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Szczepocka E, Mokros Ł, Kazmierski J, Nowakowska K, Łucka A, Antoszczyk A, Oltra-Cucarella J, Werzowa W, Hellevik MM, Skouras S, Bagger K. The Effectiveness of Virtual Reality-Based Training on Cognitive, Social, and Physical Functioning in High-Functioning Older Adults (CoSoPhy FX): 2-Arm, Parallel-Group Randomized Controlled Trial. JMIR Res Protoc 2024; 13:e53261. [PMID: 38837194 PMCID: PMC11187518 DOI: 10.2196/53261] [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: 10/01/2023] [Revised: 01/27/2024] [Accepted: 02/20/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Virtual reality (VR) has emerged as a promising technology for enhancing the health care of older individuals, particularly in the domains of cognition, physical activity, and social engagement. However, existing VR products and services have limited availability and affordability; hence, there is a need for a scientifically validated and personalized VR service to be used by older adults in their homes, which can improve their overall physical, cognitive, and social well-being. OBJECTIVE The main purpose of the CoSoPhy FX (Cognitive, Social, and Physical Effects) study was to analyze the effects of a VR-based digital therapeutics app on the cognitive, social, and physical performance abilities of healthy (high-functioning) older adults. This paper presents the study protocol and the results from the recruitment phase. METHODS A group of 188 healthy older adults aged 65-85 years, recruited at the Medical University of Lodz, Poland, were randomly allocated to the experimental group (VR dual-task training program) or to the control group (using a VR headset app showing nature videos). A total of 3 cognitive exercises were performed in various 360° nature environments delivered via a VR head-mounted display; the participants listened to their preferred music genre. Each patient received 3 sessions of 12 minutes per week for 12 weeks, totaling a minimum of 36 sessions per participant. Attention and working memory (Central Nervous System Vital Signs computerized cognitive battery) were used as primary outcomes, while other cognitive domains in the Central Nervous System Vital Signs battery, quality of life (World Health Organization-5 Well-Being Index), health-related quality of life (EQ-5D-5L), and anxiety (General Anxiety Disorder 7-item questionnaire) were the secondary outcomes. The group-by-time interaction was determined using linear mixed models with participants' individual slopes. RESULTS In total, 122 (39%) of the initial 310 participants failed to meet the inclusion criteria, resulting in a recruitment rate of 61% (188/310). Among the participants, 68 successfully completed the intervention and 62 completed the control treatment. The data are currently being analyzed, and we plan to publish the results by the end of September 2024. CONCLUSIONS VR interventions have significant potential among healthy older individuals. VR can address various aspects of well-being by stimulating cognitive functions, promoting physical activity, and facilitating social interaction. However, challenges such as physical discomfort, technology acceptance, safety concerns, and cost must be considered when implementing them for older adults. Further research is needed to determine the long-term effects of VR-based interventions, optimal intervention designs, and the specific populations that would benefit most. TRIAL REGISTRATION ClinicalTrials.gov NCT05369897; https://clinicaltrials.gov/study/NCT05369897. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53261.
