified with 11 meeting the inclusion criteria; another study was added after searching reference lists of included articles, resulting in 12 included articles. The quality, study design and type of virtual reality intervention varied. Only three studies used immersive virtual reality. Several studies demonstrated significant improvement in the physical activity level and a reduction in fatigue in patients during haemodialysis, with no adverse events. Despite the demands of haemodialysis sessions, this study showed that virtual reality interventions may improve the level of haemodialysis patients' adherence and engagement with treatment. CONCLUSIONS Findings favour the use of virtual reality to improve physical health and engagement with treatment. However, there is a need for more rigorous study designs within different clinical settings to provide high-quality evidence regarding other ways that virtual reality interventions could improve the quality of life of haemodialysis patients.
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Affiliation(s)
- Olumuyiwa Omonaiye
- Centre for Nursing and Midwifery Research, James Cook University, Townsville, Queensland, Australia.,School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Deakin University, Burwood, Victoria, Australia
| | - Wendy Smyth
- Centre for Nursing and Midwifery Research, James Cook University, Townsville, Queensland, Australia.,Institute of Health Research and Innovation, Townsville Hospital and Health Service, Douglas, Queensland, Australia
| | - Cate Nagle
- Centre for Nursing and Midwifery Research, James Cook University, Townsville, Queensland, Australia.,Institute of Health Research and Innovation, Townsville Hospital and Health Service, Douglas, Queensland, Australia
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Hernandez R, Burrows B, Browning MH, Solai K, Fast D, Litbarg NO, Wilund KR, Moskowitz JT. Mindfulness-based Virtual Reality Intervention in Hemodialysis Patients: A Pilot Study on End-user Perceptions and Safety. KIDNEY360 2021; 2:435-444. [PMID: 35369024 PMCID: PMC8786010 DOI: 10.34067/kid.0005522020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/07/2021] [Indexed: 02/04/2023]
Abstract
Background Virtual reality (VR) is an evolving technology that is becoming a common treatment for pain management and psychologic phobias. Although nonimmersive devices (e.g., the Nintendo Wii) have been previously tested with patients on hemodialysis, no studies to date have used fully immersive VR as a tool for intervention delivery. This pilot trial tests the initial safety, acceptability, and utility of VR during maintenance hemodialysis treatment sessions-particularly, whether VR triggers motion sickness that mimics or negatively effects treatment-related symptoms (e.g., nausea). Methods Patients on hemodialysis (n=20) were enrolled in a phase 1 single-arm proof-of-concept trial. While undergoing hemodialysis, participants were exposed to our new Joviality VR program. This 25-minute program delivers mindfulness training and guided meditation using the Oculus Rift head-mounted display. Participants experienced the program on two separate occasions. Before and immediately after exposure, participants recorded motion-related symptoms and related discomfort on the Simulator Sickness Questionnaire. Utility measures included the end-user's ability to be fully immersed in the virtual space, interact with virtual objects, find hardware user friendly, and easily navigate the Joviality program with the System Usability Scale. Results Mean age was 55.3 (±13.1) years; 80% male; 60% Black; and mean dialysis vintage was 3.56 (±3.75) years. At the first session, there were significant decreases in treatment and/or motion-related symptoms after VR exposure (22.6 versus 11.2; P=0.03); scores >20 indicate problematic immersion. Hemodialysis end-users reported high levels of immersion in the VR environment and rated the software easy to operate, with average System Usability Scale scores of 82.8 out of 100. Conclusions Patients on hemodialysis routinely suffer from fatigue, nausea, lightheadedness, and headaches that often manifest during their dialysis sessions. Our Joviality VR program decreased symptom severity without adverse effects. VR programs may be a safe platform to improve the experience of patients on dialysis.
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Affiliation(s)
- Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Brett Burrows
- College of Applied Health Sciences, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Matthew H.E.M. Browning
- Virtual Reality and Nature Lab, Department of Parks, Recreation and Tourism Management, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, South Carolina
| | - Killivalavan Solai
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Drew Fast
- Center for Innovation in Teaching and Learning, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Natalia O. Litbarg
- Division of Nephrology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Kenneth R. Wilund
- College of Applied Health Sciences, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois
| | - Judith T. Moskowitz
- Department of Medical Social Sciences, Northwestern University, Chicago, Illinois
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Ioannou A, Papastavrou E, Avraamides MN, Charalambous A. Virtual Reality and Symptoms Management of Anxiety, Depression, Fatigue, and Pain: A Systematic Review. SAGE Open Nurs 2020; 6:2377960820936163. [PMID: 33415290 PMCID: PMC7774450 DOI: 10.1177/2377960820936163] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 05/06/2020] [Accepted: 05/19/2020] [Indexed: 11/16/2022] Open
Abstract
In recent years, virtual reality (VR) has become an interesting alternative to traditional exposure-based therapies for many symptoms. VR involves immersion in a computer-generated virtual environment that minimizes avoidance and facilitates emotional processing. The objective of this systematic review is to evaluate evidence on the intervention effect of VR on anxiety, depression, fatigue, and pain. The research strategy of this systematic review included three electronic databases (MEDLINE/PubMed, Cochrane Library, and ScienceDirect) based on predetermined inclusion and exclusion criteria. Published quantitative studies from 2000 to 2020 were identified, which examined the effect of VR intervention on four different symptoms related to symptoms experienced by cancer patients. Quality assessments, data extractions, and analysis were completed on all included studies. A total of 882 titles and abstracts were screened, and 23 studies were included in the review. The studies were grouped according to the symptoms: anxiety and depression, fatigue, and pain. The review showed that VR intervention is more effective compared with the control (i.e., standard care) for anxiety, depression, fatigue, and pain. VR can reduce effectively these symptoms in different contexts and diseases, including cancer. The evidence suggests that there is value in exploring this intervention as a potential crossover treatment for these symptoms in patients. This study contributes to evidence that distraction is an effective symptom management mechanism. The findings are congruent with the theoretical framework, supporting the premise that VR, as an emotion-focused distraction intervention, decreases the severity of these symptoms.
