1
|
Brookman R, Hulm Z, Hearn L, Siette J, Mathew N, Deodhar S, Cass A, Smith J, Kenny B, Liu KPY, Harris CB. Evaluation of an exercise program incorporating an international cycling competition: a multimodal intervention model for physical, psychological, and social wellbeing in residential aged care. BMC Geriatr 2024; 24:435. [PMID: 38755554 PMCID: PMC11100139 DOI: 10.1186/s12877-024-05033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The transition into residential aged care is frequently associated with a reduction in physical activity, social engagement, and emotional wellbeing. Our aim was to evaluate the impact of a 26-day international cycling competition (Road Worlds Competition for Seniors), incorporating elements of exercise, audiovisual cycling footage, social engagement, and gamification, on the physical, psychological, and social well-being of aged care residents. We aimed to use findings to inform the development of a multi-modal intervention model to maximise wellbeing for older adults. METHODS Residents (N = 32) participated in a mixed-methods single-group intervention pilot study that compared pre-and post-competition measures for the following wellbeing domains; physical, psychological, and social. In addition, interviews were conducted with residents (n = 27) and staff (n = 6) to explore their experiences. RESULTS Measures identified significant improvements across multiple wellbeing domains, including functional fitness, depression, self-efficacy, and social network sizes. Findings from the interview data indicated that the multimodal components involved in the program delivery were valued by staff and residents who enjoyed the gamification, audiovisual cycling footage, social engagement, opportunities for reminiscence, and camaraderie between peers, staff, and volunteers. CONCLUSIONS Findings highlight a constellation of benefits across physical, psychological, and social domains of wellbeing and inform a model for innovative multidimensional programs in residential aged care. The benefits for residents with varying physical and cognitive abilities support the use of creative strategies that maximise inclusion and engagement for residents.
Collapse
Affiliation(s)
- Ruth Brookman
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia.
| | - Zac Hulm
- Harbison, 2 Charlotte St, Burradoo, NSW, 2576, Australia
| | - Leigh Hearn
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Joyce Siette
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Nitish Mathew
- Harbison, 2 Charlotte St, Burradoo, NSW, 2576, Australia
| | - Saili Deodhar
- Harbison, 2 Charlotte St, Burradoo, NSW, 2576, Australia
| | - Angela Cass
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Jamilla Smith
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Belinda Kenny
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Celia B Harris
- The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| |
Collapse
|
2
|
Latgé-Tovar S, Bertrand E, Piolino P, Mograbi DC. The use of virtual reality as a perspective-taking manipulation to improve self-awareness in Alzheimer's disease. Front Aging Neurosci 2024; 16:1376413. [PMID: 38725536 PMCID: PMC11079167 DOI: 10.3389/fnagi.2024.1376413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Lack of awareness of symptoms or having a condition referred to as anosognosia is a common feature of individuals with Alzheimer's Disease (AD). Previous literature on AD reported difficulties in evaluating self-abilities, often showing underestimation of limitations. There is increasing evidence that the perspective through which information is presented may moderate the performance appraisal and that anosognosia in AD might be a consequence of a deficit in assuming a third-person perspective. In this context, some studies showed that subjects may better recognize self-and other-difficulties when exposed to a third-person perspective. Considering the variety of approaches aiming to investigate the lack of awareness, there is still a scarcity of methods that provide great ecological validity and consider more than one facet of awareness, thus failing to offer more accurate evaluations of daily experiences. The present paper primarily addresses the theme of the multidimensional character of awareness of abilities in AD and the effect of perspective-taking on its trajectories. The focus turns to virtual reality as a promising tool for a greater evaluation of perspective-taking and self-awareness. Particularly, these systems offer the possibility to involve users in cognitive and sensorimotor tasks that simulate daily life conditions within immersive and realistic environments, and a great sense of embodiment. We propose that virtual reality might allow a great level of complexity, veracity, and safety that is needed for individuals with AD to behave according to their actual abilities and enable to explore the liaison between the subject's viewpoint, performance, and self-evaluation. In addition, we suggest promising clinical implications of virtual reality-based methods for individualized assessments, investigating specific impacts on subjects' life and possible improvements in their awareness.
Collapse
Affiliation(s)
- Sofia Latgé-Tovar
- Institute of Psychiatry - Center for Alzheimer’s Disease, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Elodie Bertrand
- Laboratoire Mémoire, Cerveau et Cognition (LMC), Institut de Psychologie, Université Paris Cité, Paris, France
| | - Pascale Piolino
- Laboratoire Mémoire, Cerveau et Cognition (LMC), Institut de Psychologie, Université Paris Cité, Paris, France
| | - Daniel C. Mograbi
- Institute of Psychiatry - Center for Alzheimer’s Disease, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, Brazil
- Institute of Psychiatry – Psychology and Neuroscience King’s College London, London, United Kingdom
| |
Collapse
|
3
|
Koh WQ, Heins P, Flynn A, Mahmoudi Asl A, Garcia L, Malinowsky C, Brorsson A. Bridging gaps in the design and implementation of socially assistive technologies for dementia care: the role of occupational therapy. Disabil Rehabil Assist Technol 2024; 19:595-603. [PMID: 35972877 DOI: 10.1080/17483107.2022.2111610] [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: 03/25/2022] [Revised: 07/06/2022] [Accepted: 08/05/2022] [Indexed: 10/15/2022]
Abstract
Dementia is a global health challenge, and people living with dementia (PLWD) are especially susceptible to reduced engagement in meaningful occupations, including social participation. In the past few decades, socially assistive technologies continue to be developed amidst a rapidly evolving technological landscape to support the social health of PLWD and their caregivers. Examples include social robots, virtual reality, smart home technology, and various digital technologies, such as mobile applications for tablets and smartphones. Despite an increasing body of research and interest in this field, several gaps relating to the design and implementation process of socially assistive technologies continue to undermine their relevance for PLWD in daily life. In this paper, some of these gaps are highlighted and the role of occupational therapy in the design and implementation of socially assistive technology is presented. In the design process, occupational therapists are uniquely skilled to advise and advocate for the tailoring and personalisation of technology to address the occupational needs of PLWD. In the implementation of socially assistive technologies, occupational therapists are skilled to educate, train, and conduct ongoing evaluations with PLWD and their caregivers, to incorporate socially assistive technologies into their routine and daily lives. We recommend that occupational therapists should continue to be acquainted with such technologies through continuous professional development and educational curricula. Moreover, we highlight the necessary collaboration between occupational therapists, technology developers, and researchers to enhance the process of designing and implementing socially assistive technology, so that their relevance for PLWD and their caregivers can be maximised.Implications for rehabilitationDevelopers and designers of socially assistive technology should consider the disease trajectory of different types of dementia, as well as the different needs, abilities, preferences, occupations and routines of people living with dementia (PLWD) and/or their caregivers.Collaborations between technology developers, researchers, and occupational therapists should take place iteratively throughout the process of designing and implementing socially assistive technology to maximise their relevance and applicability for people living with dementia and their caregivers.To continue enhancing the current role of occupational therapy in socially assistive technology provision, occupational therapists should keep up to date with socially assistive technology that are being developed to support the social health of PLWD.
Collapse
Affiliation(s)
- Wei Qi Koh
- School of Nursing and Midwifery, College of Nursing, Medicine and Health Sciences, National University of Ireland Galway, Galway, Ireland
| | - Pascale Heins
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | | | - Aysan Mahmoudi Asl
- Biomedical Research Institute of Salamanca, University of Salamanca, Salamanca, Spain
| | - Lesley Garcia
- Department of Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK
| | - Camilla Malinowsky
- Department of Neurobiology, Care Sciences and Society (NVS), Huddinge, Sweden
| | - Anna Brorsson
- Department of Neurobiology, Care Sciences and Society (NVS), Huddinge, Sweden
| |
Collapse
|
4
|
Li Y, Wilke C, Shiyanov I, Muschalla B. Impact of Virtual Reality-Based Group Activities on Activity Level and Well-Being Among Older Adults in Nursing Homes: Longitudinal Exploratory Study. JMIR Serious Games 2024; 12:e50796. [PMID: 38551635 PMCID: PMC11015370 DOI: 10.2196/50796] [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: 07/12/2023] [Revised: 10/27/2023] [Accepted: 02/02/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND In addition to illness, inactivity is a risk factor for high mortality in nursing homes. Using innovative technology, such as virtual reality (VR), for meaningful group activities could provide new opportunities for solving this problem. VR interventions have already been approved as a promising method for enhancing the health of older adults. OBJECTIVE In this study, we examined whether VR-based group activities can have a positive impact on activity level and group interaction among older adults living in nursing homes. METHODS We conducted a longitudinal study and provided VR interventions as a group activity once a week for 4 consecutive weeks in nursing homes. Participants were recruited based on the experience of the nursing staff members and the natural decisions of the older adults. Within a virtual cottage, designed according to the needs of the target group, older adults were able to perform daily tasks that they were no longer able to do in real life, such as gardening and making pizza. Overall, 2 psychologists measured the psychosocial capacities, activities of daily life, and well-being before and after the interventions using standardized instruments. RESULTS The results focus on a total of 84 older adults from 14 nursing homes who completed at least 3 VR interventions. The results indicate that several psychosocial capacities among the older adults improved, including adherence to regulations (P<.001; η²=0.122), flexibility (P<.001; η²=0.109), and group integration (P<.001; η²=0.141). Problems related to competence also showed a slight decrease (P=.04; η²=0.039). In addition, the VR intervention promoted their proactivity (P<.001; η²=0.104) and mobility (P=.04; η²=0.039). During the VR group intervention, older adults' well-being could be maintained at a high level. The results highlight the beneficial effects of VR intervention as a meaningful activity in nursing homes, showcasing the potential of VR applications in this setting. CONCLUSIONS This study provides a novel and naturalistic perspective, offering new insights into the use of VR in nursing homes. The VR intervention was well accepted and fulfilled the aim of enhancing capacity and well-being. It could be a meaningful group activity in nursing homes to improve social group interaction. To provide stronger evidence, randomized controlled trials are necessary.
Collapse
Affiliation(s)
- Yijun Li
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Institute of Psychology, Braunschweig, Germany
| | - Carlotta Wilke
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Institute of Psychology, Braunschweig, Germany
| | | | - Beate Muschalla
- Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Institute of Psychology, Braunschweig, Germany
| |
Collapse
|
5
|
McGhee WRG, Doherty CJ, Graham-Wisener L, Fallis R, Stone C, Axiaq A, Dempster M. Immersive virtual reality and psychological well-being in adult chronic physical illness: systematic review. BMJ Support Palliat Care 2024; 14:14-24. [PMID: 37848219 DOI: 10.1136/spcare-2023-004502] [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: 07/18/2023] [Accepted: 08/11/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION Individuals with chronic physical illness are at increased risk of negative psychological sequelae. Immersive virtual reality (VR) is an emerging treatment that might reduce these negative effects and increase quality of life in individuals with chronic physical illness. OBJECTIVE To systematically review literature examining the use of immersive VR in adult populations with chronic physical illness to understand: (1) how immersive VR is used to improve psychological well-being of adults with chronic physical illness (2) what effect this immersive VR has on the psychological well-being of adults with chronic physical illness. DESIGN Systematic literature review and meta-analysis. Searches of Ovid Medline/PubMed, PsycINFO, Embase, Web of Science and Scopus between July 1993 and March 2023 inclusive. RESULTS 12 811 texts were identified; 31 met the inclusion criteria. Relaxing and engaging immersive VR interventions were shown to be acceptable and feasible among adults with cancer, dementia, cardiovascular disease, kidney disease and multiple sclerosis. Many of the studies reviewed were feasibility or pilot studies and so the evidence about effectiveness is more limited. The evidence, mostly from studies of people with cancer, suggests that immersive VR can have a positive effects on anticipatory anxiety symptoms and pain. CONCLUSIONS Environment-based and game-based relaxing immersive VR offer novel interventions, with beneficial effects among people with cancer and, potentially, beneficial effects in those with other long-term physical illness.
Collapse
Affiliation(s)
| | | | | | | | | | - Ariana Axiaq
- Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Martin Dempster
- School of Psychology, Queen's University Belfast, Belfast, UK
| |
Collapse
|
6
|
Varma N, Han JK, Passman R, Rosman LA, Ghanbari H, Noseworthy P, Avari Silva JN, Deshmukh A, Sanders P, Hindricks G, Lip G, Sridhar AR. Promises and Perils of Consumer Mobile Technologies in Cardiovascular Care: JACC Scientific Statement. J Am Coll Cardiol 2024; 83:611-631. [PMID: 38296406 DOI: 10.1016/j.jacc.2023.11.024] [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: 11/01/2023] [Accepted: 11/16/2023] [Indexed: 02/08/2024]
Abstract
Direct-to-consumer (D2C) wearables are becoming increasingly popular in cardiovascular health management because of their affordability and capability to capture diverse health data. Wearables may enable continuous health care provider-patient partnerships and reduce the volume of episodic clinic-based care (thereby reducing health care costs). However, challenges arise from the unregulated use of these devices, including questionable data reliability, potential misinterpretation of information, unintended psychological impacts, and an influx of clinically nonactionable data that may overburden the health care system. Further, these technologies could exacerbate, rather than mitigate, health disparities. Experience with wearables in atrial fibrillation underscores these challenges. The prevalent use of D2C wearables necessitates a collaborative approach among stakeholders to ensure effective integration into cardiovascular care. Wearables are heralding innovative disease screening, diagnosis, and management paradigms, expanding therapeutic avenues, and anchoring personalized medicine.
