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Maggio MG, Luca A, Cicero CE, Calabrò RS, Drago F, Zappia M, Nicoletti A. Effectiveness of telerehabilitation plus virtual reality (Tele-RV) in cognitive e social functioning: A randomized clinical study on Parkinson's disease. Parkinsonism Relat Disord 2024; 119:105970. [PMID: 38142630 DOI: 10.1016/j.parkreldis.2023.105970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Telemedicine could represent an emerging and innovative approach to support cognitive and behavioral rehabilitation reducing the overload of healthcare facilities, favoring home care therapy. The present study aimed to assess the potential efficacy of Tele-VR apps in enhancing cognitive performance and improving social skills in patients with Parkinson's disease (PD). METHODS Thirty-four patients with PD were included in the study. Patients were assigned to one of the following treatment groups: Experimental Group 1 (EG1) underwent a Tele-VR program using two cognitive rehabilitation applications (app) on smartphones (Neuronation-Brain Training and Train your Brain); Experimental Group 2 (EG2) received a Tele-VR program through one cognitive rehabilitation app (Neuronation-Brain Training) and one socio-cognitive rehabilitation App (The Sims) on smartphones; Active Control Group (aCG) performed a conventional training using pencil and paper exercises (Not-VR). RESULTS At the end of the study, the aCG and EG1 presented an improvement in the executive, attentional and visuospatial cognitive domains. Mood and subjective memory also improved in the EG1. Moreover, in the EG2 group, a significant improvement was found in all cognitive domains, including social cognition skills (theory of mind). The inter-group comparison showed that both EG1 and EG2 had significantly greater improvements than aCG in MoCA score. Finally, both EG1 and EG2 showed a higher improvement in the FAB score, as compared to the aCG. CONCLUSION Rehabilitation with smartphone apps could be more useful than conventional rehabilitation in improving cognitive and social cognition skills in patients with PD. Combining cognitive and social cognition training could improve the cognitive and affective domains, also aiding in the long-term maintenance of cognitive outcomes.
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Affiliation(s)
| | - Antonina Luca
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Calogero Edoardo Cicero
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | | | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, Catania, 95123, Italy
| | - Mario Zappia
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
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Maggio MG, Luca A, Calabrò RS, Drago F, Nicoletti A. Can mobile health apps with smartphones and tablets be the new frontier of cognitive rehabilitation in older individuals? A narrative review of a growing field. Neurol Sci 2024; 45:37-45. [PMID: 37702829 PMCID: PMC10761459 DOI: 10.1007/s10072-023-07045-8] [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: 06/18/2023] [Accepted: 08/26/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION A recent interesting field of application of telemedicine/e-health involved smartphone apps. Although research on mHealth began in 2014, there are still few studies using these technologies in healthy elderly and in neurodegenerative disorders. Thus, the aim of the present review was to summarize current evidence on the usability and effectiveness of the use of mHealth in older adults and patients with neurodegenerative disorders. METHODS This review was conducted by searching for recent peer-reviewed articles published between June 1, 2010 and March 2023 using the following databases: Pubmed, Embase, Cochrane Database, and Web of Science. After duplicate removal, abstract and title screening, 25 articles were included in the full-text assessment. RESULTS Ten articles assessed the acceptance and usability, and 15 articles evaluated the efficacy of e-health in both older individuals and patients with neurodegenerative disorders. The majority of studies reported that mHealth training was well accepted by the users, and was able to stimulate cognitive abilities, such as processing speed, prospective and episodic memory, and executive functioning, making smartphones and tablets valuable tools to enhance cognitive performances. However, the studies are mainly case series, case-control, and in general small-scale studies and often without follow-up, and only a few RCTs have been published to date. CONCLUSIONS Despite the great attention paid to mHealth in recent years, the evidence in the literature on their effectiveness is scarce and not comparable. Longitudinal RCTs are needed to evaluate the efficacy of mHealth cognitive rehabilitation in the elderly and in patients with neurodegenerative disorders.
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Affiliation(s)
- Maria Grazia Maggio
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy
| | - Antonina Luca
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy
| | | | - Filippo Drago
- Department of Biomedical and Biotechnological Sciences, Biological Tower, School of Medicine, University of Catania, Via S. Sofia 97, 95123, Catania, Italy
| | - Alessandra Nicoletti
- Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Catania, Italy.
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Maggio MG, Billeri L, Cardile D, Quartarone A, Calabrò RS. The Role of Innovation Technology in the Rehabilitation of Patients Affected by Huntington's Disease: A Scoping Review. Biomedicines 2023; 12:39. [PMID: 38255146 PMCID: PMC10813604 DOI: 10.3390/biomedicines12010039] [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: 11/22/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Huntington's disease is an autosomal dominant neurodegenerative disease caused by the repetition of cytosine, adenine, and guanine trinucleotides on the short arm of chromosome 4p16.3 within the Huntingtin gene. In this study, we aim to examine and map the existing evidence on the use of innovations in the rehabilitation of Huntington's disease. A scoping review was conducted on innovative rehabilitative treatments performed on patients with Huntington's disease. A search was performed on PubMed, Embase, Web of Science, and Cochrane databases to screen references of included studies and review articles for additional citations. Of an initial 1117 articles, only 20 met the search criteria. These findings showed that available evidence is still limited and that studies generally had small sample sizes and a high risk of bias. Regarding cognitive rehabilitation, it has emerged that VR- and PC-based methods as well as NIBS techniques are feasible and may have promising effects in individuals with Huntington's disease. On the other hand, scarce evidence was found for cognitive and motor training that might have a slight impact on overall cognitive function in individuals with Huntington's disease. Data show that further investigation is needed to explore the effects of innovative rehabilitation tools on cognition, especially considering that cognitive and psychiatric symptoms can precede the onset of motor symptoms by many years.
