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Touloudi E, Hassandra M, Stavrou VT, Panagiotounis F, Galanis E, Goudas M, Theodorakis Y. Exploring the Acute Effects of Immersive Virtual Reality Biking on Self-Efficacy and Attention of Individuals in the Treatment of Substance Use Disorders: A Feasibility Study. Brain Sci 2024; 14:724. [PMID: 39061464 PMCID: PMC11274936 DOI: 10.3390/brainsci14070724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The role of exercise programs during substance use disorder (SUD) treatment is considered particularly supportive in fostering positive psychological and behavioral changes. The treatment of SUD is a challenging and demanding process. Therefore, it is crucial to discover innovative methods to enhance and facilitate it. Integrating exercise into a virtual environment is an innovative approach for drug rehabilitation, offering multiple benefits to individuals undergoing treatment. The aim of this feasibility study was to explore the acute effects of cycling exercise in an immersive virtual reality (VR) environment on attentional control and self-efficacy expectations of individuals undergoing SUD treatment. METHODS A total of 20 individuals (mean age of 37.75 years) enrolled in a SUD treatment program participated in the study. They were instructed to complete a single session of cycling with a self-selected duration within the VR system. RESULTS Following the cycling session, pre-post measures indicated a statistically significant improvement in self-efficacy expectations and attentional control measured with the Stroop test. The results revealed that participants expressed high levels of intention for future use, interest/enjoyment, and positive attitudes toward the VR exercise system. Qualitative data indicated that participants found the VR exercise system enjoyable, expressed a strong intention to use it, and did not encounter technical difficulties or negative emotions. CONCLUSIONS In conclusion, it seems that engaging in a brief period of self-selected exercise within a virtual environment can result in temporary activation of cognitive changes, heightened self-efficacy expectations, and a motivating approach to increasing physical activity participation among individuals with SUD, thus suggesting the feasibility of this approach.
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Affiliation(s)
- Evlalia Touloudi
- Department of Physical Education and Sport Sciences, University of Thessaly, 42100 Trikala, Greece; (E.T.); (M.H.); (E.G.); (M.G.)
| | - Mary Hassandra
- Department of Physical Education and Sport Sciences, University of Thessaly, 42100 Trikala, Greece; (E.T.); (M.H.); (E.G.); (M.G.)
| | - Vasileios T. Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | | | - Evangelos Galanis
- Department of Physical Education and Sport Sciences, University of Thessaly, 42100 Trikala, Greece; (E.T.); (M.H.); (E.G.); (M.G.)
| | - Marios Goudas
- Department of Physical Education and Sport Sciences, University of Thessaly, 42100 Trikala, Greece; (E.T.); (M.H.); (E.G.); (M.G.)
| | - Yannis Theodorakis
- Department of Physical Education and Sport Sciences, University of Thessaly, 42100 Trikala, Greece; (E.T.); (M.H.); (E.G.); (M.G.)
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Hasnan N, Hamzaid NA, Magenthran V, Davis GM. Exercise Responses During Outdoor Versus Virtual Reality Indoor Arm+FES-Leg Cycling in Individuals with Spinal Cord Injury. Games Health J 2024. [PMID: 38709784 DOI: 10.1089/g4h.2023.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
Background: Virtual reality (VR)-enhanced indoor hybrid cycling in people with spinal cord injury (SCI) can be comparable to outdoor hybrid cycling. Method: Eight individuals with chronic thoracic-lesion SCI performed voluntary arm and electrically assisted leg cycling on a hybrid recumbent tricycle. Exercises were conducted outdoors and indoors incorporating VR technology in which the outdoor environment was simulated on a large flat screen monitor. Electrical stimulation was applied bilaterally to the leg muscle groups. Oxygen uptake (VO2), heart rate, energy expenditures, and Ratings of Perceived Exertion were measured over a 30-minute outdoor test course that was also VR-simulated indoors. Immediately after each exercise, participants completed questionnaires to document their perceptual-psychological responses. Results: Mean 30-minute VO2 was higher for indoor VR exercise (average VO2-indoor VR-exercise: 1316 ± mL/min vs. outdoor cycling: 1255 ± 53 mL/min; highest VO2-indoor VR-exercise: 1615 ± 67 mL/min vs. outdoor cycling: 1725 ± 67 mL/min). Arm and leg activity counts were significantly higher during indoor VR-assisted hybrid functional electrical stimulation (FES) cycling than outdoors; 42% greater for the arms and 23% higher for the legs (P < 0.05). Similar responses were reported for exercise effort and perceptual-psychological outcomes during both modes. Conclusion: This study proposes that combining FES and VR technology provides new opportunities for physical activity promotion or exercise rehabilitation in the SCI population, since these modes have similar "dose-potency" and self-perceived effort. Human Research Ethics Committee of the University of Sydney Ref. No. 01-2010/12385.
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Affiliation(s)
- Nazirah Hasnan
- Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nur Azah Hamzaid
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Vhinoth Magenthran
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Glen M Davis
- Discipline of Exercise and Sport Science, Sydney School of Health Sciences, Faculty of Medicine and Health. The University of Sydney, Sydney, New South Wales, Australia
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Siette J, Campbell C, Adam PJ, Harris CB. Exploring the usability of the virtual reality module LEAF CAFÉ: a qualitative think-aloud study. BMC Geriatr 2024; 24:162. [PMID: 38365613 PMCID: PMC10870684 DOI: 10.1186/s12877-024-04767-y] [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: 09/07/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND The global healthcare system faces increasing strain from our ageing population, primarily due to the growing prevalence of age-related health conditions such as dementia. While modern healthcare technology offers potential solutions, it frequently lacks user-friendliness for older adults. Virtual Reality (VR) has emerged as a promising tool for diagnosing cognitive impairment, offering innovative solutions where traditional methods may fall short. This study explores older adults' perspectives on the usability of a newly designed VR module for cognitive assessment. METHODS During a 100-min session, participants were asked to engage and complete recall and recognition tasks within the VR module (think-aloud approach) and provide feedback upon completion (semi-structured interviews). Audio materials were transcribed for analysis and recordings of the users' interactions with the module were annotated to provide additional context. These combined textual data were analysed using content coding and thematic analysis to identify themes that reflect how participants used the module's features and what features are desirable to support that process better. RESULTS Participants (N = 10; Mean age = 73.3, SD = 7.53, range = 65-83 years) perceived the VR module as user-friendly and endorsed its potential as a cognitive screener due to its engaging and immersive nature. Older adults highlighted three key aspects of the module: the usefulness of the platform's ability to offer a comprehensive and reliable evaluation of an individual's cognitive abilities; the need to present concise and relevant content to optimise engagement and use; and the importance of overcoming barriers to support implementation. Suggested game improvements centred on food recognition and adjusting difficulty levels. Barriers to implementation included technology challenges for older adults and concerns about the game's suitability for everyday scenarios. Participants stressed the need for reliable implementation strategies, proposing locations such as libraries and advocating for home-based screening. CONCLUSION Continued improvements in accessibility suggest that VR tools could help with diagnosing cognitive impairment in older adults. Using a simulated environment to assess cognitive status might fill the gap between current diagnostic methods, aiding treatment planning and early intervention. However, these findings should be approached cautiously, as more research is needed to fully grasp the potential impact of VR tools in this context.