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Affiliation(s)
- Ewa Szczepocka
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Jakub Kazmierski
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Karina Nowakowska
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Anna Łucka
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Anna Antoszczyk
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Javier Oltra-Cucarella
- Senopi AG (Aktiengesellschaft), Zurich, Switzerland
- Department of Health Psychology, University Miguel Hernández de Elche, Elche, Spain
| | | | | | - Stavros Skouras
- Senopi AG (Aktiengesellschaft), Zurich, Switzerland
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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Szczepocka E, Mokros Ł, Kaźmierski J, Nowakowska K, Łucka A, Antoszczyk A, Oltra-Cucarella J, Werzowa W, Hellevik M, Skouras S, Bagger K. Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults - preliminary results of a randomized controlled study. BMC Psychiatry 2024; 24:347. [PMID: 38720251 PMCID: PMC11080129 DOI: 10.1186/s12888-024-05811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 05/03/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND/AIMS Older age and cognitive inactivity have been associated with cognitive impairment, which in turn is linked to economic and societal burdens due to the high costs of care, especially for care homes and informal care. Emerging non-pharmacological interventions using new technologies, such as virtual reality (VR) delivered on a head-mounted display (HMD), might offer an alternative to maintain or improve cognition. The study aimed to evaluate the efficacy and safety of a VR-based Digital Therapeutics application for improving cognitive functions among healthy older adults. METHODS Seventy-two healthy seniors (experimental group N = 35, control group N = 37), aged 65-85 years, were recruited by the Medical University of Lodz (Poland). Participants were randomly allocated to the experimental group (a VR-based cognitive training which consists of a warm-up module and three tasks, including one-back and dual-N-back) or to the control group (a regular VR headset app only showing nature videos). The exercises are performed in different 360-degree natural environments while listening to a preferred music genre and delivered on a head-mounted display (HMD). The 12-week intervention of 12 min was delivered at least three times per week (36 sessions). Compliance and performance were followed through a web-based application. Primary outcomes included attention and working memory (CNS-Vital Signs computerized cognitive battery). Secondary outcomes comprised other cognitive domains. Mixed linear models were constructed to elucidate the difference in pre- and post-intervention measures between the experimental and control groups. RESULTS The users performed, on average, 39.8 sessions (range 1-100), and 60% performed more than 36 sessions. The experimental group achieved higher scores in the visual memory module (B = 7.767, p = 0.011) and in the one-back continuous performance test (in terms of correct responses: B = 2.057, p = 0.003 and omission errors: B = -1.950, p = 0.007) than the control group in the post-test assessment. The results were independent of participants' sex, age, and years of education. The differences in CNS Vital Signs' global score, working memory, executive function, reaction time, processing speed, simple and complex attention, verbal memory, cognitive flexibility, motor speed, and psychomotor speed were not statistically significant. CONCLUSIONS VR-based cognitive training may prove to be a valuable, efficacious, and well-received tool in terms of improving visual memory and some aspect of sustainability of attention among healthy older adults. This is a preliminary analysis based on part of the obtained results to that point. Final conclusions will be drawn after the analysis of the target sample size. TRIAL REGISTRATION Clinicaltrials.gov ID NCT05369897.
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Affiliation(s)
- Ewa Szczepocka
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland.
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Jakub Kaźmierski
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland
| | - Karina Nowakowska
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland
| | - Anna Łucka
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland
| | - Anna Antoszczyk
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Czechosłowacka 8/10, Lodz, 92-216, Poland
| | - Javier Oltra-Cucarella
- Senopi AG, Zurich, Switzerland
- Department of Health Psychology, University Miguel Hernández de Elche, Elche, Spain
| | | | | | - Stavros Skouras
- Senopi AG, Zurich, Switzerland
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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Adamo P, Longhi G, Temporiti F, Marino G, Scalona E, Fabbri-Destro M, Avanzini P, Gatti R. Effects of Action Observation Plus Motor Imagery Administered by Immersive Virtual Reality on Hand Dexterity in Healthy Subjects. Bioengineering (Basel) 2024; 11:398. [PMID: 38671819 PMCID: PMC11048356 DOI: 10.3390/bioengineering11040398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Action observation and motor imagery (AOMI) are commonly delivered through a laptop screen. Immersive virtual reality (VR) may enhance the observer's embodiment, a factor that may boost AOMI effects. The study aimed to investigate the effects on manual dexterity of AOMI delivered through immersive VR compared to AOMI administered through a laptop. To evaluate whether VR can enhance the effects of AOMI, forty-five young volunteers were enrolled and randomly assigned to the VR-AOMI group, who underwent AOMI through immersive VR, the AOMI group, who underwent AOMI through a laptop screen, or the control group, who observed landscape video clips. All participants underwent a 5-day treatment, consisting of 12 min per day. We investigated between and within-group differences after treatments relative to functional manual dexterity tasks using the Purdue Pegboard Test (PPT). This test included right hand (R), left hand (L), both hands (B), R + L + B, and assembly tasks. Additionally, we analyzed kinematics parameters including total and sub-phase duration, peak and mean velocity, and normalized jerk, during the Nine-Hole Peg Test to examine whether changes in functional scores may also occur through specific kinematic patterns. Participants were assessed at baseline (T0), after the first training session (T1), and at the end of training (T2). A significant time by group interaction and time effects were found for PPT, where both VR-AOMI and AOMI groups improved at the end of training. Larger PPT-L task improvements were found in the VR-AOMI group (d: 0.84, CI95: 0.09-1.58) compared to the AOMI group from T0 to T1. Immersive VR used for the delivery of AOMI speeded up hand dexterity improvements.