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Affiliation(s)
| | | | - Marios N Avraamides
- Department of Psychology, University of Cyprus.,Silversky3D Virtual Reality Technologies Ltd., Nicosia, Cyprus
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25
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Chou HY, Chen SC, Yen TH, Han HM. Effect of a Virtual Reality-Based Exercise Program on Fatigue in Hospitalized Taiwanese End-Stage Renal Disease Patients Undergoing Hemodialysis. Clin Nurs Res 2020; 29:368-374. [PMID: 30009636 DOI: 10.1177/1054773818788511] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
The purpose of this study was to evaluate the short-term effect of a virtual reality-based exercise program on fatigue in patients with end-stage renal disease (ESRD) who receive hemodialysis (HD). In this quasi-experimental study design, an experimental group (n = 32) received virtual reality training that promoted exercise, and a control group (n = 32) received routine care (advice on physical activities). Fatigue and physiologic parameters were assessed pretest (before intervention) as well as posttest (4 weeks after the onset of intervention). Our results showed that patients in the experimental group had significantly lower levels of overall fatigue, reduction in vigor and motivation, distress and loss of control in mood, and higher hemoglobin levels compared with the control group. ANCOVA revealed that there were no differences in overall fatigue and different domains of fatigue. Exercise only increased the blood urea nitrogen (BUN) and creatinine levels significantly in the intervention group.
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Affiliation(s)
- Hsiao-Yu Chou
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Shu-Ching Chen
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Tzung-Hai Yen
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University, Taoyuan, Taiwan
| | - Hui-Mei Han
- Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Chang Gung University of Science and Technology, Taoyuan, Taiwan
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26
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The Effectiveness of Virtual Reality Exercise on Individual's Physiological, Psychological and Rehabilitative Outcomes: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114133. [PMID: 32531906 PMCID: PMC7312871 DOI: 10.3390/ijerph17114133] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 12/24/2022]
Abstract
Objective purpose: This review synthesized the literature examining the effects of virtual reality (VR)-based exercise on physiological, psychological, and rehabilitative outcomes in various populations. Design: A systematic review. Data sources: 246 articles were retrieved using key words, such as "VR", "exercise intervention", "physiological", "psychology", and "rehabilitation" through nine databases including Academic Search Premier and PubMed. Eligibility criteria for selecting studies: 15 articles which met the following criteria were included in the review: (1) peer-reviewed; (2) published in English; (3) randomized controlled trials (RCTs), controlled trials or causal-comparative design; (4) interventions using VR devices; and (5) examined effects on physiological, psychological, and/or rehabilitative outcomes. Descriptive and thematic analyses were used. Results: Of the 12 articles examining physiological outcomes, eight showed a positive effect on physical fitness, muscle strength, balance, and extremity function. Only four articles examined the effects on psychological outcomes, three showed positive effects such that VR exercise could ease fatigue, tension, and depression and induce calmness and enhance quality of life. Nine articles investigated the effects of VR-based exercise on rehabilitative outcomes with physiological and/or psychological outcomes, and six observed significant positive changes. In detail, patients who suffered from chronic stroke, hemodialysis, spinal-cord injury, cerebral palsy in early ages, and cognitive decline usually saw better improvements using VR-based exercise. Conclusion: The findings suggest that VR exercise has the potential to exert a positive impact on individual's physiological, psychological, and rehabilitative outcomes compared with traditional exercise. However, the quality, quantity, and sample size of existing studies are far from ideal. Therefore, more rigorous studies are needed to confirm the observed positive effects.
