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Raghuraman N, Bedford T, Tran N, Haycock NR, Wang Y, Colloca L. The Interplay Between Health Disparities and Acceptability of Virtual Reality: A Survey Study. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2024. [PMID: 39088356 DOI: 10.1089/cyber.2023.0694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
Virtual reality (VR) has emerged as a nonpharmacological adjuvant to manage acute and chronic pain symptoms. The goal of this survey study was to determine the acceptability of VR among chronic pain participants hailing from distressed and prosperous neighborhoods in the state of Maryland. We hypothesized that pain severity and interference vary in groups experiencing health disparities, potentially influencing VR's acceptability. From March 11 to March 15, 2020, we surveyed a cohort of clinically phenotyped participants suffering from chronic orofacial pain. Participants were asked to express their willingness to participate in a longitudinal VR study and their expectation of pain relief from using VR. Seventy out of 350 participants with chronic pain completed the survey (response rate: 20%). There was no difference in the likelihood of responding to the survey based on their neighborhood distress. Among survey respondents and nonrespondents, similar proportions of participants were from distressed neighborhoods. Among the respondents, 63 (90%) and 59 (84.3%) were willing to participate and expected to experience pain relief from the VR intervention, respectively. Age, sex, race, neighborhood distress, severity of pain, and prior VR experience did not influence willingness to participate in the VR trial or the expectations of VR-induced improvement. These findings suggest that VR as an adjuvant intervention is potentially accepted by chronic pain participants, irrespective of neighborhood-level social determinants of health.
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Affiliation(s)
- Nandini Raghuraman
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, USA
- Graduate Program in Life Sciences, Program in Epidemiology and Human Genetics, School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Theresa Bedford
- 711th Human Performance Wing, En Route Care, Wright-Patterson AFB, Ohio, USA
| | - Nhi Tran
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Nathaniel R Haycock
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - Yang Wang
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, USA
- Placebo Beyond Opinions Center, University of Maryland, Baltimore, Maryland, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland, USA
| | - Luana Colloca
- Department of Pain and Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, USA
- Placebo Beyond Opinions Center, University of Maryland, Baltimore, Maryland, USA
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland, USA
- Department of Anesthesiology & Psychiatry, University of Maryland, School of Medicine, Baltimore, Maryland, USA
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Cano N, Gómez-Hernández J, Ariza M, Mora T, Roche D, Porras-Garcia B, Garolera M. A multimodal group-based immersive virtual reality intervention for improving cognition and mental health in patients with post-covid-19 condition. A quasi-experimental design study. Front Psychol 2024; 15:1441018. [PMID: 39131859 PMCID: PMC11311793 DOI: 10.3389/fpsyg.2024.1441018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/15/2024] [Indexed: 08/13/2024] Open
Abstract
Introduction Adults with Post-COVID-19 Condition (PCC) may show cognitive impairments in attention, processing speed, memory, and executive function. Multimodal programs that combine cognitive training, physical activity and emotional tasks, such as mindfulness-based interventions (MBIs), may offer a suitable alternative for improving PCC treatments. Immersive Virtual Reality (IVR) is a promising technology that can enhance traditional cognitive training, physical activity, and MBIs. The use of IVR technology may increase engagement with these interventions and potentially enhance the individual benefits of cognitive training, exercise and MBIs. The current study evaluated the impact of a multimodal IVR intervention, comparing this with a usual care intervention (control group), in order to assess changes in cognition and mental health in adults with PCC. We also aimed to assess user experience factors such as enjoyment, perceived improvement, and fatigue following each multimodal IVR session within the experimental group. Method Thirty-one participants with PCC symptoms were assigned to either the experimental group (IVR, n = 15) or the control group (usual care intervention, n = 16) in a quasi-experimental design study. The multimodal IVR intervention consisted of MBI, cognitive training and physical exercise and was delivered in a 60-min group session with 5 participants, twice a week, for 8 weeks (16 sessions in total). Measures of global cognition, attention, processing speed, verbal episodic memory and subjective memory complaints (primary measures), and depressive and anxiety symptoms and fatigue (secondary measures) were assessed at baseline and also after 8 weeks (post-intervention). Results Mixed between-group (group) and within-group (pre-post assessments) ANOVAs revealed significant group*time interactions in global cognition, simple attention, processing speed, memory and depressive symptoms, with large effect sizes (p < 0.05; partial η2 > 0.14). There was also a marginally significant group*time interaction for executive function (p = 0.05). Follow-up analyses comparing pre-and post-intervention outcomes for each group separately showed that the experimental group significantly improved in global cognition, processing speed, memory and depressive symptoms, while the control group showed no significant pre-post changes. Friedman tests showed a significant main effect of time (χ2(2) = 6.609, p = 0.04), with a gradual increase in enjoyment from the first, to the mid, and then to the final session. In addition, perceived improvement scores remained high throughout the intervention, and patient-reported fatigue levels did not fluctuate significantly throughout the intervention. Conclusion To our knowledge, no previous research has combined cognitive training, physical exercise and MBI using an IVR paradigm in adults with PCC. Despite their inherent limitations, our findings mark a pioneering step toward improving cognition and mental health outcomes in PCC through the innovative use of new technology and multimodal approaches. This first study should be accompanied by more extensive, randomized clinical trials aimed at further exploring and refining these interventions.
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Affiliation(s)
- Neus Cano
- Brain, Cognition and Behavior Research Group, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
- BrainXRLab, Department of Psychology, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - Josep Gómez-Hernández
- Brain, Cognition and Behavior Research Group, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
| | - Mar Ariza
- Brain, Cognition and Behavior Research Group, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
- Unit of Medical Psychology, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Toni Mora
- Research Institute for Evaluation and Public Policy (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain
| | - David Roche
- Research Institute for Evaluation and Public Policy (IRAPP), Universitat Internacional de Catalunya, Barcelona, Spain
| | - Bruno Porras-Garcia
- Brain, Cognition and Behavior Research Group, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
- BrainXRLab, Department of Psychology, Universitat Internacional de Catalunya, Sant Cugat, Spain
| | - Maite Garolera
- Brain, Cognition and Behavior Research Group, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
- BrainXRLab, Department of Psychology, Universitat Internacional de Catalunya, Sant Cugat, Spain
- Neuropsychology Unit, Consorci Sanitari de Terrassa (CST), Terrassa, Spain
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Zhou X, Cai F, Li S, Li G, Zhang C, Xie J, Yang Y. Machine learning techniques for prediction in pregnancy complicated by autoimmune rheumatic diseases: Applications and challenges. Int Immunopharmacol 2024; 134:112238. [PMID: 38735259 DOI: 10.1016/j.intimp.2024.112238] [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: 03/05/2024] [Revised: 05/01/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024]
Abstract
Autoimmune rheumatic diseases are chronic conditions affecting multiple systems and often occurring in young women of childbearing age. The diseases and the physiological characteristics of pregnancy significantly impact maternal-fetal health and pregnancy outcomes. Currently, the integration of big data with healthcare has led to the increasing popularity of using machine learning (ML) to mine clinical data for studying pregnancy complications. In this review, we introduce the basics of ML and the recent advances and trends of ML in different prediction applications for common pregnancy complications by autoimmune rheumatic diseases. Finally, the challenges and future for enhancing the accuracy, reliability, and clinical applicability of ML in prediction have been discussed. This review will provide insights into the utilization of ML in identifying and assisting clinical decision-making for pregnancy complications, while also establishing a foundation for exploring comprehensive management strategies for pregnancy and enhancing maternal and child health.
