Offering Outworld Experiences to In-Patients With Dementia Through Virtual Reality: Mixed Methods Study

Background

Research has suggested that institutionalization can increase the behavioral and psychological symptoms of dementia. To date, recent studies have reported a growing number of successful deployments of virtual reality for people with dementia to alleviate behavioral and psychological symptoms of dementia and improve quality of life. However, virtual reality has yet to be rigorously evaluated, since the findings are still in their infancy, with nonstatistically significant and inconclusive results.

Objective

Unlike prior works, to overcome limitations in the current literature, our virtual reality system was co-designed with people with dementia and experts in dementia care and was evaluated with a larger population of patients with mild to severe cases of dementia.

Methods

Working with 44 patients with dementia and 51 medical experts, we co-designed a virtual reality system to enhance the symptom management of in-patients with dementia residing in long-term care. We evaluated the system with 16 medical experts and 20 people with dementia.

Results

This paper explains the screening process and analysis we used to identify which environments patients would like to receive as an intervention. We also present the system's evaluation results by discussing their impact in depth. According to our findings, virtual reality contributes significantly to the reduction of behavioral and psychological symptoms of dementia, especially for aggressive, agitated, anxious, apathetic, depressive, and fearful behaviors.

Conclusions

Ultimately, we hope that the results from this study will offer insight into how virtual reality technology can be designed, deployed, and used in dementia care.

Single and Combined Effects of Preferred Music and Endpoint Knowledge on Jump Performance in Basketball Players

Both music and endpoint knowledge of exercise have been shown to independently influence exercise performance. However, whether these factors work as synergists or counteract one another during exercise is unknown. The purpose of this study was to determine the single and combined effect of listening to preferred music and types of endpoint knowledge on repeated countermovement jump (CMJ) test performance. Twenty-four (n = 24) current or previously competitive basketball players underwent CMJ testing under the following endpoint knowledge conditions: (1) unknown/no knowledge, (2) knowledge of the number of jumps, and (3) knowledge of exercise duration. For each of these, participants listened to either their preferred music or no music during the duration of testing. For the exercise portion, participants completed repeated CMJs where participants were encouraged to jump as high as possible with jump height, contact time, and flight time as outcomes. Rate of perceived exertion (RPE) and feeling scale were measured before and after exercise. The results showed that, regardless of knowledge type, preferred music resulted in a significant decrease in both contact time and flight time (F ≥ 10.4, p ≤ 0.004, and η_p² ≥ 0.35), and a significant improvement of jump height (F = 11.36, p = 0.001, and η_p² = 0.09) and feeling scale ratings (F = 36.9, p < 0.001, and η_p² = 0.66) compared to no-music condition, while RPE was not significantly affected. Regardless of the presence of music, knowledge of the number of jumps and duration resulted in lower contact time (p < 0.001, 0.9 < d < 1.56) versus unknown condition during CMJs. Moreover, a significant decrease in RPE values was found during prior endpoint knowledge of number (p = 0.005; d = 0.72) and duration (p = 0.045; d = 0.63) compared to unknown condition. However, feeling scale ratings were not significantly affected. Moreover, no interactions with significance findings were found for any parameters. Overall, data suggest that listening to music and endpoint knowledge alter exercise responses in basketball players, but they do not interact with one another.

Characterizing cardiac autonomic dynamics of fear learning in humans

Understanding transient dynamics of the autonomic nervous system during fear learning remains a critical step to translate basic research into treatment of fear-related disorders. In humans, it has been demonstrated that fear learning typically elicits transient heart rate deceleration. However, classical analyses of heart rate variability (HRV) fail to disentangle the contribution of parasympathetic and sympathetic systems, and crucially, they are not able to capture phasic changes during fear learning. Here, to gain deeper insight into the physiological underpinnings of fear learning, a novel frequency-domain analysis of heart rate was performed using a short-time Fourier transform, and instantaneous spectral estimates extracted from a point-process modeling algorithm. We tested whether spectral transient components of HRV, used as a noninvasive probe of sympathetic and parasympathetic mechanisms, can dissociate between fear conditioned and neutral stimuli. We found that learned fear elicited a transient heart rate deceleration in anticipation of noxious stimuli. Crucially, results revealed a significant increase in spectral power in the high frequency band when facing the conditioned stimulus, indicating increased parasympathetic (vagal) activity, which distinguished conditioned and neutral stimuli during fear learning. Our findings provide a proximal measure of the involvement of cardiac vagal dynamics into the psychophysiology of fear learning and extinction, thus offering new insights for the characterization of fear in mental health and illness.