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27
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Maynard LG, de Menezes DL, Lião NS, de Jesus EM, Andrade NLS, Santos JCD, da Silva Júnior WM, Bastos KDA, Barreto Filho JAS. Effects of Exercise Training Combined with Virtual Reality in Functionality and Health-Related Quality of Life of Patients on Hemodialysis. Games Health J 2020; 8:339-348. [PMID: 31539293 DOI: 10.1089/g4h.2018.0066] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The progression of chronic kidney disease can directly affect patient's health-related quality of life (HRQoL). Exercise training is a good option to reverse the impacts caused by the disease. To escape from the monotonous routine and stimulate further practice, the therapist should consider making physical activity more playful. Using videogames during exercise training is possible to rehabilitate the patient aiming for fun beyond the organic condition. The present study aimed to evaluate the effects of exercise training combined with Virtual Reality (VR) in functionality and HRQoL of patients on hemodialysis. Materials and Methods: A randomized controlled study in which control group (n = 20) maintained only hemodialysis without any physical effort or intervention from the researchers and intervention group (n = 20) who performed endurance and strength physical exercises in combination with VR during hemodialysis for 12 weeks. All eligible patients underwent a familiarization of games and were evaluated by an investigator-blind for functional capacity, quality of life, and depressive symptoms. Functional capacity tests included walking speed, timed up and go (TUG), and Duke Activity Status Index (DASI). To evaluate a HRQoL, Kidney Disease and Quality-of-Life Short-Form (KDQOL-SF™, v. 1.3) was used and to investigate depressive symptoms, the Center for Epidemiological Scale-Depression. Paired sample t-tests were conducted to determine differences within each group. Repeated-measures analysis of variance (group vs. time) was used to assess group differences in our major outcomes. The level of significance was 5%. Results: The exercise improved functional capacity (TUG: P = 0.002, DASI: P < 0.001) and HRQoL in physical and specific domains: physical functioning (P = 0.047), role physical (P = 0.021), as well as in physical composite summary (P < 0.001) and effects of kidney disease (P = 0.013). There was no influence on depressive symptoms (P = 0.154). Conclusion: Physical training combined with VR improved functional capacity and some quality-of-life domains of hemodialysis patients.
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Affiliation(s)
- Luana Godinho Maynard
- Tiradentes University (UNIT), Aracaju, Brazil.,Health Sciences, Federal University of Sergipe, São Cristóvão, Brazil
| | | | - Noelma Santos Lião
- Department of Physiotherapy, Federal University of Sergipe, São Cristóvão, Brazil
| | | | | | | | | | - Kleyton de Andrade Bastos
- Clinic of Nephrology of Sergipe (Clinese), Division of Nephrology, Federal University of Sergipe, Aracaju, Brazil
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Effects of Exergames on Physical Fitness in Middle-Aged and Older Adults in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072565. [PMID: 32276515 PMCID: PMC7177712 DOI: 10.3390/ijerph17072565] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022]
Abstract
Using exergaming for exercise training was found to improve physical fitness. Yet, few studies have used the "Xbox Kinect" to examine its effects on physical fitness in healthy middle-aged and older adults. The purpose of this study was to investigate the effect of 10-weeks of Xbox Kinect training on physical fitness in healthy middle-aged and older adults. Forty participants (average 64.00 ± 4.44 years old, eight males and 32 females) were randomized to either intervention (n = 20) or control group (n = 20). The intervention group played Xbox Kinect three times per week, for an average of 50 min per session for 10 weeks. The control group was instructed to maintain their levels of physical activity. All the participants completed assessments of body composition, muscle strength, flexibility, balance and cardiopulmonary endurance at baseline and after 10-week intervention. After 10 weeks of training, the intervention group showed significant improvements in cardiopulmonary endurance and leg muscle strength. Moreover, there were significant differences between the intervention and control group in changes in aerobic fitness and leg muscle strength. The exergame program effectively improved cardiopulmonary endurance and leg muscle strength in healthy middle-aged and older adults. It could be an alternative to conventional exercise.
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29
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Analyzing Consumer Loyalty through Service Experience and Service Convenience: Differences between Instructor Fitness Classes and Virtual Fitness Classes. SUSTAINABILITY 2020. [DOI: 10.3390/su12030828] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The eruption of technology has revolutionized the sports sector, incorporating new elements and new forms, and has therefore targeted sports activities. The inclusion of virtual fitness classes is leading to an increase in the offers available to consumers, expanding the hours that consumers can exercise and leading to a greater variability of customer services. The present study intends to go deeper into the knowledge of the fitness center sector in the Spanish context by evaluating the poorly analyzed area of directed activities, either with a teacher or in a virtual mode, and how these are perceived by the users of the centers. The sample consisted of a total of 1943 users, 1143 of whom were customers who conducted fitness activities directed by instructors, and 800 questionnaires were completed by customers who conducted virtual fitness activities in fitness centers classified as low-cost, medium, and boutique business models. The relationships between service experience, service convenience, satisfaction, and future intentions were analyzed. The results show positive relationships in all the variables studied in the instructor fitness classes. However, they are not significant in some variables studied involving virtual fitness classes.
