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Pooja R, Ghosh P, Sreekumar V. Towards an ecologically valid naturalistic cognitive neuroscience of memory and event cognition. Neuropsychologia 2024; 203:108970. [PMID: 39147361 DOI: 10.1016/j.neuropsychologia.2024.108970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 07/31/2024] [Accepted: 08/08/2024] [Indexed: 08/17/2024]
Abstract
The landscape of human memory and event cognition research has witnessed a transformative journey toward the use of naturalistic contexts and tasks. In this review, we track this progression from abrupt, artificial stimuli used in extensively controlled laboratory experiments to more naturalistic tasks and stimuli that present a more faithful representation of the real world. We argue that in order to improve ecological validity, naturalistic study designs must consider the complexity of the cognitive phenomenon being studied. Then, we review the current state of "naturalistic" event segmentation studies and critically assess frequently employed movie stimuli. We evaluate recently developed tools like lifelogging and other extended reality technologies to help address the challenges we identified with existing naturalistic approaches. We conclude by offering some guidelines that can be used to design ecologically valid cognitive neuroscience studies of memory and event cognition.
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Affiliation(s)
- Raju Pooja
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India
| | - Pritha Ghosh
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India
| | - Vishnu Sreekumar
- Cognitive Science Lab, International Institute of Information Technology, Hyderabad, India.
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2
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Kwak HD, Chung E, Lee BH. The effect of balance training using touch controller-based fully immersive virtual reality devices on balance and walking ability in patients with stroke: A pilot randomized controlled trial. Medicine (Baltimore) 2024; 103:e38578. [PMID: 38968468 PMCID: PMC11224800 DOI: 10.1097/md.0000000000038578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/23/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Fully immersive virtual reality (FIVR) removes information from the real world and replaces it with computer-generated data, creating the impression of being in a genuine virtual world. OBJECTIVE To evaluate the effects of balance training using touch controller-based FIVR devices on balance and walking abilities in patients with stroke. METHODS The participants were randomly categorized into the FIVR group (n = 18) and control group (n = 18). The control group received conventional therapy for 5 sessions, 30 minutes per week, for 5 weeks. The FIVR group practiced additional touch controller-based FIVR balance training for 3 sessions of 30 minutes per week for 5 weeks and changes in balance and walking ability were measured for both groups. RESULTS Touch controller-based FIVR balance training significantly improved the Berg Balance Scale (BBS) and, timed up-and-go (TUG) test results (P < .01). There was also significant improvement in gait abilities, including gait velocity, step length of the affected side, stride length, and single limb support of the affected side (P < .01). CONCLUSION Touch controller-based FIVR balance training improved balance and gait in patients with stroke. These results indicate that touch controller-based FIVR balance training is feasible and suitable for patients with stroke, providing a promising avenue for rehabilitation.
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Affiliation(s)
- Ho-Dong Kwak
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, Seoul, Republic of Korea
| | - Eunjung Chung
- Department of Physical Therapy, Andong Science College, andong-si, Republic of Korea
| | - Byoung-Hee Lee
- Department of Physical Therapy, College of Health and Welfare, Sahmyook University, Seoul, Republic of Korea
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3
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Zhang J, Wu M, Li J, Song W, Lin X, Zhu L. Effects of virtual reality-based rehabilitation on cognitive function and mood in multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials. Mult Scler Relat Disord 2024; 87:105643. [PMID: 38735202 DOI: 10.1016/j.msard.2024.105643] [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: 01/20/2024] [Revised: 03/16/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Multiple sclerosis (MS) is a disabling neurological disease that causes cognitive impairment and mental problems that occur in all MS phenotypes but are most common in patients with secondary progressive MS. Various degrees of cognitive impairment and mental health concerns are common among patients with MS (PwMS). Virtual reality (VR)-based rehabilitation is an innovative approach aimed at enhancing cognitive function and mood in PwMS. This study aims to perform a meta-analysis to assess the effects of VR-based rehabilitation on cognitive function and mood in PwMS. METHODS Using PubMed, Embase, the Cochrane Library, Web of Science, and the Physiotherapy Evidence Database (PEDro), a thorough database search was performed to identify randomized controlled trials (RCTs) examining the effects of VR on PwMS. Trials published until October 31, 2023, that satisfied our predetermined inclusion and exclusion criteria were included. Data were extracted, literature was examined, and the methodological quality of the included trials was assessed. StataSE version 16 was used for the meta-analysis. RESULTS Our meta-analysis included 461 patients from 10 RCTs. PRIMARY OUTCOMES The Montreal Cognitive Assessment (MoCA) (weighted mean difference [WMD]=1.93, 95 % confidence interval [CI]=0.51-3.36, P = 0.008, I² = 75.4 %) the Spatial Recall Test (SPART) (WMD=3.57, 95 % CI=1.65-5.50, P < 0.001, I² = 0 %), immediate recall (standard mean difference [SMD]=0.37, 95 % CI=0.10-0.64, P = 0.007, I² = 0 %) and delayed recall ([SMD]=0.30, 95 % CI=0.06-0.54, P = 0.013, I² = 35.4 %) showed improvements in comparison to the control group in terms of global cognitive function immediate recall, delayed recall, and visuospatial abilities. SECONDARY OUTCOMES Compared to the control group, anxiety improved (standard mean difference [SMD]=0.36, 95 % CI=0.10-0.62, P = 0.007, I² = 43.1 %). However, there were no significant differences in processing speed, attention, working memory or depression. CONCLUSIONS This systematic review provides valuable evidence for improving cognitive function and mood in PwMS through VR-based rehabilitation. In the future, VR-based rehabilitation may be a potential method to treat cognitive function and emotional symptoms of MS. SYSTEMATIC REVIEW REGISTRATION PROSPERO; identifier: CRD42023474467.
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Affiliation(s)
- Jiongliang Zhang
- Heilongjiang University of Chinese Medicine, Harbin 150000, China
| | - Minmin Wu
- Heilongjiang University of Chinese Medicine, Harbin 150000, China
| | - Jinting Li
- Heilongjiang University of Chinese Medicine, Harbin 150000, China
| | - Wenjing Song
- Heilongjiang University of Chinese Medicine, Harbin 150000, China
| | - Xiaoguang Lin
- Heilongjiang University of Chinese Medicine, Harbin 150000, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150000, China.