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Affiliation(s)
- Paola Adamo
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Gianluca Longhi
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Federico Temporiti
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
| | - Giorgia Marino
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - Emilia Scalona
- Dipartimento di Scienze Medico Chirurgiche, Scienze Radiologiche e Sanità Pubblica (DSMC), Università Degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Brescia, Italy
| | - Maddalena Fabbri-Destro
- Consiglio Nazionale Delle Ricerche, Istituto di Neuroscienze, Via Volturno, 39-E, 43125 Parma, Parma, Italy
| | - Pietro Avanzini
- Consiglio Nazionale Delle Ricerche, Istituto di Neuroscienze, Via Volturno, 39-E, 43125 Parma, Parma, Italy
| | - Roberto Gatti
- Physiotherapy Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanuele, Milan, Italy
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Rose Sin Yi L, Jing Jing S, Hammoda AO, Jonathan B, Ladislav B, Jing Q. Effects of virtual reality-based cognitive interventions on cognitive function and activity of daily living among stroke patients: Systematic review and meta-analysis. J Clin Nurs 2024; 33:1169-1184. [PMID: 38234275 DOI: 10.1111/jocn.16986] [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: 10/14/2022] [Revised: 10/24/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
AIMS To examine the effects of virtual reality-based cognitive interventions on cognitive function and activities of daily living among stroke patients, and to identify the optimal design for such intervention. DESIGN Systematic review and meta-analysis. DATA SOURCES Medline, EMBASE, Cochrane, CINANL, JBI-EBP and Web of Science from inception to October 2023. METHODS Methodological quality was assessed by Risk of Bias Tool. Meta-analyses were assessed by Review Manager 5.4. Subgroup analyses were conducted to explore the influence of study design. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to assess the certainty of evidence. RESULTS Twenty-five randomized controlled trials (1178 participants) were included. Virtual reality-based cognitive interventions demonstrated moderate-to-large effects in improving global cognitive function (SMD = 0.43; 95% CI [0.01, 0.85]), executive function (SMD = 0.84; 95% CI [0.25, 1.43]) and memory (SMD = 0.65; 95% CI [0.15, 1.16]) compared to control treatments. No significant effects were found on language, visuospatial ability and activities of daily living. Subgroup analyses indicated one-on-one coaching, individualized design and dynamic difficulty adjustment, and interventions lasting ≥ 6 weeks had particularly enhanced effects, especially for executive function. CONCLUSIONS Virtual reality-based cognitive interventions improve global cognitive function, executive function and memory among stroke patients. IMPLICATIONS FOR THE PATIENT CARE This review underscores the broad cognitive advantages offered by virtual technology, suggesting its potential integration into standard stroke rehabilitation protocols for enhanced cognitive recovery. IMPACT The study identifies key factors in virtual technology interventions that effectively improve cognitive function among stroke patients, offering healthcare providers a framework for leveraging such technology to optimize cognitive outcomes in stroke rehabilitation. REPORTING METHOD PRISMA 2020 statement. PROSPERO REGISTRATION NUMBER CRD42022342668.