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Affiliation(s)
- Xiaoshi Zhou
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Feifei Cai
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shiran Li
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Guolin Li
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Changji Zhang
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Jingxian Xie
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; College of Pharmacy, Southwest Medical University, Luzhou, China
| | - Yong Yang
- Department of Pharmacy, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
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Obrero-Gaitán E, Chau-Cubero CY, Lomas-Vega R, Osuna-Pérez MC, García-López H, Cortés-Pérez I. Effectiveness of virtual reality-based therapy in pulmonary rehabilitation of chronic obstructive pulmonary disease. A systematic review with meta-analysis. Heart Lung 2024; 65:1-10. [PMID: 38330853 DOI: 10.1016/j.hrtlng.2024.01.011] [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: 08/25/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND In addition to conventional pulmonary rehabilitation (PR) programs for the treatment of chronic obstructive pulmonary disease (COPD), the use of virtual reality-based therapy (VRBT) has been proposed as an effective complementary tool to be included in PR programs for COPD. OBJECTIVES To analyze the effectiveness of VRBT on functional capacity, pulmonary function, and functional mobility in patients with COPD. METHODS A meta-analysis was carried out through a bibliographic search in PubMed (Medline), WOS, PEDro, CINAHL, CENTRAL, and Scopus since inception up to June 2023. The risk of bias was assessed using the PEDro scale, and the effect was determined using the standardized mean difference (SMD) and its 95 % confidence interval (95 % CI) in a random effects model. RESULTS Five RCTs, providing data from 344 participants with a mean age 65.7 ± 5.3 years old, were included. The mean methodological quality of the studies included was good (6.8 ± 1.6 points). The meta-analysis showed that VRBT was effective in increasing functional capacity, assessed with the 6 Min Walking Test, (SMD=0.4, 95 % CI 0.07 to 0.71, p = 0.017); pulmonary function, assessed with FEV1 (SMD=0.33, 95 %CI 0.01 to 0.65, p = 0.048); and functional mobility, assessed with the Get Up and Go Test (SMD=0.77, 95 % CI 0.5 to 1.1, p<0.001) in patients with COPD. CONCLUSION VRBT is suggested to be effective in increasing functional capacity, pulmonary function, and functional mobility in patients with COPD. Non-immersive VRBT is the most used modality of VRBT in PR.
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Affiliation(s)
- Esteban Obrero-Gaitán
- Faculty of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, 23071, Jaén Spain
| | - Celim Yem Chau-Cubero
- Faculty of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, 23071, Jaén Spain
| | - Rafael Lomas-Vega
- Faculty of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, 23071, Jaén Spain
| | | | - Héctor García-López
- Faculty of Nursing, Physiotherapy and Medicine. University of Almería. Ctra. Sacramento s/n, La Cañada, 04120, Almería Spain.
| | - Irene Cortés-Pérez
- Faculty of Health Sciences. University of Jaén. Campus Las Lagunillas s/n, 23071, Jaén Spain
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Melo AS, Moreira JS, Afreixo V, Moreira-Gonçalves D, Donato H, Cruz EB, Vilas-Boas JP, Sousa AS. Effectiveness of specific scapular therapeutic exercises in patients with shoulder pain: a systematic review with meta-analysis. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:161-174. [PMID: 38706660 PMCID: PMC11065746 DOI: 10.1016/j.xrrt.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Background Therapeutic exercise has been considered a useful tool to rehabilitate shoulder pain, namely through its influence on scapular dynamics. Accordingly, the effectiveness of scapular therapeutic exercise needs to be explored. The present study aims to evaluate the effectiveness of scapular therapeutic exercises in shoulder pain and to identify the most effective exercise type (focal or multijoint) and ways of delivering them (as dose and progression). Methods Search was conducted at EMBASE, Cochrane Library, MEDLINE via PubMed, Web of Science, PEDro (Physiotherapy Evidence Database), and trial registration databases. The meta-analysis considered randomized controlled/crossover trials that compared the effect of scapular exercises against other types of intervention in the shoulder pain, shoulder function, scapular motion, and/or muscular activity. The risk of bias was assessed through the PEDro scale. Results From the 8318 records identified, 8 (high to low risk of bias- scoring from 4 to 8 on the PEDro scale) were included. The overall data, before sensitivity analysis, indicated that the scapular therapeutic exercises are: a) more effective than comparators in improving shoulder function (standardized mean difference [SMD] = 0.52 [95% Cl: 0.05, 0.99], P = .03, I2 = 76%); and b) as effective as comparators in reducing shoulder pain (SMD = 0.32 [95% Cl: -0.09, 0.73], P = .13, I2 = 70%). Subgroup analysis revealed that scapular exercises are more effective in improving shoulder function when the program duration is equal to or higher than 6 weeks (SMD = 0.43 [95% Cl: 0.09, 0.76] P = .01, I2 = 21%) and/or when the maximum number of exercise repetitions per session is lower than 30 (SMD = 0.79 [95% Cl: 0.15, 1.42], P = .01, I2 = 77%). Only 1 study considered scapular motion as an outcome measure, revealing therapeutic exercise effectiveness to improve scapular range of motion. Conclusions Intervention programs involving scapular therapeutic exercises are effective in improving shoulder function, presenting benefits when performed for 6 or more weeks and/or when used up to a maximum of 30 repetitions per exercise, per session.