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Uddin M, Ganapathy K, Syed-Abdul S. Digital Technology Enablers of Tele-Neurorehabilitation in Pre- and Post-COVID-19 Pandemic Era - A Scoping Review. Int J Telerehabil 2024; 16:e6611. [PMID: 39022438 PMCID: PMC11250154 DOI: 10.5195/ijt.2024.6611] [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: 07/20/2024] Open
Abstract
Neurorehabilitation (NR), a major component of neurosciences, is the process of restoring a patient's damaged/disorganized neurological function, through training, therapy, and education, while focusing on patient's independence and well-being. Since the advent of the COVID-19 pandemic, various applications of telecare and telehealth services surged drastically and became an integral part of current clinical practices. Tele-Neurorehabilitation (TNR) is one of such applications. When rehabilitation services were disrupted globally due to lockdown and travel restrictions, the importance of TNR was recognized, especially in developed, low, and middle-income countries. With exponential deployment of telehealth interventions in neurosciences, TNR has become a distinct stand-alone sub-specialty of neurosciences and telehealth. Digital technologies, such as wearables, robotics, and Virtual Reality (VR) have enabled TNR to improve the quality of patients' lives. Providing NR remotely using digital technologies and customized digital devices is now a reality, and likely to be the new norm soon. This article provides an overview of the needs, utilization, and deployment of TNR, and focuses on digital technology enablers of TNR in pre- and post-COVID-19 pandemic era.
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Affiliation(s)
- Mohy Uddin
- Research Quality Management Section, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Krishnan Ganapathy
- Distinguished Visiting Professor IIT Kanpur & Director Apollo Telemedicine Networking Foundation, India
| | - Shabbir Syed-Abdul
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
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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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Strauss DJ, Francis AL, Vibell J, Corona-Strauss FI. The role of attention in immersion: The two-competitor model. Brain Res Bull 2024; 210:110923. [PMID: 38462137 DOI: 10.1016/j.brainresbull.2024.110923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/19/2023] [Accepted: 03/06/2024] [Indexed: 03/12/2024]
Abstract
Currently, we face an exponentially increasing interest in immersion, especially sensory-driven immersion, mainly due to the rapid development of ideas and business models centered around a digital virtual universe as well as the increasing availability of affordable immersive technologies for education, communication, and entertainment. However, a clear definition of 'immersion', in terms of established neurocognitive concepts and measurable properties, remains elusive, slowing research on the human side of immersive interfaces. To address this problem, we propose a conceptual, taxonomic model of attention in immersion. We argue (a) modeling immersion theoretically as well as studying immersion experimentally requires a detailed characterization of the role of attention in immersion, even though (b) attention, while necessary, cannot be a sufficient condition for defining immersion. Our broader goal is to characterize immersion in terms that will be compatible with established psychophysiolgical measures that could then in principle be used for the assessment and eventually the optimization of an immersive experience. We start from the perspective that immersion requires the projection of attention to an induced reality, and build on accepted taxonomies of different modes of attention for the development of our two-competitor model. The two-competitor model allows for a quantitative implementation and has an easy graphical interpretation. It helps to highlight the important link between different modes of attention and affect in studying immersion.
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Affiliation(s)
- Daniel J Strauss
- Systems Neuroscience & Neurotechnology Unit, Faculty of Medicine, Saarland University & School of Engineering, htw saar, Homburg/Saar, Germany.
| | - Alexander L Francis
- Speech Perception & Cognitive Effort Lab, Dept. of Speech, Language & Hearing Sciences, Purdue University, West Lafayette, IN, USA
| | - Jonas Vibell
- Brain & Behavior Lab, Dept. of Psychology, University of Hawai'i at Manoa, Honololulu, HI, USA
| | - Farah I Corona-Strauss
- Systems Neuroscience & Neurotechnology Unit, Faculty of Medicine, Saarland University & School of Engineering, htw saar, Homburg/Saar, Germany
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Lachowicz M, Żurek A, Jamro D, Serweta-Pawlik A, Żurek G. Changes in concentration performance and alternating attention after short-term virtual reality training in E-athletes: a pilot study. Sci Rep 2024; 14:8904. [PMID: 38632364 PMCID: PMC11024211 DOI: 10.1038/s41598-024-59539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
In the dynamic landscape of e-sports, where intense competitive gaming demands high cognitive abilities, concentration performance and alternating attention play a pivotal role. E-sports encompass diverse genres, each requiring specific cognitive functions. Maintaining unwavering focus is crucial, as split-second decisions can determine victory. The study explores the potential of Virtual Reality (VR) training to enhance concentration performance and alternating attention, shedding light on the importance and possibilities of optimizing cognitive abilities for e-athletes. VR training emerges as a promising intervention, offering immersive environments for cognitive exercises. The study investigates the impact of VR training on concentration performance and alternating attention in amateur e-athletes, utilizing standardized tests. A randomized controlled trial with 66 participants reveals significant improvements in the VR training group, highlighting the adaptability and plasticity of cognitive processes. The findings suggest that VR training can enhance concentration abilities, providing valuable insights for e-sports and potentially extending to other fields requiring sustained attention and rapid task-switching. The study underscores the convergence of cognitive psychology, neuroscience, and VR technology, paving the way for innovative training methodologies and advancements in e-sports performance.
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Affiliation(s)
- Maciej Lachowicz
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612, Wrocław, Poland.
| | - Alina Żurek
- Institute of Psychology, University of Wrocław, 50-137, Wrocław, Poland
| | - Dariusz Jamro
- Department of Physical Education and Sport, General Tadeusz Kosciuszko Military University of Land Forces, 51-147, Wrocław, Poland
| | - Anna Serweta-Pawlik
- Department of Occupational Therapy, Wroclaw University of Health and Sport Sciences, 51-612, Wrocław, Poland
| | - Grzegorz Żurek
- Department of Biostructure, Wroclaw University of Health and Sport Sciences, 51-612, Wrocław, Poland
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Bissolotti L, Artiles-Sánchez J, Alonso-Pérez JL, Fernández-Carnero J, Abuín-Porras V, Sinatti P, Villafañe JH. Virtual Reality-Based Assessment for Rehabilitation of the Upper Limb in Patients with Parkinson's Disease: A Pilot Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:555. [PMID: 38674201 PMCID: PMC11051709 DOI: 10.3390/medicina60040555] [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: 02/16/2024] [Revised: 03/20/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: This study aimed to examine the responsiveness and concurrent validity of a serious game and its correlation between the use of serious games and upper limbs (UL) performance in Parkinson's Disease (PD) patients. Materials and Methods: Twenty-four consecutive upper limbs (14 males, 8 females, age: 55-83 years) of PD patients were assessed. The clinical assessment included: the Box and Block test (BBT), Nine-Hole Peg test (9HPT), and sub-scores of the Unified Parkinson's Disease Rating-Scale Motor section (UPDRS-M) to assess UL disability. Performance scores obtained in two different tests (Ex. A and Ex. B, respectively, the Trolley test and Mushrooms test) based on leap motion (LM) sensors were used to study the correlations with clinical scores. Results: The subjective fatigue experienced during LM tests was measured by the Borg Rating of Perceived Exertion (RPE, 0-10); the BBT and 9HPT showed the highest correlation coefficients with UPDRS-M scores (ICCs: -0.652 and 0.712, p < 0.05). Exercise A (Trolley test) correlated with UPDRS-M (ICC: 0.31, p < 0.05), but not with the 9HPT and BBT tests (ICCs: -0.447 and 0.390, p < 0.05), while Exercise B (Mushroom test) correlated with UPDRS-M (ICC: -0.40, p < 0.05), as did these last two tests (ICCs: -0.225 and 0.272, p < 0.05). The mean RPE during LM tests was 3.4 ± 3.2. The evaluation of upper limb performance is feasible and does not induce relevant fatigue. Conclusions: The analysis of the ICC supports the use of Test B to evaluate UL disability and performance in PD patients, while Test A is mostly correlated with disability. Specifically designed serious games on LM can serve as a method of impairment in the PD population.
