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Cerda IH, Zhang E, Dominguez M, Ahmed M, Lang M, Ashina S, Schatman ME, Yong RJ, Fonseca ACG. Artificial Intelligence and Virtual Reality in Headache Disorder Diagnosis, Classification, and Management. Curr Pain Headache Rep 2024:10.1007/s11916-024-01279-7. [PMID: 38836996 DOI: 10.1007/s11916-024-01279-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE OF REVIEW This review provides an overview of the current and future role of artificial intelligence (AI) and virtual reality (VR) in addressing the complexities inherent to the diagnosis, classification, and management of headache disorders. RECENT FINDINGS Through machine learning and natural language processing approaches, AI offers unprecedented opportunities to identify patterns within complex and voluminous datasets, including brain imaging data. This technology has demonstrated promise in optimizing diagnostic approaches to headache disorders and automating their classification, an attribute particularly beneficial for non-specialist providers. Furthermore, AI can enhance headache disorder management by enabling the forecasting of acute events of interest, such as migraine headaches or medication overuse, and by guiding treatment selection based on insights from predictive modeling. Additionally, AI may facilitate the streamlining of treatment efficacy monitoring and enable the automation of real-time treatment parameter adjustments. VR technology, on the other hand, offers controllable and immersive experiences, thus providing a unique avenue for the investigation of the sensory-perceptual symptomatology associated with certain headache disorders. Moreover, recent studies suggest that VR, combined with biofeedback, may serve as a viable adjunct to conventional treatment. Addressing challenges to the widespread adoption of AI and VR in headache medicine, including reimbursement policies and data privacy concerns, mandates collaborative efforts from stakeholders to enable the equitable, safe, and effective utilization of these technologies in advancing headache disorder care. This review highlights the potential of AI and VR to support precise diagnostics, automate classification, and enhance management strategies for headache disorders.
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Affiliation(s)
| | - Emily Zhang
- Harvard Medical School, Boston, MA, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Moises Dominguez
- Department of Neurology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA
| | | | - Min Lang
- Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Sait Ashina
- Harvard Medical School, Boston, MA, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - R Jason Yong
- Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital, Department of Anesthesiology, Perioperative, and Pain Medicine, 75 Francis Street, Boston, MA, 02115, USA
| | - Alexandra C G Fonseca
- Harvard Medical School, Boston, MA, USA.
- Brigham and Women's Hospital, Department of Anesthesiology, Perioperative, and Pain Medicine, 75 Francis Street, Boston, MA, 02115, USA.
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Skidmore N, Ryan CG, Mankelow J, Martin D. Acceptability and feasibility of virtual reality to promote health literacy in primary care from the health professional's view: A qualitative study. PATIENT EDUCATION AND COUNSELING 2024; 123:108179. [PMID: 38367303 DOI: 10.1016/j.pec.2024.108179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 12/12/2023] [Accepted: 01/26/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE The development of health literacy is important in the management of chronic pain and virtual reality may be an effective medium for its development. This study aims to understand the usability and acceptability of a virtual reality-based pain education system for the facilitation of health literacy. METHODS Semi-structured interviews were conducted with health professionals who had used a VR-based pain education system within their clinical practice, to explore perceptions of feasibility. Data collection and analyses were informed by the Unified Theory of Acceptance and Use of Technology and the Integrated Model of Health Literacy. RESULTS From 10 participants, the VR-based system was considered feasible in providing immersive experiential learning which addressed patient understanding and health-related communication. CONCLUSION VR appears to be perceived as an acceptable and feasible technology to support the development of health literacy in people with chronic pain. Its largest perceived benefit was its capacity to provide an immersive and entertaining alternative to conventional methods of pain education. PRACTICE IMPLICATIONS Virtual reality is considered as a feasible method of facilitating patient understanding and health-related communication related to chronic pain. Feasibility of such a tool relies clinically on time available, social expectations of VR, and the role of immersive and experiential learning within the management of chronic pain.