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Affiliation(s)
- Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia.
| | - Christopher Campbell
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia
| | - Patrick J Adam
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia
| | - Celia B Harris
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Westmead, NSW, 2145, Australia
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4
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Yan S, Shen S, Lu Q, Zhong S, Lv S, Lai S, Luo Y, Ran H, Duan M, Song K, Ye K, Jia Y. Virtual reality working memory training improves cognitive performance of acute and remitted patients with major depressive disorder. J Affect Disord 2024; 344:267-276. [PMID: 37838265 DOI: 10.1016/j.jad.2023.10.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/14/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Cognitive training is effective in treating neuropsychological impairment in patients with major depressive disorder (MDD), and virtual reality (VR) is a promising tool to provide such training. However, studies using VR-based working memory (WM) training in treating depressed patients' cognitive impairment are extremely scarce and how it affects cognitive performance remains unclear. Therefore, we aimed to determine the efficacy of VR-WM training in acute and remitted depressed patients and try to investigate its potential mechanisms. METHODS Forty-two patients with MDD (22 acute patients and 20 remitted patients) received 20-session VR-WM training, while 22 healthy controls (HC) received no intervention. WM and other cognitive domains' performance were assessed by the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ) and the MATRICS Consensus Cognitive Battery (MCCB) before and after the intervention. Depressive symptoms were assessed by the 24-item Hamilton Depression Rating Scale (24-HDRS) at the same time points. RESULTS Acute and remitted MDD patients both exhibited significant improvements from pre- to post-training in WM, processing speed, visual learning, reasoning and problem-solving, and total cognition (all p < 0.05). Significant groups-by-time interactions were observed for the 24-HDRS score (p < 0.05). Mediation analysis showed that 24-HDRS score partially mediated the association between the effect of VR-WM training on WM and total cognition performance in total depressive samples. CONCLUSIONS VR-WM training effectively improved WM and other cognitive domains' performance in both acute and remitted MDD patients. Besides, VR-WM training improves WM and total cognition performance in MDD patients partially via the enhancement of depressive symptoms.
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Affiliation(s)
- Shuya Yan
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shiyi Shen
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; School of Management, Jinan University, Guangzhou 510630, China
| | - Qianyi Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China; Guangdong University of Finance, Guangzhou 510521, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Sihui Lv
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Yange Luo
- School of Management, Jinan University, Guangzhou 510630, China; Department of Clinical Psychology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen 518033, China
| | - Hanglin Ran
- School of Management, Jinan University, Guangzhou 510630, China; School of Public Health, Chongqing Medical University, Chongqing 400016, China
| | - Manying Duan
- School of Management, Jinan University, Guangzhou 510630, China
| | - Kailin Song
- School of Management, Jinan University, Guangzhou 510630, China
| | - Kaiwei Ye
- School of Management, Jinan University, Guangzhou 510630, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Moffitt RL. A psychosocial investigation of exercise preferences in real and virtual environments. PSYCHOLOGY OF SPORT AND EXERCISE 2024; 70:102530. [PMID: 37678040 DOI: 10.1016/j.psychsport.2023.102530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/03/2023] [Accepted: 08/31/2023] [Indexed: 09/09/2023]
Abstract
Three studies explored exercise preferences in real-world and virtual environments, and their relationship with social physique anxiety (SPA), social comparison, and self-presentational efficacy (SPE). In Study 1 (N = 230), real-world exercise preferences were explored. Study 2 (N = 228) measured preferences for real-world and virtual reality (VR) exercise, and Study 3 (N = 249) investigated preferences for avatar embodiment and virtual companions within VR. Results revealed that participants who preferred home-based exercise had lower exercise behaviour, more negative fitness-related social comparisons, or lower SPE expectancy and outcome value (Study 1). Individuals with lower exercise behaviour, more negative fitness-related social comparisons, lower SPE expectancy, or higher SPA were also more likely to choose VR than real-world exercise (Study 2). In a VR exercise setting, participants with higher SPA and more negative social comparisons also preferred to embody a non-human and fantasy avatar more than a realistic avatar. A heightened threat of negative social comparison when imagining exercise with a physically superior virtual companion resulted in the strongest preference to embody a fantasy avatar (Study 3). The results suggest that individuals who place high importance on self-presentation and have low belief in their capacity to project an image of competence to others, are more likely to prefer exercise contexts that minimise physique- and fitness-related evaluation. Moreover, VR may afford a less psychosocially threatening context for individuals who feel self-conscious or comparatively inferior to others during exercise.
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Affiliation(s)
- Robyn L Moffitt
- School of Psychology, Faculty of Health, Deakin University, Geelong, VIC, Australia; School of Applied Psychology, Griffith University, Gold Coast, QLD, Australia.