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Affiliation(s)
- Luciano Bissolotti
- Fondazione Teresa Camplani Casa di Cura Domus Salutis, 25123 Brescia, Italy;
| | - Justo Artiles-Sánchez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, C/Inocencio García 1, 38300 Santa Cruz de Tenerife, Spain;
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
| | - José Luís Alonso-Pérez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, C/Inocencio García 1, 38300 Santa Cruz de Tenerife, Spain;
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (V.A.-P.); (P.S.)
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
- Onelife Center, Multidisciplinary Pain Treatment Center, 28925 Alcorcón, Spain
| | - Josué Fernández-Carnero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28032 Madrid, Spain;
- Grupo Multidisciplinar de Investigación y Tratamiento del Dolor, Grupo de Excelencia Investigadora URJC-Banco de Santander, 28922 Madrid, Spain
- Motion in Brains Research Group, Institute of Neuroscience and Movement Sciences (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autonoma de Madrid, 28049 Madrid, Spain
- La Paz Hospital Institute for Health Research, IdiPAZ, 28029 Madrid, Spain
| | - Vanesa Abuín-Porras
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (V.A.-P.); (P.S.)
| | - Pierluigi Sinatti
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (V.A.-P.); (P.S.)
| | - Jorge Hugo Villafañe
- Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain; (V.A.-P.); (P.S.)
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670 Villaviciosa de Odón, Spain
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Albert L, Potheegadoo J, Herbelin B, Bernasconi F, Blanke O. Numerosity estimation of virtual humans as a digital-robotic marker for hallucinations in Parkinson's disease. Nat Commun 2024; 15:1905. [PMID: 38472203 DOI: 10.1038/s41467-024-45912-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
Hallucinations are frequent non-motor symptoms in Parkinson's disease (PD) associated with dementia and higher mortality. Despite their high clinical relevance, current assessments of hallucinations are based on verbal self-reports and interviews that are limited by important biases. Here, we used virtual reality (VR), robotics, and digital online technology to quantify presence hallucination (vivid sensations that another person is nearby when no one is actually present and can neither be seen nor heard) in laboratory and home-based settings. We establish that elevated numerosity estimation of virtual human agents in VR is a digital marker for experimentally induced presence hallucinations in healthy participants, as confirmed across several control conditions and analyses. We translated the digital marker (numerosity estimation) to an online procedure that 170 PD patients carried out remotely at their homes, revealing that PD patients with disease-related presence hallucinations (but not control PD patients) showed higher numerosity estimation. Numerosity estimation enables quantitative monitoring of hallucinations, is an easy-to-use unobtrusive online method, reaching people far away from medical centers, translating neuroscientific findings using robotics and VR, to patients' homes without specific equipment or trained staff.
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Affiliation(s)
- Louis Albert
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Jevita Potheegadoo
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Bruno Herbelin
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Fosco Bernasconi
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Neuro-X Institute, Faculty of Life Sciences, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland.
- Department of Clinical Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Catania V, Rundo F, Panerai S, Ferri R. Virtual Reality for the Rehabilitation of Acquired Cognitive Disorders: A Narrative Review. Bioengineering (Basel) 2023; 11:35. [PMID: 38247912 PMCID: PMC10813804 DOI: 10.3390/bioengineering11010035] [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: 11/13/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
This review article explores the use of Virtual Reality (VR) technology in cognitive rehabilitation for individuals with neurological conditions, such as stroke, traumatic brain injury, and neurodegenerative diseases. The introduction highlights the challenges posed by cognitive impairments and the limitations of traditional rehabilitation methods. VR is presented as a transformative tool that immerses individuals in interactive environments, offering promising opportunities for enhancing cognitive functions and improving quality of life. This article covers the foundational principles of VR, its applications across different clinical conditions and cognitive domains, and evaluates empirical evidence supporting its efficacy. It also discusses the advantages, limitations, challenges, and ethical considerations in the use of VR for cognitive rehabilitation. This review concludes by exploring future developments, including advancements in VR technology, the integration of Augmented Reality (AR) and artificial intelligence (AI), and the importance of standardized assessment tools for the objective evaluation of rehabilitation outcomes.
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Affiliation(s)
| | | | | | - Raffaele Ferri
- Units of Psychology I.C. and Unit of Bioinformatics and Statistics, Oasi Research Institute-IRCCS, 94018 Troina, Italy; (V.C.); (F.R.); (S.P.)
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Gangemi A, De Luca R, Fabio RA, Lauria P, Rifici C, Pollicino P, Marra A, Olivo A, Quartarone A, Calabrò RS. Effects of Virtual Reality Cognitive Training on Neuroplasticity: A Quasi-Randomized Clinical Trial in Patients with Stroke. Biomedicines 2023; 11:3225. [PMID: 38137446 PMCID: PMC10740852 DOI: 10.3390/biomedicines11123225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Cognitive Rehabilitation (CR) is a therapeutic approach designed to improve cognitive functioning after a brain injury, including stroke. Two major categories of techniques, namely traditional and advanced (including virtual reality-VR), are widely used in CR for patients with various neurological disorders. More objective outcome measures are needed to better investigate cognitive recovery after a stroke. In the last ten years, the application of electroencephalography (EEG) as a non-invasive and portable neuroimaging method has been explored to extract the hallmarks of neuroplasticity induced by VR rehabilitation approaches, particularly within the chronic stroke population. The aim of this study is to investigate the neurophysiological effects of CR conducted in a virtual environment using the VRRS device. Thirty patients with moderate-to-severe ischemic stroke in the chronic phase (at least 6 months after the event), with a mean age of 58.13 (±8.33) for the experimental group and 57.33 (±11.06) for the control group, were enrolled. They were divided into two groups: an experimental group and a control group, receiving neurocognitive stimulation using VR and the same amount of conventional neurorehabilitation, respectively. To study neuroplasticity changes after the training, we focused on the power band spectra of theta, alpha, and beta EEG rhythms in both groups. We observed that when VR technology was employed to amplify the effects of treatments on cognitive recovery, significant EEG-related neural improvements were detected in the primary motor circuit in terms of power spectral density and time-frequency domains. Indeed, EEG analysis suggested that VR resulted in a significant increase in both the alpha band power in the occipital areas and the beta band power in the frontal areas, while no significant variations were observed in the theta band power. Our data suggest the potential effectiveness of a VR-based rehabilitation approach in promoting neuroplastic changes even in the chronic phase of ischemic stroke.
