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Shen J, Wang Y, Quinn S, Suskauer SJ, Birch J, Busch T, Svingos A, Crawfis R, Yeates KO, Taylor HG. Efficacy of a virtual reality-based cognitive interactive training program for children with traumatic brain injuries: study protocol for a parallel-group randomized controlled trial. Trials 2024; 25:185. [PMID: 38481293 PMCID: PMC10935958 DOI: 10.1186/s13063-024-08049-1] [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: 12/26/2023] [Accepted: 03/08/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of disability in children. Cognitive rehabilitation for this population is critical for their long-term health outcomes. This trial aims to evaluate the efficacy of a virtual reality-based program (VICT) for training executive functions in children with TBI. METHODS A parallel group randomized controlled trial will be conducted among up to 32 children with TBI. Children in the intervention group will receive the VICT training while children in the control group will play a comparable VR game without executive function training. Each participant will be assessed at baseline, post-intervention, and 1-month follow-up. Outcomes will include core executive functions, attention, and health-related quality of life measured by computerized tasks or standardized questionnaires. DISCUSSION Cognitive rehabilitation is among the top healthcare needs for pediatric TBI patients. Virtual reality-based training is promising due to its versatile content, flexibility, and potential cost savings for both patients and providers. Findings of this trial will provide data on the efficacy of the VICT program on core executive functions, attention problems, and health-related quality of life and serve as the empirical foundation for future larger multi-site effectiveness trials. TRIAL REGISTRATION ClinicalTrials.gov NCT04526639 . Registered on August 18, 2020.
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Affiliation(s)
- Jiabin Shen
- Department of Psychology, University of Massachusetts Lowell, Lowell, USA.
| | - Yan Wang
- Department of Psychology, University of Massachusetts Lowell, Lowell, USA
| | - Susan Quinn
- Inpatient Rehabilitation Unit, Spaulding Rehabilitation Hospital, Boston, USA
| | - Stacy J Suskauer
- Kennedy Krieger Institute and Departments of Physical Medicine & Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Julia Birch
- Spaulding Rehabilitation Hospital, Boston, USA
| | - Tyler Busch
- Brain Injury Clinical Research Center, Kennedy Krieger Institute, Departments of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Adrian Svingos
- Brain Injury Clinical Research Center, Kennedy Krieger Institute, Departments of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Roger Crawfis
- Department of Computer Science & Engineering, The Ohio State University, Columbus, USA
| | | | - H Gerry Taylor
- Abigail Research Institute at Nationwide Children's Hospital, The Ohio State University, Columbus, USA
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Dicianno BE, Joseph J, Eckstein S, Zigler CK, Quinby E, Schmeler MR, Schein RM, Pearlman J, Cooper RA. The Voice of the Consumer: A Survey of Veterans and Other Users of Assistive Technology. Mil Med 2019; 183:e518-e525. [PMID: 29635318 DOI: 10.1093/milmed/usy033] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/12/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction A total of 3.6 million Americans and over 250,000 veterans use wheelchairs. The need for advancements in mobility-assistive technologies is continually growing due to advances in medicine and rehabilitation that preserve and prolong the lives of people with disabilities, increases in the senior population, and increases in the number of veterans and civilians involved in conflict situations. The purpose of this study is to survey a large sample of veterans and other consumers with disabilities who use mobility-assistive technologies to identify priorities for future research and development. Materials and Methods This survey asked participants to provide opinions on the importance of developing various mobility-assistive technologies and to rank the importance of certain technologies. Participants were also asked to provide open-ended comments and suggestions. Results A total of 1,022 individuals, including 500 veterans, from 49 states within the USA and Puerto Rico completed the survey. The average age of respondents was 54.3 yr, and they represented both new and experienced users of mobility-assistive technologies. The largest diagnostic group was spinal cord injury (SCI) (N = 491, 48.0%). Several themes on critical areas of research emerged from the open-ended questions, which generated a total of 1,199 comments. Conclusion This survey revealed several themes for future research and development. Advanced wheelchair design, smart device applications, human-machine interfaces, and assistive robotics and intelligent systems emerged as priorities. Survey results also demonstrated the importance for researchers to understand the effects of policy and cost on translational research and to be involved in educating both consumers and providers.