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30
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A new assessment scale for post-dialysis fatigue in hemodialysis patients. RENAL REPLACEMENT THERAPY 2020. [DOI: 10.1186/s41100-019-0252-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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32
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Davey CH, Webel AR, Sehgal AR, Voss JG, Huml A. Fatigue in Individuals with End Stage Renal Disease. Nephrol Nurs J 2019; 46:497-508. [PMID: 31566345 PMCID: PMC7047987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Fatigue is a subjective overwhelming feeling of tiredness at rest, exhaustion with activity, lack of energy that impedes daily tasks, lack of endurance, or a loss of vigor. Individuals with end stage renal disease (ESRD) experience a high rate and severity of fatigue. Symptom management of fatigue in this population is critical, since fatigue has been linked with lower quality of life and higher mortality rates. In this article, we present a definition and overview of fatigue, a review of factors contributing to fatigue, and ways to manage fatigue in individuals with ESRD.
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Affiliation(s)
- Christine Horvat Davey
- Research Associate, Case Western Reserve University, Cleveland, OH
- a VAQS Post doctoral Fellow, Cleveland VA, Cleveland, OH
- member of ANNA's Black Swamp Chapter
| | - Allison R Webel
- Associate Professor of Nursing, Case Western Reserve University, Cleveland, OH
| | - Ashwini R Sehgal
- Nephrologist, MetroHealth Medical Center, Cleveland, OH
- Director and Duncan Neuhauser Professor of Community Health Improvement, Center for Reducing Health Disparities School of Medicine, Cleveland, OH
| | - Joachim G Voss
- Professor of Nursing, Case Western Reserve University; and is the Director of the Sarah Cole Hirsh Institute for Evidence-Based Practice, the Frances Payne Bolton School of Nursing at Case Western Reserve University, Cleveland, OH
| | - Anne Huml
- Nephrologist, MetroHealth Medical Center, Cleveland, OH
- Instructor of Medicine, the Center for Reducing Health Disparities, the MetroHealth System, Cleveland, OH
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33
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Wender CLA, Ahn SJ, O'Connor PJ. Interactive Virtual Reality Reduces Quadriceps Pain during High-Intensity Cycling. Med Sci Sports Exerc 2019; 51:2088-2097. [PMID: 31033903 DOI: 10.1249/mss.0000000000002016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
PURPOSE Brief, high-intensity cycling is popular because physiological benefits accrue with a short workout time, but burning pain in the quadriceps is a potential barrier to engaging in this type of exercise. Virtual reality (VR) can temporarily decrease pain, but its effect on muscle pain during high-intensity exercise is unknown. The primary purpose of this experiment was to test whether adding interactive VR (I-VR) to high-intensity cycling could reduce quadriceps pain or improve performance. METHODS Ninety-four adults who were physically active in their leisure time and age 18 to 29 yr completed three 30-s sprint interval cycling trials at a high resistance (0.085- and 0.075-kg resistance to the flywheel per kilogram body weight for men and women, respectively). In this randomized between-subject experiment, participants cycled while wearing a head-mounted display and viewing either (i) a dynamically changing cityscape perceived as interactively cycling through a virtual city (I-VR group) or (ii) a static picture of the cityscape with instructions to mentally imagine cycling through that city (static VR/motor imagery control group). RESULTS Sphericity-adjusted 2 × 3 (group-time) ANOVA revealed a significant group-time interaction (F = 4.568; df = 1.499, 133.301; ηp = 0.047, P = 0.021) for pain intensity. With I-VR, pain intensities were 13.3% (mean, 4.60 vs 5.31; d = 0.28) and 11.8% (mean, 5.68 vs 6.44; d = 0.27) lower at sprint trials 2 and 3, respectively. The group-time interaction (P = 0.412) was not significant for total work. CONCLUSION Compared with a static VR/motor imagery control condition, I-VR during brief, high-intensity, fatigue-inducing leg cycling attenuates quadriceps pain intensity without reducing performance.
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Affiliation(s)
| | - Sun Joo Ahn
- Grady College of Journalism and Mass Communication, University of Georgia, Athens, GA
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34
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Segura-Ortí E, García-Testal A. Intradialytic virtual reality exercise: Increasing physical activity through technology. Semin Dial 2019; 32:331-335. [PMID: 30916415 DOI: 10.1111/sdi.12788] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Intradialytic exercise can improve physical function and health-related quality of life (HRQoL) in hemodialysis (HD) patients, but is not implemented in routine clinical practice. Virtual reality (VR) exercise has resulted in benefits in non-dialysis contexts, but implementation in HD patients has been limited. The aim of this review was to provide an overview of VR, present the results of a 12-week intradialytic VR exercise intervention, and compare VR to conventional exercise. The secondary aim was to review the effect of VR exercise during the last 30 minutes of the HD session on hemodynamic stability. We conclude that VR exercise during HD is safe and can improve physical function and HRQoL, and can be performed safely toward the end of the HD session.