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Affiliation(s)
| | | | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy; (M.G.M.); (L.B.)
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Chapman R, Zeissler ML, Meinert E, Mullin S, Whipps S, Whipps J, Hockey K, Hockey P, Carroll CB. Incorporating usability evaluation into iterative development of an online platform to support research participation in Parkinson's disease: a mixed methods protocol. BMJ Open 2023; 13:e078638. [PMID: 38114283 DOI: 10.1136/bmjopen-2023-078638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Many people with Parkinson's (PwP) are not given the opportunity or do not have adequate access to participate in clinical research. To address this, we have codeveloped with users an online platform that connects PwP to clinical studies in their local area. It enables site staff to communicate with potential participants and aims to increase the participation of the Parkinson's community in research. This protocol outlines the mixed methods study protocol for the usability testing of the platform. METHODS AND ANALYSIS We will seek user input to finalise the platform's design, which will then be deployed in a limited launch for beta testing. The beta version will be used as a recruitment tool for up to three studies with multiple UK sites. Usability data will be collected from the three intended user groups: PwP, care partners acting on their behalf and site study coordinators. Usability questionnaires and website analytics will be used to capture user experience quantitatively, and a purposive sample of users will be invited to provide further feedback via semistructured interviews. Quantitative data will be analysed using descriptive statistics, and a thematic analysis undertaken for interview data. Data from this study will inform future platform iterations. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Plymouth (3291; 3 May 2022). We will share our findings via a 'Latest News' section within the platform, presentations, conference meetings and national PwP networks.
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Affiliation(s)
- Rebecca Chapman
- Applied Parkinson's Research Group, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Marie-Louise Zeissler
- Applied Parkinson's Research Group, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Edward Meinert
- Centre for Health Technology, Faculty of Health, University of Plymouth, Plymouth, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Stephen Mullin
- Applied Parkinson's Research Group, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Sue Whipps
- Patient and Public Involvement (PPI) Representative, University of Plymouth, Plymouth, UK
| | - John Whipps
- Patient and Public Involvement (PPI) Representative, University of Plymouth, Plymouth, UK
| | - Kate Hockey
- Patient and Public Involvement (PPI) Representative, University of Plymouth, Plymouth, UK
| | - Philip Hockey
- Patient and Public Involvement (PPI) Representative, University of Plymouth, Plymouth, UK
| | - Camille B Carroll
- Applied Parkinson's Research Group, Faculty of Health, University of Plymouth, Plymouth, UK
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
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Duncan RP, Earhart GM. Remote Delivery of Allied Health Therapies in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2023:JPD230214. [PMID: 38007673 DOI: 10.3233/jpd-230214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Remote delivery of allied health therapies has long been possible, but adoption has been limited in some disciplines until relatively recently. The COVID-19 pandemic drove dramatic increases in use of remote delivery within allied health. This review summarizes the latest evidence on remotely-delivered physical therapy, occupational therapy, and speech therapy and discusses associated challenges and opportunities.
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Affiliation(s)
- Ryan P Duncan
- Washington University in St. Louis, School of Medicine, Program in Physical Therapy, St. Louis, MO, USA
- Washington University in St. Louis, School of Medicine, Department of Neurology, St. Louis, MO, USA
| | - Gammon M Earhart
- Washington University in St. Louis, School of Medicine, Program in Physical Therapy, St. Louis, MO, USA
- Washington University in St. Louis, School of Medicine, Department of Neurology, St. Louis, MO, USA
- Washington University in St. Louis, Department of Neuroscience, St. Louis, MO, USA
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Wang C, Kong J, Qi H. Areas of Research Focus and Trends in the Research on the Application of VR in Rehabilitation Medicine. Healthcare (Basel) 2023; 11:2056. [PMID: 37510497 PMCID: PMC10379147 DOI: 10.3390/healthcare11142056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE To establish the areas of research focus in the application of VR in rehabilitation medicine, analyze its themes and trends, and offer a reference for future related research in this field. METHODS This paper provides an in-depth analysis of the development process, areas of research focus, and research trends in the field of the application of VR in rehabilitation medicine, using the Web of Science core dataset as the source and using a bibliometric analysis with CiteSpace. RESULTS The application of VR in rehabilitation medicine was composed of three stages, and the research topics were reviewed from five perspectives: neurological rehabilitation, psychological treatment, pain distraction, cardiopulmonary rehabilitation, and visual-spatial disorder. LIMITATIONS The research data were sourced from the Web of Science core dataset only, and the data-sample size was not comprehensive. CONCLUSIONS Overcoming VR-technology-induced vertigo, mental disorders from the overuse of VR, individualized treatments, and integration with traditional therapy are all challenges in the application of VR in rehabilitation medicine that require research. In addition, developing VR products with better experiences, constructing standardized guidelines, and conducting more high-quality clinical studies are all future research topics related to the application of VR in rehabilitation medicine.
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Affiliation(s)
- Chen Wang
- Department of Health Informatics and Management, The School of Health Humanities, Peking University, Beijing 100191, China
| | - Jingqi Kong
- Department of Language and Culture in Medicine, The School of Health Humanities, Peking University, Beijing 100191, China
| | - Huiying Qi
- Department of Health Informatics and Management, The School of Health Humanities, Peking University, Beijing 100191, China
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