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Affiliation(s)
- Nathan Skidmore
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom.
| | - Cormac G Ryan
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
| | - Jagjit Mankelow
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom
| | - Denis Martin
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, Tees Valley, TS1 3BX, United Kingdom; NIHR Applied Research Collaboration for the North East and Cumbria, United Kingdom
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González Moraga FR, Enebrink P, Perrin S, Sygel K, Veling W, Wallinius M. VR-assisted aggression treatment in forensic psychiatry: a qualitative study in patients with severe mental disorders. Front Psychiatry 2024; 15:1307633. [PMID: 38818023 PMCID: PMC11137625 DOI: 10.3389/fpsyt.2024.1307633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 04/15/2024] [Indexed: 06/01/2024] Open
Abstract
Introduction Improvements in virtual reality (VR) have made it possible to create realistic, virtual settings for behavioral assessment and skills training that cannot otherwise be accessed in a safe way in forensic psychiatric settings. VR interventions are under development but little is known how forensic psychiatric patients with severe mental disorders experience VR-assisted assessments or treatments. Methods The present study aimed to help fill this knowledge gap via qualitative interviews with seven patients with severe mental disorders at a high-security forensic psychiatric clinic who had completed the newly revised Virtual Reality Aggression Prevention Training (VRAPT). All participants were interviewed 12 weeks after the VRAPT intervention, and interview data analyzed with manifest inductive content analysis. Results Six manifest content categories were identified: 1. Therapeutic process, 2. VRAPT method, 3. VR technology, 4. Previous treatment experiences, 5. Challenges to treatment of aggression, and 6. Unexpected experiences. The participants had diverse experiences related to both the VRAPT intervention and forensic psychiatric care. Participants described a mixture of positive experiences in relation to VR-assisted role-plays, and less positive in relation to motivation for aggression-focused treatment and technological limitations. Discussion The present findings suggest further studies are needed on how to best implement VR-assisted treatments for aggression in forensic settings, and potentially further modification of treatment content in interventions like VRAPT.
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Affiliation(s)
- Fernando Renee González Moraga
- Evidence-based Forensic Psychiatry, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Pia Enebrink
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sean Perrin
- Department of Psychology, Lund University, Lund, Sweden
| | - Kristina Sygel
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Forensic Psychiatry, National Board of Forensic Medicine, Stockholm, Sweden
| | - Wim Veling
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Märta Wallinius
- Evidence-based Forensic Psychiatry, Department of Clinical Sciences Lund, Psychiatry, Lund University, Lund, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
- Centre for Ethics, Law and Mental Health, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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Jayousi S, Barchielli C, Alaimo M, Caputo S, Paffetti M, Zoppi P, Mucchi L. ICT in Nursing and Patient Healthcare Management: Scoping Review and Case Studies. SENSORS (BASEL, SWITZERLAND) 2024; 24:3129. [PMID: 38793983 PMCID: PMC11125011 DOI: 10.3390/s24103129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 04/21/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024]
Abstract
Over the past few decades, Information and Communication Technologies (ICT) have revolutionized the fields of nursing and patient healthcare management. This scoping review and the accompanying case studies shed light on the extensive scope and impact of ICT in these critical healthcare domains. The scoping review explores the wide array of ICT tools employed in nursing care and patient healthcare management. These tools encompass electronic health records systems, mobile applications, telemedicine solutions, remote monitoring systems, and more. This article underscores how these technologies have enhanced the efficiency, accuracy, and accessibility of clinical information, contributing to improved patient care. ICT revolution has revitalized nursing care and patient management, improving the quality of care and patient satisfaction. This review and the accompanying case studies emphasize the ongoing potential of ICT in the healthcare sector and call for further research to maximize its benefits.
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Affiliation(s)
- Sara Jayousi
- ICT Applications Lab, PIN—Polo Universitario “Città di Prato”, 59100 Prato, Italy
| | - Chiara Barchielli
- Management and Health Laboratory, Institute of Management, Sant’Anna School of Advanced Studies of Pisa, 56127 Pisa, Italy
| | - Marco Alaimo
- Department of Nursing and Midwifery, Local Health Unit Toscana Centro, 50134 Florence, Italy; (M.A.); (M.P.); (P.Z.)
| | - Stefano Caputo
- Department of Information Engineering, University of Florence, 50121 Florence, Italy; (S.C.); (L.M.)
| | - Marzia Paffetti
- Department of Nursing and Midwifery, Local Health Unit Toscana Centro, 50134 Florence, Italy; (M.A.); (M.P.); (P.Z.)
| | - Paolo Zoppi
- Department of Nursing and Midwifery, Local Health Unit Toscana Centro, 50134 Florence, Italy; (M.A.); (M.P.); (P.Z.)
| | - Lorenzo Mucchi
- Department of Information Engineering, University of Florence, 50121 Florence, Italy; (S.C.); (L.M.)