Collapse
Affiliation(s)
- Niraj Varma
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA.
| | - Janet K Han
- Department of Cardiology, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA; Department of Cardiology, David Geffen School of Medicine at the University of California-Los Angeles, Los Angeles, California, USA
| | - Rod Passman
- Department of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lindsey Anne Rosman
- Division of Cardiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Hamid Ghanbari
- Department of Cardiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Peter Noseworthy
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Abhishek Deshmukh
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Prashanthan Sanders
- Department of Cardiology, University of Adelaide, South Australia, Australia
| | | | - Gregory Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University, and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
| | - Arun R Sridhar
- Department of Cardiology, Pulse Heart Institute, Seattle, Washington, USA; Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
| |
Collapse
|
7
|
Appel L, Appel E, Kisonas E, Lewis-Fung S, Pardini S, Rosenberg J, Appel J, Smith C. Evaluating the Impact of Virtual Reality on the Behavioral and Psychological Symptoms of Dementia and Quality of Life of Inpatients With Dementia in Acute Care: Randomized Controlled Trial (VRCT). J Med Internet Res 2024; 26:e51758. [PMID: 38289666 PMCID: PMC10865216 DOI: 10.2196/51758] [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: 08/11/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Virtual reality (VR) is increasingly considered a valuable therapeutic tool for people with dementia. However, rigorous studies are still needed to evaluate its impact on behavioral and psychological symptoms of dementia (BPSDs) and quality of life (QoL) across care settings. OBJECTIVE The primary aim of this study was to evaluate the impact of VR therapy on managing BPSDs, falls, length of stay, and QoL in inpatients with dementia admitted to an acute care hospital. The secondary aim was to evaluate the intervention's feasibility in terms of acceptability, safety, and patient experience. METHODS A prospective, open-label, mixed methods, randomized controlled clinical trial was conducted between April 2019 and March 2020. A total of 69 participants (aged ≥65 years with a diagnosis of dementia and who did not meet the exclusion criteria) were randomly assigned to either the control (n=35, 51%) or VR (n=34, 49%) arm. Participants in the experimental (VR) arm were visited by a researcher and watched 360° VR films on a head-mounted display for up to 20 minutes every 1 to 3 days, whereas individuals in the control arm received standard of care. Instances of daily BPSDs and falls were collected from nurses' daily notes. QoL was measured through semistructured interviews and the Quality of Life in Late-Stage Dementia scale. Structured observations and semistructured interviews were used to measure treatment feasibility. The primary outcomes were analyzed at a 95% significance level based on the intention-to-treat method. RESULTS VR therapy had a statistically significant effect on reducing aggressiveness (ie, physical aggression and loud vociferation; P=.01). Substantial impact of VR therapy was not found for other BPSDs (eg, apathy), falls, length of stay, or QoL as measured using the Quality of Life in Late-Stage Dementia scale. The average VR therapy session lasted 6.8 (SD 6.6; range 0-20) minutes, and the intervention was overall an acceptable and enjoyable experience for participants. No adverse events occurred as a result of VR therapy. CONCLUSIONS Immersive VR therapy appears to have an effect on aggressive behaviors in patients with dementia in acute care. Although the randomized controlled trial was stopped before reaching the intended sample size owing to COVID-19 restrictions, trends in the results are promising. We suggest conducting future trials with larger samples and, in some cases, more sensitive data collection instruments. TRIAL REGISTRATION ClinicalTrials.gov NCT03941119; https://clinicaltrials.gov/study/NCT03941119. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/22406.
Collapse
Affiliation(s)
- Lora Appel
- School of Health Policy and Management, Faculty of Health, York Universtiy, Toronto, ON, Canada
- OpenLab, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Michael Garron Hospital, Toronto, ON, Canada
| | - Eva Appel
- OpenLab, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Erika Kisonas
- OpenLab, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Samantha Lewis-Fung
- OpenLab, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | | | | - Julian Appel
- Ted Rogers School of Management, Toronto Metropolitan University, Toronto, ON, Canada
| | | |
Collapse
|
8
|
Zulkarnain AHB, Cao X, Kókai Z, Gere A. Self-Assessed Experience of Emotional Involvement in Sensory Analysis Performed in Virtual Reality. Foods 2024; 13:375. [PMID: 38338511 PMCID: PMC10855596 DOI: 10.3390/foods13030375] [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: 12/20/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Virtual reality (VR) technology has gained significant attention in various fields, including education for health professionals, sensory science, psychology, and consumer research. The first aim of the paper is to explore the self-assessed experience of emotional involvement in sensory analysis performed in VR. The Positive and Negative Affect Schedule (PANAS) is a widely used self-report measure that assesses positive and negative affective states. VR sensory analysis involves the use of immersive, interactive, and multi-sensory environments to evaluate sensory perception and emotional responses. By synthesizing relevant literature, this paper provides insights into the impact of VR on affective states, the effectiveness of VR in eliciting emotions, and the potential applications of the PANAS in VR sensory analysis. Furthermore, the second aim of the paper is to uncover the effect of VR sensory evaluation on the participant's emotional states, as it has a significant effect on their evaluations. The results suggest an increase in the sum of positive effects and a decrease in the negative ones. Although these results are promising, the relationship between the PANAS and VR sensory analysis is still underexplored, with limited research investigating the specific effects of VR on affective states measured using the PANAS. Further research is needed to better understand the potential of the PANAS in assessing emotional responses in VR environments and its implications for sensory analysis.
Collapse
Affiliation(s)
| | | | | | - Attila Gere
- Institute of Food Science and Technology, Hungarian University of Agriculture and Life Sciences, Villányi út. 29-31, H-1118 Budapest, Hungary; (A.H.B.Z.); (X.C.); (Z.K.)
| |
Collapse
|
9
|
Holloway H, Conroy B, Isbel S, D’Cunha NM. Immersive virtual reality in the promotion of health and well-being for people in residential aged care without cognitive impairment: A scoping review. Digit Health 2024; 10:20552076241249568. [PMID: 38680734 PMCID: PMC11055491 DOI: 10.1177/20552076241249568] [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: 01/25/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024] Open
Abstract
Objective Sustaining the health and well-being of older people living in residential aged care (RAC) requires new means of providing safe and stimulating recreational and therapeutic programs such as using virtual reality (VR). The aim of the scoping review was to investigate the utility of immersive VR interventions using head-mounted display technology to promote the health and well-being of people without cognitive impairment living in RAC. Method The following databases were searched from inception until January 2024: PubMed, PsycINFO, Scopus, Cochrane and CINAHL. The eligibility criteria were quantitative, qualitative or mixed methods studies published in English, conducted in RAC, using VR with head-mounted display with people without cognitive impairment. Results Of the 274 articles identified, 9 articles with a total of 310 residents and 50 staff met the inclusion criteria. Seven factors to either impede or enable the use of VR with head-mounted displays in RAC were: residents' agency; the nature of the VR experience; the content of the experience; the ease of use and comfort of the technology; the role of RAC staff; and the role of residents' family members. Conclusion Immersive VR has potential as a tool to promote the health and well-being of people without cognitive impairment living in RAC. Small sample sizes, variations in study design, and selection bias mean that generalisability of the results is limited. Further research is recommended to inform the design and implementation of immersive VR programs tailored specifically for this population.
Collapse
Affiliation(s)
- Helen Holloway
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australia
- Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Bruce, Australia
| | - Brenda Conroy
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australia
| | - Stephen Isbel
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australia
- Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Bruce, Australia
| | - Nathan M D’Cunha
- School of Rehabilitation and Exercise Sciences, Faculty of Health, University of Canberra, Bruce, Australia
- Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Bruce, Australia
| |
Collapse
|
10
|
Isbel S, Holloway H, Greber C, Nguyen K, Frost J, Pearce C, D’Cunha NM. Virtual reality after stroke: Identifying important characteristics when designing experiences to improve engagement in upper limb rehabilitation. Digit Health 2024; 10:20552076241251634. [PMID: 38817838 PMCID: PMC11138195 DOI: 10.1177/20552076241251634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 04/12/2024] [Indexed: 06/01/2024] Open
Abstract
Objective Virtual reality (VR) has been used to improve upper limb function after stroke but there is little to guide product developers in building experiences that engage users in the sustained, repetitive training required. This research sought to understand the characteristics of VR scenarios best suited to engaging someone with a stroke during recovery to achieve therapeutic outcomes. Methods Five creative immersive VR scenarios were designed by an experienced VR content creator containing unique combinations of VR characteristics. The usefulness of the scenarios was reviewed by expert clinicians experienced in stroke rehabilitation. Following this review, seven stroke survivors participated in each experience and reported on their engagement and motivation. Outcome measures were the User Satisfaction Evaluation Questionnaire and the modified Intrinsic Motivation Inventory. Semi-structured interviews were conducted with five participants following their immersive VR experience and analysed thematically. Results Expert clinicians reported potential therapeutic value in the immersive VR scenarios by providing opportunities for repeated and graded practice of upper limb movements. Stroke survivors reported varied levels of enjoyment and engagement for each scenario. They recommended changes to the experiences, primarily relating to the tailoring of the scenarios to match varied upper limb capacities. Conclusion This study highlights the characteristics of immersive VR scenarios that are important in sustaining motivation and providing high-repetition task-specific movement experiences. Differences in the experience and preferences of stroke participants regarding the characteristics of immersive VR experiences indicate that a variety of experiences are necessary to engage and sustain participation in an immersive VR-related therapy programme.
Collapse
Affiliation(s)
- Stephen Isbel
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Helen Holloway
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| | - Craig Greber
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Kelly Nguyen
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Jane Frost
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Claire Pearce
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
| | - Nathan M D’Cunha
- Faculty of Health, School of Exercise and Rehabilitation Sciences, University of Canberra, Canberra, ACT, Australia
- Faculty of Health, Centre for Ageing Research and Translation, University of Canberra, Bruce, ACT, Australia
| |
Collapse
|
11
|
Bolouki A. The impact of virtual reality natural and built environments on affective responses: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:73-89. [PMID: 36201684 DOI: 10.1080/09603123.2022.2130881] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
This study aims to evaluate the extent to which virtual reality (VR) natural and built settings affect emotional states. Web of Science, SCOPUS, and PubMed were searched for relevant articles prior to February 2022. Of 15 articles identified for systematic review, 6 met the inclusion criteria for meta-analysis (studies with only pre- and post-condition measures of the Positive and Negative Affect Schedule (PANAS) were included). Both positive affect (g = 0.20, p = 0.001) and negative affect (g = - 0.30, p = 0.001) change scores for the VR natural environment were statistically significant. On the other hand, change scores for VR built environment were not significant in both positive affect (g = - 0.08, p = 0.355) and negative affect (g = - 0.08, p = 0.058). The findings revealed that, in addition to a VR natural environment, a VR built environment is capable of providing restorative experiences against negative mood in some circumstances.
Collapse
Affiliation(s)
- Ahmad Bolouki
- Master of urban design, Tehran University of Art, Tehran, Iran
| |
Collapse
|
12
|
Baldimtsi E, Mouzakidis C, Karathanasi EM, Verykouki E, Hassandra M, Galanis E, Hatzigeorgiadis A, Goudas M, Zikas P, Evangelou G, Papagiannakis G, Bellis G, Kokkotis C, Tsatalas T, Giakas G, Theodorakis Y, Tsolaki M. Effects of Virtual Reality Physical and Cognitive Training Intervention On Cognitive Abilities of Elders with Mild Cognitive Impairment. J Alzheimers Dis Rep 2023; 7:1475-1490. [PMID: 38225966 PMCID: PMC10789285 DOI: 10.3233/adr-230099] [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: 08/03/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background Virtual reality (VR) technology has become increasingly used for assessment and intervention in the neuroscience field. Objective We aimed to investigate the effects of a VR Training System, named VRADA (VR Exercise App for Dementia and Alzheimer's Patients), on the cognitive functioning of older people with mild cognitive impairment (MCI). Methods In this intervention study, 122 older adults with MCI were randomly assigned to five groups (the VRADA group (n = 28), a bike group (n = 11), a physical exercise group (n = 24), a mixed group (physical and cognitive exercise) (n = 31), and a non-contact control group (n = 28). The VRADA group underwent 32 physical and cognitive training sessions, performed 2 or 3 times weekly for 12 weeks in the VR environment. All participants had detailed neuropsychological assessments before and after intervention. Results A series of linear regression models revealed that the VRADA group showed improvement or no deterioration in cognitive decline in global cognitive function (MMSE), verbal memory (Rey Auditory Verbal Learning Test and WAIS forward test), and executive functions, mental flexibility (Trail Making Test B). Conclusions This interventionstudy indicates that the VRADA system improves the cognitive function of elders with MCI.