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Affiliation(s)
- Ana S.C. Melo
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro Interdisciplinar de Investigação Aplicada em Saúde (CIIAS), Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
| | - Juliana S. Moreira
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - Vera Afreixo
- Department of Mathematics, Center for Research and Development in Mathematics and Applications – CIDMA, University of Aveiro, Portugal
| | - Daniel Moreira-Gonçalves
- Centro de Investigação em Actividade Física, Saúde e Lazer (CIAFEL), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
- ITR, Laboratory for Integrative and Translational Research in Population Health, Porto, Portugal
| | - Helena Donato
- Documentation and Scientific Information Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Eduardo B. Cruz
- Departamento de Fisioterapia, Escola Superior de Saúde, Instituto Politécnico de Setúbal, Setúbal, Portugal
- Centro de Investigação Integrada em Saúde (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
| | - J. Paulo Vilas-Boas
- Laboratório de Biomecânica do Porto (LABIOMEP), Universidade do Porto, Porto, Portugal
- Centro de Investigação, Formação, Inovação e Intervenção em Desporto (CIFI2D), Faculdade de Desporto, Universidade do Porto, Porto, Portugal
| | - Andreia S.P. Sousa
- Centro de Investigação em Reabilitação (CIR), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
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Fernández Ó, Sörensen PS, Comi G, Vermersch P, Hartung HP, Leocani L, Berger T, Van Wijmeersch B, Oreja-Guevara C. Managing multiple sclerosis in individuals aged 55 and above: a comprehensive review. Front Immunol 2024; 15:1379538. [PMID: 38646534 PMCID: PMC11032020 DOI: 10.3389/fimmu.2024.1379538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
Multiple Sclerosis (MS) management in individuals aged 55 and above presents unique challenges due to the complex interaction between aging, comorbidities, immunosenescence, and MS pathophysiology. This comprehensive review explores the evolving landscape of MS in older adults, including the increased incidence and prevalence of MS in this age group, the shift in disease phenotypes from relapsing-remitting to progressive forms, and the presence of multimorbidity and polypharmacy. We aim to provide an updated review of the available evidence of disease-modifying treatments (DMTs) in older patients, including the efficacy and safety of existing therapies, emerging treatments such as Bruton tyrosine kinase (BTKs) inhibitors and those targeting remyelination and neuroprotection, and the critical decisions surrounding the initiation, de-escalation, and discontinuation of DMTs. Non-pharmacologic approaches, including physical therapy, neuromodulation therapies, cognitive rehabilitation, and psychotherapy, are also examined for their role in holistic care. The importance of MS Care Units and advance care planning are explored as a cornerstone in providing patient-centric care, ensuring alignment with patient preferences in the disease trajectory. Finally, the review emphasizes the need for personalized management and continuous monitoring of MS patients, alongside advocating for inclusive study designs in clinical research to improve the management of this growing patient demographic.
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Affiliation(s)
- Óscar Fernández
- Departament of Pharmacology, Faculty of Medicine; Institute of Biomedical Research of Malaga (IBIMA), Regional University Hospital of Malaga, Malaga, Spain
- Department of Pharmacology and Pediatry, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Per Soelberg Sörensen
- Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Copenhagen and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Giancarlo Comi
- Department of Neurorehabilitation Sciences, Multiple Sclerosis Centre Casa di Cura Igea, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Patrick Vermersch
- Univ. Lille, Inserm U1172 LilNCog, CHU Lille, FHU Precise, Lille, France
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
- Brain and Mind Center, University of Sydney, Sydney, NSW, Australia
- Department of Neurology, Palacky University Olomouc, Olomouc, Czechia
| | - Letizia Leocani
- Department of Neurorehabilitation Sciences, Multiple Sclerosis Centre Casa di Cura Igea, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Bart Van Wijmeersch
- University MS Centre, Hasselt-Pelt, Belgium
- Rehabilitation and Multiple Sclerosis (MS), Noorderhart Hospitals, Pelt, Belgium
| | - Celia Oreja-Guevara
- Department of Neurology, Hospital Clínico Universitario San Carlos, IdISSC, Madrid, Spain
- Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
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Maggio MG, Rizzo A, Quartarone A, Manuli A, Calabrò RS. Virtual reality rehabilitation in patients affected by multiple sclerosis: Impact on quality of life and sexual functions. Mult Scler Relat Disord 2024; 84:105470. [PMID: 38350226 DOI: 10.1016/j.msard.2024.105470] [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: 11/04/2023] [Revised: 01/16/2024] [Accepted: 01/23/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Multiple Sclerosis (MS) can present several neurological symptoms with a progression that often leads to loss of cognitive and physical abilities. Sexual dysfunctions are frequent, although underestimated, MS symptoms significantly affecting the quality of life of these patients. The primary objective of this study was to assess the effectiveness of VR rehabilitation in enhancing the quality of life in individuals with MS. The secondary objective aimed to investigate whether the improvement in quality of life would also lead to enhanced sexual satisfaction and sexual function. MATERIALS AND METHODS Patients diagnosed with relapsing-remitting and secondary progressive MS and attending from November 2018 to March 2020 the Rehabilitation Laboratory of IRCCS Neurolesi "Bonino Pulejo" in Messina, Italy were enrolled in this study. All patients were randomized into either the control group (CG: 35 patients) that received traditional cognitive rehabilitation (CR) or the experimental group (EG: 35) undergoing VR. RESULTS The EG showed substantial improvements in various aspects of Multiple Sclerosis Quality of Life (MSQOL) between T0 and T1. Sexual function significantly improved, along with sexual satisfaction. Conversely, the CG achieved significant changes only in overall quality of life. Pearson's correlations highlighted the positive associations between sexual function and satisfaction, as well as with physical and mental well-being, underscoring the importance of improving sexual function as a marker of overall health. DISCUSSION This study is meant as exploratory as it addresses a fundamental yet overlooked aspect of rehabilitation, i.e., sexual function and sexual satisfaction, which could potentially be enhanced through rehabilitation in a VR environment. Registration DOI number: DOI 10.17605/OSF.IO/NB4MJ.