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Affiliation(s)
- Antonio Gangemi
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Rosaria De Luca
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Rosa Angela Fabio
- Department of Economics, University of Messina, Via Consolare Valeria, 98125 Messina, Italy;
| | - Paola Lauria
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Carmela Rifici
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Patrizia Pollicino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Angela Marra
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Antonella Olivo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113, Cda Casazza, 98124 Messina, Italy; (A.G.); (R.D.L.); (P.L.); (C.R.); (P.P.); (A.M.); (A.O.); (A.Q.)
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12
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Melkikh AV. Thinking, holograms, and the quantum brain. Biosystems 2023; 229:104926. [PMID: 37196892 DOI: 10.1016/j.biosystems.2023.104926] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/19/2023]
Abstract
This article continues the development of the idea that all human behavior and thinking are innate. A model of thinking and functioning of the brain has been constructed, which is capable of explaining both the accuracy of molecular processes and the innateness of behaviors. The focus of the model is the phase of the wave function of the particle, which is an additional (free) parameter. It should also be emphasized that the phase of the wave function of a particle is inextricably linked with the quantum action S in the Feynman's formulation of quantum mechanics (path integrals). A hypothesis is proposed: the set of particles that make up neurons and the brain is controlled by changing the phases from the outside (by a higher order system). Such a control system must be outside our world because our measurement methods do not allow us to determine the phase of an elementary particle. In a sense, it can be viewed as an extension of Bohm's ideas about the holographic brain and the holographic universe. Experiments are proposed that could confirm or disprove this model.
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Varela-Aldás J, Buele J, López I, Palacios-Navarro G. Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4609. [PMID: 36901618 PMCID: PMC10002257 DOI: 10.3390/ijerph20054609] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
Few works analyze the parameters inherent to immersive virtual reality (IVR) in applications for memory evaluation. Specifically, hand tracking adds to the immersion of the system, placing the user in the first person with full awareness of the position of their hands. Thus, this work addresses the influence of hand tracking in memory assessment with IVR systems. For this, an application based on activities of daily living was developed, where the user must remember the location of the elements. The data collected by the application are the accuracy of the answers and the response time; the participants are 20 healthy subjects who pass the MoCA test with an age range between 18 to 60 years of age; the application was evaluated with classic controllers and with the hand tracking of the Oculus Quest 2. After the experimentation, the participants carried out presence (PQ), usability (UMUX), and satisfaction (USEQ) tests. The results indicate no difference with statistical significance between both experiments; controller experiments have 7.08% higher accuracy and 0.27 ys. faster response time. Contrary to expectations, presence was 1.3% lower for hand tracking, and usability (0.18%) and satisfaction (1.43%) had similar results. The findings indicate no evidence to determine better conditions in the evaluation of memory in this case of IVR with hand tracking.
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Affiliation(s)
- José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
| | - Jorge Buele
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
- Department of Electronic Engineering and Communications, University of Zaragoza, 44003 Teruel, Spain
| | - Irene López
- SISAu Research Group, Facultad de Ingeniería, Industria y Producción FAINPRO, Universidad Indoamérica, Ambato 180103, Ecuador
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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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Tovar MA, Zebley JA, Higgins M, Herur-Raman A, Zwemer CH, Pierce AZ, Ranniger C, Sarani B, Phillips JP. Exposure to a Virtual Reality Mass-Casualty Simulation Elicits a Differential Sympathetic Response in Medical Trainees and Attending Physicians. Prehosp Disaster Med 2023; 38:1-9. [PMID: 36606324 PMCID: PMC9885434 DOI: 10.1017/s1049023x22002448] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/18/2022] [Accepted: 11/29/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Previous studies have demonstrated the use of virtual reality (VR) in mass-casualty incident (MCI) simulation; however, it is uncertain if VR simulations can be a substitute for in-person disaster training. Demonstrating that VR MCI scenarios can elicit the same desired stress response achieved in live-action exercises is a first step in showing non-inferiority. The primary objective of this study was to measure changes in sympathetic nervous system (SNS) response via a decrease in heart rate variability (HRV) in subjects participating in a VR MCI scenario. METHODS An MCI simulation was filmed with a 360º camera and shown to participants on a VR headset while simultaneously recording electrocardiography (EKG) and HRV activity. Baseline HRV was measured during a calm VR scenario immediately prior to exposure to the MCI scenarios, and SNS activation was captured as a decrease in HRV compared to baseline. Cognitive stress was measured using a validated questionnaire. Wilcoxon matched pairs signed rank analysis, Welch's t-test, and multivariate logistic regression were performed with statistical significance established at P <.05. RESULTS Thirty-five subjects were enrolled: eight attending physicians (two surgeons, six Emergency Medicine [EM] specialists); 13 residents (five Surgery, eight EM); and 14 medical students (six pre-clinical, eight clinical-year students). Sympathetic nervous system activation was observed in all groups during the MCI compared to baseline (P <.0001) and occurred independent of age, sex, years of experience, or prior MCI response experience. Overall, 23/35 subjects (65.7%) reported increased cognitive stress in the MCI (11/14 medical students, 9/13 residents, and 3/8 attendings). Resident and attending physicians had higher odds of discordance between SNS activation and cognitive stress compared to medical students (OR = 8.297; 95% CI, 1.408-64.60; P = .030). CONCLUSIONS Live-actor VR MCI simulation elicited a strong sympathetic response across all groups. Thus, VR MCI training has the potential to guide acquisition of confidence in disaster response.