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Affiliation(s)
- Eva Segura-Ortí
- Physical Therapy Department, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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35
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A Behavioral Physical Activity Intervention to Manage Moderate and Severe Fatigue Among Head and Neck Cancer Patients—Pre-efficacy Study in the National Institutes of Health ORBIT Model. Cancer Nurs 2019; 42:E1-E14. [DOI: 10.1097/ncc.0000000000000568] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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36
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Segura‐Ortí E, Pérez‐Domínguez B, Ortega‐Pérez de Villar L, Meléndez‐Oliva E, Martínez‐Gramage J, García‐Maset R, Gil‐Gómez JA. Virtual reality exercise intradialysis to improve physical function: A feasibility randomized trial. Scand J Med Sci Sports 2018; 29:89-94. [DOI: 10.1111/sms.13304] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/08/2018] [Accepted: 09/14/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Eva Segura‐Ortí
- Department of PhysiotherapyUniversidad Cardenal Herrera‐CEU, CEU Universities Valencia Spain
| | - Borja Pérez‐Domínguez
- Department of PhysiotherapyUniversidad Cardenal Herrera‐CEU, CEU Universities Valencia Spain
| | | | - Erika Meléndez‐Oliva
- Department of PhysiotherapyUniversidad Cardenal Herrera‐CEU, CEU Universities Valencia Spain
| | - Javier Martínez‐Gramage
- Department of PhysiotherapyUniversidad Cardenal Herrera‐CEU, CEU Universities Valencia Spain
| | | | - José Antonio Gil‐Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València Valencia Spain
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37
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Ortega-Pérez de Villar L, Martínez-Olmos FJ, Junqué-Jiménez A, Amer-Cuenca JJ, Martínez-Gramage J, Mercer T, Segura-Ortí E. Test-retest reliability and minimal detectable change scores for the short physical performance battery, one-legged standing test and timed up and go test in patients undergoing hemodialysis. PLoS One 2018; 13:e0201035. [PMID: 30133445 PMCID: PMC6104925 DOI: 10.1371/journal.pone.0201035] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 07/06/2018] [Indexed: 12/11/2022] Open
Abstract
Functional tests are commonly used for chronic kidney disease (CKD) patients undergoing hemodialysis (HD). However, the relative and absolute reliability of such physical performance-outcome assessments must first be determined in specific patient cohorts. The aims of this study were to assess the relative and the absolute reliability of the Short Physical Performance Battery (SPPB), One-Legged Stance Test (OLST), and Timed Up and Go (TUG) test, as well as the minimal detectable change (MDC) scores for these tests in CKD patients receiving HD. Seventy-one end-stage CKD patients receiving HD therapy, aged between 21 and 90 years, participated in the study. The patients completed two testing sessions one to two weeks apart and performed by the same examiner, comprising the following tests: the SPPB (n = 65), OLST (n = 62), and TUG test (n = 66). High intraclass correlation coefficients (≥0.90) were found for all the tests, suggesting that their relative reliability is excellent. The MDC scores for the 90% confidence intervals were as follows: 1.7 points for the SPPB, 11.3 seconds for the OLST, and 2.9 seconds for the TUG test. The reliability of the SPPB, OLST, and TUG test for this sample were all considered to be acceptable. The MDC data generated by these tests can be used to monitor meaningful changes in the functional capacity of the daily living-related activity of CKD patients on HD.
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Affiliation(s)
| | | | - Anna Junqué-Jiménez
- Nephrology Department, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Spain
| | - Juan José Amer-Cuenca
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Javier Martínez-Gramage
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Tom Mercer
- Centre for Health, Activity and Rehabilitation Research School of Health Sciences, Queen Margaret University, Musselburgh, Edinburgh
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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38
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Afsar B, Siriopol D, Aslan G, Eren OC, Dagel T, Kilic U, Kanbay A, Burlacu A, Covic A, Kanbay M. The impact of exercise on physical function, cardiovascular outcomes and quality of life in chronic kidney disease patients: a systematic review. Int Urol Nephrol 2018; 50:885-904. [DOI: 10.1007/s11255-018-1790-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/07/2018] [Indexed: 12/18/2022]
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Tripette J, Murakami H, Ryan KR, Ohta Y, Miyachi M. The contribution of Nintendo Wii Fit series in the field of health: a systematic review and meta-analysis. PeerJ 2017; 5:e3600. [PMID: 28890847 PMCID: PMC5590553 DOI: 10.7717/peerj.3600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/29/2017] [Indexed: 12/22/2022] Open
Abstract
Background Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect. Method A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG). Findings A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training. Conclusion Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.
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Affiliation(s)
- Julien Tripette
- Ochanomizu University, Bunkyo, Tokyo, Japan.,Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Haruka Murakami
- Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Katie Rose Ryan
- Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Yuji Ohta
- Ochanomizu University, Bunkyo, Tokyo, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
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Qiu Z, Zheng K, Zhang H, Feng J, Wang L, Zhou H. Physical Exercise and Patients with Chronic Renal Failure: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7191826. [PMID: 28316986 PMCID: PMC5337868 DOI: 10.1155/2017/7191826] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 09/21/2016] [Accepted: 10/20/2016] [Indexed: 12/19/2022]
Abstract
Chronic renal failure is a severe clinical problem which has some significant socioeconomic impact worldwide and hemodialysis is an important way to maintain patients' health state, but it seems difficult to get better in short time. Considering these, the aim in our research is to update and evaluate the effects of exercise on the health of patients with chronic renal failure. The databases were used to search for the relevant studies in English or Chinese. And the association between physical exercise and health state of patients with chronic renal failure has been investigated. Random-effect model was used to compare the physical function and capacity in exercise and control groups. Exercise is helpful in ameliorating the situation of blood pressure in patients with renal failure and significantly reduces VO2 in patients with renal failure. The results of subgroup analyses show that, in the age >50, physical activity can significantly reduce blood pressure in patients with renal failure. The activity program containing warm-up, strength, and aerobic exercises has benefits in blood pressure among sick people and improves their maximal oxygen consumption level. These can help patients in physical function and aerobic capacity and may give them further benefits.