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van Wolffelaar BR, van Horn JE, Hoogsteder LM. Treatment of aggression regulation problems with virtual reality: study protocol for a randomized controlled trial. Front Psychol 2024; 15:1324644. [PMID: 38638522 PMCID: PMC11024330 DOI: 10.3389/fpsyg.2024.1324644] [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: 10/19/2023] [Accepted: 03/22/2024] [Indexed: 04/20/2024] Open
Abstract
Background Aggressive conduct among delinquents presents a pervasive issue, bearing substantial implications for not only society at large but also for the victims and the individuals displaying the aggression. Traditional approaches to treating aggression regulation deficiencies generally employ Cognitive Behavioral Therapy (CBT) in conjunction with analog role-playing exercises. A body of research supports the efficacy of various therapeutic models for aggression regulation, including Responsive Aggression Regulation Therapy (Re-ART). Role-playing within a therapeutic context has been shown to contribute significantly to reductions in violent reoffending. However, the practical application of these skills in real-world settings remains challenging due to the inherent risk of aggressive outbreaks. Additionally, the conventional role-playing scenarios, often conducted in a therapy room, lack contextual realism and may induce role confusion between the patient and the therapist. Virtual Reality (VR) technology could offer a viable solution to these limitations by allowing for skill training in both behavioral and cognitive domains within a realistic yet safe and controlled setting. The technology also facilitates real-time awareness of emotional states and tension levels in the patient. This paper describes the study protocol of a randomized controlled trial in which Re-ART offered in a virtual environment (Re-ART VR) is compared to Re-ART offered as treatment as usual. Methods and analysis Adult forensic outpatients with aggression regulation problems are randomly assigned to either Re-ART VR or Re-ART. The Controlling Skills, Influence of Thinking and Handling Conflicts modules will be offered to both groups during 3-6 months. Pre- and post-intervention measurements are performed. The primary outcome measurement is the degree of aggression regulation, while secondary outcome measurements include impulsivity and cognitive biases. Additionally, patient motivation and therapist motivation are expected to act as moderating factors. Discussion To date, scarcely previous research has been done on the effectiveness of VR in treatment of aggression regulation problems in forensic outpatients. Forensic outpatients who do not benefit sufficiently from mainly CBT-based interventions may benefit more from experiential learning. The unique capabilities of VR in this regard have the potential to enhance the treatment effect.Clinical trial registration: [https://clinicaltrials.gov/], identifier [NL78265.018.21].
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Affiliation(s)
| | | | - Larissa M. Hoogsteder
- De Forensische Zorgspecialisten, de Waag, Utrecht, Netherlands
- Program Group: Forensic Child and Youth Care, University of Amsterdam, Amsterdam, Netherlands
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Alhammad SA. Advocating for Action: Exploring the Potential of Virtual Reality in Breathing Exercise - A Review of The Clinical Applications. Patient Prefer Adherence 2024; 18:695-707. [PMID: 38524197 PMCID: PMC10960537 DOI: 10.2147/ppa.s451609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 03/26/2024] Open
Abstract
The emergence of virtual reality (VR) technologies is currently shaping the healthcare system and is now being employed in various healthcare interventions. Pulmonary rehabilitation remains one such area in which VR is currently thriving to ensure overall health and well-being. While the importance of these novel technologies is being primarily researched in pulmonary rehabilitation, especially over passive conventional breathing exercise training, there seems to be a limited number of studies that have comprehensively put together these findings. This study utilizes a scoping review methodology to review VR exercises in clinical settings related to pulmonary rehabilitation. To achieve this objective, three electronic databases (Web of Science, PubMed, and Cochrane Library) were searched using a formulated search string related to the research objective. Following the database search, a total of 236 references were retrieved and managed using the reference manager. The screening of references was conducted according to the PRISMA 2020 screening process, and their quality was assessed using the JBI checklist. Ultimately, a total of eight publications of high quality were selected for inclusion in the scoping review. The results of the synthesis validate the importance of utilizing VR in the context of breathing exercise in rehabilitation. The effectiveness and rapid development of VR breathing exercises are primarily attributed to the engaging and immersive experience they provide. The use of biofeedback and self-regulation techniques into VR exercise systems was also seen to have a notable impact on the effectiveness of the breathing exercise system.