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Affiliation(s)
- Matthew A. Tovar
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - James A. Zebley
- Department of Surgery, George Washington University, Washington, DCUSA
| | - Mairead Higgins
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - Aalap Herur-Raman
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - Catherine H. Zwemer
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
| | - Ayal Z. Pierce
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
| | - Claudia Ranniger
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
| | - Babak Sarani
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
- Department of Surgery, George Washington University, Washington, DCUSA
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
| | - James P. Phillips
- School of Medicine and Health Sciences, George Washington University, Washington, DCUSA
- Department of Emergency Medicine, George Washington University, Washington, DCUSA
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Tay JL, Xie H, Sim K. Effectiveness of Augmented and Virtual Reality-Based Interventions in Improving Knowledge, Attitudes, Empathy and Stigma Regarding People with Mental Illnesses-A Scoping Review. J Pers Med 2023; 13:jpm13010112. [PMID: 36675773 PMCID: PMC9864845 DOI: 10.3390/jpm13010112] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 01/06/2023] Open
Abstract
Interventions adopting augmented and virtual reality (AR/VR) modalities allow participants to explore and experience realistic scenarios, making them useful psycho-educational tools for mental illnesses. This scoping review aims to evaluate the effectiveness of AR/VR interventions in improving (1) knowledge, (2) attitudes, (3) empathy and (4) stigma regarding people with mental illnesses. Literature on published studies in English up till April 2022 was searched within several databases. Sixteen articles were included. The majority of studies were conducted in the West (93.8%), within undergraduates (68.8%) but also amongst high school students, patients, caregivers, public including online community, and covered conditions including psychotic illnesses, dementia, anxiety and depression. A preponderance of these included studies which employed AR/VR based interventions observed improvements in knowledge (66.7%), attitudes (62.5%), empathy (100%) and reduction of stigma (71.4%) pertaining to people with mental illnesses. In the context of relatively limited studies, extant AR/VR based interventions could potentially improve knowledge, attitudes, empathy and decrease stigma regarding people with mental illness. Further research needs to be conducted in larger and more diverse samples to investigate the relatively beneficial effects of different AR/VR modalities and the durability of observed improvements of relevant outcomes of interests over time for different mental conditions.
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Affiliation(s)
- Jing Ling Tay
- Institute of Mental Health, West Region, Buangkok Green Medical Park, Singapore 539747, Singapore
- Correspondence:
| | - Huiting Xie
- Institute of Mental Health, Buangkok Green Medical Park, Singapore 539747, Singapore
| | - Kang Sim
- Institute of Mental Health, West Region, Buangkok Green Medical Park, Singapore 539747, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Clinical Sciences, Singapore 308232, Singapore
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Fasilis T, Patrikelis P, Messinis L, Kimiskidis V, Korfias S, Nasios G, Alexoudi A, Verentzioti A, Dardiotis E, Gatzonis S. Cognitive Neurorehabilitation in Epilepsy Patients via Virtual Reality Environments: Systematic Review. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1424:135-144. [PMID: 37486487 DOI: 10.1007/978-3-031-31982-2_14] [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: 07/25/2023]
Abstract
OBJECTIVE Epilepsy patients could possibly benefit from the remuneration observed in the use of virtual reality (VR) and virtual environments (VEs), especially in cognitive difficulties associated with visuospatial navigation (memory, attention, and processing speed). AIM Research questions under consideration in the present systematic review are associated to VEs' efficiency as a cognitive rehabilitation practice in epilepsy and the particular VR methods indicated for epilepsy patients. To meet criteria, studies included participants suffering from any form of epilepsy and a methodological design with a structured rehabilitation program/model. Data were collected online, using academic databases. RESULTS Fourteen studies were included in the literature review and 6 in the statistical analysis. ROBINS-I protocol was implemented to assess the risk of bias. An inverse variance analysis (random effects) of pooled estimates of differences was implemented, in the form of continuous data. Despite the heterogeneity of the studies, all of them agree on the beneficial aspects of VR and VEs in cognitive rehabilitation in relation to visuospatial memory, attention, and information processing speed. CONCLUSION We suggest that patients suffering from epilepsy may benefit from the use of VR cognitive rehabilitation interventions, concerning visuospatial memory, attention, and information processing speed. However, further investigation is needed in order to gain a better understanding of the mechanisms involved in cognitive rehabilitation via VEs and establish efficient and dynamic rehabilitation protocols.
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Affiliation(s)
- Theodoros Fasilis
- 1st Department of Neurosurgery, Clinical Neuropsychology Laboratory, School of Medicine, Faculty of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Patrikelis
- 1st Department of Neurosurgery, Clinical Neuropsychology Laboratory, School of Medicine, Faculty of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lambros Messinis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Vasileios Kimiskidis
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stefanos Korfias
- 1st Department of Neurosurgery, Clinical Neuropsychology Laboratory, School of Medicine, Faculty of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Athanasia Alexoudi
- 1st Department of Neurosurgery, Clinical Neuropsychology Laboratory, School of Medicine, Faculty of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Verentzioti
- 1st Department of Neurosurgery, Clinical Neuropsychology Laboratory, School of Medicine, Faculty of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, Volos, Greece
| | - Stylianos Gatzonis
- 1st Department of Neurosurgery, Clinical Neuropsychology Laboratory, School of Medicine, Faculty of Health Sciences, National & Kapodistrian University of Athens, Athens, Greece
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Pau M, Porta M, Bertoni R, Mattos FGM, Cocco E, Cattaneo D. Effect of immersive virtual reality training on hand-to-mouth task performance in people with Multiple Sclerosis: A quantitative kinematic study. Mult Scler Relat Disord 2023; 69:104455. [PMID: 36508937 DOI: 10.1016/j.msard.2022.104455] [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: 09/14/2022] [Revised: 11/08/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Although the use of Virtual Reality (VR) has received increasing interest as an add-on treatment in neurorehabilitation programs in the last fifteen years, there is scarce information about the effectiveness of fully immersive VR-based treatments on upper limb (UL) motor function in people with Multiple Sclerosis (PwMS). METHODS In this bicentric 2-period interventional crossover study, 19 PwMS with moderate to severe disability (mean EDSS score 5.5) and relevant UL impairment underwent 12 immersive-VR sessions over a period of 4 weeks, using commercially available VR platform (Oculus Quest) and games (Fruit Ninja, Beat Saber and Creed - Rise to Glory). Possible changes associated with the treatment were objectively assessed through instrumental kinematic analysis of the "hand-to-mouth" (HTM) movement by means of optical motion capture system. Clinical tests to assess gross and fine manual dexterity (i.e., the Box and Blocks and Nine Hole Peg Test) were also administered. RESULTS The results of the kinematic analysis suggest that the VR training positively impacted the ability of the tested PwMS to perform the HTM task. In particular, a significant reduction of the overall time required to complete the task of approximately 20% for both most and least affected limb, and an improved degree of precision and stability of the movement, as indicated by the reduced value of adjusting sway, especially for the most affected limb (-60%). CONCLUSION Based on the results of the quantitative analysis, a 4-week treatment with immersive VR is able to improve speed and stability of the HTM movement in PwMS. This suggests that such an approach might be considered suitable to facilitate an immediate transfer of the possible positive effects associated with the training to common activities of daily living.