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Affiliation(s)
| | - Kai Zheng
- Department of Urology, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Haoxiang Zhang
- Department of Gastroenterology, General Hospital of Tibet Military Region, Lhasa, Tibet, China
| | - Ji Feng
- Department of Gastroenterology, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China
| | - Lizhi Wang
- Department of Chronic Infectious Disease Prevention and Control, Hongkou District Center for Disease Control and Prevention, Shanghai, China
| | - Hao Zhou
- Department of Urology, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine (The People's Hospital of Fujian Province), No. 602, Middle Road 817, Fuzhou, Fujian, China
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41
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Tang Q, Yang B, Fan F, Li P, Yang L, Guo Y. Effects of individualized exercise program on physical function, psychological dimensions, and health-related quality of life in patients with chronic kidney disease: A randomized controlled trial in China. Int J Nurs Pract 2017; 23. [PMID: 28217935 DOI: 10.1111/ijn.12519] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/23/2016] [Accepted: 12/03/2016] [Indexed: 12/27/2022]
Abstract
The aim of this study was to examine the effects of a 12-week home-based exercise program on physical function, psychological dimensions, and health-related quality of life for patients with chronic kidney disease. Ninety eligible patients were enrolled and randomly separated into the exercise group and the control group from November 2015 to May 2016. The exercise group received an individualized exercise program while the control group received only usual care and continued primary lifestyle. Physical function was measured using 6-minute walk test and 10 repetitions of the sit-to-stand test while psychological dimensions were assessed by the Hospital Anxiety and Depression scale and the Self-Efficacy for Exercise scale. Quality of life was evaluated by a disease-specific instrument, the Kidney Disease Quality of Life scale. The differences between the exercise group and the control group were statistically significant for 6-minute walk distance, the time to complete 10 repetitions of the sit-to-stand test, self-efficacy for exercise, anxiety and depression, and all domains of health-related quality of life after a 12-week exercise. This study suggests that home-based individualized exercise program is an effective and feasible way of improving physical function, psychological stress, and health-related quality of life for early stage of chronic kidney disease patients.
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Affiliation(s)
- Qing Tang
- School of Nursing, Nantong University, Nantong, China
| | - Bin Yang
- Department of Infection, Immunity & Inflammation, University of Leicester, Leicester, UK.,College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK
| | - Fengyan Fan
- Department of Nephrology, Nantong University Affiliated Hospital, Nantong, China
| | - Ping Li
- School of Nursing, Nantong University, Nantong, China
| | - Lei Yang
- School of Nursing, Nantong University, Nantong, China
| | - Yujie Guo
- School of Nursing, Nantong University, Nantong, China
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42
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Chigira Y, Oda T, Izumi M, Yoshimura T. Effects of exercise therapy during dialysis for elderly patients undergoing maintenance dialysis. J Phys Ther Sci 2017; 29:20-23. [PMID: 28210031 PMCID: PMC5300797 DOI: 10.1589/jpts.29.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/14/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Exercise therapy during dialysis is currently being recommended since it is easy for patients to follow and results in high participation rates. In this study, this therapy was performed for elderly patients undergoing maintenance dialysis, and its effects were examined. [Subjects and Methods] Seven elderly patients (age: 70.6 ± 4.4) with chronic renal failure, who were able to perform exercises during maintenance dialysis, received the exercise therapy 2 or 3 times weekly for 3 months. Lower-limb muscle strength as well as the standardized dialysis dose (Kt/V) was measured before and after intervention. The patients were also evaluated using the 30-sec chair stand test (CS-30), the World Health Organization QOL Assessment 26 (WHO-QOL26), and a questionnaire. [Results] The lower-limb muscle strength and circumference, CS-30 score, and Kt/V values improved after intervention, but the difference was not significant. Significant differences were observed only in the WHO-QOL26 score. [Conclusion] The outcome was particularly favorable in terms of the quality of life (QOL). Based on the results from the questionnaire, the higher QOL may be due to the patients' development of a positive attitude toward these activities. Although there were no significant differences, the values for the other criteria also improved, thereby supporting the effectiveness of exercise therapy to maintain or improve the patients' motor functions and activity daily living (ADL) ability.