Collapse
Affiliation(s)
- Eleni Baldimtsi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- 1st Department of Neurology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Christos Mouzakidis
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Maria Karathanasi
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
| | - Eleni Verykouki
- School of Medicine, Department of Hygiene, Social-Preventive Medicine and Medical Statistics, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Department of Agriculture, Crop Production and Rural Environment, School of Agricultural Sciences, University of Thessaly, Volos, Greece
| | - Mary Hassandra
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Evangelos Galanis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Marios Goudas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Paul Zikas
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - Giannis Evangelou
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
| | - George Papagiannakis
- ORamaVR S.A., Science and Technology Park of Crete, Heraklion, Crete, Greece
- Institute of Computer Science, Foundation for Research and Technology – Hellas (FORTH), University of Crete, Heraklion, Crete, Greece
| | - George Bellis
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Christos Kokkotis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Biomechanical Solutions Engineering (BME), Karditsa, Greece
| | - Themistoklis Tsatalas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Giannis Giakas
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Yannis Theodorakis
- School of Physical Education, Sport Science and Dietetics, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Magda Tsolaki
- Greek Association of Alzheimer’s Disease & Related Disorders, Alzheimer Hellas, Thessaloniki, Macedonia, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Building A, Greece
| |
Collapse
|
13
|
Catania V, Rundo F, Panerai S, Ferri R. Virtual Reality for the Rehabilitation of Acquired Cognitive Disorders: A Narrative Review. Bioengineering (Basel) 2023; 11:35. [PMID: 38247912 PMCID: PMC10813804 DOI: 10.3390/bioengineering11010035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
This review article explores the use of Virtual Reality (VR) technology in cognitive rehabilitation for individuals with neurological conditions, such as stroke, traumatic brain injury, and neurodegenerative diseases. The introduction highlights the challenges posed by cognitive impairments and the limitations of traditional rehabilitation methods. VR is presented as a transformative tool that immerses individuals in interactive environments, offering promising opportunities for enhancing cognitive functions and improving quality of life. This article covers the foundational principles of VR, its applications across different clinical conditions and cognitive domains, and evaluates empirical evidence supporting its efficacy. It also discusses the advantages, limitations, challenges, and ethical considerations in the use of VR for cognitive rehabilitation. This review concludes by exploring future developments, including advancements in VR technology, the integration of Augmented Reality (AR) and artificial intelligence (AI), and the importance of standardized assessment tools for the objective evaluation of rehabilitation outcomes.
Collapse
Affiliation(s)
| | | | | | - Raffaele Ferri
- Units of Psychology I.C. and Unit of Bioinformatics and Statistics, Oasi Research Institute-IRCCS, 94018 Troina, Italy; (V.C.); (F.R.); (S.P.)
| |
Collapse
|
14
|
Muurling M, de Boer C, Vairavan S, Harms RL, Chadha AS, Tarnanas I, Luis EV, Religa D, Gjestsen MT, Galluzzi S, Ibarria Sala M, Koychev I, Hausner L, Gkioka M, Aarsland D, Visser PJ, Brem AK. Augmented reality versus standard tests to assess cognition and function in early Alzheimer's disease. NPJ Digit Med 2023; 6:234. [PMID: 38110486 PMCID: PMC10728213 DOI: 10.1038/s41746-023-00978-6] [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: 05/17/2023] [Accepted: 11/29/2023] [Indexed: 12/20/2023] Open
Abstract
Augmented reality (AR) apps, in which the virtual and real world are combined, can recreate instrumental activities of daily living (IADL) and are therefore promising to measure cognition needed for IADL in early Alzheimer's disease (AD) both in the clinic and in the home settings. The primary aim of this study was to distinguish and classify healthy controls (HC) from participants with AD pathology in an early AD stage using an AR app. The secondary aims were to test the association of the app with clinical cognitive and functional tests and investigate the feasibility of at-home testing using AR. We furthermore investigated the test-retest reliability and potential learning effects of the task. The digital score from the AR app could significantly distinguish HC from preclinical AD (preAD) and prodromal AD (proAD), and preAD from proAD, both with in-clinic and at-home tests. For the classification of the proAD group, the digital score (AUCclinic_visit = 0.84 [0.75-0.93], AUCat_home = 0.77 [0.61-0.93]) was as good as the cognitive score (AUC = 0.85 [0.78-0.93]), while for classifying the preAD group, the digital score (AUCclinic_visit = 0.66 [0.53-0.78], AUCat_home = 0.76 [0.61-0.91]) was superior to the cognitive score (AUC = 0.55 [0.42-0.68]). In-clinic and at-home tests moderately correlated (rho = 0.57, p < 0.001). The digital score was associated with the clinical cognitive score (rho = 0.56, p < 0.001). No learning effects were found. Here we report the AR app distinguishes HC from otherwise healthy Aβ-positive individuals, both in the outpatient setting and at home, which is currently not possible with standard cognitive tests.
Collapse
Affiliation(s)
- Marijn Muurling
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands.
| | - Casper de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
| | - Srinivasan Vairavan
- Janssen Research & Development, LLC, 1125 Trenton Harbourton Road, Titusville, NJ, 08560, USA
| | | | | | - Ioannis Tarnanas
- Altoida Inc., Washington, DC, USA
- Trinity College Dublin, Global Brain Health Institute - GHBI, Dublin, Ireland
| | - Estefania Vilarino Luis
- Centre de la mémoire, Université de Genève (UNIGE), Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Dorota Religa
- Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Martha Therese Gjestsen
- Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Samantha Galluzzi
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Marta Ibarria Sala
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Lucrezia Hausner
- Central Institute for Mental Health, Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Mara Gkioka
- Alzheimer Hellas and Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh), Balkan Center, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dag Aarsland
- Centre for Age-related Medicine, Stavanger University Hospital, Stavanger, Norway
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Anna-Katharine Brem
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| |
Collapse
|
15
|
Drazich BF, McPherson R, Gorman EF, Chan T, Teleb J, Galik E, Resnick B. In too deep? A systematic literature review of fully-immersive virtual reality and cybersickness among older adults. J Am Geriatr Soc 2023; 71:3906-3915. [PMID: 37560978 DOI: 10.1111/jgs.18553] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/14/2023] [Accepted: 07/16/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Virtual reality technology holds great promise in improving the health and well-being of older adults; however, this technology is associated with potential risks that may outweigh the benefits. The purpose of this systematic review is to synthesize and critique the existing literature on fully-immersive virtual reality interventions for older adults and the associated risk of cybersickness. METHODS We searched eight databases for studies that utilized fully-immersive virtual reality, stated the population as older adults, provided outcomes related to cybersickness, and were written or translated into the English language. Our search generated 332 articles, 39 of which were selected for inclusion in this systematic synthesis and appraisal. RESULTS We found that the majority of studies utilized a one-time session. The studies generally had weak sample generalizability and methodological design, but strong data collection and participant retention. The studies nearly all used the Simulator Sickness Questionnaire to measure cybersickness, but the scoring for the Simulator Sickness Questionnaire varied or was not mentioned. Most included studies reported only minor cybersickness among older adult participants. CONCLUSION Researchers might conclude that the benefits of virtual reality interventions outweigh the risk of cybersickness in this population. Going forward, researchers should concentrate on the efficacy of virtual reality interventions among older adults, using larger samples and randomized controlled study design, along with measuring dosage effects.
Collapse
Affiliation(s)
- Brittany F Drazich
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Rachel McPherson
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Emily F Gorman
- Health Sciences and Human Services Library, University of Maryland, Baltimore, Maryland, USA
| | - Thomas Chan
- Health Equity Research and Education Center & Autonomy Research Center for STEAHM, California State University Northridge, Northridge, California, USA
| | - Jejomar Teleb
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Elizabeth Galik
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| | - Barbara Resnick
- School of Nursing, University of Maryland Baltimore, Baltimore, Maryland, USA
| |
Collapse
|
16
|
Vaillant-Ciszewicz AJ, Lantermino L, Quin C, Cuni A, Guerin O. [Setting up, running and evaluating NMIs as part of the "ageing well" project]. SOINS. GERONTOLOGIE 2023; 28:13-23. [PMID: 37977760 DOI: 10.1016/j.sger.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Non-drug interventions (NDIs) are recommended as a first-line treatment in gerontology to address the psychological and behavioral symptoms of dementia. This article illustrates the NMIs implemented, how they are carried out and how they are evaluated as part of the Bien vieillir project at Nice University Hospital.
Collapse
Affiliation(s)
| | | | - Cassandra Quin
- Projet Bien vieillir, Laboratoire CoBTeK EA 72-76, France
| | - Alice Cuni
- Projet Bien vieillir, Laboratoire CoBTeK EA 72-76, France
| | - Olivier Guerin
- Inserm U1081, IRCAN, CNRS UMR 7284, Université Côte-d'Azur, CHU de Nice, 4 avenue Reine-Victoria, 06000 Nice, Alpes-Maritimes, France
| |
Collapse
|
17
|
Tsertsidis A, Kolkowska E, Rapado I. Consumer direction in the field of digital technologies and people with dementia: a literature review. Disabil Rehabil Assist Technol 2023; 18:1364-1376. [PMID: 34927508 DOI: 10.1080/17483107.2021.2008529] [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: 02/09/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Digital technologies have a great potential to improve the quality of life of people with dementia. However, this group is usually not involved in their development and dissemination. A consumer-directed role in the delivery of digital technologies could allow this group to regain autonomy and certain independence. This article aims to conceptualise the components of the Consumer Direction theory in the context of digital technologies and people with dementia. METHOD A literature review was conducted. We searched for studies within the aforementioned context in five relevant databases, covering the years 2012-2020. Identified studies were screened and assessed for inclusion. The data were categorised using two-stage qualitative content analysis. RESULTS Forty articles were included. The results provide definitions of the four components of the Consumer Direction theory in the context of this study. Namely, what it means for people with dementia to be (1) in control of technology use, (2) offered a variety of technological options, (3) informed and supported regarding the use and training of digital technologies, and (4) actively participating in systems design. These can lead to the empowerment of people with dementia. CONCLUSION The four theoretical components of the Consumer Direction theory are conceptualised differently in the context of this study. By providing new definitions, this paper contributes to research and practice. We expect the definitions to be deployed by researchers, practitioners, and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia.Implications for rehabilitationDigital technologies have a great potential to improve the quality of life of people with dementia.A consumer-directed role in the delivery of digital technologies could empower people with dementia and give them the opportunity to take control over the offered services as well as maintain a degree of independence.The Consumer Direction theory and its components should be conceptualised differently in the context of digital technologies and people with dementia than in previous contexts that used the theory.The new definitions can be utilised by researchers, practitioners and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia.
Collapse
Affiliation(s)
| | - Ella Kolkowska
- Department of Informatics, Örebro University, Örebro, Sweden
| | - Irene Rapado
- Department of Philosophy, Linguistics and Theory of Science, Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
18
|
Lu Z, Wang W, Yan W, Kew CL, Seo JH, Ory M. The Application of Fully Immersive Virtual Reality on Reminiscence Interventions for Older Adults: Scoping Review. JMIR Serious Games 2023; 11:e45539. [PMID: 37801360 PMCID: PMC10589832 DOI: 10.2196/45539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/15/2023] [Accepted: 08/23/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The increasing number of older adults with mental, behavioral, and memory challenges presents significant public health concerns. Reminiscence is one type of nonpharmacological intervention that can effectively evoke memories, stimulate mental activities, and improve psychological well-being in older adults through a series of discussions on previous experiences. Fully immersive virtual reality (FIVR) may be a useful tool for reminiscence interventions because it uses realistic virtual environments connected to a person's significant past stories. OBJECTIVE This review aims to examine empirical evidence regarding the application of FIVR in reminiscence interventions, its usability and acceptability, and its effectiveness in assisting the intervention to achieve optimal outcomes. METHODS We followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach for scoping reviews. The PubMed, PsycINFO, Embase, CINAHL, Web of Science, ACM, and IEEE Xplore electronic databases were used for the search. We included peer-reviewed studies that used FIVR as an assistive tool for reminiscence interventions; were published between January 1, 2000, and August 1, 2022; reported empirical research; involved older adults as participants; and addressed health- and behavior-related outcomes or the feasibility and usability of FIVR. We used Endnote X9 to organize the search results and Microsoft Excel for data extraction and synthesis. RESULTS Of the 806 articles collected from the databases and other resources, 11 were identified. Most of the studies involved participants aged between 70 and 90 years. Only 1 study did not involve those with cognitive impairments, whereas 3 specifically targeted people living with dementia. The results indicated that FIVR reminiscence interventions enhanced engagement and reduced fatigue. Although some studies have observed positive effects on anxiety, apathy, depression, cognitive functions, and caregiver burden reduction, these findings were inconsistent across other research. In addition, FIVR showed overall usability and acceptability with manageable side effects among older adults across various health conditions during reminiscence sessions. However, 1 study reported adverse feelings among participants, triggered by unpleasant memories evoked by the virtual reality content. CONCLUSIONS The role of FIVR in reminiscence interventions remains nascent, with limited studies evaluating its impacts on older adults. Many of the reviewed studies had notable limitations: small sample sizes, absence of rigorous research design, limited assessment of long-term effects, lack of measures for health and behavior outcomes, and quality of life. Beyond these limitations, this review identified a list of future research directions in 6 categories. On the basis of the review findings, we provide practical recommendations to enhance FIVR reminiscence interventions, covering topics such as virtual reality content, device choice, intervention types, and the role and responsibility of facilitators.