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Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Piazza d'Armi, Cagliari 09123, Italy.
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Piazza d'Armi, Cagliari 09123, Italy
| | - Rita Bertoni
- IRCSS Fondazione Don Carlo Gnocchi, Via Capecelatro 66, Milano 20148, Italy
| | | | - Eleonora Cocco
- Multiple Sclerosis Centre, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Cattaneo
- IRCSS Fondazione Don Carlo Gnocchi, Via Capecelatro 66, Milano 20148, Italy; Department of Pathophysiology and Transplantation, University of Milano, Milano, Italy
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Bofanova NS, Tychkov AY, Khanfar YA, Zolotarev RV. [Virtual reality technology as a promising direction in neurorehabilitation]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:131-136. [PMID: 36719129 DOI: 10.17116/jnevro2023123011131] [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: 02/01/2023]
Abstract
Nervous system damage affects more than a billion people worldwide and is one of the leading causes of cognitive impairment. An urgent issue in modern medicine is the neurorehabilitation of this particular group of patients. The purpose of this article is to search for new approaches to achieve more effective recovery of cognitive functions, precisely by using virtual reality technology as a promising direction in neurorehabilitation. It has been shown that neurobiological effects of virtual reality have a positive effect on the plasticity of neurons, improve cognitive functions and positively affect the psychoemotional state. A case of the positive impact of being in the virtual environment «Outer Space» in a female patient with cognitive impairment and chronic pain is presented.
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Perspective: Present and Future of Virtual Reality for Neurological Disorders. Brain Sci 2022; 12:brainsci12121692. [PMID: 36552152 PMCID: PMC9775006 DOI: 10.3390/brainsci12121692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Since the emergence of Virtual Reality technology, it has been adopted in the field of neurology. While Virtual Reality has contributed to various rehabilitation approaches, its potential advantages, especially in diagnosis, have not yet been fully utilized. Moreover, new tides of the Metaverse are approaching rapidly, which will again boost public and research interest and the importance of immersive Virtual Reality technology. Nevertheless, accessibility to such technology for people with neurological disorders has been critically underexplored. Through this perspective paper, we will briefly look over the current state of the technology in neurological studies and then propose future research directions, which hopefully facilitate beneficial Virtual Reality studies on a wider range of topics in neurology.
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Ochandorena-Acha M, Terradas-Monllor M, Nunes Cabrera TF, Torrabias Rodas M, Grau S. Effectiveness of virtual reality on functional mobility during treadmill training in children with cerebral palsy: a single-blind, two-arm parallel group randomised clinical trial (VirtWalkCP Project). BMJ Open 2022; 12:e061988. [PMID: 36328390 PMCID: PMC9639079 DOI: 10.1136/bmjopen-2022-061988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Treadmill training and virtual reality have been investigated in children with cerebral palsy. However, few studies have assessed the effectiveness of the combination of both treatments on children's functional and balance activities. The project aims to compare the effects of treadmill training with and without virtual reality on walking endurance and speed, static and dynamic balance, gross motor function, functional independence, quality of life and occupational participation in children with spastic cerebral palsy between the ages of 4 and 12 years classified at levels I, II and III of the Gross Motor Function Classification System. METHODS AND ANALYSIS This study is a single-blind, two-arm parallel group, randomised, controlled clinical trial. Participants will be recruited at the Pediatric Department of the Vic Hospital Consortium, and the research will be conducted at the University of Vic - Central University of Catalonia. The participants will be randomly allocated into two groups: (1) the experimental group, which will receive the treadmill training at the same time as the virtual reality; and (2) the control group, which will undertake treadmill gait training alone. The training will be provided in 10 sessions over 2 weeks with 30 min for each session. Assessments will be performed on three occasions: 1 week before the intervention, 1 week following the intervention and 1 month after the end of the intervention. The evaluations will involve the 6 min walk test, stabilometry, the Berg Balance Scale, the 10 m walk test, the Gross Motor Function Measure, the Functional Independence Measure, the paediatric quality of life inventory and the Children Participation Questionnaire. For between-within group comparison, a mixed-effect linear model will be used. ETHICS AND DISSEMINATION The study has been approved by the Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (2021061). Results will be published in peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER NCT05131724.
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Affiliation(s)
- Mirari Ochandorena-Acha
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), C.Sagrada Família, 7, 08500 Vic, Spain
- Neurology department, Sant Joan de Deu Barcelona Children's Hospital, Barcelona, Catalonia, Spain
| | - Marc Terradas-Monllor
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC), C.Sagrada Família, 7, 08500 Vic, Spain
- Pain Medicine Section, Anesthesiology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Tania Fabiola Nunes Cabrera
- Neurology department, Sant Joan de Deu Barcelona Children's Hospital, Barcelona, Catalonia, Spain
- Pediatric Department, Consorci Hospitalari de Vic, Vic, Catalunya, Spain
| | | | - Sergi Grau
- Faculty of Science and Technology, University of Vic - Central University of Catalonia, Vic, Spain
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22
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Castellano-Aguilera A, Biviá-Roig G, Cuenca-Martínez F, Suso-Martí L, Calatayud J, Blanco-Díaz M, Casaña J. Effectiveness of Virtual Reality on Balance and Risk of Falls in People with Multiple Sclerosis: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114192. [PMID: 36361069 PMCID: PMC9656689 DOI: 10.3390/ijerph192114192] [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: 09/23/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 05/04/2023]
Abstract
The aim of this study was to systematically review the scientific evidence related to the physiotherapy interventions in neurorehabilitation that utilize virtual reality (VR) for balance training and risk of falls in people with multiple sclerosis (MS). A search was conducted in Medline (PubMed), PEDro, and Google Scholar to identify all the relevant studies. Clinical trials assessing the effects of VR in people with MS were included. Risk of bias was evaluated using the Cochrane Risk of Bias Tool and PEDro scale. Qualitative analysis was performed according to the GRADE. In total, 16 studies (n = 663) were included. The meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for balance, with a moderate clinical effect in eight studies (SMD: 0.63; 95% CI 0.34-0.92; p < 0.05). In addition, the meta-analysis showed statistically significant differences for the VR intervention in comparison with conventional treatment for risk of falls, with a small clinical effect in six studies (SMD: -0.55; 95% CI -1.07-0.04; p < 0.05). VR-based treatments are more effective than non-intervention in improving balance and fall risk in people with MS, with a very low certainty of evidence. In addition, they also show to be more effective than conventional rehabilitation, with a very low certainty of evidence.