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Affiliation(s)
| | - Amelia Rizzo
- Department of Clinical and Experimental Medicine, University of Messina, Piazza Pugliatti, 1, 98122, Messina, Italy.
| | | | - Alfredo Manuli
- A.O.U. Policlinico "G. Martino", Via Consolare Valeria, 98124, Messina, Italy
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Pau M, Arippa F, Leban B, Porta M, Casu G, Frau J, Lorefice L, Coghe G, Cocco E. Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality. Bioengineering (Basel) 2024; 11:115. [PMID: 38391601 PMCID: PMC10886275 DOI: 10.3390/bioengineering11020115] [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: 12/25/2023] [Revised: 01/15/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired postural control (i.e., cybersickness). Since these symptoms can significantly impact the safety and tolerability of the treatment, it appears important to correctly estimate their presence and magnitude. Given the existing data scarcity, this study aims to assess the existence and severity of possible adverse effects associated with exposure to immersive VR in a cohort of pwMS using both objective measurements of postural control effectiveness and subjective evaluations of perceived symptoms. To this aim, postural sway under upright quiet posture (in the presence and absence of visual input) of 56 pwMS with an Expanded Disability Status Scale score (EDSS) in the range of 0-6.5 (mean EDSS 2.3) and 33 unaffected individuals was measured before and after a 10-min immersive VR session and at 10 min follow-up on the basis of center of pressure (COP) trajectories. The severity of cybersickness symptoms associated with VR exposure was also self-rated by the participants using the Italian version of the Simulator Sickness Questionnaire (SSQ). Temporary impairments of postural control in terms of significantly increased sway area were observed after the VR session only in pwMS with mild-moderate disability (i.e., EDSS in the range of 2.5-6.5) in the presence of visual input. No changes were observed in pwMS with low disability (EDSS 0-2) and unaffected individuals. In contrast, when the visual input was removed, there was a decrease in sway area (pwMS with mild-moderate disability) and COP path length relating to the use of VR (pwMS with mild-moderate disability and unaffected individuals), thus suggesting a sort of "balance training effect". Even in this case, the baseline values were restored at follow-up. All participants, regardless of their status, experienced significant post-VR side effects, especially in terms of blurred vision and nausea. Taken together, the findings of the present study suggest that a short immersive VR session negatively (eyes open) and positively (eyes closed) impacts the postural control of pwMS and causes significant disorientation. However, such effects are of limited duration. While it is reasonable to state that immersive VR is sufficiently safe and tolerable to not be contraindicated in the rehabilitation/training of pwMS, in order to reduce possible negative effects and maximize the efficacy, safety and comfort of the treatment, it appears necessary to develop specific guidelines that consider important factors like individual susceptibility, maximum exposure time according to the specific features of the simulation, posture to adopt and protocols to assess objective and perceived effects on participants.
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Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy
| | - Federico Arippa
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy
| | - Bruno Leban
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy
| | - Giulia Casu
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09123 Cagliari, Italy
| | - Jessica Frau
- Multiple Sclerosis Center, Binaghi Hospital, ASL Cagliari, 09123 Cagliari, Italy
| | - Lorena Lorefice
- Multiple Sclerosis Center, Binaghi Hospital, ASL Cagliari, 09123 Cagliari, Italy
| | - Giancarlo Coghe
- Multiple Sclerosis Center, Binaghi Hospital, ASL Cagliari, 09123 Cagliari, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Center, Binaghi Hospital, ASL Cagliari, 09123 Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, 09123 Cagliari, Italy
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Willingham TB, Stowell J, Collier G, Backus D. Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:79. [PMID: 38248542 PMCID: PMC10815484 DOI: 10.3390/ijerph21010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024]
Abstract
Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities. Therefore, there is great need for research and innovation focusing on the development of strategies to expand accessibility and promote participation in rehabilitation and exercise programs for people with disabilities. Here, we discuss how cutting-edge technologies related to telecommunications, wearables, virtual and augmented reality, artificial intelligence, and cloud computing are providing new opportunities to improve accessibility in rehabilitation and exercise for people with disabilities. In addition, we highlight new frontiers in digital health technology and emerging lines of scientific research that will shape the future of precision care strategies for people with disabilities.
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Affiliation(s)
- T. Bradley Willingham
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - Julie Stowell
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
- Department of Physical Therapy, Georgia State University, Atlanta, GA 30302, USA
| | - George Collier
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
| | - Deborah Backus
- Shepherd Center, Virginia C. Crawford Research Institute, Atlanta, GA 30309, USA (D.B.)
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10
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Sokołowska B. Being in Virtual Reality and Its Influence on Brain Health-An Overview of Benefits, Limitations and Prospects. Brain Sci 2024; 14:72. [PMID: 38248287 PMCID: PMC10813118 DOI: 10.3390/brainsci14010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/17/2023] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Dynamic technological development and its enormous impact on modern societies are posing new challenges for 21st-century neuroscience. A special place is occupied by technologies based on virtual reality (VR). VR tools have already played a significant role in both basic and clinical neuroscience due to their high accuracy, sensitivity and specificity and, above all, high ecological value. OBJECTIVE Being in a digital world affects the functioning of the body as a whole and its individual systems. The data obtained so far, both from experimental and modeling studies, as well as (clinical) observations, indicate their great and promising potential, but apart from the benefits, there are also losses and negative consequences for users. METHODS This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework across electronic databases (such as Web of Science Core Collection; PubMed; and Scopus, Taylor & Francis Online and Wiley Online Library) to identify beneficial effects and applications, as well as adverse impacts, especially on brain health in human neuroscience. RESULTS More than half of these articles were published within the last five years and represent state-of-the-art approaches and results (e.g., 54.7% in Web of Sciences and 63.4% in PubMed), with review papers accounting for approximately 16%. The results show that in addition to proposed novel devices and systems, various methods or procedures for testing, validation and standardization are presented (about 1% of articles). Also included are virtual developers and experts, (bio)(neuro)informatics specialists, neuroscientists and medical professionals. CONCLUSIONS VR environments allow for expanding the field of research on perception and cognitive and motor imagery, both in healthy and patient populations. In this context, research on neuroplasticity phenomena, including mirror neuron networks and the effects of applied virtual (mirror) tasks and training, is of interest in virtual prevention and neurogeriatrics, especially in neurotherapy and neurorehabilitation in basic/clinical and digital neuroscience.
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Affiliation(s)
- Beata Sokołowska
- Bioinformatics Laboratory, Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
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Yuenyongchaiwat K, Boonkawee T, Pipatsart P, Tavonudomgit W, Sermsinsaithong N, Songsorn P, Charususin N, Harnmanop S, Namdaeng P, Kulchanarat C, Thanawattano C. Effects of virtual exercise on cardio-pulmonary performance and depression in cardiac rehabilitation phase I: A randomized control trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2066. [PMID: 38009369 DOI: 10.1002/pri.2066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/03/2023] [Accepted: 11/12/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND Cardiac rehabilitation is recommended for patients undergoing open-heart surgery (OHS). During the hospital admission, these patients suffer from reduced cardiopulmonary performance and decreased psychological health, leading to poor physical function, depression, and morbidity. To prevent post-operative pulmonary complications, a pre and post-operative physical therapy intervention is recommended for patients undergoing heart surgery. Virtual reality (VR) promotes the health status of healthy individuals and those with health conditions. However, few studies have reported the beneficial effects of VR exercise programs on the pulmonary performance and mental health status of patients undergoing OHS. OBJECTIVES To determine whether by using training enhanced by VR, patients who have undergone OHS can more effectively attain cardiopulmonary performance and improve depression than through conventional physical therapy. METHOD 60 participants were randomly assigned to a conventional physical therapy and VR exercise program. Each session was conducted once daily until discharge from the hospital. Cardiorespiratory performance and depression were evaluated before surgery and at the time of discharge from the hospital. A two-way mixed ANOVA was performed to compare within (i.e., pre and post-operation) and between (i.e., VR and conventional physical therapy) groups. RESULTS No significant cardiopulmonary performance gains were detected in patients receiving the VR exercise program when compared with those who participated in conventional physical therapy prior to post-operative OHS (p > 0.05). However, the conventional physical therapy group showed significantly higher depression scores than the VR group (∆4.00 ± 0.98 vs. ∆1.68 ± 0.92). However, cardiopulmonary performance did not differ in both VR exercise and conventional physical therapy.