Collapse
Affiliation(s)
- Zhipeng Lu
- Department of Architecture, Texas A&M University, College Station, TX, United States
| | - Wenjin Wang
- Department of Architecture, Texas A&M University, College Station, TX, United States
| | - Wei Yan
- Department of Architecture, Texas A&M University, College Station, TX, United States
| | - Chung Lin Kew
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Jinsil Hwaryoung Seo
- School of Performance, Visualization & Fine Arts, Texas A&M University, College Station, TX, United States
| | - Marcia Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
| |
Collapse
|
19
|
Zhang T, Liu W, Bai Q, Gao S. Virtual reality technology in the rehabilitation of post-stroke cognitive impairment: an opinion article on recent findings. Front Psychol 2023; 14:1271458. [PMID: 37849482 PMCID: PMC10577207 DOI: 10.3389/fpsyg.2023.1271458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/20/2023] [Indexed: 10/19/2023] Open
Affiliation(s)
- Ting Zhang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
- Department of Traditional Chinese Medicine, University Hospital, Zhejiang Normal University, Jinhua, China
| | - Wei Liu
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Qingping Bai
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Song Gao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| |
Collapse
|
20
|
Gómez-Cáceres B, Cano-López I, Aliño M, Puig-Perez S. Effectiveness of virtual reality-based neuropsychological interventions in improving cognitive functioning in patients with mild cognitive impairment: A systematic review and meta-analysis. Clin Neuropsychol 2023; 37:1337-1370. [PMID: 36416175 DOI: 10.1080/13854046.2022.2148283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
Objective: Increased prevalence of mild cognitive impairment (MCI) has led to a need for new neuropsychological intervention tools in this population. This meta-analysis aimed to learn about the efficacy of virtual reality (VR)-based neuropsychological interventions in improving cognitive functioning in patients with MCI. Method: This review followed the recommendations of the PRISMA statement, and it was registered in PROSPERO. The studies examined were collected from the PsycINFO, Web of Science, Pubmed/MEDLINE, Embase, Scopus, and Cochrane Library databases. Results: The systematic search yielded 258 articles, of which 13 randomized controlled trials were selected. VR-based neuropsychological interventions had moderate effects on global cognition (g = 0.30; 95% CI = 0.05, 0.56; p = 0.02), small effects on attention (g = 0.27; 95% CI = 0.04, 0.49; p = 0.02), and large effects on executive function (g = 0.60; 95% CI = 0.38, 0.81; p < 0.0001), but non-significant effects on working memory, episodic memory, language, or visuoconstruction. When the length of the intervention was considered, VR-based interventions of 15 or more hours had moderate effects on working memory (g = 0.55; 95% CI = 0.11, 0.99; p = 0.01), and large effects on language (g = 0.60; 95% CI = 0.01, 1.20; p = 0.05) and visuoconstruction (g = 1.13; 95% CI = 0.58, 1.67; p < 0.0001). Conclusions: Results suggest that VR-based interventions are beneficial for improving cognitive functioning in patients with MCI, and allow us to make recommendations that could have implications for clinical decision-making in this population.
Collapse
Affiliation(s)
| | - Irene Cano-López
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| | - Marta Aliño
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| | - Sara Puig-Perez
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
- VIU-NED Chair of Global Neuroscience and Social Change, Valencian International University, Valencia, Spain
- Research Group in Psychology and Quality of Life (PsiCal), Valencian International University, Valencia, Spain
| |
Collapse
|
21
|
Matsangidou M, Solomou T, Frangoudes F, Papayianni E, Pattichis CS. Offering Outworld Experiences to In-Patients With Dementia Through Virtual Reality: Mixed Methods Study. JMIR Aging 2023; 6:e45799. [PMID: 37656031 PMCID: PMC10501499 DOI: 10.2196/45799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/19/2023] [Accepted: 06/05/2023] [Indexed: 09/02/2023] Open
Abstract
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.
Collapse
Affiliation(s)
| | - Theodoros Solomou
- Department of Computer Science, University of Cyprus, Nicosia, Cyprus
| | - Fotos Frangoudes
- CYENS Centre of Excellence, Nicosia, Cyprus
- Department of Computer Science, University of Cyprus, Nicosia, Cyprus
| | - Ersi Papayianni
- Archangelos Michael Elderly People Nursing Home/Rehabilitation Centre for Patients with Alzheimer, Nicosia, Cyprus
| | - Constantinos S Pattichis
- CYENS Centre of Excellence, Nicosia, Cyprus
- Department of Computer Science, University of Cyprus, Nicosia, Cyprus
| |
Collapse
|
22
|
Beyene DA, Berha AB. Management Practice and Clinical Outcomes of Dementia in Sub-Saharan Africa: A Systematic Review. Behav Neurol 2023; 2023:2307443. [PMID: 37533682 PMCID: PMC10393511 DOI: 10.1155/2023/2307443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 06/03/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dementia is a severe neurodegenerative disorder and it is a group of acquired symptoms associated with impaired cognitive functions. In low-income settings particularly in Sub-Saharan Africa (SSA), it is often seen as part of normal aging. Environmental, behavioral, and lifestyle interventions have the potential to alter the disease course of dementia. Objective This study is aimed to synthesize the literature/evidence(s) on the management practice and treatment outcomes of dementia in SSA. Method Comprehensive literature was searched in PubMed database, Cochrane Library, and Google Scholar. Eligibility has been set, and based on the criteria, initially, a total of 442 results were obtained, and from those around 183 articles were duplicated. After examining titles and abstracts of records 26 articles were identified. Finally, five randomized clinical trials (RCT) and three prospective cohort studies that were reported on the management practice and treatment outcome of dementia in SSA were eligible for analysis. RCT and prospective cohort studies were used to strengthen the quality of evidence. The quality of the included RCT studies was assessed by using the Cochrane Risk of Bias Tool. Result A total of 2781 patient data were included in the final analysis. Of these, 2354 patients were obtained from 5 RCTs and 427 patients from 3 prospective cohort studies, which were conducted in SSA countries. RCT studies were done on the feasibility and clinical effectiveness of cognitive stimulation therapy (CST) showed improvements in language memory domains and physical health. In addition, studies that focus on the management of human immunodeficiency virus-associated dementia (HIVAD) were reported to improve neurocognitively. Conclusion CST is applicable in low-resource settings and it shows improvements in cognitive function and quality of life. Early initiation of combination antiretroviral therapy in resource-limited settings has been associated with improvement in the cognitive function of HIVAD.
Collapse
Affiliation(s)
- Dessale Abate Beyene
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Alemseged Beyene Berha
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
23
|
Kalantari S, Xu TB, Mostafavi A, Kim B, Dilanchian A, Lee A, Boot WR, Czaja SJ. Using Immersive Virtual Reality to Enhance Social Interaction Among Older Adults: A Cross-Site Investigation. Innov Aging 2023; 7:igad031. [PMID: 37213325 PMCID: PMC10198775 DOI: 10.1093/geroni/igad031] [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: 10/19/2022] [Indexed: 05/23/2023] Open
Abstract
Background and Objectives Virtual reality (VR) applications are increasingly being targeted toward older adults as a means to maintain physical and cognitive skills and to connect with others, especially during the coronavirus disease 2019 era. Our knowledge about how older adults interact with VR is limited, however, since this is an emerging area and the related research literature is still rather slim. The current study focused specifically on older adults' reactions to a social-VR environment, examining participant's views about the possibility of meaningful interactions in this format, the impacts of social-VR immersion on mood and attitude, and features of the VR environment that affected these outcomes. Research Design and Methods The researchers designed a novel social-VR environment with features intended to prompt conversation and collaborative problem-solving among older adults. Participants were recruited from 3 diverse geographic locations (Tallahassee, FL; Ithaca, NY; and New York City, NY), and were randomly assigned to a partner from one of the other sites for social-VR interaction. The sample consisted of 36 individuals aged 60 and older. Results Reactions to the social VR were quite positive. Older adults reported high levels of engagement in the environment and perceived the social VR to be enjoyable and usable. Perceived spatial presence was found to be a central driver of positive outcomes. A majority of the participants indicated a willingness to reconnect with their VR partner in the future. The data also identified important areas for improvement that were of concern to older adults, such as the use of more realistic avatars, larger controllers more suited to aging hands, and more time for training/familiarization. Discussion and Implications Overall, these findings suggest that VR can be an effective format for social engagement among older adults.
Collapse
Affiliation(s)
- Saleh Kalantari
- Human Centered Design, Cornell University, Ithaca, New York, USA
| | - Tong Bill Xu
- Human Centered Design, Cornell University, Ithaca, New York, USA
| | - Armin Mostafavi
- Human Centered Design, Cornell University, Ithaca, New York, USA
| | - Benjamin Kim
- Division of Geriatrics and Palliative Medicine, Center on Aging and Behavioral Research, Weill Cornell Medicine, New York City, New York, USA
| | - Andrew Dilanchian
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Angella Lee
- Human Centered Design, Cornell University, Ithaca, New York, USA
| | - Walter R Boot
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Sara J Czaja
- Division of Geriatrics and Palliative Medicine, Center on Aging and Behavioral Research, Weill Cornell Medicine, New York City, New York, USA
| |
Collapse
|
24
|
Chen Y, Hou L, Li Y, Lou Y, Li W, Struble LM, Yang H. Barriers and motivators to promotion of physical activity participation for older adults with mild cognitive impairment or dementia: An umbrella review. Int J Nurs Stud 2023; 143:104493. [PMID: 37105046 DOI: 10.1016/j.ijnurstu.2023.104493] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Due to the growing aging population worldwide, cognitive disorders including mild cognitive impairment and dementia is considered a major public health priority. Currently, physical activity is a promising non-drug therapy, however, people with mild cognitive impairment or dementia are more likely to be physically inactive. OBJECTIVE To identify the barriers and motivators affecting participation in physical activity in older people with mild cognitive impairment or dementia. DESIGN An umbrella review. METHODS The Joanna Briggs Institute (JBI) methodology for umbrella reviews was adopted in this study. We searched the PubMed, Embase, Web of science, CINAHL, Cochrane, Scopus and Proquest to identify relevant articles published in English from inception to October 2022. Two researchers independently screened and selected articles against preselected inclusion criteria. Eligible studies were appraised for methodological quality using the combined Meta Quality Appraisal Tool and Assessment of Multiple Systematic Reviews Tool. The Grading of Recommendations Assessment Development and Evaluation- Confidence in the Evidence from Reviews of Qualitative Research tool was employed to determine the confidence level in the evidence of the extracted factors. Theoretical Domain Framework (TDF) was used to map barriers and motivators to physical activity participation. Behavior change techniques (BCTs) was utilized to develop theoretically-informed implementation strategies. RESULTS Fourteen relevant reviews (covered over 219 primary studies) were included in this review. A total of 31 factors were identified from the selected reviews. Three factors with the strongest supporting evidence for their influence on participation were: resources/material resources, social support, and perceived competence. According to the behavior change techniques, six implementation strategies (providing supervision, developing tailored interventions, providing safe and promoting environment, helping to increase participants' motivation and adherence, integrating all kinds of social support, and providing suitable staffing) were developed. CONCLUSIONS The evidence presented in this umbrella review suggests that a multilevel stakeholder approach and a system-wide viewpoint should be adopted. Through the Theoretical Domain Framework, we not only identified construct factors for future interventions, but also revealed understudied fields in this research areas. This umbrella review generates data that is expected to inform the development of implementation strategies based on the intervention-mapping approach, which will promote participation in physical activity. REGISTRATION This study was registered with the PROSPERO (CRD42022371535).