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Baldimtsi E, Mouzakidis C, Karathanasi EM, Verykouki E, Hassandra M, Galanis E, Hatzigeorgiadis A, Goudas M, Zikas P, Evangelou G, Papagiannakis G, Bellis G, Kokkotis C, Tsatalas T, Giakas G, Theodorakis Y, Tsolaki M. Effects of Virtual Reality Physical and Cognitive Training Intervention On Cognitive Abilities of Elders with Mild Cognitive Impairment. J Alzheimers Dis Rep 2023; 7:1475-1490. [PMID: 38225966 PMCID: PMC10789285 DOI: 10.3233/adr-230099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background Virtual reality (VR) technology has become increasingly used for assessment and intervention in the neuroscience field. Objective We aimed to investigate the effects of a VR Training System, named VRADA (VR Exercise App for Dementia and Alzheimer's Patients), on the cognitive functioning of older people with mild cognitive impairment (MCI). Methods In this intervention study, 122 older adults with MCI were randomly assigned to five groups (the VRADA group (n = 28), a bike group (n = 11), a physical exercise group (n = 24), a mixed group (physical and cognitive exercise) (n = 31), and a non-contact control group (n = 28). The VRADA group underwent 32 physical and cognitive training sessions, performed 2 or 3 times weekly for 12 weeks in the VR environment. All participants had detailed neuropsychological assessments before and after intervention. Results A series of linear regression models revealed that the VRADA group showed improvement or no deterioration in cognitive decline in global cognitive function (MMSE), verbal memory (Rey Auditory Verbal Learning Test and WAIS forward test), and executive functions, mental flexibility (Trail Making Test B). Conclusions This interventionstudy indicates that the VRADA system improves the cognitive function of elders with MCI.
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Affiliation(s)
- Eleni Baldimtsi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Christos Mouzakidis
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Maria Karathanasi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Verykouki
- School of Medicine, Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Agriculture, Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, Volos, Greece
| | - Mary Hassandra
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Evangelos Galanis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Marios Goudas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Paul Zikas
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - Giannis Evangelou
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - George Papagiannakis
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology – Hellas (FORTH), University of Crete, Heraklion, Crete, Greece
| | - George Bellis
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Christos Kokkotis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Themistoklis Tsatalas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Giannis Giakas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Yannis Theodorakis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Building A, Greece
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Moore RC, Hancock JT, Bailenson JN. From 65 to 103, Older Adults Experience Virtual Reality Differently Depending on Their Age: Evidence from a Large-Scale Field Study in Nursing Homes and Assisted Living Facilities. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:886-895. [PMID: 38011717 DOI: 10.1089/cyber.2023.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
There is growing interest in applications of virtual reality (VR) to improve the lives of older adults, but the limited research on older adults and VR largely treats older adults as a monolith, ignoring the substantial differences across 65 to 100+ year olds that may affect their experience of VR. There are also few existing studies examining the experiences and challenges facing those who facilitate VR for older adults (e.g., caregiving staff). We address these limitations through two studies. In study 1, we explore variation within older adults' experiences with VR through a field study of VR use among a large (N = 245) and age-diverse (Mage = 83.6 years, SDage = 7.9, range = 65-103 years) sample of nursing home and assisted living facility residents across 10 U.S. states. Age was negatively associated with the extent to which older adults enjoyed VR experiences. However, the negative relationship between age and older adults' attitudes toward VR was significantly less negative than the relationship between age and their attitudes toward other technologies (cell phones and voice assistants). In study 2, we surveyed caregiving staff (N = 39) who facilitated the VR experiences for older adult residents and found that the caregiving staff generally enjoyed the activity relative to other activities and felt it to be beneficial to their relationship with residents.
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Affiliation(s)
- Ryan C Moore
- Department of Communication, Stanford University, Stanford, California, USA
| | - Jeffrey T Hancock
- Department of Communication, Stanford University, Stanford, California, USA
| | - Jeremy N Bailenson
- Department of Communication, Stanford University, Stanford, California, USA
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Park SJ, Lee JW. Effects of Virtual Reality Pilates Training on Duration of Posture Maintenance and Flow in Young, Healthy Individuals: Randomized Crossover Trial. JMIR Serious Games 2023; 11:e49080. [PMID: 37856178 PMCID: PMC10623234 DOI: 10.2196/49080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/10/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND This study explored the use of virtual reality (VR) technology to enhance the effectiveness and duration of low-intensity movements and postures in Pilates-derived exercises. We postulate that by leveraging the flow state in VR, individuals can engage in these exercises for longer periods while maintaining a high level of flow. OBJECTIVE The purpose of this study was to compare differences in posture maintenance and flow between VR Pilates training and conventional Pilates training, and the correlation between the 2 factors. METHODS The 18 participants in each group received either VR training or conventional training and were switched to the other training type after a 2-day wash-out period. Each group performed Pilates movements in a VR environment and a conventional environment, divided into 4 types. After training sessions, participants were evaluated for flow using a self-report questionnaire. In addition, a sports video analysis program was used to measure the duration of posture maintenance in 2 video-recorded sessions. Repeated-measures ANOVA and correlation analysis were performed on the measured duration of posture maintenance and flow scores. In all cases, the statistical significance level was set at P<.05. RESULTS Results for the duration of posture maintenance verification by type showed that simple behavior (F1,16=17.631; P<.001), upper body-arm coordination behavior (F1,16=6.083; P=.04), upper body-leg coordination behavior (F1,16=8.359; P<.001), and whole-body coordination behavior (F1,16=8.426; P<.001) all showed an interaction effect at P<.05. Flow (F1,16=15.250; P<.001) also showed an interaction effect. In addition, significant correlations were determined between duration of all types of posture maintenance and flow in the VR training group at P<.05. CONCLUSIONS Our results indicate that VR Pilates training may be more useful than conventional Pilates training in improving the duration of posture maintenance and that it promotes a significantly higher degree of flow when compared with conventional Pilates training.