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Affiliation(s)
- Kornanong Yuenyongchaiwat
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
- Thammasat University Research Unit for Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat University, Khlong Nueng, Thailand
| | - Tunchanok Boonkawee
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
| | - Phansaporn Pipatsart
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
| | - Wararat Tavonudomgit
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
| | - Natsinee Sermsinsaithong
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
| | - Preyaphorn Songsorn
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
- Thammasat University Research Unit for Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat University, Khlong Nueng, Thailand
| | - Noppawan Charususin
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
- Thammasat University Research Unit for Physical Therapy in Respiratory and Cardiovascular Systems, Thammasat University, Khlong Nueng, Thailand
| | - Somrudee Harnmanop
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
| | - Phuwarin Namdaeng
- Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Khlong Nueng, Thailand
| | - Chitima Kulchanarat
- Physical Therapy Center, Thammasat University Hospital, Khlong Nueng, Thailand
| | - Chusak Thanawattano
- National Science and Technology Development Agency (NSTDA), Khlong Nueng, Thailand
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Pinarello C, Elmers J, Inojosa H, Beste C, Ziemssen T. Management of multiple sclerosis fatigue in the digital age: from assessment to treatment. Front Neurosci 2023; 17:1231321. [PMID: 37869507 PMCID: PMC10585158 DOI: 10.3389/fnins.2023.1231321] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Fatigue is one of the most disabling symptoms of Multiple Sclerosis (MS), affecting more than 80% of patients over the disease course. Nevertheless, it has a multi-faceted and complex nature, making its diagnosis, evaluation, and treatment extremely challenging in clinical practice. In the last years, digital supporting tools have emerged to support the care of people with MS. These include not only smartphone or table-based apps, but also wearable devices or novel techniques such as virtual reality. Furthermore, an additional effective and cost-efficient tool for the therapeutic management of people with fatigue is becoming increasingly available. Virtual reality and e-Health are viable and modern tools to both assess and treat fatigue, with a variety of applications and adaptability to patient needs and disability levels. Most importantly, they can be employed in the patient's home setting and can not only bridge clinic visits but also be complementary to the monitoring and treatment means for those MS patients who live far away from healthcare structures. In this narrative review, we discuss the current knowledge and future perspectives in the digital management of fatigue in MS. These may also serve as sources for research of novel digital biomarkers in the identification of disease activity and progression.
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Affiliation(s)
- Chiara Pinarello
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Julia Elmers
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technical University of Dresden, Dresden, Germany
| | - Hernán Inojosa
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technical University of Dresden, Dresden, Germany
| | - Tjalf Ziemssen
- Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany
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Behrouz Jazi AH, Rasti J, Etemadifar M. Balance rehabilitation for patients with Multiple Sclerosis using a Kinect®-based virtual training program. J Clin Neurosci 2023; 116:104-111. [PMID: 37683420 DOI: 10.1016/j.jocn.2023.08.026] [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: 04/19/2023] [Revised: 08/22/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND Patients with multiple sclerosis (MS) often experience balance issues during physical activities. Traditional rehabilitation exercises such as stretching, resistance, and aerobic training have been found to be effective, but can be repetitive and tedious, leading to reduced patient motivation and adherence. Furthermore, direct supervision by a therapist is not always possible. METHODS The aim of this study was to develop and evaluate the effectiveness of a virtual training program incorporating visual feedback from the Kinect® sensor in male patients with multiple sclerosis. Forty-five participants, with an age range of 22-56 years (mean age = 39), were randomly assigned to one of three equal groups, including two experimental groups and one control group. The experimental groups participated in eight-week exercise interventions, with each session lasting 20 to 30 min and occurring three times per week. In contrast, the control group received no interventions. Within the experimental groups, one was exposed to conventional balance exercises, whereas the other engaged in the proposed virtual training program. Both of these groups undertook three balance exercises, namely the single-foot stance, lunge maneuvers, and arm/leg stretching routines. The assessment encompassed diverse facets of balance, including parameters of 10 Meter Walk Time, Berg Balance Scale, Static Balance Score, and Time-Up and Go Scale, as well as the quality of life, gauged through the Multiple Sclerosis Quality of Life (MSQOL)-54 Questionnaire. The effect of test variables was investigated using analysis of covariance (ANCOVA), while the independent samples t-test was used to check for significant differences among the groups. The effects of the groups were compared using a paired samples t-test. RESULTS The findings revealed that both rehabilitation programs positively affected the dependent variables compared to the control group. However, the significant difference between the pre-test and post-test scores of the experimental groups indicated the effectiveness of the proposed program compared to the traditional method. CONCLUSIONS Entertaining virtual training programs utilizing visual feedback can be effective for rehabilitating patients with MS. The proposed method enables patients to perform rehabilitation exercises at home with high motivation, while accurate information about the treatment process are provided to the therapist.
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Affiliation(s)
| | - Javad Rasti
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran.
| | - Masoud Etemadifar
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
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14
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Faraclas E. Interventions to Improve Quality of Life in Multiple Sclerosis: New Opportunities and Key Talking Points. Degener Neurol Neuromuscul Dis 2023; 13:55-68. [PMID: 37744305 PMCID: PMC10517677 DOI: 10.2147/dnnd.s395733] [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: 05/20/2023] [Accepted: 09/05/2023] [Indexed: 09/26/2023] Open
Abstract
Background Today, living well with multiple sclerosis (MS) is often measured by a person's overall quality of life rather than being limited to the more traditional metrics of reduced frequency of relapses or progression of disability. This change in focus, to a more holistic view of health, such as overall quality of life, has shifted the views of what both providers and people with multiple sclerosis view as essential for living well with MS. Purpose This narrative review aims to examine the relevant literature on existing and emerging non-pharmacological interventions shown to improve the quality of life for people with multiple sclerosis across all health domains. Methods A literature search was conducted on MEDLINE, CINAHL, and Scopus electronic databases using the following search terms: quality of life, health-related quality of life, life quality, life satisfaction, non-pharmacological intervention, non-drug, and intervention. After screening the abstracts, 24 were selected for this review. Results Common non-pharmacological interventions were used for fatigue and sleep, mental and emotional health, cognition, physical health, and chronic pain. Several non-pharmacological interventions included in this review positively improved the overall quality of life for people with multiple sclerosis. These interventions included exercise, cognitive behavior therapy, and cognitive rehabilitation. Conclusion Non-pharmacological interventions such as exercise and cognitive behavioral therapy improve the quality of life for people with MS. These interventions should be prescribed more during routine medical care. Translating this research into standard clinical practice should be one area of focus. In addition, higher quality studies, such as randomized control trials, need to be conducted on emerging nonpharmacological interventions to assess effectiveness.