Effects of Small-Sided Games Training versus High-Intensity Interval Training Approaches in Young Basketball Players

This study aimed to investigate the effects of the 6-week small-sided games training (SSGs) vs. high-intensity interval training (HIIT) on the psychophysiological and performance responses, and technical skills of young basketball players. Thirty-two male players (age: 14.5 ± 0.5 years of age) were randomly divided into SSGs group (n = 16) and HIIT group (n = 16) training methods thrice per week for 6 weeks. The players in the SSGs group performed two 5-8 min of 2 vs. 2 with 2 min rest periods, while the players in HIIT performed 12-18 min of runs at intensities (90 to 95%) related to the velocity obtained in the 30-15 intermittent fitness test (IFT). Pre-testing and post-testing sessions involved assessments of Yo-Yo Intermittent Recovery Test level 1, 30-15 intermittent fitness test, 5 and 30 m sprint times, vertical jump height, repeated sprint ability, defensive and offensive agility, and technical skills. The SSGs group demonstrated significantly higher agility-based technical responses in terms of the control dribbling and shooting skills (d = 1.71 vs. 0.20, d = 1.41 vs. 0.35, respectively) compared with the HIIT group. Conversely, the HIIT induced greater improvements in 30 m sprint times (d = 3.15 vs. 0.68). These findings provided that SSGs in youth basketball players may allow similar positive physical adaptations to HIIT, with an extra advantage of improving technical skills while improving enjoyability.

The Effects of Exercise Order on the Psychophysiological Responses, Physical and Technical Performances of Young Soccer Players: Combined Small-Sided Games and High-Intensity Interval Training

This study aimed to compare the order effects of combined small-sided games (SSGs) and high-intensity interval training (HIIT) on the psychophysiological responses and physical and technical performances of young soccer players. Twenty-four soccer players (aged 14.63 ± 0.71 years) were randomly divided into SSGs + HIIT (n = 12) and HIIT + SSGs (n = 12) for 6 weeks. The SSGs consisted of two 4-16 min rounds of 2, 3, and four-a-side games with 2 min of passive resting, whereas the HIIT consisted of 6-10 min of high-intensity runs at varying intensities (from 90 to 100%). Pre-test and post-test elements included a 5-30 m sprint test, countermovement jump test, zigzag agility test with the ball and without the ball, repeated sprint ability test, speed dribbling ability test, three-corner run test, and Yo-Yo Intermittent Recovery Test level 1. Both combined training interventions produced similar improvements in physical performance and technical responses (p ≥ 0.05, d values ranging from 0.40 to 1.10). However, the combined HIIT + SSGs training produced meaningfully lower perceived exertion (p = 0.00, d = 2.98) and greater physical enjoyment (p = 0.00, d = 4.28) compared with the SSGs + HIIT intervention. Furthermore, the SSGs + HIIT group showed a higher training load than those from the HIIT + SSGs group for all weeks (p ≤ 0.05, d values ranging from 1.36 to 2.05). The present study's results might be used by coaches and practitioners to design training programmes for youth soccer players.

Effect of Coach Encouragement on the Psychophysiological and Performance Responses of Young Tennis Players

This study aimed to compare the effects of coach encouragement during the on-court tennis training drills (OTDs) on the psychophysiological and performance responses of young tennis players. Twenty-five young male tennis players (14.0 ± 0.3 years of age) performed six bouts of each of the four common OTDs; Star, Suicide, Box and Big X (30:60 s; 1:2 work to rest ratio). The heart rate (HR) and total distance covered were monitored using two portable multivariable integrated 10 Hz GPS monitoring devices during all OTDs, and the rating of perceived exertion (RPE-10) and short form Physical Activity Enjoyment Scale (PACES) values were determined after each OTDs bout. The results demonstrated that OTDs with coach encouragement induced significantly higher psychophysiological and performance responses compared to OTDs without coach encouragement (p < 0.05). The results of this study confirm that coach encouragement improves the intensity, performance and physical enjoyment level during OTDs. These findings might inform training practices in youth tennis players in order to improve tennis performance.