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Affiliation(s)
- Sung Je Park
- College of Sport, Chung-Ang University, Anseong-si, Republic of Korea
| | - Jea Woog Lee
- Intelligence Information Processing Lab, Chung-Ang University, Seoul, Republic of Korea
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9
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Tarasova I, Trubnikova O, Kukhareva I, Syrova I, Sosnina A, Kupriyanova D, Barbarash O. A Comparison of Two Multi-Tasking Approaches to Cognitive Training in Cardiac Surgery Patients. Biomedicines 2023; 11:2823. [PMID: 37893196 PMCID: PMC10604887 DOI: 10.3390/biomedicines11102823] [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: 08/21/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The multi-tasking approach may be promising for cognitive rehabilitation in cardiac surgery patients due to a significant effect on attentional and executive functions. This study aimed to compare the neuropsychological changes in patients who have undergone two variants of multi-tasking training and a control group in the early postoperative period of coronary artery bypass grafting (CABG). METHODS One hundred and ten CABG patients were divided into three groups: cognitive training (CT) I (a postural balance task with mental arithmetic, verbal fluency, and divergent tasks) (n = 30), CT II (a simple visual-motor reaction with mental arithmetic, verbal fluency, and divergent tasks) (n = 40), and control (n = 40). RESULTS Two or more cognitive indicators improved in 93.3% of CT I patients, in 72.5% of CT II patients, and in 62.5% of control patients; CT I patients differed from CT II and control (p = 0.04 and p = 0.008, respectively). The improving short-term memory and attention was found more frequently in the CT I group as compared to control (56.7% vs. 15%; p = 0.0005). The cognitive improvement of all domains (psychomotor and executive functions, attention, and short-term memory) was also revealed in CT I patients more frequently than CT II (46.7% vs. 20%; p = 0.02) and control (46.7% vs. 5%; p = 0.0005). CONCLUSIONS The CT I multi-tasking training was more effective at improving the cognitive performance in cardiac surgery patients as compared to CT II training and standard post-surgery management. The findings of this study will be helpful for future studies involving multi-tasking training.
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Affiliation(s)
- Irina Tarasova
- Department of Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, Sosnovy Blvd., 6, 650002 Kemerovo, Russia; (O.T.); (I.S.)
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Reiss AB, Muhieddine D, Jacob B, Mesbah M, Pinkhasov A, Gomolin IH, Stecker MM, Wisniewski T, De Leon J. Alzheimer's Disease Treatment: The Search for a Breakthrough. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1084. [PMID: 37374288 PMCID: PMC10302500 DOI: 10.3390/medicina59061084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/22/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023]
Abstract
As the search for modalities to cure Alzheimer's disease (AD) has made slow progress, research has now turned to innovative pathways involving neural and peripheral inflammation and neuro-regeneration. Widely used AD treatments provide only symptomatic relief without changing the disease course. The recently FDA-approved anti-amyloid drugs, aducanumab and lecanemab, have demonstrated unclear real-world efficacy with a substantial side effect profile. Interest is growing in targeting the early stages of AD before irreversible pathologic changes so that cognitive function and neuronal viability can be preserved. Neuroinflammation is a fundamental feature of AD that involves complex relationships among cerebral immune cells and pro-inflammatory cytokines, which could be altered pharmacologically by AD therapy. Here, we provide an overview of the manipulations attempted in pre-clinical experiments. These include inhibition of microglial receptors, attenuation of inflammation and enhancement of toxin-clearing autophagy. In addition, modulation of the microbiome-brain-gut axis, dietary changes, and increased mental and physical exercise are under evaluation as ways to optimize brain health. As the scientific and medical communities work together, new solutions may be on the horizon to slow or halt AD progression.
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Affiliation(s)
- Allison B. Reiss
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
| | - Dalia Muhieddine
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
| | - Berlin Jacob
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
| | - Michael Mesbah
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
| | - Aaron Pinkhasov
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
| | - Irving H. Gomolin
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
| | | | - Thomas Wisniewski
- Center for Cognitive Neurology, Departments of Neurology, Pathology and Psychiatry, NYU School of Medicine, New York, NY 10016, USA;
| | - Joshua De Leon
- Department of Medicine and Biomedical Research Institute, NYU Long Island School of Medicine, Mineola, NY 11501, USA; (D.M.); (B.J.); (M.M.); (A.P.); (I.H.G.); (J.D.L.)
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11
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Tuena C, Serino S, Stramba-Badiale C, Pedroli E, Goulene KM, Stramba-Badiale M, Riva G. Usability of an Embodied CAVE System for Spatial Navigation Training in Mild Cognitive Impairment. J Clin Med 2023; 12:jcm12051949. [PMID: 36902733 PMCID: PMC10003531 DOI: 10.3390/jcm12051949] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Individuals with mild cognitive impairment (MCI) usually report navigation and spatial memory impairments. Spatial navigation is an embodied process that requires the active involvement of both physical (e.g., motor commands and proprioception) and cognitive (e.g., decision-making and mental rotation) information. Immersive virtual reality (IVR) is a valuable tool that employs this information as real-world navigation does. Given the crucial impact of spatial navigation on daily life, research should focus on ways to enhance it. Though they are still in their development, contemporary IVR methods for spatial navigation training in MCI seem promising. In this usability study, eight patients with MCI syndrome tested an IVR spatial navigation training demo and interacted with the CAVE using active stereo glasses, a foot-motion pad, and a joypad. During the demo, users were asked to report their impressions on the IVR training using the thinking-aloud procedure. Moreover, questionnaires regarding usability, presence and cybersickness were administered at the end of the experience. Our results show that the first version of this system is usable by the patients even if most of them did not have experience with PC/IVR. The system provided a moderate sense of spatial presence and limited negative effects. Issues found during the thinking-aloud procedure concerned the visual aspects, which affected the interaction user-system. Participants reported that they needed more practice with the foot-motion pad even though the overall experience was positively evaluated. Identifying these critical features was essential to develop an improved version of the current system.