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Affiliation(s)
- Erin Faraclas
- Physical Therapy Department, Johnson & Wales University, Providence, RI, USA
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15
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Yangöz ŞT, Turan Kavradım S, Özer Z. The effects of virtual reality-based exercise in adults receiving haemodialysis treatment: A systematic review and meta-analysis of randomized controlled studies. Appl Psychol Health Well Being 2023; 15:1182-1217. [PMID: 36584408 DOI: 10.1111/aphw.12426] [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: 07/13/2022] [Accepted: 11/28/2022] [Indexed: 12/31/2022]
Abstract
This meta-analysis aimed to synthesize the effects of virtual reality-based exercise on physical function, depression symptoms and quality of life in adults receiving haemodialysis. Data were analysed using Comprehensive Meta-Analysis Version 3. The random-effects meta-analysis was performed to pool intervention effects. A total of five studies were included. The majority of included studies compared intervention with passive control group. This meta-analysis showed with a moderate to high quality of evidence that virtual reality-based exercise has positive medium effect on improving physical function such as gait speed (g = .40, 95% CI 0.00 to 0.81), sit to stand 10 times (g = -.41, 95% CI -0.825 to -0.009), sit to stand in 60 s (g = .56, 95% CI 0.151 to 0.974), 6-min walk test (g = .66, 95% CI 0.247 to 1.079), not affect time up and go and sit to stand five times. The study indicated with moderate quality of evidence that virtual reality-based exercise had no effect on depression symptoms. The study also showed with a moderate quality of evidence that the intervention had a positive medium effect on improving physical function (g = .64, 95% CI 0.20 to 1.09). In conclusion, virtual reality-based exercise can be performed to improve physical function and quality of life of adults receiving haemodialysis for health professionals.
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Affiliation(s)
- Şefika Tuğba Yangöz
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Pamukkale University, Denizli, Turkey
| | - Selma Turan Kavradım
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Zeynep Özer
- Department of Internal Medicine Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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16
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Toker E, Gökduman Keleş M. The effect of virtual reality on fetal movement, fetal heart rate, maternal satisfaction, fatigue, and anxiety levels and vital signs of pregnant women during non-stress test: A randomized controlled trial. Health Care Women Int 2023; 45:765-781. [PMID: 37347556 DOI: 10.1080/07399332.2023.2223159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Abstract
The study was conducted to investigate the effect of virtual reality on fetal movement, fetal heart rate, maternal satisfaction, fatigue and anxiety levels. The data of this randomized control experimental design study were collected using the State Anxiety Inventory, the Visual Analogue for Fatigue and the Newcastle-Satisfaction-Nursing-Care-Scale. A total of 88 pregnant women were included in the study. While the pregnant women in the experimental group watched a nature video with virtual reality during the Non-Stress Test procedure, those in the control group underwent the routine Non-Stress Test. The anxiety scores, the maternal satisfaction scores significantly higher in the experimental group. The virtual reality application is effective in reducing fatigue. There was a significant difference only in the experimental group in terms of systolic blood pressure, pulse values, the number of fetal movements and accelerations. It is recommended to have pregnant women use virtual reality during the Non-Stress Test procedure.
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Affiliation(s)
- Eylem Toker
- Department of Midwifery, Faculty of Health Sciences, Tarsus University, Tarsus/Mersin, Turkey
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Pau M, Cocco E, Arippa F, Casu G, Porta M, Menascu S, Achiron A, Kalron A. An Immersive Virtual Kitchen Training System for People with Multiple Sclerosis: A Development and Validation Study. J Clin Med 2023; 12:jcm12093222. [PMID: 37176662 PMCID: PMC10179608 DOI: 10.3390/jcm12093222] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/19/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Rehabilitation via virtual reality (VR) training tools allows repetitive, intensive, and task-specific practice in a controlled and safe environment. Our goal was to develop and validate a novel immersive VR system based on the practice of real-life activities in a kitchen environment in people with multiple sclerosis (pwMS) with upper-limb dysfunction. The novel immersive VR kitchen application includes several tasks, i.e., tidying up the kitchen, preparing a hamburger and soup meal, and dish washing. Following the development phase, the system was tested for an 8-week intervention period on a small sample of pwMS suffering from upper-limb dysfunction. The Suitability Evaluation Questionnaire for VR systems served as the primary outcome. The scores for enjoyment, sense of comfort with the system, feelings of success and control, realism, easy-to-understand instructions, assists in rehabilitation therapy, were between 4.0 and 4.6, indicating a high satisfaction. The scores for eye discomfort, dizziness, nausea, and disorientation during practice were between 2.8 and 1.3, indicating a low-to-moderate interference of the system. The virtual kitchen training system is feasible and safe for upper-limb training in pwMS and paves the way for future RCTs to examine the benefits of the system compared with standard care, thus improving the functionality of the upper limbs in pwMS.