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Affiliation(s)
- Saad A Alhammad
- Department of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Shepherd T, Trinder M, Theophilus M. Does virtual reality in the preoperative setting for colorectal cancer surgery improve patient understanding? A randomized pilot study. ANZ J Surg 2024; 94:391-396. [PMID: 37994285 DOI: 10.1111/ans.18787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 10/29/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Virtual reality (VR) enhanced radiology could help improve communication with colorectal cancer patients and therefore increase understanding in the perioperative setting. The objective of this pilot trial is to assess the feasibility of conducting a randomized control trial in terms of recruitment, use and acceptability of the VR technology and validity of data collection methods. METHODS A prospective, single-centre randomized control trial was conducted at St John of God Midland Hospital in Western Australia from November to December 2021. After standard informed consent with their surgeon, elective patients planned for resection of colorectal cancer were randomized to either 'standard consent' (shown computed tomography (CT) images only) or 'VR consent' (shown CT images and immersive VR models). RESULTS Nine patients were recruited (four control; five intervention). There was a trend towards improved patient reported understanding without reaching statistical significance. Most patients preferred the use of VR as compared to CT as an educational tool during the consent process (P = 0.03). There were no adverse effects. CONCLUSION VR was well tolerated and patients enjoyed using the technology. Its use in an outpatient clinic setting for elective colorectal cancer surgery is feasible. Improvement in patient understanding using VR compared to standard consent processes in colorectal surgery should be tested in a statistically powered, high quality study design.
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Affiliation(s)
- Talia Shepherd
- General Surgery Department, SJOG Midland Public and Private Hospital, Midland, Western Australia, Australia
| | - Matthew Trinder
- General Surgery Department, SJOG Midland Public and Private Hospital, Midland, Western Australia, Australia
| | - Mary Theophilus
- General Surgery Department, SJOG Midland Public and Private Hospital, Midland, Western Australia, Australia
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Cerda IH, Therond A, Moreau S, Studer K, Donjow AR, Crowther JE, Mazzolenis ME, Lang M, Tolba R, Gilligan C, Ashina S, Kaye AD, Yong RJ, Schatman ME, Robinson CL. Telehealth and Virtual Reality Technologies in Chronic Pain Management: A Narrative Review. Curr Pain Headache Rep 2024; 28:83-94. [PMID: 38175490 DOI: 10.1007/s11916-023-01205-3] [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] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE OF REVIEW This review provides medical practitioners with an overview of the present and emergent roles of telehealth and associated virtual reality (VR) applications in chronic pain (CP) management, particularly in the post-COVID-19 healthcare landscape. RECENT FINDINGS Accumulated evidence points to the efficacy of now well-established telehealth modalities, such as videoconferencing, short messaging service (SMS), and mobile health (mHealth) applications in complementing remote CP care. More recently, and although still in early phases of clinical implementation, a wide range of VR-based interventions have demonstrated potential for improving the asynchronous remote management of CP. Additionally, VR-associated technologies at the leading edge of science and engineering, such as VR-assisted biofeedback, haptic technology, high-definition three-dimensional (HD3D) conferencing, VR-enabled interactions in a Metaverse, and the use of wearable monitoring devices, herald a new era for remote, synchronous patient-physician interactions. These advancements hold the potential to facilitate remote physical examinations, personalized remote care, and innovative interventions such as ultra-realistic biofeedback. Despite the promise of VR-associated technologies, several limitations remain, including the paucity of robust long-term effectiveness data, heterogeneity of reported pain-related outcomes, challenges with scalability and insurance coverage, and demographic-specific barriers to patient acceptability. Future research efforts should be directed toward mitigating these limitations to facilitate the integration of telehealth-associated VR into the conventional management of CP. Despite ongoing barriers to widespread adoption, recent evidence suggests that VR-based interventions hold an increasing potential to complement and enhance the remote delivery of CP care.
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Affiliation(s)
- Ivo H Cerda
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA.