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Affiliation(s)
- Lin Rose Sin Yi
- School of Nursing, Elaine C. Hubbard Center for Nursing Research on Aging, University of Rochester, Rochester, New York, USA
| | - Su Jing Jing
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Abu-Odah Hammoda
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Bayuo Jonathan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Batalik Ladislav
- Department of Rehabilitation, University Hospital Brno, Brno, Czech Republic
- Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Qin Jing
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Zulkarnain AHB, Kókai Z, Gere A. Assessment of a virtual sensory laboratory for consumer sensory evaluations. Heliyon 2024; 10:e25498. [PMID: 38333840 PMCID: PMC10850967 DOI: 10.1016/j.heliyon.2024.e25498] [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: 05/10/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024] Open
Abstract
As technology advances in the field of food sciences, the sensory experience of food consumption remains complex and influenced by various factors. Traditional consumer testing, often conducted in isolated booth environments, presents challenges in terms of construct validity and user engagement for perception formation. The growing accessibility and sophistication of virtual reality (VR) technology offer a promising avenue for research. This study focuses on the assessment of a virtual sensory laboratory, seamlessly integrating traditional sensory practices into the virtual realm to explore disparities in consumer responses, especially in sensory analysis. The virtual laboratory, designed for compatibility with VR gear, closely resembles a sensory booth. The virtual environment enables the researchers to change the visual clues of the products being tested as well as the surroundings (e.g., colors, furniture, or even the environment). Additionally, the level of immersion can be enhanced by playing any type of music, if needed. One crucial question is to assess the opinions of the participants, if they feel comfortable in the created environment. Specific participant numbers are omitted, and the study engages participants. The success of this initiative could signify a substantial advance in analysis and cost savings, adding a layer of significance to the study's potential impact on optimizing research practices. The study lays the groundwork for optimal VR practices and anticipates further exploration with immersive elements to deepen our understanding of how virtual reality influences consumer behaviour in food selection compared to traditional sensory methods.
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Affiliation(s)
- Abdul Hannan Bin Zulkarnain
- Department of Postharvest Science, Trade, Supply Chain and Sensory Analysis, Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118 Budapest, Villányi út. 29-31, Hungary
| | - Zoltán Kókai
- Department of Postharvest Science, Trade, Supply Chain and Sensory Analysis, Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118 Budapest, Villányi út. 29-31, Hungary
| | - Attila Gere
- Department of Postharvest Science, Trade, Supply Chain and Sensory Analysis, Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, H-1118 Budapest, Villányi út. 29-31, Hungary
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Šlosar L, Peskar M, Pišot R, Marusic U. Environmental enrichment through virtual reality as multisensory stimulation to mitigate the negative effects of prolonged bed rest. Front Aging Neurosci 2023; 15:1169683. [PMID: 37674784 PMCID: PMC10477372 DOI: 10.3389/fnagi.2023.1169683] [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: 02/19/2023] [Accepted: 08/07/2023] [Indexed: 09/08/2023] Open
Abstract
Prolonged bed rest causes a multitude of deleterious physiological changes in the human body that require interventions even during immobilization to prevent or minimize these negative effects. In addition to other interventions such as physical and nutritional therapy, non-physical interventions such as cognitive training, motor imagery, and action observation have demonstrated efficacy in mitigating or improving not only cognitive but also motor outcomes in bedridden patients. Recent technological advances have opened new opportunities to implement such non-physical interventions in semi- or fully-immersive environments to enable the development of bed rest countermeasures. Extended Reality (XR), which covers augmented reality (AR), mixed reality (MR), and virtual reality (VR), can enhance the training process by further engaging the kinesthetic, visual, and auditory senses. XR-based enriched environments offer a promising research avenue to investigate the effects of multisensory stimulation on motor rehabilitation and to counteract dysfunctional brain mechanisms that occur during prolonged bed rest. This review discussed the use of enriched environment applications in bedridden patients as a promising tool to improve patient rehabilitation outcomes and suggested their integration into existing treatment protocols to improve patient care. Finally, the neurobiological mechanisms associated with the positive cognitive and motor effects of an enriched environment are highlighted.
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Affiliation(s)
- Luka Šlosar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
| | - Manca Peskar
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Biological Psychology and Neuroergonomics, Department of Psychology and Ergonomics, Faculty V: Mechanical Engineering and Transport Systems, Technische Universität Berlin, Berlin, Germany
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Uros Marusic
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
- Alma Mater Europaea – ECM, Department of Health Sciences, Maribor, Slovenia
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