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Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Correspondence: ; Tel.: +39-02-61-911-2726
| | - Silvia Serino
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
| | - Chiara Stramba-Badiale
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Faculty of Psychology, Università eCampus, Via Isimbardi 10, 22060 Novedrate, Italy
| | - Karine Marie Goulene
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Via Mosè Bianchi 90, 20149 Milan, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Via Mosè Bianchi 90, 20149 Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Via Magnasco 2, 20149 Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121 Milan, Italy
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12
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Barreras Diaz TA, Esquer-Rochin M, Gutierrez-Garcia JO, Rodriguez LF. Design and Evaluation of a Technological Platform for Monitoring Patients with Dementia: Unifying Requirements from Mexican Day Centers. J Med Syst 2023; 47:30. [PMID: 36840849 PMCID: PMC9959949 DOI: 10.1007/s10916-023-01917-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 02/08/2023] [Indexed: 02/26/2023]
Abstract
The monitoring of patients with dementia who receive comprehensive care in day centers allows formal caregivers to make better decisions and provide better care to patients. For instance, cognitive and physical therapies can be tailored based on the current stage of disease progression. In the context of day centers of the Mexican Federation of Alzheimer, this work aims to design and evaluate Alzaid, a technological platform for assisting formal caregivers in monitoring patients with dementia. Alzaid was devised using a participatory design methodology that consisted in eliciting and validating requirements from 22 and 9 participants, respectively, which were unified to guide the construction of a high-fidelity prototype evaluated by 14 participants. The participants were formal caregivers, medical staff, and management. This work contributes a high-fidelity prototype of a technological platform for assisting formal caregivers in monitoring patients with dementia considering restrictions and requirements of four Mexican day centers. In general, the participants perceived the prototype as quite likely to be useful, usable, and relevant in the job of monitoring patients with dementia (p-value < 0.05). By evaluating and designing Alzaid that unifies requirements for monitoring patients of four day centers, this work is the first effort towards a standard monitoring process of patients with dementia in the context of the Mexican Federation of Alzheimer.
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Affiliation(s)
- Tania-Arisdelci Barreras Diaz
- Department of Computing and Design, Instituto Tecnológico de Sonora, 5 de Febrero 818-Sur, Ciudad Obregón, 85000 Sonora Mexico
| | - Marco Esquer-Rochin
- Department of Computing and Design, Instituto Tecnológico de Sonora, 5 de Febrero 818-Sur, Ciudad Obregón, 85000 Sonora Mexico
| | | | - Luis-Felipe Rodriguez
- Department of Computing and Design, Instituto Tecnológico de Sonora, 5 de Febrero 818-Sur, Ciudad Obregón, 85000 Sonora Mexico
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13
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Protopsaltis PZA, Lydatakis N, Kentros M, Geronikolakis S, Kateros S, Kamarianakis M, Evangelou G, Filippidis A, Grigoriou E, Angelis D, Tamiolakis M, Dodis M, Kokiadis G, Petropoulos J, Pateraki M, Papagiannakis G. MAGES 4.0: Accelerating the world's transition to VR training and democratizing the authoring of the medical metaverse. IEEE COMPUTER GRAPHICS AND APPLICATIONS 2023; PP:43-56. [PMID: 37022419 DOI: 10.1109/mcg.2023.3242686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
In this work, we propose MAGES 4.0, a novel Software Development Kit (SDK) to accelerate the creation of collaborative medical training applications in VR/AR. Our solution is essentially a low-code metaverse authoring platform for developers to rapidly prototype high-fidelity and high-complexity medical simulations. MAGES breaks the authoring boundaries across extended reality, since networked participants can also collaborate using different virtual/augmented reality as well as mobile and desktop devices, in the same metaverse world. With MAGES we propose an upgrade to the outdated 150-year-old master-apprentice medical training model. Our platform incorporates, in a nutsell, the following novelties: a) 5G edge-cloud remote rendering and physics dissection layer, b) realistic real-time simulation of organic tissues as soft-bodies under 10ms, c) a highly realistic cutting and tearing algorithm, d) neural network assessment for user profiling and, e) a VR recorder to record and replay or debrief the training simulation from any perspective.
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14
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McLean E, Cornwell MA, Bender HA, Sacks-Zimmerman A, Mandelbaum S, Koay JM, Raja N, Kohn A, Meli G, Spat-Lemus J. Innovations in Neuropsychology: Future Applications in Neurosurgical Patient Care. World Neurosurg 2023; 170:286-295. [PMID: 36782427 DOI: 10.1016/j.wneu.2022.09.103] [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: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/11/2023]
Abstract
Over the last century, collaboration between clinical neuropsychologists and neurosurgeons has advanced the state of the science in both disciplines. These advances have provided the field of neuropsychology with many opportunities for innovation in the care of patients prior to, during, and following neurosurgical intervention. Beyond giving a general overview of how present-day advances in technology are being applied in the practice of neuropsychology within a neurological surgery department, this article outlines new developments that are currently unfolding. Improvements in remote platform, computer interface, "real-time" analytics, mobile devices, and immersive virtual reality have the capacity to increase the customization, precision, and accessibility of neuropsychological services. In doing so, such innovations have the potential to improve outcomes and ameliorate health care disparities.