| | - Alexandra Therond
- Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sacha Moreau
- Massachusetts Institute of Technology, Boston, MA, USA
| | - Kachina Studer
- Department of Earth and Planetary Science, Harvard University, Cambridge, MA, USA
- Department Mechanical Engineering, Cambridge, Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| | | | - Jason E Crowther
- Department of Anesthesiology and Perioperative Medicine, University of Massachusetts, Worcester, MA, USA
| | - Maria Emilia Mazzolenis
- Paulson School of Engineering and Applied Sciences, John A, Harvard University, Boston, MA, USA
| | - Min Lang
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Reda Tolba
- Pain Management Department in the Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - Christopher Gilligan
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Sait Ashina
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center Shreveport, Shreveport, LA, USA
| | - R Jason Yong
- Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health-Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - Christopher L Robinson
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Komariah M, Amirah S, Abdurrahman MF, Handimulya MFS, Platini H, Maulana S, Nugrahani AD, Mulyana AM, Qadous SG, Mediani HS, Mago A. Effectivity of Virtual Reality to Improve Balance, Motor Function, Activities of Daily Living, and Upper Limb Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis. Ther Clin Risk Manag 2024; 20:95-109. [PMID: 38375076 PMCID: PMC10875340 DOI: 10.2147/tcrm.s432249] [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: 07/28/2023] [Accepted: 02/03/2024] [Indexed: 02/21/2024] Open
Abstract
Background Cerebral palsy (CP) is the most common motor disorder in childhood. CP limits movement, which can interfere with children's daily activities. As a technology that provides intensive mass practice to children, virtual reality (VR) can create an interactive and motivating environment. With the intensity set by the therapist and feedback that can be used to produce individualized therapy, VR has great potential to improve CP patients' quality of life, especially in a safe, enjoyable, and playful environment. Purpose This systematic review and meta-analysis sought to determine the effectiveness of VR for children with CP. Methods We conducted a comprehensive literature search based on the PRISMA guidelines through PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of VR in managing children with CP up to 15 September 2022. Risk assessment of bias was performed using Cochrane RoB 2. Results Nineteen randomized controlled trials with 467 and 427 patients with CP were included in the intervention and control groups in qualitative and quantitative analyses. Participants consisted of cerebral palsy with hemiplegia (n=7), diplegia (n=2), a combination of both (n=4), and undefined (n=13). From all studies conducted, VR showed significant results where VR could improve balance (MD: 2.71[1.95, 3.48]; p < 0.00001), motor function (MD: 3.73 [1.67, 5.79]; p = 0.0004), and activity daily living (MD: 10.05 [2.89, 17.22]. However, VR showed not effective in improving upper limb function. Conclusion With its advantages and excellent effectiveness, VR may improve functional mobility and the quality of life of children with CP.
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Affiliation(s)
- Maria Komariah
- Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Shakira Amirah
- Faculty of Medicine, Universitas Indonesia, Depok, West Java, 16424Indonesia
| | | | | | - Hesti Platini
- Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Sidik Maulana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Annisa Dewi Nugrahani
- Maternal Fetal Division, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, 40161, Indonesia
| | - Aep Maulid Mulyana
- Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, 45363, Indonesia
| | - Shurouq Ghalib Qadous
- Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 45363, Indonesia
| | - Arpit Mago
- Department of Clinical Medicine, Jawaharlal Nehru Medical College, Belagavi, Karnataka, 590010, India
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du Plessis J, Jordaan J. The impact of virtual reality on the psychological well-being of hospitalised patients: A critical review. Heliyon 2024; 10:e24831. [PMID: 38312552 PMCID: PMC10835256 DOI: 10.1016/j.heliyon.2024.e24831] [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: 08/25/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 02/06/2024] Open
Abstract
Background and objectives Improving hospitalised patients' psychological well-being (PWB) is relevant to their recovery and overall quality of life. Virtual Reality (VR) holds the potential to emerge as a novel tool for increasing the PWB of hospitalised patients. This study critically reviewed existing research concerning the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The primary aim of this study was to evaluate the efficacy and practical applicability of VR in enhancing the PWB for hospitalised patients dealing with serious illnesses. Methodology In the initial search, the authors identified 106 sources that provided valuable insights into the broader field of VR, PWB, and the influence of VR on the psychological functioning of hospitalised patients. However, only eight articles were selected for the critical review, following the SALSA method. The SALSA method comprises the following steps: (S) Search, (AL) Appraisal, (S) Synthesis and (A) Analysis. Data extracted from these eight articles were subjected to reflexive thematic analysis, through which patterns were identified to examine the use and impact of VR on the PWB of hospitalised patients with serious illnesses. The thematic analysis process involves data gathering and familiarisation, code identification, and formulating and refining various themes to produce a thematic analysis report. Results The themes that emerged from the analysis were (i) positive psychological effects (with sub-themes including the effectiveness of VR in improving psychological symptoms, its role as an equivalent or adjunctive treatment, and symptom reduction), (ii) perceptions and the adoption of novel technology, (iii) characteristics that influence the effectiveness of VR, and (iv) statistical and practical applicability and diversity of VR. Conclusion and recommendation The use of VR to increase the PWB of hospitalised patients is a relatively recent innovation. Nevertheless, the themes identified in this study indicate that the use of VR within the context of hospitalised patients can benefit their psychological functioning, ultimately contributing to an improvement in their overall PWB. Further in-depth studies are needed to provide a comprehensive conclusion on the potential benefits of VR on the PWB of hospitalised patients dealing with serious illnesses.