Collapse
Affiliation(s)
- Yiping Chen
- School of Nursing, Shanxi Medical University, Shanxi Province, China; Department of Neurology, First Hospital of Shanxi Medical University, Shanxi Province, China
| | - Liyuan Hou
- School of Nursing, Shanxi Medical University, Shanxi Province, China; Department of Neurology, First Hospital of Shanxi Medical University, Shanxi Province, China
| | - Yao Li
- School of Nursing, Shanxi Medical University, Shanxi Province, China; Department of Neurology, First Hospital of Shanxi Medical University, Shanxi Province, China
| | - Yan Lou
- Hangzhou Normal University, Zhejiang Province, China
| | - Wei Li
- International Medical Department, Peking Union Medical College Hospital, Beijing, China
| | | | - Hui Yang
- Department of Nursing, First Hospital of Shanxi Medical University, Shanxi Province, China.
| |
Collapse
|
25
|
Marin AE, Redolat R, Gil-Gómez JA, Mesa-Gresa P. Addressing Cognitive Function and Psychological Well-Being in Chronic Kidney Disease: A Systematic Review on the Use of Technology-Based Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3342. [PMID: 36834042 PMCID: PMC9961918 DOI: 10.3390/ijerph20043342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 02/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
Patients with chronic kidney disease (CKD) are at risk of both a gradual decline in cognitive function and an increase in psychological distress. This includes symptoms of anxiety, depression, and sleep disturbances, all of which are factors that have been associated with increased morbidity and mortality. In response, we are now seeing that interventions based on new digital technologies are increasingly used in order to optimize patients' quality of life. Systematic research of the literature on electronic databases (MEDLINE/PubMed, Scopus, Web of Science, and PsycInfo/ProQuest) covering the period from 2012 to 2022 was conducted in order to methodically review the existing evidence regarding the implementation and effectiveness of technology-based interventions in the management of cognitive and psychological well-being symptoms in patients with CKD. A total of 739 articles were retrieved, 13 of which are included in the present review. All the studies focused on the usability, acceptability, and feasibility of technology-based interventions aimed at psychological symptoms, with no studies targeting cognitive functioning. Technology-based interventions offer feelings of safety, fun, and satisfaction, and they also have the potential to improve CKD patients' health outcomes regarding their psychological well-being. The diverseness of technologies allows an approximation towards the identification of those types of technologies most frequently used, as well as the symptoms targeted. There was considerable heterogeneity in the types of technologies used for interventions in so few studies, making it difficult to draw conclusive findings with regard to their efficiency. In order to adequately assess the technology-based health interventions effect, future lines of research should consider designing non-pharmacological treatments for the improvement of cognitive and psychological symptoms in this type of patient.
Collapse
Affiliation(s)
- Alexandra-Elena Marin
- Department of Psychobiology, Faculty of Psychology and Logopedics, Universitat de València, 46010 Valencia, Spain
| | - Rosa Redolat
- Department of Psychobiology, Faculty of Psychology and Logopedics, Universitat de València, 46010 Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Patricia Mesa-Gresa
- Department of Psychobiology, Faculty of Psychology and Logopedics, Universitat de València, 46010 Valencia, Spain
| |
Collapse
|
26
|
Panerai S, Catania V, Rundo F, Tasca D, Musso S, Babiloni C, Prestianni G, Muratore S, Ferri R. Functional Living Skills in Patients with Major Neurocognitive Disorder Due to Degenerative or Non-Degenerative Conditions: Effectiveness of a Non-Immersive Virtual Reality Training. SENSORS (BASEL, SWITZERLAND) 2023; 23:1896. [PMID: 36850494 PMCID: PMC9966630 DOI: 10.3390/s23041896] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/26/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
Virtual reality has gained attention as an effective tool for cognitive, motor, and daily activity rehabilitation in patients with major neurocognitive disorder (M-NCD). The first objective of this study was to check for differences between M-NCD caused by degenerative and non-degenerative conditions (DC and NDC, respectively) in terms of relearning four functional living skills (FLSs), by means of a non-immersive virtual reality training (VRT). The second purpose was to verify whether spontaneous transfer from the virtual environment to the real environment occurred. Four FLS apps were developed in our institute (Information, Suitcase, Medicine, and Supermarket). A nonrandomized interventional study was carried out, comparing experimental and control groups (EG and CG, respectively). The study included three phases: in vivo test at T1; VRT at T2 only for EG; in vivo test at T3. During the in vivo test, the four FLSs were assessed in their natural environments. Both EG-DC and EG-NDC significantly improved in all of the VRT variable scores (the EG-NDC group seemed to show better outcomes than the EG-DC group). Moderate-to-high satisfaction with the VRT was reported. EG-DC and EG-NDC also enhanced their performances in the in vivo test. No statistically significant differences between them were found. CG-DC and CG-NDC improved only in the execution time of Information in the in vivo test. These findings confirm the ecological validity of VRT for FLSs.
Collapse
Affiliation(s)
- Simonetta Panerai
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Valentina Catania
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Francesco Rundo
- Unit of Bioinformatics and Statistics, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Domenica Tasca
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Sabrina Musso
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Stefano Muratore
- Unit of Psychology I.C., Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Raffaele Ferri
- Unit of Neurology I.C., Oasi Research Institute-IRCCS, 94018 Troina, Italy
| |
Collapse
|
27
|
Matsangidou M, Solomou T, Frangoudes F, Ioannou K, Theofanous P, Papayianni E, Pattichis CS. Affective Out-World Experience via Virtual Reality for Older Adults Living with Mild Cognitive Impairments or Mild Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2919. [PMID: 36833616 PMCID: PMC9957279 DOI: 10.3390/ijerph20042919] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
Older adults with cognitive impairments may face barriers to accessing experiences beyond their physical premises. Previous research has suggested that missing out on emotional experiences may affect mental health and impact cognitive abilities. In recent years, there has been growing research interest in designing non-pharmacological interventions to improve the health-related quality of life of older adults. With virtual reality offering endless opportunities for health support, we must consider how virtual reality can be sensitively designed to provide comfortable, enriching out-world experiences to older adults to enhance their emotional regulation. Thirty older adults living with mild cognitive impairment or mild dementia participated in the study. Affect and emotional behavior were measured. The usability and the sense of presence were also assessed. Finally, we assessed the virtual reality experiences based on physiological responses and eye-tracking data. The results indicated that virtual reality can positively enhance the mental health of this population by eliciting a positive affective state and enhancing their emotional regulation. Overall, this paper raises awareness of the role of virtual reality in emotion elicitation, regulation, and expression and enhances our understanding of the use of virtual reality by older adults living with mild cognitive impairments or mild dementia.
Collapse
Affiliation(s)
| | - Theodoros Solomou
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| | | | - Konstantinos Ioannou
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| | - Panagiotis Theofanous
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| | - Ersi Papayianni
- Archangelos Michael Elderly People Nursing Home/Rehabilitation Centre for Patients with Alzheimer (AMEN), Nicosia 1022, Cyprus
| | - Constantinos S. Pattichis
- CYENS Center of Excellence, Nicosia 1016, Cyprus
- Department of Computer Science, School of Natural & Applied Sciences, University of Cyprus, Nicosia 1678, Cyprus
| |
Collapse
|
28
|
Restout J, Bernache-Assollant I, Morizio C, Boujut A, Angelini L, Tchalla A, Perrochon A. Fully Immersive Virtual Reality Using 360° Videos to Manage Well-Being in Older Adults: A Scoping Review. J Am Med Dir Assoc 2023; 24:564-572. [PMID: 36758621 DOI: 10.1016/j.jamda.2022.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/20/2022] [Accepted: 12/31/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The development of negative behavioral and psychosocial factors (depression, anxiety, apathy, etc) is associated with poor well-being, which can contribute to health issues in ageing, especially in the context of COVID-19. Despite its relative novelty, fully immersive virtual reality (VR) interventions through 360° immersive videos are becoming more accessible and flexible and constitute an emerging method to potentially enhance well-being. The aim of this scoping review is to assess the effectiveness of 360° interventions on well-being in older adults with or without cognitive impairment, as well as cybersickness and attitudes toward this technology. DESIGN Scoping review. SETTING AND PARTICIPANTS Older adults with or without cognitive impairment. METHODS The PRISMA-SR guideline was followed. Four databases were used, and we selected articles published until April 2022. We have analyzed the effect of 360° videos on the well-being of older adults with respect to the study design, the population, the contents, the duration of intervention, and the outcomes. RESULTS A total of 2262 articles were screened, of which 10 articles were finally included in this review. Most of them are pilot studies and used mixed methods including scales and interviews. The material and content of VR are diversified. Many behavioral and psychological outcomes were assessed, including anxiety, apathy, loneliness, depression, social engagement, quality of life, and emotions. The results were positive or mixed, according to the outcomes. We recorded few adverse events, and the interviews show contrasting results concerning the participants' feelings (ie, degree of immersion, familiarity with technology, and VR content). CONCLUSIONS AND IMPLICATIONS The use of VR 360° videos seems feasible in community-dwelling older adults or residential aged care facilities, as they are safe and provide enjoyment. It constitutes an emerging and promising therapeutic tool to manage psychosocial disorders. This review provides key considerations for the design and implementation of interventions using VR 360° video in clinical practice.
Collapse
Affiliation(s)
- J Restout
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | | | - C Morizio
- Université de Limoges, HAVAE, UR20217, Limoges, France
| | - A Boujut
- Université de Limoges, HAVAE, UR20217, Limoges, France; 3iL Groupe, Limoges, France
| | - L Angelini
- School of Management Fribourg, HES-SO, Fribourg, Switzerland; Humantech Institute, HES-SO, Fribourg, Switzerland
| | - A Tchalla
- CHU de Limoges, Pôle HU gérontologie clinique, Limoges, France; Laboratoire VieSanté, UR 24134 (Vieillissement, Fragilité, Prévention, e-Santé), IFR OMEGA HEALTH, Université de Limoges, Limoges, France
| | - A Perrochon
- Université de Limoges, HAVAE, UR20217, Limoges, France.
| |
Collapse
|
29
|
Finnegan DJ, Campbell S. Tackling Loneliness and Isolation in Older Adults With Virtual Reality: How do We Move Forward? Gerontol Geriatr Med 2023; 9:23337214231186204. [PMID: 37465186 PMCID: PMC10350751 DOI: 10.1177/23337214231186204] [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: 04/13/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 07/20/2023] Open
Abstract
Current trends in gerontology conceptualize Virtual Reality (VR) as a tool for rehabilitation, lauding its potential for cognitive rehabilitation or as an intervention to reduce cognitive function decline. However, we must take a critical stance and identify not just the potential positive impact, but also how things may go wrong without appropriate guidelines, and the need for careful design around the interaction affordances of the technology. We conducted co-discovery and co-design workshops involving expert stakeholders and older adults (N = 25) over a period of 6 months, involving practical activities including user personas and focus groups to understand the complexities of loneliness and identify possible solutions with VR. Based on our findings we focus our argument on two key factors in the conceptualization of loneliness: spaces, and activities which may take place within said spaces. We present our reconceptualization of VR as a tool for group activities instead of passive consumption of content and make suggestions to the community for reducing feelings of loneliness with VR.
Collapse
|
30
|
Reggente N. VR for Cognition and Memory. Curr Top Behav Neurosci 2023; 65:189-232. [PMID: 37440126 DOI: 10.1007/7854_2023_425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
This chapter will provide a review of research into human cognition through the lens of VR-based paradigms for studying memory. Emphasis is placed on why VR increases the ecological validity of memory research and the implications of such enhancements.
Collapse
Affiliation(s)
- Nicco Reggente
- Institute for Advanced Consciousness Studies, Santa Monica, CA, USA.
| |
Collapse
|
31
|
Khan S, Naeem MK, Tania MH, Refat N, Rahman MA, Patwary M. A modified mental state assessment tool for impact analysis of virtual reality-based therapeutic interventions in patients with cognitive impairment. Digit Health 2023; 9:20552076231203800. [PMID: 38025104 PMCID: PMC10647984 DOI: 10.1177/20552076231203800] [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: 03/12/2023] [Accepted: 09/08/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This work has developed a modified mental state assessment tool for impact analysis of therapeutic interventions for patients with cognitive impairment. This work includes a pilot study to validate the proposed tool and assess the impact of virtual reality-based interventions on patient well-being, which includes assessment of cognitive ability and mood. Methods The suggested tool's robustness and reliability are assessed in care home facilities with elderly residents over the age of 55. Because of the repetitive nature of the pilot study, test-retest strategy for Cronbach's alpha coefficient is employed to validate the internal consistency of the proposed tool over time. Qualitative and quantitative analyses are performed on the collected data to draw inferences on the impact of virtual reality-based interventions on patients with cognitive impairments. Results The Cronbach's alpha coefficient value shows that the proposed tool's resilience is comparable to that of its pre-intervention counterparts. The Cronbach's alpha coefficient values are determined for Pre-virtual reality and Post-virtual reality interventions, which include 116 virtual reality sessions for 52-participant, and three cohorts of virtual reality sessions for 21 participants. These values for a majority of the interventions remained within the acceptable range of 0.6-0.8. Conclusions The proposed modified mental state assessment tool is observed to be a reliable tool for investigating the impact of virtual reality-based interventions on patients with cognitive impairments. One of the notable significance of the proposed tool is that this allows for resource allocation for such interventions to be tailored to the needs of the patient, leading to greater therapeutic efficacy and resource efficiency.