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Affiliation(s)
- Yusuke Chigira
- Department of Physical Therapy, Faculty of Health Science, Takasaki University of Health and Welfare, Japan
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Chen CC, Chen Y, Liu X, Wen Y, Ma DY, Huang YY, Pu L, Diao YS, Yang K. The Efficacy of a Nurse-Led Disease Management Program in Improving the Quality of Life for Patients with Chronic Kidney Disease: A Meta-Analysis. PLoS One 2016; 11:e0155890. [PMID: 27191392 PMCID: PMC4871412 DOI: 10.1371/journal.pone.0155890] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 05/05/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The impacts of nurse-led disease management programs on the quality of life for patients with chronic kidney disease have not been extensively studied. Furthermore, results of the existing related studies are inconsistent. The focus of the proposed meta-analysis is to evaluate the efficacy of nurse-led disease management programs in improving the quality of life for patients with chronic kidney disease. METHODS Literature survey was performed to identify the eligible studies from PubMed, Current Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials with predefined terms. The outcome measured was quality of life. This meta-analysis was conducted in line with recommendations from the preferred reporting items for systematic reviews and meta-analyses. RESULTS Eight studies comprising a total of 1520 patients were included in this meta-analysis, with 766 patients assigned to the nurse-led disease management program. Nurse-led disease management improved the quality of life in terms of symptoms, sleep, staff encouragement, pain, general health perception, energy/fatigue, overall health and mental component summary when evaluated 6 weeks after the beginning of intervention. When evaluated 12 weeks later, the quality of life in terms of symptoms, sleep, staff encouragement, energy/fatigue, and physical component summary was improved. Stratified by the modalities of dialysis, similar results of pooled analyses were observed for patients with peritoneal dialysis or hemodialysis, compared with the overall analyses. The results of sensitivity analyses were the same as the primary analyses. The symmetric funnel plot suggested that the possibility of potential publication bias was relatively low. CONCLUSION Nurse-led disease management program seems effective to improve some parameters of quality of life for patients with chronic kidney disease. However, the seemingly promising results should be cautiously interpreted and generalized and still need to be confirmed through well-designed large-scale prospective randomized controlled trials.
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Affiliation(s)
- Chong-Cheng Chen
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yi Chen
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Xia Liu
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yue Wen
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Deng-Yan Ma
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yue-Yang Huang
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Li Pu
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
| | - Yong-Shu Diao
- Department of Nephrology, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
- * E-mail: (YSD); (KY)
| | - Kun Yang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No.37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, P.R.China
- * E-mail: (YSD); (KY)
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Shiota K, Hashimoto T. Promotion and support of physical activity in elderly patients on hemodialysis: a case study. J Phys Ther Sci 2016; 28:1378-83. [PMID: 27190487 PMCID: PMC4868247 DOI: 10.1589/jpts.28.1378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to ascertain the optimum strategy for implementing a
physical activity intervention in patients on hemodialysis by investigating the physical
characteristics of elderly patients on hemodialysis, and their attitude to physical
activity and level of daily activity. [Subjects] The Subject were 10 elderly patients on
hemodialysis. [Methods] They wore a physical activity monitor for 1 week. Data obtained
were analyzed for hemodialysis and non- hemodialysis days, and two-way analysis of
variance was used to compare the number of steps and activity levels. A questionnaire was
administered to investigate the stage of psychological preparedness for exercise and
attitudes toward/awareness of exercise. [Results] There was no significant difference in
the number of steps or exercise levels on hemodialysis and non- hemodialysis days.
However, on both types of days, subjects spent long periods not engaged in any activity.
Most of their activity was either inactivity or sedentary behavior. [Conclusion] Patients
on hemodialysis with low physical activity levels are considered to have poor physical
function and exercise tolerance. To maintain and improve the physical function of patients
on hemodialysis, it will be necessary to reduce their time spent in inactive, and
comprehensive care that covers psychosocial aspects should be provided to promote the
proactive improvement of physical activity and their attitudes to exercise.
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45
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Bossola M, Tazza L. Postdialysis Fatigue: A Frequent and Debilitating Symptom. Semin Dial 2016; 29:222-7. [DOI: 10.1111/sdi.12468] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Maurizio Bossola
- Hemodialysis Service; Department of Urology and Nephrology; Catholic University; Rome Italy
| | - Luigi Tazza
- Hemodialysis Service; Department of Urology and Nephrology; Catholic University; Rome Italy
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Noguchi M, Yamaguchi S, Koshino Y, Kimura A, Miyagi S. Validity of body impedance analysis for evaluating body composition in patients undergoing long-term hemodialysis. J Phys Ther Sci 2015; 27:1649-52. [PMID: 26180290 PMCID: PMC4499953 DOI: 10.1589/jpts.27.1649] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 02/07/2015] [Indexed: 12/11/2022] Open
Abstract
[Purpose] This study assessed changes in body composition before and after dialysis in
chronic hemodialysis patients and determined the relationships between various body
composition parameters and blood lipid levels in these patients. [Subjects] The
cross-sectional study included 19 dialysis outpatients (17 men and 2 women, aged
35–82 years). [Methods] Body mass index, body weight, percent body fat, and percent
skeletal muscle were measured before and after dialysis by using body impedance analysis.