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Affiliation(s)
- Jolize du Plessis
- Department of Psychology, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 9301, South Africa
| | - Jacques Jordaan
- Department of Psychology, University of the Free State, 205 Nelson Mandela Drive, Park West, Bloemfontein, 9301, South Africa
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Terkildsen MD, Bollerup S, Palmhøj C, Jensen LG, Lou S. How institutional logics shape the adoption of virtual reality in mental health care: A qualitative study. Digit Health 2024; 10:20552076241248914. [PMID: 38665887 PMCID: PMC11044789 DOI: 10.1177/20552076241248914] [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] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Objective To analyse institutional logics' role in adopting virtual reality in mental health care. Methods Data were collected via qualitative, semi-structured interviews with four frontline staff and seven administrative and service staff, two focus group interviews with three frontline staff and four administrative and service staff, and via participant observation in meetings between stakeholders working on virtual reality. Data were collected from May 2021 to February 2022, analysed using thematic analysis, and theoretically driven by the framework of Institutional logics. Results We identified two different forms of institutional logics being drawn upon by frontline staff and administrative and service staff, respectively, when working with the adoption of virtual reality in mental health care. Frontline staff drew mainly on a Professional logic; administrative and service staff drew on a Diffusion logic. Each logic defined a unique focal point, causal pathway, and perceptions of a meaningful adoption process for virtual reality. Conclusions By taking institutional logics as our theoretical and analytical point of departure, this study demonstrates how the meaning of virtual reality and its adoption in mental health care is grounded in multiple and sometimes conflicting institutional logics. Acknowledging the existence and influence of often multiple institutional logics in the adoption process is crucial to guide the future adoption of virtual reality in mental health care. Organising collaborative venues for stakeholders where their multiple institutional logics are made the subject of joint reflection is essential to counter frictions.
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Affiliation(s)
- Morten D Terkildsen
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Forensic Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Stina Bollerup
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Camilla Palmhøj
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lotte G Jensen
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
| | - Stina Lou
- DEFACTUM – Public Health Research, Central Denmark Region, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Slatman S, Groenveld T, Ostelo R, van Goor H, Staal JB, Knoop J. Development of a Multimodal, Personalized Intervention of Virtual Reality Integrated Within Physiotherapy for Patients With Complex Chronic Low-Back Pain. JOURNAL OF MEDICAL EXTENDED REALITY 2024; 1:30-43. [PMID: 38505475 PMCID: PMC10945762 DOI: 10.1089/jmxr.2023.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/01/2023] [Indexed: 03/21/2024]
Abstract
Background Chronic low-back pain (CLBP) is the leading cause of years lived with disability. Physiotherapy is the most common treatment option for CLBP, but effects are often unsatisfactory. Virtual reality (VR) offers possibilities to enhance the effectiveness of physiotherapy treatment. Primary aim was to develop and test a personalized VR intervention integrated within a physiotherapy treatment for patients with CLBP. Methods This study describes an intervention development process using mixed methods design that followed the Medical Research Council (MRC) framework. This involved a cocreation process with patients, physiotherapists, and researchers. A draft intervention was constructed based on a literature review and focus groups, and subsequently tested in a feasibility study and evaluated in focus groups. Focus group data were analyzed using thematic analysis. This intervention development process resulted in a final intervention. Results Focus group data showed that VR and physiotherapy can strengthen each other when they are well integrated, and that VR needs to be administered under the right conditions including flawless technology, physiotherapists with sufficient affinity and training, and the right expectations from patients. The draft intervention was considered feasible after evaluation by four patients and three physiotherapists and was further complemented by expanding the training for physiotherapists and improving the protocols for physiotherapists and patients. The final intervention consisted of a 12-week physiotherapy treatment with three integrated VR modules: pain education, physical exercise, and relaxation. Conclusion Using the MRC framework in cocreation with the end users, a personalized VR intervention integrated within a physiotherapy treatment for patients with CLBP was developed. This intervention was found to be feasible and will subsequently be evaluated for (cost-)effectiveness in a cluster randomized controlled trial.
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Affiliation(s)
- Syl Slatman
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Musculoskeletal Rehabilitation Research Group, School for Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Department of Biomedical Signals and Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Tjitske Groenveld
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Raymond Ostelo
- Department of Health Sciences, Faculty of Science and Amsterdam Movement Science Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit and Amsterdam Movement Sciences, Musculoskeletal Health, Amsterdam, The Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. Bart Staal
- Department of Musculoskeletal Rehabilitation Research Group, School for Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jesper Knoop
- Department of Musculoskeletal Rehabilitation Research Group, School for Allied Health, HAN University of Applied Sciences, Nijmegen, The Netherlands
- Department of Health Sciences, Faculty of Science and Amsterdam Movement Science Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
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13
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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.