Collapse
Affiliation(s)
- Samiya Khan
- School of Engineering, Computing and Mathematical Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Muhammad Kamran Naeem
- School of Engineering, Computing and Mathematical Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Marzia Hoque Tania
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Nadia Refat
- School of Engineering, Computing and Mathematical Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Md Arafatur Rahman
- School of Engineering, Computing and Mathematical Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Mohammad Patwary
- School of Engineering, Computing and Mathematical Sciences, University of Wolverhampton, Wolverhampton, UK
| |
Collapse
|
32
|
Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study. Brain Sci 2022; 13:brainsci13010079. [PMID: 36672060 PMCID: PMC9856594 DOI: 10.3390/brainsci13010079] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
Background: The society is aging in China, and the cognitive level of elderly post-stroke patients gradually declines. Face-to-face cognitive functional training is no longer sufficient. Immersive virtual reality (IVR) is a promising rehabilitation training device. In this study, we developed an IVR-based puzzle game to explore its effectiveness, feasibility, and safety in elderly stroke patients with cognitive dysfunction. Methods: A total of 30 patients with mild post-stroke cognitive impairment after stroke were randomly assigned to a control or IVR group. Patients in both groups received routine rehabilitation therapy. Patients in the control group received traditional cognitive training, and those in the IVR group received IVR-based puzzle game therapy. Before and after treatment, Montreal cognitive assessment (MOCA), trail-making test-A (TMT-A), digit symbol substitution test (DSST), digital span test (DST), verbal fluency test (VFT), and modified Barthel index (MBI) were evaluated in both groups. In addition, the IVR group was administered a self-report questionnaire to obtain feedback on user experience. Results: There was no significant difference in the baseline data between the two groups. After six weeks of treatment, the cognitive assessment scores were improved in both groups. Moreover, the IVR group showed more improvements than the control group in the DSST (Z = 2.203, p = 0.028 < 0.05, η2 = 0.16); MOCA (T = 1.186, p = 0.246 > 0.05, d = 0.44), TMT-A (T = 1.791, p = 0.084 > 0.05, d = 0.65), MBI (T = 0.783, p = 0.44 > 0.05, d = 0.28), FDST (Z = 0.78, p = 0.435 > 0.05, η2 = 0.02), BDST (Z = 0.347, p = 0.728 > 0.05, η2 = 0.004), and VFT(Z = 1.087, p = 0.277 > 0.05, η2 = 0.039) did not significantly improve. The significant difference in DSST represents an improvement in executive function and visual−spatial cognitive characteristics. The other assessment scores did not show such features. Therefore, we did not observe significant differences through this measure. According to the results of the self-report questionnaire, most of the patients were satisfied with the equipment stability and training content. Several individuals reported mild adverse reactions. Conclusions: This pilot study suggests that IVR-based puzzle games are a promising approach to improve post-stroke cognitive function, especially executive cognitive function, and visual−spatial attention in older adults.
Collapse
|
33
|
Zary N, Healy D, Barry M, Brennan A, Redfern S, Houghton C, Casey D. Key Stakeholders' Experiences and Perceptions of Virtual Reality for Older Adults Living With Dementia: Systematic Review and Thematic Synthesis. JMIR Serious Games 2022; 10:e37228. [PMID: 36563042 PMCID: PMC9823606 DOI: 10.2196/37228] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/01/2022] [Accepted: 07/21/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Technology is increasingly being used and evolving in the dementia care landscape. One such technology that has gained traction over the last decade is virtual reality (VR). VR is being applied in many areas of dementia care, including cognitive assessment and training, reminiscence therapy, music therapy, and other recreational VR applications. Despite the plethora of applications, they are often not shaped by the experiences and perceptions of older adults living with dementia. Currently, there is no qualitative evidence synthesis (QES) to explore this area. This review aimed to provide qualitative evidence supporting existing systematic reviews in this area. OBJECTIVE The aim of this QES was to explore key stakeholders' experiences and perceptions of VR for older adults living with dementia. It aimed to explore the barriers and facilitators to VR use and provide recommendations for future design and implementation. METHODS QES was used, which involved a systematic search of 6 databases to identify studies that qualitatively explored key stakeholders' experiences and perceptions of VR for older adults living with dementia. Thematic synthesis was used to integrate the findings of 14 studies (from 15 reports). The Critical Appraisal Skills Programme tool was used to assess the methodological quality of the included studies. The confidence placed in the review findings was assessed using the GRADE-CERQUAL (Confidence in the Evidence from Reviews of Qualitative research). RESULTS A total of 15 reports from 14 studies were included in the review, consisting of a range of levels of VR immersion, stages of dementia, and care contexts. Three analytical themes were generated: stepping into virtuality, a virtual world, and returning to reality. The results indicate the importance of sensitively designing and introducing VR to this population, as older adults living with dementia often have no prior experience of using this technology. VR can be a positive experience for older adults living with dementia and can provide meaningful interactions, positive expressions, and long-term impacts on everyday functioning. However, it should be acknowledged that some negative associations must be accounted for before, during, and after use. CONCLUSIONS This review highlights the positive implications as well as negative associations of VR use. It emphasizes the need for VR design and implementation driven by the needs and views of older adults living with dementia as well as with other key stakeholders. Future research needs to explore the vital role that older adults living with dementia can play in the design process and how they can be empowered to meaningfully design and use this technology.
Collapse
Affiliation(s)
| | - David Healy
- School of Psychology, University of Galway, Galway, Ireland
| | - Marguerite Barry
- School of Information and Communication Studies, ADAPT Centre, University College Dublin, Dublin, Ireland
| | - Attracta Brennan
- Engineering and Informatics, University of Galway, Galway, Ireland
| | - Sam Redfern
- Engineering and Informatics, University of Galway, Galway, Ireland
| | | | - Dympna Casey
- School of Nursing and Midwifery, Aras Moyola, Galway, Ireland
| |
Collapse
|
34
|
Flynn A, Barry M, Qi Koh W, Reilly G, Brennan A, Redfern S, Casey D. Introducing and Familiarising Older Adults Living with Dementia and Their Caregivers to Virtual Reality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16343. [PMID: 36498417 PMCID: PMC9736737 DOI: 10.3390/ijerph192316343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Virtual Reality (VR) is increasingly being applied in dementia care across a range of applications and domains including health and wellbeing. Despite the commercial availability of VR, informants of design are not always aware of its functionality and capabilities, to meaningfully contribute to VR design. In designing VR applications for people living with dementia, it is recommended that older adults living with dementia and their support persons be involved in the design process using participatory approaches, thereby giving them a voice on the design of technology from the outset. A VR technology probe is a useful means of familiarising older adults living with dementia and their informal caregivers with the knowledge and understanding of interactive VR to employ technology that supports them to maintain their social health. This paper charts the implementation and evaluation of a VR technology probe, VR FOUNDations. To explore their experiences, nine older adults living with dementia and their nine informal caregivers trialled VR FOUNDations and completed semi-structured interviews after its use. Overall, older adults living with dementia and their informal caregivers perceived VR FOUNDations to achieve its aim of increasing understanding and inspiring future design decisions. The findings also identified promising positive experiences using a VR technology probe which may be indicative of its applicability to social health and wellbeing domains. This paper advocates for the structured design and implementation of VR technology probes as a pre-requisite to the participatory design of VR applications for the health and wellbeing of people living with dementia. The use of such technology probes may afford older adults living with dementia and their informal caregivers the best opportunity to contribute to design decisions and participate in technology design to support their health and wellbeing.
Collapse
Affiliation(s)
- Aisling Flynn
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| | - Marguerite Barry
- Information and Communication Studies, ADAPT Centre, University College Dublin, D04 V1W8 Dublin, Ireland
| | - Wei Qi Koh
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| | - Gearóid Reilly
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Attracta Brennan
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Sam Redfern
- School of Computer Science, University of Galway, H91 TK33 Galway, Ireland
| | - Dympna Casey
- School of Nursing and Midwifery, University of Galway, H91 TK33 Galway, Ireland
| |
Collapse
|
35
|
Sohn M, Yang J, Sohn J, Lee JH. Digital healthcare for dementia and cognitive impairment: A scoping review. Int J Nurs Stud 2022; 140:104413. [PMID: 36821951 DOI: 10.1016/j.ijnurstu.2022.104413] [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: 04/29/2022] [Revised: 11/11/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive disorders, such as Alzheimer's disease, are a global health problem. Digital healthcare technology is an innovative management tool for delaying the progression of dementia and mild cognitive impairment. Thanks to digital technology, the possibility of safe and effective care for patients at home and in the community is increasing, even in situations that threaten the continuity of care, such as the COVID-19 pandemic. However, it is difficult to select appropriate technology and alternatives due to the lack of comprehensive reviews on the types and characteristics of digital technology for cognitive impairment, including their effects and limitations. OBJECTIVE This study aims to identify the types of digital healthcare technology for dementia and mild cognitive impairment and comprehensively examine how its outcome measures were constructed in line with each technology's purpose. METHODS According to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines, a literature search was conducted in August 2021 using Medline (Ovid), EMBASE, and Cochrane library. The search terms were constructed based on Population-Concept-Context mnemonic: 'dementia', 'cognitive impairment', and 'cognitive decline'; digital healthcare technology, such as big data, artificial intelligence, virtual reality, robots, applications, and so on; and the outcomes of digital technology, such as accuracy of diagnosis and physical, mental, and social health. After grasping overall research trends, the literature was classified and analysed in terms of the type of service users and technology. RESULTS In total, 135 articles were selected. Since 2015, an increase in literature has been observed, and various digital healthcare technologies were identified. For people with mild cognitive impairment, technology for predicting and diagnosing the onset of dementia was studied, and for people with dementia, intervention technology to prevent the deterioration of health and induce significant improvement was considered. Regarding caregivers, many studies were conducted on monitoring and daily living assistive technologies that reduce the burden of care. However, problems such as data collection, storage, safety, and the digital divide persisted at different intensities for each technology type. CONCLUSIONS This study revealed that appropriate technology options and considerations may differ depending on the characteristics of users. It also emphasises the role of humans in designing and managing technology to apply digital healthcare technology more effectively.
Collapse
Affiliation(s)
- Minsung Sohn
- Division of Health and Medical Sciences, The Cyber University of Korea, Seoul, Republic of Korea
| | - JungYeon Yang
- Transdisciplinary Major in Learning Health Systems, Department of Public Health Science, Graduate School, Korea University, Republic of Korea
| | - Junyoung Sohn
- Department of Artificial Intelligence, Korea University, Seoul, Republic of Korea
| | - Jun-Hyup Lee
- Department of Health Policy and Management, College of Health Sciences, Korea University, Republic of Korea.
| |
Collapse
|
36
|
Domenicucci R, Ferrandes F, Sarlo M, Borella E, Belacchi C. Efficacy of ICT-based interventions in improving psychological outcomes among older adults with MCI and dementia: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101781. [PMID: 36343879 DOI: 10.1016/j.arr.2022.101781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022]
Abstract
The purpose of this systematic review and meta-analysis was to investigate empirical evidence about the effectiveness of Information and Communication Technology-based interventions (ICTs) on different psychological outcomes in adults aged over 60 years with Mild Cognitive Impairment (MCI) or dementia. We conducted a systematic search on Pubmed, Web of Science, Scopus, and PsycInfo with publication year between January 2010 up to April 2021. Any pre-post quantitative intervention study with at least one of the following domains examined: quality of life (QoL), psychological well-being, social interaction, engagement, mood, anxiety, stress, loneliness, self-efficacy, or self-esteem was included. The risk of bias and quality of evidence were assessed using tools based on the Cochrane Handbook for Systematic Review of Interventions criteria. Forty-eight studies with a total of 1488 participants met the selection criteria. Because of the high heterogeneity, we ran nine different random effects meta-analyses divided by outcome and type of cognitive decline which indicated that these treatments were ineffective overall, with some exceptions. Only anxiety (small effect size =-0.375 [-0.609; -0.140]) and behavioral symptoms (BS) (medium effect size =-0.585 [-1.019; -0.152]) in people with dementia (PwD) were found to change significantly. Moreover, effect sizes for QoL in dementia and for mood in people with MCI became significant when moderated by type of ICT, living situation, and experimental setting. In particular, Virtual Reality (VR) appeared to be more effective than other devices for both PwD and MCI, and nursing homes were found to be the best setting for administering these treatments. The trim and fill method found no evidence of publication bias in any of the 9 analyses. However, quality of evidence within (RoB 2, RoB 2 Crossover, ROBINS) and across (GRADE assessment) studies was low, thus these findings should be interpreted with caution. In general, ICT-based intervention can be considered a promising approach for improving anxiety and BS in PwD, and for improving QoL in PwD and mood in people with MCI, specifically when VR is used, when participants live in nursing homes, and when interventions are carried out in nursing homes.1.