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Affiliation(s)
- Erin McLean
- Department of Psychology, Hofstra University, Hempstead, New York, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Jun Min Koay
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Noreen Raja
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
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15
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Tsolaki M, Makri M, Tsatali M, Teichmann Β. European Projects for Patients with Dementia and Their Caregivers. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1425:609-618. [PMID: 37581834 DOI: 10.1007/978-3-031-31986-0_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
As we all know there is no treatment that can stop or delay the progression of dementia. The treatment we use is only symptomatic. EFNS (European Federation of Neurological Societies) recommendations for dementia prevention by Sorbi et al. (2012) concluded that there is no treatment, no lifestyle, which could have an effect on prevention or delay of onset of different forms of dementia until today. The future studies in prevention must recruit younger people, larger sample, and for longer period. The last 10 years we have run, in collaboration with organizations in different European countries, many projects in order to support patients with neurodegenerative diseases, mainly patients with dementia and their caregivers. The first project was a 2-year prospective cohort study of antidementia drug non-persistency in mild-to-moderate Alzheimer's disease (AD) in Europe: predictors of discontinuation and switch in the ICTUS (Impact of Cholinergic Treatment USe) study, an FP5 project with 1380 patients. Five studies were published. The second project was DESCRIPA study, an FP5 project to DEvelopment of Screening guidelines and clinical CRIteria for Predementia Alzheimer's disease, with 881 patients with mild cognitive impairment (MCI). LLM (Long Lasting Memories) and VRADA (A virtual reality application for the exercise of dementia and Alzheimer patients) are two projects that include body and cognitive exercise for health for the elderly and patients with mild cognitive impairment. The next is the RECAGE (REspectful Caring for the AGitated Elderly) project (Horizon 2020), a prospective cohort study for coping with behavioral and psychological symptoms of dementia. With six European universities we finished a very interesting FP6 project, the AddNeuroMed one, which gives even now information about the progression of normal elderly MCI and AD patients, in collaboration with other consortia. A very interesting Innovative Medicines Initiative (IMI) project about digital biomarkers was entitled Remote Assessment of Disease and Relapse-Alzheimer's Disease (RADAR project). The main goal of this project was the development and validation of technology-enabled, quantitative and sensitive measures of functional decline in people with early-stage AD. A running project is an Erasmus+ one in the higher education field, "Genetic counseling in European universities: The case of neurodegenerative diseases" (GECONEU project). The target of this study is to develop an online course for university students focusing on genetic counseling, and support people and society to better understand the aims of genetic testing and the usefulness of genetic counseling by involving students in an innovative learning and teaching setting. AD-gaming, BRIDGE, iCONNECT (Intergenerational CONtact between studeNts and people with dEmentia through CreaTive education), E.L.So.M.C.I (English Lessons with the Use of Songs for People with Mild Cognitive Impairment), Games4CoSkills, and De-Sign are all Erasmus+ projects that aim to improve the quality of life of patients with MCI or dementia. Story2remember, Dementia right, ASPAD (Augmentation of the Support of Patients suffering from Alzheimer's Disease and their caregivers), INFOCARE (Supporting Informal Caregivers of People with Dementia), S.IN.CA.L.A (Supporting Informal Carers: A Whole-Family and Life course Approach), and PIA (Peer support workers as an Innovative force in Advocacy in dementia care) are all Erasmus+ projects for training and supporting caregivers of patients with dementia.
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Affiliation(s)
- M Tsolaki
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Makri
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M Tsatali
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Β Teichmann
- Alzheimer Hellas, Thessaloniki, Greece
- Laboratory of Neurodegenerative diseases, Center for Interdisciplinary Research and Innovation (CIRI-AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Network Aging Research, Heidelberg University, Heidelberg, Germany
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16
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Stavrou VT, Vavougios GD, Kalogiannis P, Tachoulas K, Touloudi E, Astara K, Mysiris DS, Tsirimona G, Papayianni E, Boutlas S, Hassandra M, Daniil Z, Theodorakis Y, Gourgoulianis KI. Breathlessness and exercise with virtual reality system in long-post-coronavirus disease 2019 patients. Front Public Health 2023; 11:1115393. [PMID: 36908417 PMCID: PMC9996282 DOI: 10.3389/fpubh.2023.1115393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Long-post-coronavirus disease-2019 (COVID-19) patients tend to claim residual symptomatology from various systems, most importantly the respiratory and central nervous systems. Breathlessness and brain fog are the main complaints. The pulmonary function pattern is consistent with restrictive defects, which, in most cases, are self-resolved, while the cognitive profile may be impaired. Rehabilitation is an ongoing field for holistic management of long-post-COVID-19 patients. Virtual reality (VR) applications may represent an innovative implementation of rehabilitation. We aimed to investigate the effect of exercise with and without the VR system and to assess further breathlessness and functional fitness indicators in long-post-COVID-19 patients with mild cognitive impairment after self-selected exercise duration using the VR system. Twenty long-post-COVID-19 patients were enrolled in our study (age: 53.9 ± 9.1 years, male: 80%, body mass index: 28.1 ± 3.1 kg/m2). Participants' anthropometric data were recorded, and they underwent pulmonary functional test evaluation as well as sleep quality and cognitive assessment. The participants randomly exercised with and without a VR system (VR vs. no-VR) and, later, self-selected the exercise duration using the VR system. The results showed that exercise with VR resulted in a lower dyspnea score than exercise without VR. In conclusion, VR applications seem to be an attractive and safe tool for implementing rehabilitation. They can enhance performance during exercise and benefit patients with both respiratory and cognitive symptoms.
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Affiliation(s)
- Vasileios T. Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- *Correspondence: Vasileios T. Stavrou ✉
| | - George D. Vavougios
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, Faculty of Medicine, University of Cyprus, Lefkosia, Cyprus
| | - Periklis Kalogiannis
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos Tachoulas
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Evlalia Touloudi
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Kyriaki Astara
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, 417 Army Equity Fund Hospital, Medical Institution Military Shareholder Fund (NIMTS), Athens, Greece
| | | | - Glykeria Tsirimona
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eirini Papayianni
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Stylianos Boutlas
- Department of Respiratory Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Mary Hassandra
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Zoe Daniil
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Respiratory Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Konstantinos I. Gourgoulianis
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Respiratory Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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17
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Wender CL, Sandroff BM, Krch D. Rationale and methodology for examining the acute effects of aerobic exercise combined with varying degrees of virtual reality immersion on cognition in persons with TBI. Contemp Clin Trials Commun 2022; 29:100963. [PMID: 35865279 PMCID: PMC9294260 DOI: 10.1016/j.conctc.2022.100963] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022] Open
Abstract
Persons with Traumatic Brain Injury (TBI) commonly present with long-term cognitive deficits in executive function, processing speed, attention, and learning and memory. While specific cognitive rehabilitation techniques have shown significant success for deficits in individual domains, aerobic exercise training represents a promising approach for an efficient and general treatment modality that might improve many cognitive domains concurrently. Existing studies in TBI report equivocal results, however, and are hampered by methodological concerns, including small sample sizes, uncontrolled single-group designs, and the use of suboptimal exercise modalities for eliciting cognitive improvements in this population. One particularly promising modality involves the application of environmental enrichment via virtual reality (VR) during aerobic exercise in persons with TBI, but this has yet to be investigated. One approach for systematically developing an optimal aerobic exercise intervention for persons with TBI involves the examination of single bouts of aerobic exercise (i.e., acute aerobic exercise) on cognition. Acute exercise research is a necessary first step for informing the development of high-quality exercise training interventions that are more likely to induce meaningful beneficial effects. To date, such an acute exercise paradigm has yet to be conducted in persons with TBI. To that end, we propose an acute exercise study that will investigate the acute effects of aerobic exercise with incremental degrees of environmental enrichment (VR) relative to a control comparison condition on executive function (divided attention and working memory) and processing speed in 24 people with TBI.