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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
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14
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Szekely R, Mason O, Frohlich D, Barley E. 'It's not everybody's snapshot. It's just an insight into that world': A qualitative study of multiple perspectives towards understanding the mental health experience and addressing stigma in healthcare students through virtual reality. Digit Health 2024; 10:20552076231223801. [PMID: 38188857 PMCID: PMC10768613 DOI: 10.1177/20552076231223801] [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: 09/26/2023] [Accepted: 12/14/2023] [Indexed: 01/09/2024] Open
Abstract
Objective The resurgence of virtual reality (VR) technologies has led to their increased use in contemporary healthcare education. One promising application is simulating the experiences of individuals with mental health conditions (MHCs) to reduce stigma among future healthcare professionals. This study set out to explore what those impacted by, or involved in, the education of healthcare students think about using VR in this way. Methods One individual interview and five focus groups were conducted with healthcare students (n = 7), healthcare educators (n = 6), and lived experience experts (n = 5). Before sharing their perspectives, participants familiarised themselves with VR equipment and immersive materials simulating MHCs. The constant comparative method and thematic analysis were used to analyse the data. Results Participants recognised the acceptability and utility of VR for addressing mental health stigma in healthcare students, emphasising the immersive nature of this technology. However, some participants raised concerns about the limited insight VR could provide into the experiences of patients with the same MHCs and its potential emotional impact on users. Participants recommended the incorporation of interactive, realistic environments with a person-centred focus into future VR-based stigma reduction interventions while stressing the importance of providing healthcare students with opportunities for reflection and support. Conclusions Healthcare students, healthcare educators, and lived experience experts highlighted both advantages and barriers associated with using VR to understand the experience of patients with MHCs. Furthermore, the recommendations put forward can inform the design, content, and delivery of VR-based stigma reduction interventions in healthcare education.
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Affiliation(s)
- Raul Szekely
- School of Psychology, University of Surrey, Guildford, UK
| | - Oliver Mason
- School of Psychology, University of Surrey, Guildford, UK
| | - David Frohlich
- Digital World Research Centre, University of Surrey, Guildford, UK
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Klein Haneveld L, Kip H, Bouman YHA, Weerdmeester J, Scholten H, Kelders SM. Exploring the added value of virtual reality biofeedback game DEEP in forensic psychiatric inpatient care-A qualitative study. Front Psychol 2023; 14:1201485. [PMID: 38023054 PMCID: PMC10666827 DOI: 10.3389/fpsyg.2023.1201485] [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: 04/20/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Low motivation and suboptimal cognitive skills are common among forensic psychiatric patients. By focusing on doing and experiencing, innovative technologies could offer an alternative to existing treatment for this patient group. One promising technology is DEEP, a VR biofeedback game that teaches diaphragmatic breathing, which has shown its potential in reducing stress in other populations. This exploratory study aimed at identifying if, how and for whom DEEP can be of added value in forensic mental healthcare. Methods This study used a qualitative approach. Six focus groups with 24 healthcare providers and 13 semi-structured interviews with forensic psychiatric inpatients were conducted in two Dutch forensic mental healthcare organizations. All healthcare providers and patients experienced DEEP before participating. The data were coded inductively, using the method of constant comparison. Results The data revealed six themes with accompanying (sub)codes, including (1) the possible advantages and (2) disadvantages of DEEP, (3) patient characteristics that could make DEEP more or (4) less suitable and beneficial, (5) ways DEEP could be used in current treatment, and (6) conditions that need to be met to successfully implement DEEP in forensic mental healthcare. The results showed that DEEP can offer novel ways to support forensic psychiatric patients in coping with negative emotions by practicing diaphragmatic breathing. Its appealing design might be suitable to motivate a broad range of forensic psychiatric patient groups. However, DEEP cannot be personalized, which might decrease engagement and uptake of DEEP long-term. Regarding its place in current care, DEEP could be structurally integrated in existing treatment programs or used ad hoc when the need arises. Finally, this study showed that both healthcare providers and patients would need practical support and information to use DEEP. Conclusion With its experience-based and gamified design, DEEP could be useful for forensic mental healthcare. It is recommended that patients and healthcare providers are included in the evaluation and implementation from the start. Besides, a multilevel approach should be used for formulating implementation strategies. If implemented well, DEEP can offer new ways to provide forensic psychiatric patients with coping strategies to better control their anger.