Collapse
Affiliation(s)
- Riccardo Domenicucci
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy.
| | - Federico Ferrandes
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy
| | - Michela Sarlo
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy
| | - Erika Borella
- University of Padua, Department of General Psychology, Italy
| | - Carmen Belacchi
- University of Urbino 'Carlo Bo', Department of Communication Sciences, Humanities and International Studies, Italy
| |
Collapse
|
37
|
How Telemedicine Can Improve the Quality of Care for Patients with Alzheimer's Disease and Related Dementias? A Narrative Review. Medicina (B Aires) 2022; 58:medicina58121705. [PMID: 36556907 PMCID: PMC9783876 DOI: 10.3390/medicina58121705] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/13/2022] [Accepted: 11/20/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives: Dementia affects more than 55 million patients worldwide, with a significant societal, economic, and psychological impact. However, many patients with Alzheimer's disease (AD) and other related dementias have limited access to effective and individualized treatment. Care provision for dementia is often unequal, fragmented, and inefficient. The COVID-19 pandemic accelerated telemedicine use, which holds promising potential for addressing this important gap. In this narrative review, we aim to analyze and discuss how telemedicine can improve the quality of healthcare for AD and related dementias in a structured manner, based on the seven dimensions of healthcare quality defined by the World Health Organization (WHO), 2018: effectiveness, safety, people-centeredness, timeliness, equitability, integrated care, and efficiency. Materials and Methods: MEDLINE and Scopus databases were searched for peer-reviewed articles investigating the role of telemedicine in the quality of care for patients with dementia. A narrative synthesis was based on the seven WHO dimensions. Results: Most studies indicate that telemedicine is a valuable tool for AD and related dementias: it can improve effectiveness (better access to specialized care, accurate diagnosis, evidence-based treatment, avoidance of preventable hospitalizations), timeliness (reduction of waiting times and unnecessary transportation), patient-centeredness (personalized care for needs and values), safety (appropriate treatment, reduction of infection risk),integrated care (interdisciplinary approach through several dementia-related services), efficiency (mainly cost-effectiveness) and equitability (overcoming geographical barriers, cultural diversities). However, digital illiteracy, legal and organizational issues, as well as limited awareness, are significant potential barriers. Conclusions: Telemedicine may significantly improve all aspects of the quality of care for patients with dementia. However, future longitudinal studies with control groups including participants of a wide educational level spectrum will aid in our deeper understanding of the real impact of telemedicine in quality care for this population.
Collapse
|
38
|
Asano T, Wang CW, Tsugaruya M, Ishikawa T. Effectiveness of life story book intervention on apathy and verbal fluency in people with dementia. Clin Gerontol 2022; 46:389-399. [PMID: 36409251 DOI: 10.1080/07317115.2022.2147887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study determined whether the individual intervention of using life story books (LSBs) improves apathy and verbal fluency in people with dementia (PWD). METHODS The intervention group (n = 43) underwent 3 interviews in the 10 weeks following an initial assessment. Based on the information obtained, LSBs were developed; participants received individual interventions weekly, five times for four weeks. They also received a final assessment 12 weeks after the end of the intervention. Primary outcome measures comprised the Categorical Verbal Fluency Test (CFT) and the Neuropsychiatric Inventory-Nursing Home Apathy sub-item. The control group (n = 32) underwent initial and final assessments at intervals of 28 weeks while receiving the best care services. RESULTS CFT scores for participants with mild to moderate dementia increased from 4.3 to 5.3 (P < .05) and the interaction effect of group and data collection timing was significant (p < .05). Apathy score for participants with severe dementia also improved from 4.5 to 2.5 (P < .05) immediately after the intervention period. CONCLUSIONS LSB is a comprehensive communication tool that encourages apathy and verbal fluency. CLINICAL IMPLICATIONS The use of LSB may allow caregivers to achieve intervention effects on apathy and verbal fluency in PWD.
Collapse
Affiliation(s)
- Tomoaki Asano
- Department of Occupational Therapy, Akita University, Graduate School of Health Science, Akita, Japan
| | - Chih-Wen Wang
- Department of Rehabilitation, Occupational Therapy Course, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Japan
| | - Megumi Tsugaruya
- Department of Occupational Therapy, Akita University, Graduate School of Health Science, Akita, Japan
| | - Takashi Ishikawa
- Department of Occupational Therapy, Akita University, Graduate School of Health Science, Akita, Japan
| |
Collapse
|
39
|
Pons P, Navas-Medrano S, Soler-Dominguez JL. Extended reality for mental health: Current trends and future challenges. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2022.1034307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Virtual and augmented reality have been used to diagnose and treat several mental health disorders for decades. Technological advances in these fields have facilitated the availability of commercial solutions for end customers and practitioners. However, there are still some barriers and limitations that prevent these technologies from being widely used by professionals on a daily basis. In addition, the COVID-19 pandemic has exposed a variety of new scenarios in which these technologies could play an essential role, like providing remote treatment. Disorders that traditionally had received less attention are also getting in the spotlight, such as depression or obsessive-compulsive disorder. Improvements in equipment and hardware, like Mixed Reality Head Mounted Displays, could help open new opportunities in the mental health field. Extended reality (XR) is an umbrella term meant to comprise Virtual reality (VR), mixed reality (MR), and augmented reality (AR). While XR applications are eminently visual, other senses are being explored in literature around multisensory interactions, such as auditory, olfactory, or haptic feedback. Applying such stimuli within XR experiences around mental disorders is still under-explored and could greatly enrich the therapeutic experience. This manuscript reviews recent research regarding the use of XR for mental health scenarios, highlighting trends, and potential applications as well as areas for improvement. It also discusses future challenges and research areas in upcoming topics such as the use of wearables, multisensory, and multimodal interaction. The main goal of this paper is to unpack how these technologies could be applied to XR scenarios for mental health to exploit their full potential and follow the path of other health technologies by promoting personalized medicine.
Collapse
|
40
|
Vaillant-Ciszewicz AJ, Quin C, Michel E, Sacco G, Guerin O. La réalité virtuelle personnalisée sur les troubles de l’humeur en établissement d’hébergement pour personnes âgées dépendantes et unité de soin de longue durée : étude de cas chez un résident présentant des troubles cognitifs modérés. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
41
|
Baragash RS, Aldowah H, Ghazal S. Virtual and augmented reality applications to improve older adults’ quality of life: A systematic mapping review and future directions. Digit Health 2022; 8:20552076221132099. [PMCID: PMC9629585 DOI: 10.1177/20552076221132099] [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: 09/19/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
Objective The use of virtual reality and augmented reality to improve older adults’ quality of life has rapidly increased in recent years. This systematic mapping review aimed to provide a comprehensive overview of existing research that identifies and classifies current virtual reality and augmented reality applications that enhance the quality of life of older adults to increase the understanding of the impact of these technologies. Methods To reach this objective, a systematic mapping review was conducted of the studies published between 2009 and 2020 in major scientific databases, such as IEEE Xplore, Web of Science, Scopus, and PubMed. A total of 57 studies were analyzed and classified into four main quality of life domains: physical, cognitive, psychological, and social well-being. Results The findings showed that virtual reality and augmented reality have found their places in many quality of life studies of older adults. Although virtual reality and augmented reality applications are notably growing in the physical and cognitive well-being domains in training and rehabilitation settings, they are still in the early stages of development in psychological and social well-being research as well as healthcare settings. Our findings also revealed that virtual reality games, particularly motion-based exergames, and 3D augmented reality systems are the most common virtual reality and augmented reality types among the reviewed studies. Moreover, balance and attention were the most prevalent physical and cognitive functions when using motion-based and immersive virtual reality exergames and augmented reality systems and games, respectively, while confidence and interaction were the most dominant psychological and social functions. Conclusion This mapping review provides a comprehensive overview of potential areas for further research in this field, thereby assisting researchers, technologists, and health practitioners in expanding this field of research.
Collapse
Affiliation(s)
- Reem Sulaiman Baragash
- Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia,Reem Sulaiman Baragash, Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
;
| | - Hanan Aldowah
- Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| | - Samar Ghazal
- Centre for Instructional Technology and Multimedia, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| |
Collapse
|
42
|
Preston AM, Brown L, Padala KP, Padala PR. Veterans Affairs Health Care Provider Perceptions of Virtual Reality: Brief Exploratory Survey. Interact J Med Res 2022; 11:e38490. [PMID: 36053568 PMCID: PMC9482067 DOI: 10.2196/38490] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/01/2022] [Accepted: 08/10/2022] [Indexed: 11/26/2022] Open
Abstract
Background Virtual reality (VR), a simulated experience that can be similar to or completely different from the real world, has become increasingly useful within the psychiatric and medical fields. This VR technology has been applied in medical school trainings, exposure therapy for individuals with posttraumatic stress disorder (PTSD), and reminiscence therapy associated with mood disorders for older adults. Perceptions of VR through the lens of the health care provider require further exploration. VR has grown in popularity; however, this modality continues to be underused in most Veterans Affairs (VA) hospitals. Objective A web-based survey was used to explore health care provider perceptions of immersive VR availability and use for older adults and identify potential barriers for immersive VR use in older adults with cognitive impairment. Methods An 8-item web-based survey was developed to obtain health care provider feedback. This survey was disseminated throughout a single Veterans Integrated Services Network (VISN). The VR survey was developed via the Survey Monkey platform and distributed through the secure VA email network. Providers were asked to voluntarily participate in the brief, anonymous survey and offer their perceptions of immersive VR use within their patient population. Survey data were reviewed and interpreted using descriptive statistics. Results A total of 49 respondents completed the survey over a 15-day period. Of them, 36 respondents (73%) had heard of a VR device, though the majority (n=44, 90%) had never used or prescribed a VR device. Respondents identified several potential barriers to immersive VR use in older adults with cognitive impairment (eg, hearing difficulties, perceptions of technology, cognitive concerns, access to resources, and visual impairment). Despite the barriers identified, providers (n=48, 98%) still reported that they would feel comfortable prescribing immersive VR as an intervention for their patient population. Conclusions Survey findings revealed that health care providers within this VISN for VAs have heard of VR, although they may not have actively engaged in its use. Most of the providers reported that they would prescribe the use of an immersive VR intervention for their older adult patients. This key point highlights the desire to implement VR strategies for patient use by their providers. If underlying barriers can be addressed and relatively resolved, this technological intervention has the potential to create substantial breakthroughs in clinical care.
Collapse
Affiliation(s)
- A'mie M Preston
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States
| | - Lana Brown
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States.,College of Nursing, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kalpana P Padala
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States.,Department of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Prasad R Padala
- Geriatric Research Education and Clinical Center, Eugene J Towbin Veterans Affairs Healthcare Center, North Little Rock, AR, United States.,Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States.,University of Arkansas for Medical Sciences Graduate Medical Education, Baptist Health, North Little Rock, AR, United States
| |
Collapse
|
43
|
Gambella E, Margaritini A, Benadduci M, Rossi L, D'Ascoli P, Riccardi GR, Pasquini S, Civerchia P, Pelliccioni G, Bevilacqua R, Maranesi E. An integrated intervention of computerized cognitive training and physical exercise in virtual reality for people with Alzheimer's disease: The jDome study protocol. Front Neurol 2022; 13:964454. [PMID: 36034306 PMCID: PMC9412195 DOI: 10.3389/fneur.2022.964454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionAlzheimer's disease is a neurodegenerative syndrome characterized by cognitive deficits, loss of daily functions, and mental and behavioral disorders, which cause stress and negatively affect the quality of life. Studies in the field suggest that combining cognitive training with physical activity can reduce the risk of developing the disease and, once neurodegeneration has begun, it slows its progress. In particular, virtual reality and augmented reality administer cognitive stimulation while providing a link to autobiographical memory through reminiscence, enabling the improvement of the person's quality of life. The present protocol aims to evaluate the effectiveness of cognitive and physical treatments, integrated with the addition of virtual reality and reminiscence elements, using the Brainer software, in which people will find cognitive training, and the jDome® BikeAround™ system, which will allow participants to pedal along a personalized path projected on a schematic, using an exercise bike connected to the system.Methods and analysisFor this study, 78 patients with mild Alzheimer's dementia were recruited and divided into the Experimental Group (EG) and Control Group (CG). Sixteen treatment sessions of 60 min each were conducted for both groups (2 training sessions per week, for 8 weeks), including 1 patient at a time. The EG received cognitive treatment with Brainer and physical training with jDome, while the CG received cognitive treatment with Brainer and physical training with a classic bicycle. The evaluation mainly focused on the assessment of the person's cognitive status. Other analyses were conducted on the quality of life, mood, behavioral disorders, and physical function, which were considered secondary outcomes.DiscussionsThe ultimate goal of the present study is to test the effectiveness of a treatment for people with mild Alzheimer's focused on the integration of cognitive training and aerobic physical activity, using an exercise bike, with the addition of virtual reality and reminiscence elements.Ethics and disseminationThe study was approved by the Ethics Committee of the IRCCS INRCA. It was recorded in ClinicalTrials.gov on 2 June 2022 with the number NCT05402423. The study findings will be used for publication in peer-reviewed scientific journals and presentations in scientific meetings.