Blood lipid levels were obtained from patients’ clinical records. The body composition
parameters before and after dialysis were compared using paired t-tests. Spearman’s rank
correlation coefficients were calculated to determine relationships between the body
composition parameters, before and after dialysis, and the blood lipid levels. [Results]
All body composition parameters differed significantly before and after dialysis.
High-density lipoprotein cholesterol level significantly correlated with all the body
composition parameters, whereas total cholesterol, low-density lipoprotein cholesterol,
and triglyceride levels significantly correlated with some of these parameters. The
correlation coefficients revealed no major differences in the relationships between blood
lipid parameters and body compositions before and after dialysis. [Conclusion] Our
findings suggest that body composition parameters, whether measured before or after
dialysis, can be used to evaluate obesity in longitudinal studies.
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Affiliation(s)
| | | | | | - Akira Kimura
- Faculty of Health Science, Gunma Paz College, Japan
| | - Shigeji Miyagi
- Department of Health Administration, Kagawa Nutrition University, Japan
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Bossola M, Di Stasio E, Antocicco M, Panico L, Pepe G, Tazza L. Fatigue Is Associated with Increased Risk of Mortality in Patients on Chronic Hemodialysis. Nephron Clin Pract 2015; 130:113-8. [DOI: 10.1159/000430827] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 04/20/2015] [Indexed: 11/19/2022] Open
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48
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Bae YH, Lee SM, Jo JI. Aerobic training during hemodialysis improves body composition, muscle function, physical performance, and quality of life in chronic kidney disease patients. J Phys Ther Sci 2015; 27:1445-9. [PMID: 26157237 PMCID: PMC4483415 DOI: 10.1589/jpts.27.1445] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 01/17/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We assessed the influences of individualized aerobic training on body
composition, knee joint muscle function, physical performance, and quality of life in
chronic kidney disease patients. [Subjects] Ten chronic kidney disease patients undergoing
dialysis. [Methods] Overall physical function and quality of life before and after 12
weeks of aerobic training were evaluated by body composition, the six-minute walk test,
cardiopulmonary exercise tests, and Short Form 36-item questionnaire. [Results] The
six-minute walk test distance increased significantly after 12 weeks aerobic training.
Resting metabolic rate, lactate threshold, maximum oxygen uptake, and quality of life
tended to increase after training. Post-training weight, muscle mass, body fat mass, fat
percentage, body mass index, and peak torque of right and left knee extension and flexion
did not change significantly. [Conclusion] Intra-dialytic training can a safe approach to
maintain or improve physical performance and quality of life of chronic kidney disease
patients undergoing hemodialysis without adverse events or negative cardiovascular
responses. Aerobic training may prevent a decline in body composition and knee joint
muscle function due to inactivity in chronic kidney disease patients. Clinically, aerobic
training may initially be adapted to maintain overall physical function or improve quality
of life in chronic kidney disease patients undergoing hemodialysis.
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Affiliation(s)
- Young-Hyeon Bae
- Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Republic of Korea ; Department of Physical Therapy, Angelo State University, USA
| | - Suk Min Lee
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Jong Il Jo
- Department of Physical Therapy, New York University, USA
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A nurse-led case management program on home exercise training for hemodialysis patients: A randomized controlled trial. Int J Nurs Stud 2015; 52:1029-41. [PMID: 25840898 DOI: 10.1016/j.ijnurstu.2015.03.013] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 01/19/2023]
Abstract
BACKGROUND Patients on maintenance hemodialysis suffer from diminished physical health. Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being. However, nurses seldom include an exercise intervention in the care plan for hemodialysis patients. OBJECTIVES The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients. DESIGN The study was a randomized, two-parallel group trial. SETTINGS Hemodialysis units in two tertiary hospitals in Nanjing, mainland China. PARTICIPANTS One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and randomly assigned to either the study group (n=57) or the control group (n=56). METHODS Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks. The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks. The intervention was to facilitate patients in performing regular exercise at home. Outcome measures, including gait speed, 10-repetition sit-to-stand performance, and quality of life were collected at baseline, and at 6 and 12 weeks into the program. RESULTS The results revealed that patients in the study group demonstrated greater increases in normal gait speed [F(1,111)=4.42, p=0.038] than the control group. For the study group, a mean increase of 12.02 (±3.03)centimeters/second from baseline to week 12 was found. With regard to the fast gait speed, there was a marginally significant between-group effect [F(1,111)=3.93, p=0.050]. The study group showed a mean improvement of 11.08 (±3.32)cm/s, from baseline to week 12. Patients from both groups showed improvements in their 10-repetition sit-to-stand performance. The between-group differences approached significance [F(1,111)=3.92, p=0.050], with the study group showed greater improvement than the control group. The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88)s from baseline to week 12. Significant improvements in quality of life across three time points were found only in the study group. CONCLUSIONS Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients.
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