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Affiliation(s)
- Lisa Klein Haneveld
- Department of Research, Transfore, Deventer, Netherlands
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | - Hanneke Kip
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
| | | | - Joanneke Weerdmeester
- HKU University of the Arts, Centre for Educational Research and Innovation, Utrecht, Netherlands
- Games for Emotional and Mental Health (GEMH) Lab, Enschede, Netherlands
| | - Hanneke Scholten
- Games for Emotional and Mental Health (GEMH) Lab, Enschede, Netherlands
- Communication Science, Department of Technology, Human and Institutional Behavior, University of Twente, Enschede, Netherlands
| | - Saskia M. Kelders
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, Enschede, Netherlands
- Opentia Research Unit, North-West University, Vanderbijlpark, South Africa
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Szabo DA, Neagu N, Teodorescu S, Apostu M, Predescu C, Pârvu C, Veres C. The Role and Importance of Using Sensor-Based Devices in Medical Rehabilitation: A Literature Review on the New Therapeutic Approaches. SENSORS (BASEL, SWITZERLAND) 2023; 23:8950. [PMID: 37960649 PMCID: PMC10648494 DOI: 10.3390/s23218950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/22/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023]
Abstract
Due to the growth of sensor technology, more affordable integrated circuits, and connectivity technologies, the usage of wearable equipment and sensing devices for monitoring physical activities, whether for wellness, sports monitoring, or medical rehabilitation, has exploded. The current literature review was performed between October 2022 and February 2023 using PubMed, Web of Science, and Scopus in accordance with P.R.I.S.M.A. criteria. The screening phase resulted in the exclusion of 69 articles that did not fit the themes developed in all subchapters of the study, 41 articles that dealt exclusively with rehabilitation and orthopaedics, 28 articles whose abstracts were not visible, and 10 articles that dealt exclusively with other sensor-based devices and not medical ones; the inclusion phase resulted in the inclusion of 111 articles. Patients who utilise sensor-based devices have several advantages due to rehabilitating a missing component, which marks the accomplishment of a fundamental goal within the rehabilitation program. As technology moves faster and faster forward, the field of medical rehabilitation has to adapt to the time we live in by using technology and intelligent devices. This means changing every part of rehabilitation and finding the most valuable and helpful gadgets that can be used to regain lost functions, keep people healthy, or prevent diseases.
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Affiliation(s)
- Dan Alexandru Szabo
- Department of Human Movement Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
- Department ME1, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania
| | - Nicolae Neagu
- Department of Human Movement Sciences, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540139 Targu Mures, Romania;
| | - Silvia Teodorescu
- Department of Doctoral Studies, National University of Physical Education and Sports, 060057 Bucharest, Romania;
| | - Mihaela Apostu
- Department of Special Motor and Rehabilitation Medicine, National University of Physical Education and Sports, 060057 Bucharest, Romania; (M.A.); (C.P.)
| | - Corina Predescu
- Department of Special Motor and Rehabilitation Medicine, National University of Physical Education and Sports, 060057 Bucharest, Romania; (M.A.); (C.P.)
| | - Carmen Pârvu
- Faculty of Physical Education and Sports, “Dunărea de Jos” University, 63-65 Gării Street, 337347 Galati, Romania;
| | - Cristina Veres
- Department of Industrial Engineering and Management, University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania;
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LaMarca A, Tse I, Keysor J. Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim? Healthcare (Basel) 2023; 11:2751. [PMID: 37893825 PMCID: PMC10606667 DOI: 10.3390/healthcare11202751] [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: 08/17/2023] [Revised: 10/08/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023] Open
Abstract
INTRODUCTION Chronic conditions such as stroke, Parkinson's disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care-i.e., exoskeletons, virtual/augmented reality, and remote monitoring-offer the opportunity to bring evidence-based rehabilitation into homes. Successful integration of rehabilitation techniques at home could help recovery and access and foster long term self-management. However, widespread uptake of technology in rehabilitation is still limited, leaving many technologies developed but not adopted. METHODS In this narrative review, clinical need, efficacy, and obstacles and suggestions for implementation are discussed. The use of three technologies is reviewed in the management of the most prevalent chronic diseases that utilize rehabilitation services, including common neurological, musculoskeletal, metabolic, pulmonary, and cardiac conditions. The technologies are (i) exoskeletons, (ii) virtual and augmented reality, and (iii) remote monitoring. RESULTS Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes. CONCLUSION While rehabilitation technologies bring opportunities to bridge the gap between clinics and homes, there are many challenges with adoption. Hybrid effectiveness and implementation trials are a possible path to successful technology development and adoption.
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Affiliation(s)
- Amber LaMarca
- Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA 02129, USA;
| | - Ivy Tse
- Doctor of Physical Therapy Program, MGH Institute of Health Professions, Boston, MA 02129, USA
| | - Julie Keysor
- School of Health Care Leadership, MGH Institute of Health Professions, Boston, MA 02129, USA
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