Collapse
Affiliation(s)
| | | | | | - Lorena Rossi
- Scientific Direction, IRCCS INRCA, Ancona, Italy
| | | | | | | | | | | | - Roberta Bevilacqua
- Scientific Direction, IRCCS INRCA, Ancona, Italy
- *Correspondence: Roberta Bevilacqua
| | | |
Collapse
|
44
|
Pan Y. Designing Smart Space Services by Virtual Reality-Interactive Learning Model on College Entrepreneurship Education. Front Psychol 2022; 13:913277. [PMID: 35936351 PMCID: PMC9355301 DOI: 10.3389/fpsyg.2022.913277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose was to improve the limitations of traditional entrepreneurship education, realize the virtual interactive learning between college students and teachers, and stimulate students’ exploration of entrepreneurship. This work first discusses the working principle of Virtual Reality (VR) and builds an Interactive Learning Model (ILM) using VR. Then, the VR-ILM is used to design the Smart Space services. Harris Corner Detector (HCD) is used to detect the pixel grayscale change in the Smart Space image window. Further, the VR-ILM-based Smart Space is proposed according to the Smart Space design requirements and principles. Finally, the proposed VR-ILM-based Smart Space is applied to College Entrepreneurship Education (CEE). Its impact on the CEE market, employment in different industries, and students’ satisfaction with CEE are studied. The results show that the proposed VR-ILM-based Smart Space has increased the entrepreneurship teaching courses, entrepreneurship coaching activities, and entrepreneurship practice activities by 4, 6, and 24%, respectively. It has reduced entrepreneurship competitions and other forms of entrepreneurship education by 4 and 16%. The proposed VR-ILM-based Smart Space has dramatically improved the practical teaching of CEE. Meanwhile, real estate services have felt the most significant impact of the proposed VR-ILM-based Smart Space, with an employment increase of 43%. Lastly, students’ satisfaction with entrepreneurship education practice and teaching methods has increased by nearly 50%. The satisfaction with the internal environment has increased to 78%. The satisfaction with the curriculum system, teachers, and industry financing has increased from 30 to 45%, 24 to 36%, and 45 to 63%, respectively. The satisfaction with the teaching goal has increased to 62%. Thus, the proposed VR-ILM-based Smart Space has dramatically improved students’ satisfaction with CEE and has a different impact on the market, industry, and satisfaction with CE. The finding has a certain reference for the VR interactive model.
Collapse
|
45
|
Papaioannou T, Voinescu A, Petrini K, Stanton Fraser D. Efficacy and Moderators of Virtual Reality for Cognitive Training in People with Dementia and Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2022; 88:1341-1370. [PMID: 35811514 DOI: 10.3233/jad-210672] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) and dementia result in cognitive decline which can negatively impact everyday functional abilities and quality of life. Virtual reality (VR) interventions could benefit the cognitive abilities of people with MCI and dementia, but evidence is inconclusive. OBJECTIVE To investigate the efficacy of VR training on global and domain-specific cognition, activities of daily living and quality of life. To explore the influence of priori moderators (e.g., immersion type, training type) on the effects of VR training. Adverse effects of VR training were also considered. METHODS A systematic literature search was conducted on all major databases for randomized control trial studies. Two separate meta-analyses were performed on studies with people with MCI and dementia. RESULTS Sixteen studies with people with MCI and four studies with people with dementia were included in each meta-analysis. Results showed moderate to large effects of VR training on global cognition, attention, memory, and construction and motor performance in people with MCI. Immersion and training type were found to be significant moderators of the effect of VR training on global cognition. For people with dementia, results showed moderate to large improvements after VR training on global cognition, memory, and executive function, but a subgroup analysis was not possible. CONCLUSION Our findings suggest that VR training is an effective treatment for both people with MCI and dementia. These results contribute to the establishment of practical guidelines for VR interventions for patients with cognitive decline.
Collapse
Affiliation(s)
| | | | - Karin Petrini
- Department of Psychology, University of Bath, Claverton Down, Bath, UK.,Centre for the Analysis of Motion, Entertainment Research and Applications, University of Bath, Claverton Down, Bath, UK
| | | |
Collapse
|
46
|
Mo J, Vickerstaff V, Minton O, Tavabie S, Taubert M, Stone P, White N. How effective is virtual reality technology in palliative care? A systematic review and meta-analysis. Palliat Med 2022; 36:1047-1058. [PMID: 35635018 PMCID: PMC9248003 DOI: 10.1177/02692163221099584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The efficacy of virtual reality for people living with a terminal illness is unclear. AIM To determine the feasibility and effectiveness of virtual reality use within a palliative care setting. DESIGN Systematic review and meta-analysis. PROSPERO (CRD42021240395). DATA SOURCES Medline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to March 2021. Search terms included 'virtual reality' and 'palliative care'. Eligibility: (1) adult (>18 years old) with a terminal illness (2) at least one virtual reality session and (3) feasibility data and/or at least one patient outcome reported. The ROB-2 and ROBINS tools assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool assessed the quality of the evidence. Standardised mean differences (Hedges's g) were calculated from the pre- and post-data. A DerSimonian-Laird random effects model meta-analysis was conducted. RESULTS Eight studies were included, of which five were in the meta-analysis. All studies had at least some concern for risk of bias. Virtual reality statistically significantly improved pain (p = 0.0363), tiredness (p = 0.0030), drowsiness (p = 0.0051), shortness of breath (p = 0.0284), depression (p = 0.0091) and psychological well-being (p = 0.0201). The quality of the evidence was graded as very low due to small sample sizes, non-randomisation methods and a lack of a comparator arm. CONCLUSIONS Virtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research.
Collapse
Affiliation(s)
- Jiping Mo
- UCL Division of Psychiatry, London, UK
| | - Victoria Vickerstaff
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK.,Priment Clinical Trials Unit, Research Department of Primary Care and Population Health, University College London (UCL), London, UK
| | - Ollie Minton
- Sussex Cancer Centre University Hospitals, Sussex, UK
| | | | - Mark Taubert
- Palliative Medicine, Velindre Cancer Centre, Cardiff, UK.,Palliative Care, Cardiff University School of Medicine, Cardiff, UK
| | - Patrick Stone
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| | - Nicola White
- Marie Curie Palliative Care Research Department, UCL Division of Psychiatry, London, UK
| |
Collapse
|
47
|
VR in Nursing Facilities - A randomized controlled multicenter pilot study analyzing the changes in the state of mind of seniors in nursing facilities through the viewing of 360° videos. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Abstract
Context
VR as an application to enhance well-being is sparsely researched in the elderly population. The aim of the pilot study was to analyze the effect of 360° videos of different categories on the state of mind of seniors in nursing facilities. Furthermore, for the implementation in everyday life, the usability of the system and the experience for seniors should be evaluated.
Methods
The VR experience was used as a supplement to existing care services in three facilities on eight subjects. Mood state was assessed using the Questionnaire for the Assessment of Happiness before and after the intervention. Demographic data and technology acceptance were collected beforehand. After the intervention, subjects were interviewed about confounding factors and side effects, and nursing home staff were interviewed about the usability of the system and the organizational concept of implementation.
Results
There was a positive effect on state of mind. Gender and spatial mobility turned out to be influencing factors. Categories containing people, animals and action achieved the highest increases in the state of mind. Interest in using technical devices correlated negatively with the change in mood state. None of the subjects found the VR goggles distracting or reported motion sickness. Very good usability was indicated by the employees.
Conclusion
A very high willingness to use this technology was found among nursing staff and residents. The tendencies of the positive effect of 360° videos on the state of mind, as well as differentiation based on the mentioned characteristics gender and spatial mobility, should be verified by a larger sample to empirically validate the use of this technology to increase the quality of life.
Collapse
|
48
|
Yu D, Li X, Lai FHY. The effect of virtual reality on executive function in older adults with mild cognitive impairment: a systematic review and meta-analysis. Aging Ment Health 2022; 27:663-673. [PMID: 35635486 DOI: 10.1080/13607863.2022.2076202] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES This review aimed to summarize the currently available premium evidence to determine the effect of virtual reality (VR) on executive function (EF) in older adults with mild cognitive impairment (MCI), and to detect what level of immersive VR would be the most beneficial. METHOD Five electronic databases, namely, PubMed, Embase, PsycINFO, CINAHL, and Cochrane Library were searched. Our research team screened the studies and extracted data according to our inclusion criteria. The methodological quality of each study was rated using the PEDro scale. When three or more studies reported the same outcome, a meta-analysis was conducted using Review Manager 5.4.1. RESULTS Finally, 14 randomized controlled trials with a total of 518 participants were included. VR training had an overall positive effect on cognitive flexibility, global cognitive function, attention, and short-term memory compared to the control groups. Additionally, semi-immersive VR was more effective in improving cognitive flexibility compared to the other two types of VR. The application of non-immersive level of VR had a significant effect on global cognitive function, attention, short-term memory, and cognitive flexibility. CONCLUSION VR may be effective in improving EF in older adults with MCI. However, the level of immersive VR that would be the most beneficial on EF still needs to be investigated with a greater number of well-designed studies.
Collapse
Affiliation(s)
- Dan Yu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.,Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
| | - Xun Li
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Frank Ho-Yin Lai
- Department of Social Work, Education and Community Wellbeing, Faculty of Health & Life Sciences, The Northumbria Newcastle University, United Kingdom
| |
Collapse
|
49
|
Developing the Rationale for Including Virtual Reality in Cognitive Rehabilitation and Exercise Training Approaches for Managing Cognitive Dysfunction in MS. NEUROSCI 2022. [DOI: 10.3390/neurosci3020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cognitive impairment is a common and detrimental consequence of multiple sclerosis (MS) and current rehabilitation methods are insufficient. Cognitive rehabilitation (CR) and exercise training (ET) are the most promising behavioral approaches to mitigate cognitive deficits, but effects are small and do not effectively translate to improvements in everyday function. This article presents a conceptual framework supporting the use of virtual reality (VR) as an ideal, common adjuvant traditional CR and ET in MS. VR could strengthen the effects of CR and ET by increasing sensory input and promoting multisensory integration and processing during rehabilitation. For ET specifically, VR can also help incorporate components of CR into exercise sessions. In addition, VR can enhance the transfer of cognitive improvements to everyday functioning by providing a more ecologically valid training environment. There is a clear interest in adding VR to traditional rehabilitation techniques for neurological populations, a stronger body of evidence of this unique approach is needed in MS. Finally, to better understand how to best utilize VR in rehabilitation for cognitive deficits in MS, more systematic research is needed to better understand the mechanism(s) of action of VR with CR and ET.
Collapse
|
50
|
Application of Real and Virtual Radial Arm Maze Task in Human. Brain Sci 2022; 12:brainsci12040468. [PMID: 35447999 PMCID: PMC9027137 DOI: 10.3390/brainsci12040468] [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: 01/25/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022] Open
Abstract
Virtual Reality (VR) emerges as a promising technology capable of creating different scenarios in which the body, environment, and brain are closely related, proving enhancements in the diagnosis and treatment of several spatial memory deficits. In recent years, human spatial navigation has increasingly been studied in interactive virtual environments. However, navigational tasks are still not completely adapted in immersive 3D VR systems. We stipulate that an immersive Radial Arm Maze (RAM) is an excellent instrument, allowing the participants to be physically active within the maze exactly as in the walking RAM version in reality modality. RAM is a behavioral ecological task that allows the analyses of different facets of spatial memory, distinguishing declarative components from procedural ones. In addition to describing the characteristics of RAM, we will also analyze studies in which RAM has been used in virtual modality to provide suggestions into RAM building in immersive modality.
Collapse
|