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Affiliation(s)
- Carly L.A. Wender
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
- Corresponding author. Kessler Foundation, 120 Eagle Rock Ave, Suite 100, East Hanover, NJ, 07936, USA.
| | - Brian M. Sandroff
- Center for Neuropsychology & Neuroscience Research, Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
| | - Denise Krch
- Center for Traumatic Brain Injury Research, Kessler Foundation, East Hanover, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers-NJ Medical School, Newark, NJ, USA
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18
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Touloudi E, Hassandra M, Galanis E, Goudas M, Theodorakis Y. Applicability of an Immersive Virtual Reality Exercise Training System for Office Workers during Working Hours. Sports (Basel) 2022; 10:sports10070104. [PMID: 35878115 PMCID: PMC9317041 DOI: 10.3390/sports10070104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Virtual reality is a computer-generated simulation of a real or imaginary three-dimensional environment that has entered our lives, particularly for gaming. Lately, it has been permeating into many aspects of our everyday life, such as exercise. It is important to ascertain whether exercise in an immersive virtual reality environment can be accepted from employees and lead to positive outcomes for them. The aim of this exploratory study was to examine the acceptance, future adoption, interest/enjoyment and usability of an immersive virtual reality system for exercise training by office workers during breaks within their working hours. A total of 40 female employees participated in the study with a mean age of 42.58 years (SD 10.77). Participants were requested to complete two sequential 15-min dual task cycling sessions corresponding to two experimental conditions. The first, condition A, involved cycling in a virtual environment, wearing a virtual reality head mounted display, and responding to cognitive tasks by answering multiple choice questions—on a screen, using a joystick. The second, condition B, involved cycling on a static bicycle and simultaneously responding to cognitive tasks by answering multiple choice questions in a real environment. After completion of the two conditions, participants responded to a series of scales regarding each of the experimental conditions and to a semi-structured interview. The results showed that participants noted a significant preference for the immersive virtual reality exercise, condition A, compared to condition B (bike only); and their acceptance, interest/enjoyment, usability and intention for future use were high. The qualitative data showed increased intention for future use, feelings of control and presence and most of the participants did not encounter any difficulties or require extra help to understand the immersive virtual reality system. Overall, exercising during working hours with an immersive virtual reality exercise system was well perceived by office workers and applicable. However, the effects of the immersive virtual reality training system on physical and mental health and the employees’ adherence to the exercise program should be tested with a longer intervention program.
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19
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Yu M, Yang MR. Effectiveness and Utility of Virtual Reality Infection Control Simulation for Children With COVID-19: Quasi-Experimental Study. JMIR Serious Games 2022; 10:e36707. [PMID: 35575818 PMCID: PMC9150730 DOI: 10.2196/36707] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/26/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND It is essential that nurses quickly learn the proper methods for preventing and controlling nosocomial infection and managing intensive care patients during the COVID-19 pandemic, including the donning and doffing of personal protective equipment (PPE). Virtual reality (VR) simulation offers the advantage of learning in a safe environment with a sense of realism similar to that of an actual clinical setting and has been reported to enhance self-efficacy in infection control, safety performance, and learning satisfaction among students. OBJECTIVE This study aims to develop a virtual reality infection control simulation (VRICS) program regarding donning and doffing of PPE and respiratory care for pediatric patients admitted to an isolation unit for COVID-19 and to identify the effects of the program on PPE knowledge, infection control performance, and self-efficacy for nursing students. Additionally, the realism of the VRICS program and the students' level of satisfaction with the program were assessed. METHODS This was a quasi-experimental study based on a controlled pretest-posttest design. Third- and fourth-year nursing students were divided into an experimental group (n=25) who participated in a VRICS program and a control group (n=25) with no participation. Data were collected from November 13 to December 10, 2021, and analyzed using descriptive statistics and the t test, paired t test, Mann-Whitney U test, and Wilcoxon matched-pair signed-rank test. The VRICS program consisted of a prebriefing, including direct practice of donning and doffing PPE, VR simulation, and debriefing. The VR simulation comprised 3 sessions: donning and inspection of PPE in the dressing room before entering the negative-pressure isolation unit; assessing for suction care, nasopharyngeal suctioning, and checking of COVID-19 patients in the negative-pressure isolation unit; and doffing PPE in the dressing room. The total execution time for the program was 180 min. RESULTS Compared with the control group, the experimental group showed significantly greater improvements in PPE knowledge (z=-3.28, P<.001), infection control performance (t48=4.89, P<.001), and self-efficacy (t36.2=4.93, P<.001). The experimental group's mean scores for realistic immersion and learner satisfaction were 4.49 (SD 0.50) points and 4.75 (SD 0.38) points (on a 5-point Likert scale), respectively. CONCLUSIONS The VR simulation training program involving pediatric COVID-19 patients combined skills training effectively and enhanced theoretical knowledge, respiratory care skills, and infectious disease preparedness. Thus, it could be applied to training nurses to respond more effectively to public health situations involving infectious diseases, including the COVID-19 pandemic.