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Affiliation(s)
- Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliary, Italy
| | - Eleonora Cocco
- Multiple Sclerosis Centre, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Federico Arippa
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliary, Italy
| | - Giulia Casu
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliary, Italy
| | - Micaela Porta
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, 09124 Cagliary, Italy
| | - Shay Menascu
- Multipe Sclerosis Center, Sheba Medical Center, Tel-Hashomer 52621, Israel
| | - Anat Achiron
- Multipe Sclerosis Center, Sheba Medical Center, Tel-Hashomer 52621, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
- Sagol School of Neurocience, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Alon Kalron
- Multipe Sclerosis Center, Sheba Medical Center, Tel-Hashomer 52621, Israel
- Sagol School of Neurocience, Tel-Aviv University, Tel-Aviv 69978, Israel
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
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Cortés-Pérez I, Osuna-Pérez MC, Montoro-Cárdenas D, Lomas-Vega R, Obrero-Gaitán E, Nieto-Escamez FA. Virtual reality-based therapy improves balance and reduces fear of falling in patients with multiple sclerosis. a systematic review and meta-analysis of randomized controlled trials. J Neuroeng Rehabil 2023; 20:42. [PMID: 37041557 PMCID: PMC10088228 DOI: 10.1186/s12984-023-01174-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/03/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVE This study aims to conduct a meta-analysis to assess the effect of virtual reality-based therapy (VRBT) on balance dimensions and fear of falling in patients with multiple sclerosis (PwMS). Secondarily, to determine the most recommendable dose of VRBT to improve balance. METHODS PubMed Medline, Web of Science, Scopus, CINAHL and PEDro were screened, without publication date restrictions, until September 30th, 2021. Randomized controlled trials (RCTs) comparing the effectiveness of VRBT against other interventions in PwMS were included. Functional and dynamic balance, confidence of balance, postural control in posturography, fear of falling and gait speed were the variables assessed. A meta-analysis was performed by pooling the Cohen's standardized mean difference (SMD) with 95% confidence interval (95% CI) using Comprehensive Meta-Analysis 3.0. RESULTS Nineteen RCTs, reporting 858 PwMS, were included. Our findings reported that VRBT is effective in improving functional balance (SMD = 0.8; 95%CI 0.47 to 1.14; p < 0.001); dynamic balance (SMD = - 0.3; 95%CI - 0.48 to - 0.11; p = 0.002); postural control with posturography (SMD = - 0.54; 95%CI - 0.99 to - 0.1; p = 0.017); confidence of balance (SMD = 0.43; 95%CI 0.15 to 0.71; p = 0.003); and in reducing fear of falling (SMD = - 1.04; 95%CI - 2 to - 0.07; p = 0.035); but not on gait speed (SMD = - 0.11; 95%CI: - 0.35 to 0.14; p = 0.4). Besides, the most adequate dose of VRBT to achieve the greatest improvement in functional balance was at least 40 sessions, five sessions per week and 40-45 min per sessions; and for dynamic balance, it would be between 8 and 19 weeks, twice a week and 20-30 min per session. CONCLUSION VRBT may have a short-term beneficial role in improving balance and reducing fear of falling in PwMS.
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Affiliation(s)
- Irene Cortés-Pérez
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas, s/n, Jaén, Spain
| | | | | | - Rafael Lomas-Vega
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas, s/n, Jaén, Spain
| | - Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas, s/n, Jaén, Spain.
| | - Francisco Antonio Nieto-Escamez
- Center for Neuropsychological Assessment and Neurorehabilitation (CERNEP), University of Almería, Almería, Spain
- Department of Psychology, University of Almería, Ctra. Sacramento, s/n, La Cañada, Almería, Spain
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Duan H, Jing Y, Li Y, Lian Y, Li J, Li Z. Rehabilitation treatment of multiple sclerosis. Front Immunol 2023; 14:1168821. [PMID: 37090712 PMCID: PMC10117641 DOI: 10.3389/fimmu.2023.1168821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/27/2023] [Indexed: 04/09/2023] Open
Abstract
Multiple sclerosis is a slowly progressive disease, immunosuppressants and other drugs can delay the progression and progression of the disease, but the most patients will be left with varying degrees of neurological deficit symptoms, such as muscle weakness, muscle spasm, ataxia, sensory impairment, dysphagia, cognitive dysfunction, psychological disorders, etc. From the early stage of the disease to the stage of disease progression, professional rehabilitation treatment can reduce the functional dysfunction of multiple sclerosis patients, improve neurological function, and reduce family and social burdens. With the development of various new rehabilitation technologies such as transcranial magnetic stimulation, virtual reality technology, robot-assisted gait, telerehabilitation and transcranial direct current stimulation, the advantages of rehabilitation therapy in multiple sclerosis treatment have been further established, and more treatment means have also been provided for patients.
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The Influence of Conventional and Innovative Rehabilitation Methods on Brain Plasticity Induction in Patients with Multiple Sclerosis. J Clin Med 2023; 12:jcm12051880. [PMID: 36902665 PMCID: PMC10003891 DOI: 10.3390/jcm12051880] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/15/2023] [Accepted: 02/25/2023] [Indexed: 03/08/2023] Open
Abstract
Physical rehabilitation and physical activity are known non-pharmacological methods of treating multiple sclerosis. Both lead to an improvement in physical fitness in patients with movement deficits while improving cognitive function and coordination. These changes occur through the induction of brain plasticity. This review presents the basics of the induction of brain plasticity in response to physical rehabilitation. It also analyzes the latest literature evaluating the impact of traditional physical rehabilitation methods, as well as innovative virtual reality-based rehabilitation methods, on the induction of brain plasticity in patients with multiple sclerosis.
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Stavrou VT, Vavougios GD, Kalogiannis P, Tachoulas K, Touloudi E, Astara K, Mysiris DS, Tsirimona G, Papayianni E, Boutlas S, Hassandra M, Daniil Z, Theodorakis Y, Gourgoulianis KI. Breathlessness and exercise with virtual reality system in long-post-coronavirus disease 2019 patients. Front Public Health 2023; 11:1115393. [PMID: 36908417 PMCID: PMC9996282 DOI: 10.3389/fpubh.2023.1115393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Long-post-coronavirus disease-2019 (COVID-19) patients tend to claim residual symptomatology from various systems, most importantly the respiratory and central nervous systems. Breathlessness and brain fog are the main complaints. The pulmonary function pattern is consistent with restrictive defects, which, in most cases, are self-resolved, while the cognitive profile may be impaired. Rehabilitation is an ongoing field for holistic management of long-post-COVID-19 patients. Virtual reality (VR) applications may represent an innovative implementation of rehabilitation. We aimed to investigate the effect of exercise with and without the VR system and to assess further breathlessness and functional fitness indicators in long-post-COVID-19 patients with mild cognitive impairment after self-selected exercise duration using the VR system. Twenty long-post-COVID-19 patients were enrolled in our study (age: 53.9 ± 9.1 years, male: 80%, body mass index: 28.1 ± 3.1 kg/m2). Participants' anthropometric data were recorded, and they underwent pulmonary functional test evaluation as well as sleep quality and cognitive assessment. The participants randomly exercised with and without a VR system (VR vs. no-VR) and, later, self-selected the exercise duration using the VR system. The results showed that exercise with VR resulted in a lower dyspnea score than exercise without VR. In conclusion, VR applications seem to be an attractive and safe tool for implementing rehabilitation. They can enhance performance during exercise and benefit patients with both respiratory and cognitive symptoms.