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Affiliation(s)
- Ana Castellano-Aguilera
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Gemma Biviá-Roig
- Department of Nursing and Physiotherapy, Faculty of Health Sciences, University CEU-Cardenal Herrera, CEU Universities, 46115 Valencia, Spain
| | - Ferran Cuenca-Martínez
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Luis Suso-Martí
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
- Correspondence: (L.S.-M.); (M.B.-D.)
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - María Blanco-Díaz
- Surgery and Medical Surgical Specialities Department, Faculty of Medicine and Health Sciences, University of Oviedo, 33003 Oviedo, Spain
- Correspondence: (L.S.-M.); (M.B.-D.)
| | - José Casaña
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
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23
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Corti C, Butti N, Bardoni A, Strazzer S, Urgesi C. Body Processing in Children and Adolescents with Traumatic Brain Injury: An Exploratory Study. Brain Sci 2022; 12:brainsci12080962. [PMID: 35892403 PMCID: PMC9331706 DOI: 10.3390/brainsci12080962] [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: 06/20/2022] [Revised: 07/13/2022] [Accepted: 07/21/2022] [Indexed: 01/27/2023] Open
Abstract
Dysfunctions in body processing have been documented in adults with brain damage, while limited information is available for children. This study aimed to investigate body processing in children and adolescents with traumatic brain injury (TBI) (N = 33), compared to peers with typical development. Two well-known computerized body-representation paradigms, namely Visual Body Recognition and Visuo-spatial Imagery, were administered. Through the first paradigm, the body inversion and composite illusion effects were tested with a matching to sample task as measures of configural and holistic processing of others’ bodies, respectively. The second paradigm investigated with a laterality judgement task the ability to perform first-person and object-based mental spatial transformations of own body and external objects, respectively. Body stimuli did not convey any emotional contents or symbolic meanings. Patients with TBI had difficulties with mental transformations of both body and object stimuli, displaying deficits in motor and visual imagery abilities, not limited to body processing. Therefore, cognitive rehabilitation of body processing in TBI might benefit from the inclusion of both general training on visuo-spatial abilities and specific exercises aimed at boosting visual body perception and motor imagery.
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Affiliation(s)
- Claudia Corti
- Scientific Institute, IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy; (N.B.); (A.B.); (S.S.)
- Correspondence:
| | - Niccolò Butti
- Scientific Institute, IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy; (N.B.); (A.B.); (S.S.)
- PhD Program in Neural and Cognitive Sciences, Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
| | - Alessandra Bardoni
- Scientific Institute, IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy; (N.B.); (A.B.); (S.S.)
| | - Sandra Strazzer
- Scientific Institute, IRCCS E. Medea, Via Don Luigi Monza 20, 23842 Bosisio Parini, Italy; (N.B.); (A.B.); (S.S.)
| | - Cosimo Urgesi
- Scientific Institute, IRCCS E. Medea, 33078 San Vito al Tagliamento, Italy;
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy
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Schuermans J, Van Hootegem A, Van den Bossche M, Van Gendt M, Witvrouw E, Wezenbeek E. Extended reality in musculoskeletal rehabilitation and injury prevention - A systematic review. Phys Ther Sport 2022; 55:229-240. [DOI: 10.1016/j.ptsp.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 04/29/2022] [Accepted: 04/29/2022] [Indexed: 10/18/2022]
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Virtual Reality-Based Therapy Improves Fatigue, Impact, and Quality of Life in Patients with Multiple Sclerosis. A Systematic Review with a Meta-Analysis. SENSORS 2021; 21:s21217389. [PMID: 34770694 PMCID: PMC8588272 DOI: 10.3390/s21217389] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 12/15/2022]
Abstract
Patients with multiple sclerosis (PwMS) have a high level of fatigue and a reduced quality of life (QoL) due to the impact of multiple sclerosis (MS). Virtual reality-based therapy (VRBT) is being used to reduce disability in PwMS. The aim of this study was to assess the effect of VRBT on fatigue, the impact of MS, and QoL in PwMS. Methods: A systematic review with meta-analysis was conducted through a bibliographic search on PubMed, Scopus, Web of Science, and PEDro up to April 2021. We included randomized controlled trials (RCTs) with PwMS that received VRBT in comparison to conventional therapy (CT) including physiotherapy, balance and strength exercises, and stretching or physical activity, among others; or in comparison to simple observation; in order to assess fatigue, MS-impact, and QoL. The effect size was calculated using Cohen’s standardized mean difference with a 95% confidence interval (95% CI). Results: Twelve RCTs that provided data from 606 PwMS (42.83 ± 6.86 years old and 70% women) were included. The methodological quality mean, according to the PEDro Scale, was 5.83 ± 0.83 points. Our global findings showed that VRBT is effective at reducing fatigue (SMD −0.33; 95% CI −0.61, −0.06), lowering the impact of MS (SMD −0.3; 95% CI −0.55, −0.04), and increasing overall QoL (0.5; 95% CI 0.23, 0.76). Subgroup analysis showed the following: (1) VRBT is better than CT at reducing fatigue (SMD −0.4; 95% CI −0.7, −0.11), as well as in improving the mental dimension of QoL (SMD 0.51; 95% CI 0.02, 1); (2) VRBT is better than simple observation at reducing the impact of MS (SMD −0.61; 95% CI −0.97, −0.23) and increasing overall QoL (SMD 0.79; 95% CI 0.3, 1.28); and (3) when combined with CT, VRBT is more effective than CT in improving the global (SMD 0.6, 95% CI 0.13, 1.07), physical (SMD 0.87; 95% CI 0.3, 1.43), and mental dimensions (SMD 0.6; 95% CI 0.08, 1.11) of QoL. Conclusion: VRBT is effective at reducing fatigue and MS impact and improving QoL in PwMS.
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26
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[Virtual reality in teaching of psychiatry and psychotherapy at medical school]. DER NERVENARZT 2021; 93:728-734. [PMID: 34735588 PMCID: PMC8567730 DOI: 10.1007/s00115-021-01227-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 01/15/2023]
Abstract
Hintergrund Ausbildung und Lehre müssen sich den Gegebenheiten insbesondere in Corona-Zeiten anpassen, zumal neue digitale Technologien zur Verfügung stehen. Ärztliche Interaktions- und Explorationstechniken sind die wichtigsten Werkzeuge, die Medizinstudierende im Fach Psychiatrie und Psychotherapie zu erwerben haben. Ziel der Arbeit Avatare in virtueller Realität (VR) können grundsätzlich alle Krankheitsbilder in unterschiedlichen Schweregraden zu jeder Zeit repräsentieren. Material und Methoden Im Bochumer Avatar-Explorationsprojekt (AVEX) treten Studierende in den Dialog mit „psychisch kranken“ Avataren und versuchen, unter Anleitung und Supervision Diagnose, Differenzialdiagnose und Behandlungsempfehlungen zu erarbeiten. Ergebnisse und Diskussion Dadurch können die Studierenden auch seltene oder schwere psychiatrische Krankheitsbilder durch VR vermittelt kennenlernen. Dieser Übersichtsartikel stellt erste Erfahrungen insbesondere in Aufbau und Entwicklung sowie bez. der technologischen Herausforderungen dar.