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Affiliation(s)
- Mi Yu
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Mi Ran Yang
- Department of Nursing, Kwangju Health University, Kwangju, Republic of Korea
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20
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Zygouris S, Segkouli S, Triantafylidis A, Giakoumis D, Tsolaki M, Votis K, Tzovaras D. Usability of the Virtual Supermarket Test for Older Adults with and without Cognitive Impairment. J Alzheimers Dis Rep 2022; 6:229-234. [PMID: 35719712 PMCID: PMC9198784 DOI: 10.3233/adr-210064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/19/2022] [Indexed: 11/15/2022] Open
Abstract
This study conducted a preliminary usability assessment of the Virtual Supermarket Test (VST), a serious game-based self-administered cognitive screening test for mild cognitive impairment (MCI). Twenty-four healthy older adults with subjective cognitive decline and 33 patients with MCI self-administered the VST and then completed the System Usability Scale (SUS). The average SUS score was 83.11 (SD = 14.6). The SUS score was unaffected by age, education, touch device familiarity, and diagnosis of MCI. SUS score correlated with VST performance (r = –0.496, p = 0.000). Results of this study indicate good usability of the VST.
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Affiliation(s)
- Stelios Zygouris
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Sofia Segkouli
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Andreas Triantafylidis
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Giakoumis
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Magdalini Tsolaki
- School of Medicine, Aristotle University of Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, Thessaloniki, Greece
| | - Konstantinos Votis
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
| | - Dimitrios Tzovaras
- Centre for Research and Technology Hellas/Information Technologies Institute, Thessaloniki, Greece
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21
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Birrenbach T, Zbinden J, Papagiannakis G, Exadaktylos AK, Müller M, Hautz WE, Sauter TC. Effectiveness and Utility of Virtual Reality Simulation as an Educational Tool for Safe Performance of COVID-19 Diagnostics: Prospective, Randomized Pilot Trial. JMIR Serious Games 2021; 9:e29586. [PMID: 34623315 PMCID: PMC8510143 DOI: 10.2196/29586] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/12/2021] [Accepted: 09/09/2021] [Indexed: 01/16/2023] Open
Abstract
Background Although the proper use of hygiene and personal protective equipment (PPE) is paramount for preventing the spread of diseases such as COVID-19, health care personnel have been shown to use incorrect techniques for donning/doffing of PPE and hand hygiene, leading to a large number of infections among health professionals. Education and training are difficult owing to the social distancing restrictions in place, shortages of PPE and testing material, and lack of evidence on optimal training. Virtual reality (VR) simulation can offer a multisensory, 3-D, fully immersive, and safe training opportunity that addresses these obstacles. Objective The aim of this study is to explore the short- and long-term effectiveness of a fully immersive VR simulation versus a traditional learning method regarding a COVID-19–related skill set and media-specific variables influencing training outcomes. Methods This was a prospective, randomized controlled pilot study on medical students (N=29; intervention VR training, n=15, vs control video-based instruction, n=14) to compare the performance of hand disinfection, nasopharyngeal swab taking, and donning/doffing of PPE before and after training and 1 month later as well as variables of media use. Results Both groups performed significantly better after training, with the effect sustained over one month. After training, the VR group performed significantly better in taking a nasopharyngeal swab, scoring a median of 14 out of 17 points (IQR 13-15) versus 12 out of 17 points (IQR 11-14) in the control group, P=.03. With good immersion and tolerability of the VR simulation, satisfaction was significantly higher in the VR group compared to the control group (median score of User Satisfaction Evaluation Questionnaire 27/30, IQR 23-28, vs 22/30, IQR 20-24, in the control group; P=.01). Conclusions VR simulation was at least as effective as traditional learning methods in training medical students while providing benefits regarding user satisfaction. These results add to the growing body of evidence that VR is a useful tool for acquiring simple and complex clinical skills.
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Affiliation(s)
- Tanja Birrenbach
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland.,Centre for Health Sciences Education, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Josua Zbinden
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - George Papagiannakis
- ORamaVR SA, Geneva, Switzerland.,Institute of Computer Science, Foundation for Research and Technology, Hellas, Heraklion, Greece.,Department of Computer Science, University of Crete, Heraklion, Greece
| | | | - Martin Müller
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Wolf E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
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22
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Formative Development of a Technology-Based Physical Activity Intervention for Grandparents and Grandchildren. J Aging Phys Act 2021; 30:482-494. [PMID: 34611054 DOI: 10.1123/japa.2020-0481] [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: 11/28/2020] [Revised: 06/17/2021] [Accepted: 08/17/2021] [Indexed: 11/18/2022]
Abstract
Physical inactivity is a major public health issue among older adults and children. This study presents preliminary results that will inform the development of a technology-based physical activity intervention for grandparents and grandchildren (ages 6-12 years old). The authors used an iterative user-centered design framework to gather quantitative data from grandparents (n = 35) and subsequently invited a subset of 12 of them to engage in qualitative interviews. Participants were 63.1 ± 9.8 years old, 80% female, 64% U.S.-born, 43% Hispanic, 66% single, and 40% <$15K income. The majority of grandparents reported mobile device proficiency, very close relationships with their grandchildren, and interest in participating in an intergenerational intervention. Four key themes related to family closeness, dynamics, routines, and technology informed intervention development. Next steps involved a pilot trial using Fitbits and a fully functioning technology-based prototype. Grandparents are uniquely positioned within their families to serve as agents of change in health-promoting interventions.
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23
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Gagandeep S, Tejasvi K, Nihal M, Shubham J, Anatoliy V, Vadim S, Prateek P, Sunil M. Editorial. Long-term solutions in neurosurgery using extended reality technologies. Neurosurg Focus 2021; 51:E2. [PMID: 34333475 DOI: 10.3171/2021.5.focus21235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Singh Gagandeep
- 1Neuroradiology Division, Department of Radiology, Newark Beth Israel Medical Center, Newark, New Jersey
| | | | - Manjila Nihal
- 3Department of Biology, Case Western Reserve University, Cleveland, Ohio; and
| | - Jain Shubham
- 4Computer Science, Stony Brook University, Stony Brook; and
| | - Vaysberg Anatoliy
- 1Neuroradiology Division, Department of Radiology, Newark Beth Israel Medical Center, Newark, New Jersey
| | - Spektor Vadim
- 5Neuroradiology Division, Department of Radiology, Columbia University Medical Center, New York, New York
| | | | - Manjila Sunil
- 6Department of Neurosurgery, Mountain View Regional Medical Center, Las Cruces, New Mexico
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