Comparison of the effect of typical firefighting activities, live fire drills and rescue operations at height on firefighters' physiological responses and cognitive function

This study examined the impact of various types of firefighting activities on firefighters' physiological responses and cognitive function. Each firefighter was engaged in three conditions: (1) Live-fire activities (LFA), (2) Typical firefighting activities (TFA), and (3) Rescue operations at height (ROH). The effects of various types of firefighting activities on the physiological responses and cognitive function were evaluated by heart rate (HR), temporal artery temperature (TT), and the correct response (CR) on a cognitive test. The results indicated that, compared to the baseline, physiological response increased, while information processing performance decreased after the activity. Furthermore, HR and TT were significantly lower at the end of the firefighting activity in the LFA (149.33 bpm; 38.08 °C) compared with the TFA (152.22 bpm; 38.17 °C) and ROH (159.28 bpm; 38.24 °C) conditions. Also, CR was significantly higher at the end of the activity in the LFA and TFA compared with the ROH condition. The results showed that rescue at height was more intensive than the other firefighting tasks in decreasing physiological and cognitive function capacity after the experiment. Practitioner Summary: We assumed that various types of firefighting activities would have different effects on physiological and cognitive functions during firefighting activities. The Findings suggest that rescue at height operations, performed without the use of special protective equipment, was more influential than other firefighting duties in changing firefighters' physiological and cognitive capacity. Abbreviations: CR: correct response; LFA: live-fire activities; TFA: typical firefighting activities; ROH: rescue operations at height; HR: heart rate; TT: temporal artery tempearture; PASAT: pased auditory serila addition teat; FPC: firefighting protective clothing.

Altered reward processing in pathological computer gamers--ERP-results from a semi-natural gaming-design

INTRODUCTION

Internet Gaming Disorder has been added as a research diagnosis in section III for the DSM-V. Previous findings from neuroscientific research indicate an enhanced motivational attention toward cues related to computer games, similar to findings in substance-related addictions. On the other hand in clinical observational studies tolerance effects are reported by patients with Internet Gaming disorder. In the present study we investigated whether an enhanced motivational attention or tolerance effects are present in patients with Internet Gaming Disorder.

METHODS

A clinical sample from the Outpatient Clinic for Behavioral Addictions in Mainz, Germany was recruited, fulfilling the diagnostic criteria for Internet Gaming Disorder. In a semi-natural EEG design participants played a computer game during the recording of event-related potentials to assess reward processing.

RESULTS

The results indicated an attenuated P300 for patients with Internet Gaming Disorder in response to rewards in comparison to healthy controls, while the latency of N100 was prolonged and the amplitude of N100 was increased.

CONCLUSIONS

Our findings support the hypothesis that tolerance effects are present in patients with Internet Gaming Disorder, when actively playing computer games. In addition, the initial orienting toward the gaming reward is suggested to consume more capacity for patients with Internet Gaming Disorder, which has been similarly reported by other studies with other methodological background in disorders of substance-related addictions.

Music and Autonomic Nervous System (Dys)function

Despite a wealth of evidence for the involvement of the autonomic nervous system (ANS) in health and disease and the ability of music to affect ANS activity, few studies have systematically explored the therapeutic effects of music on ANS dysfunction. Furthermore, when ANS activity is quantified and analyzed, it is usually from a point of convenience rather than from an understanding of its physiological basis. After a review of the experimental and therapeutic literatures exploring music and the ANS, a "Neurovisceral Integration" perspective on the interplay between the central and autonomic nervous systems is introduced, and the associated implications for physiological, emotional, and cognitive health are explored. The construct of heart rate variability is discussed both as an example of this complex interplay and as a useful metric for exploring the sometimes subtle effect of music on autonomic response. Suggestions for future investigations using musical interventions are offered based on this integrative account.