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Affiliation(s)
- Vasileios T. Stavrou
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- *Correspondence: Vasileios T. Stavrou ✉
| | - George D. Vavougios
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, Faculty of Medicine, University of Cyprus, Lefkosia, Cyprus
| | - Periklis Kalogiannis
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos Tachoulas
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Evlalia Touloudi
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Kyriaki Astara
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, 417 Army Equity Fund Hospital, Medical Institution Military Shareholder Fund (NIMTS), Athens, Greece
| | | | - Glykeria Tsirimona
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eirini Papayianni
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Stylianos Boutlas
- Department of Respiratory Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Mary Hassandra
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Zoe Daniil
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Respiratory Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece
| | - Konstantinos I. Gourgoulianis
- Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly, Larissa, Greece
- Department of Respiratory Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
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22
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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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23
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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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Montoro-Cárdenas D, Cortés-Pérez I, Ibancos-Losada MDR, Zagalaz-Anula N, Obrero-Gaitán E, Osuna-Pérez MC. Nintendo ® Wii Therapy Improves Upper Extremity Motor Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12343. [PMID: 36231643 PMCID: PMC9566093 DOI: 10.3390/ijerph191912343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Nintendo® Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We aimed primarily to elucidate the effectiveness of NWT in improving UE motor and functional impaired abilities in children with CP, compared to conventional therapy or no intervention. The secondary aim was to assess if NWT is more effective when used alone or combined with conventional therapy. METHODS A systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science, and CINHAL, ending in October 2021, in accordance with PRISMA guidelines. We included randomized controlled trials that compared NWT vs. conventional therapy or no intervention in terms of their impact on different UE impaired abilities (grip strength, tip grip strength, UE dissociated movements, functional capacity in daily living activities, gross and fine motor dexterity, and grasping ability) in children with CP. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). RESULTS Nine studies (276 participants) were included. NWT is more effective than conventional therapy at improving grip strength (SMD = 0.5, 95% CI 0.08, 0.91), tip grip strength (SMD = 0.95, 95% CI 0.3, 1.61), and grasping ability (SMD = 0.72, 95%CI 0.14, 1.3). NWT is more effective than conventional therapy at improving functional capacity in daily living activities (SMD = 0.83, 95% CI 0.07, 1.56). For fine manual dexterity, NWT was better than no intervention (SMD = 3.12, 95% CI 1.5, 4.7). CONCLUSIONS Our results indicate that NWT is effective at improving various UE impaired motor skills in children with CP.
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25
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Effects of immersive virtual reality on upper limb function in subjects with multiple sclerosis: A cross-over study. Mult Scler Relat Disord 2022; 65:104004. [DOI: 10.1016/j.msard.2022.104004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/19/2022]
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26
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Obrero-Gaitán E, Cortés-Pérez I, Calet-Fernández T, García-López H, López Ruiz MDC, Osuna-Pérez MC. Digital and Interactive Health Interventions Minimize the Physical and Psychological Impact of Breast Cancer, Increasing Women's Quality of Life: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:4133. [PMID: 36077670 PMCID: PMC9454975 DOI: 10.3390/cancers14174133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 12/24/2022] Open
Abstract
Digital and interactive health interventions (DIHIs), such as virtual-reality-based therapy (VRBT) and smartphone-app-based therapy (SABT), may be useful for reducing the impact of the signs and symptoms of breast cancer (BC) in women. The aim of this meta-analysis was to explore the effect of DIHIs on improving pain, anxiety, depression, quality of life (QoL), and upper extremity (UE) disability-related lymphedema in women with BC. METHODS We searched PubMed Medline, Web of Science, Scopus, CINAHL, Physiotherapy Evidence Database, and SciELO for the period ending February 2022. We included studies that assessed the effect of DIHIs on UE motor disability, pain, anxiety, depression, and QoL in women with BC. The effect size was calculated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI). RESULTS Twenty studies providing data from 1613 women with BC were included. With respect to UE disability, DIHIs increased flexion (SMD, 1.92; 95%CI: -1.16, 2.68), abduction (SMD, 1.66; 95%CI: 0.91, 2.42), external rotation shoulder range of motion (SMD, 1.1; 95%CI: 0.36, 1.85), UE function (SMD, -0.72; 95%CI: -1.31, -0.13), and handgrip strength (SMD, 0.4; 95%CI: 0.21, 0.59). DIHIs reduced pain (SMD, -0.8; 95%CI: -1.31, -0.26), anxiety (SMD, -1.02; 95%CI: -1.71, -0.34), and depression (SMD, -1.57; 95%CI: -3.1, -0.08). Finally, DIHIs increased overall health (SMD, 0.6; 95%CI: 0.31, 0.89). CONCLUSIONS Right at the end of therapy, DIHIs are effective at improving UE function, pain, anxiety, depression, and QoL in women with BC. VRBT has a greater effect than SABT for the assessed outcomes.
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Affiliation(s)
- Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain
| | | | - Héctor García-López
- Physical Therapy and Medicine, Department of Nursing, University of Almeria, Road Sacramento s/n, 04120 Almeria, Spain
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Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature. Cancers (Basel) 2022; 14:cancers14133163. [PMID: 35804933 PMCID: PMC9264833 DOI: 10.3390/cancers14133163] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
Rehabilitation plays a crucial role in cancer care, as the functioning of cancer survivors is frequently compromised by impairments that can result from the disease itself but also from the long-term sequelae of the treatment. Nevertheless, the current literature shows that only a minority of patients receive physical and/or cognitive rehabilitation. This lack of rehabilitative care is a consequence of many factors, one of which includes the transportation issues linked to disability that limit the patient’s access to rehabilitation facilities. The recent COVID-19 pandemic has further shown the benefits of improving telemedicine and home-based rehabilitative interventions to facilitate the delivery of rehabilitation programs when attendance at healthcare facilities is an obstacle. In recent years, researchers have been investigating the benefits of the application of virtual reality to rehabilitation. Virtual reality is shown to improve adherence and training intensity through gamification, allow the replication of real-life scenarios, and stimulate patients in a multimodal manner. In our present work, we offer an overview of the present literature on virtual reality-implemented cancer rehabilitation. The existence of wide margins for technological development allows us to expect further improvements, but more randomized controlled trials are needed to confirm the hypothesis that VRR may improve adherence rates and facilitate telerehabilitation.
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THE EFFECT OF VIRTUAL REALITY-BASED THERAPY ON FEAR OF FALLING IN MULTIPLE SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. Mult Scler Relat Disord 2022; 63:103791. [DOI: 10.1016/j.msard.2022.103791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/25/2022] [Accepted: 04/01/2022] [Indexed: 11/19/2022]
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