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27
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Montag M, Paschall C, Ojemann J, Rao R, Herron J. A Platform for Virtual Reality Task Design with Intracranial Electrodes. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6659-6662. [PMID: 34892635 DOI: 10.1109/embc46164.2021.9630231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research with human intracranial electrodes has traditionally been constrained by the limitations of the inpatient clinical setting. Immersive virtual reality (VR), however, can transcend setting and enable novel task design with precise control over visual and auditory stimuli. This control over visual and auditory feedback makes VR an exciting platform for new in-patient, human electrocorticography (ECOG) and stereo-electroencephalography (sEEG) research. The integration of intracranial electrode recording and stimulation with VR task dynamics required foundational systems engineering. In this work, we present a custom API that bridges Unity, the leading VR game development engine, and Synapse, the proprietary software of the Tucker Davis Technologies (TDT) neural recording and stimulation platform. To demonstrate the functionality and efficiency of our API, we developed a closed-loop brain-computer interface (BCI) task in which filtered neural signals controlled the movement of a virtual object and virtual object dynamics triggered neural stimulation. This closed-loop VR-BCI task confirmed the utility, safety, and efficacy of our API and its readiness for human task deployment.
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28
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van Deursen M, Reuvers L, Duits JD, de Jong G, van den Hurk M, Henssen D. Virtual reality and annotated radiological data as effective and motivating tools to help Social Sciences students learn neuroanatomy. Sci Rep 2021; 11:12843. [PMID: 34145335 PMCID: PMC8213773 DOI: 10.1038/s41598-021-92109-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 06/04/2021] [Indexed: 02/07/2023] Open
Abstract
Neuroanatomy as a subject is important to learn, because a good understanding of neuroanatomy supports the establishment of a correct diagnosis in neurological patients. However, rapid changes in curricula reduced time assigned to study (neuro)anatomy. Therefore, it is important to find alternative teaching methods to study the complex three-dimensional structure of the brain. The aim of this manuscript was to explore the effectiveness of Virtual Reality (VR) in comparison with Radiological Data (RaD) as suitable learning methods to build knowledge and increase motivation for learning neuroanatomy. Forty-seven students (mean age of 19.47 ± 0.54 years; 43 females; 4 males) were included; 23 students comprised the VR group. Both methods showed to improve knowledge significantly, the improvement between groups was not different. The RaD group showed to have a significantly higher score on expectancy than students in the VR group. Task value scores regarding finding a task interesting, useful and fun were found to be significantly different in favor of the VR group. Consequently, significant higher Motivation scores were found in the VR group. Motivation and expectancy, however, did not moderate learning results, whereas task value impacted the results in favour of the VR group. This study concludes that VR and RaD are effective and diverting methods to learn neuroanatomy, with VR being more motivating than RaD. Future research should investigate motivation and task value when using VR over a longer period of time.
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Affiliation(s)
- Margot van Deursen
- Department of Educational Sciences, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Laura Reuvers
- Department of Educational Sciences, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Jacobus Dylan Duits
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Guido de Jong
- Radboudumc 3D Lab, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marianne van den Hurk
- Department of Educational Sciences, Faculty of Social Sciences, Radboud University, Nijmegen, The Netherlands
| | - Dylan Henssen
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.
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29
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Anwar N, Karimi H, Ahmad A, Gilani SA, Khalid K, Aslam AS, Hanif A. VIRTUAL REALITY TRAINING THROUGH NINTENDO WII GAMES IN STROKE PATIENTS: A RANDOMISED CLINICAL TRIAL (Preprint). JMIR Serious Games 2021; 10:e29830. [PMID: 35699989 PMCID: PMC9237768 DOI: 10.2196/29830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/30/2021] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Stroke is a leading cause of disability. It is difficult to devise an optimal rehabilitation plan once stroke survivors are back home. Conventional rehabilitative therapies are extensively used in patients with stroke to recover motor functioning and disability, but these are arduous and expensive. Virtual reality (VR) video games inspire patients to get involved in their therapeutic exercise routine in a fun way. VR in the form of games provides a fruitful, secure, and challenging learning environment for motor control and neural plasticity development in rehabilitation. The effects of upper limb sensorimotor functioning and balance are the main focus of this trial. Objective The aim of this study is to compare the effects of VR training and routine physical therapy on balance and upper extremity sensorimotor function in patients with stroke. Methods It was a single assessor-blinded randomized clinical trial. A total of 74 participants with their first chronic stroke were included and rehabilitated in a clinical setting. The lottery method was used to randomly assign patients to either the VR group (n=37) or the routine physical therapy group (n=37). The VR group received a 1-hour session of VR training for 3 weekdays over 6 weeks, and the routine physical therapy group received different stretching and strengthening exercises. The outcome measuring tools were the Berg Balance Scale for balance and the Fugl-Meyer Assessment (upper extremity) scale for sensorimotor, joint pain, and range assessment. The assessment was done at the start of treatment and after the 6 weeks of intervention. Data analysis was done using SPSS 22. Results The trial was completed by 68 patients. A significant difference between the two groups was found in the Berg Balance Scale score (P<.001), Fugl-Meyer Assessment for motor function (P=.03), and Fugl-Meyer Assessment for joint pain and joint range (P<.001); however, no significant difference (P=.19) in the Fugl-Meyer Assessment for upper extremity sensation was noted. Conclusions VR training is helpful for improving balance and function of the upper extremities in the routine life of patients with stroke; although, it was not found to be better than conventional training in improving upper limb sensation. VR training can be a better option in a rehabilitation plan designed to increase functional capability. Trial Registration Iranian Registry of Clinical Trials RCT20190715044216N1; https://www.irct.ir/user/trial/40898/view
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Affiliation(s)
- Naveed Anwar
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
- Department of Physical Therapy, Nur International University, Lahore, Pakistan
| | - Hossein Karimi
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Ashfaq Ahmad
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Syed Amir Gilani
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
| | - Kehkshan Khalid
- Department of Physical Therapy, Avicenna Medical College, Lahore, Pakistan
| | - Ahmed Sohaib Aslam
- Department of Physical Therapy, Kanaan Healthcare Center, Lahore, Pakistan
| | - Asif Hanif
- University Institute of Physical Therapy, University of Lahore, Lahore, Pakistan
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