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Affiliation(s)
- Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - James Joseph
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Stacy Eckstein
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Christina K Zigler
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Eleanor Quinby
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Mark R Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Richard M Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Jon Pearlman
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
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Baria AM, Pangarkar S, Abrams G, Miaskowski C. Adaption of the Biopsychosocial Model of Chronic Noncancer Pain in Veterans. PAIN MEDICINE 2019; 20:14-27. [PMID: 29727005 DOI: 10.1093/pm/pny058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Population Veterans with chronic noncancer pain (CNCP) are a vulnerable population whose care remains a challenge for clinicians, policy-makers, and researchers. As a result of military experience, veterans are exposed to high rates of musculoskeletal injuries, trauma, psychological stressors (e.g., post-traumatic stress disorder, depression, anxiety, substance abuse), and social factors (e.g., homelessness, social isolation, disability, decreased access to medical care) that contribute to the magnitude and impact of CNCP. In the veteran population, sound theoretical models are needed to understand the specific physiological, psychological, and social factors that influence this unique experience. Objective This paper describes an adaption of Gatchel and colleagues' biopsychosocial model of CNCP to veterans and summarizes research findings that support each component of the revised model. The paper concludes with a discussion of important implications for the use of this revised model in clinical practice and future directions for research. Conclusions The adaption of the biopsychosocial model of CNCP for veterans provides a useful and relevant conceptual framework that can be used to guide future research and improve clinical care in this vulnerable population.
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Affiliation(s)
- Ariel M Baria
- Veterans Affairs Greater Los Angeles Healthcare, Los Angeles, California.,School of Nursing
| | - Sanjog Pangarkar
- Veterans Affairs Greater Los Angeles Healthcare, Los Angeles, California.,David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Gary Abrams
- School of Medicine, University of California, San Francisco, San Francisco, California
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Cooper RA, Tuakli-Wosornu YA, Henderson GV, Quinby E, Dicianno BE, Tsang K, Ding D, Cooper R, Crytzer TM, Koontz AM, Rice I, Bleakney AW. Engineering and Technology in Wheelchair Sport. Phys Med Rehabil Clin N Am 2018; 29:347-369. [PMID: 29627093 DOI: 10.1016/j.pmr.2018.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Technologies capable of projecting injury and performance metrics to athletes and coaches are being developed. Wheelchair athletes must be cognizant of their upper limb health; therefore, systems must be designed to promote efficient transfer of energy to the handrims and evaluated for simultaneous effects on the upper limbs. This article is brief review of resources that help wheelchair users increase physiologic response to exercise, develop ideas for adaptive workout routines, locate accessible facilities and outdoor areas, and develop wheelchair sports-specific skills.
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Affiliation(s)
- Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA.
| | - Yetsa A Tuakli-Wosornu
- Yale University Orthopaedics & Rehabilitation, Yale Physicians Building, 800 Howard Avenue, New Haven, CT 06510, USA
| | - Geoffrey V Henderson
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Kaufmann Medical Building, Suite 201, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Eleanor Quinby
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Kaufmann Medical Building, Suite 201, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Kalai Tsang
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Dan Ding
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Rosemarie Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Theresa M Crytzer
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Alicia M Koontz
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Ian Rice
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, Louise Freer Hall, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Adam W Bleakney
- Disability Resources & Educational Services, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, 1207 S. Oak Street, Champaign, IL 61820, USA
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Dicianno BE, Joseph J, Eckstein S, Zigler CK, Quinby EJ, Schmeler MR, Schein RM, Pearlman J, Cooper RA. The future of the provision process for mobility assistive technology: a survey of providers. Disabil Rehabil Assist Technol 2018; 14:338-345. [PMID: 29557196 DOI: 10.1080/17483107.2018.1448470] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the opinions of providers of mobility assistive technologies to help inform a research agenda and set priorities. MATERIALS AND METHODS This survey study was anonymous and gathered opinions of individuals who participate in the process to provide wheelchairs and other assistive technologies to clients. Participants were asked to rank the importance of developing various technologies and rank items against each other in terms of order of importance. Participants were also asked to respond to several open-ended questions or statements. RESULTS A total of 161 providers from 35 states within the USA consented to participation and completed the survey. CONCLUSIONS This survey revealed themes of advanced wheelchair design, assistive robotics and intelligent systems, human machine interfaces and smart device applications. It also outlined priorities for researchers to provide continuing education to clients and providers. These themes will be used to develop research and development priorities. Implications for Rehabilitation • Research in advanced wheelchair design is needed to facilitate travel and environmental access with wheelchairs and to develop alternative power sources for wheelchairs.• New assistive robotics and intelligent systems are needed to help wheelchairs overcome obstacles or self-adjust, assist wheelchair navigation in the community, assist caregivers and transfers, and aid ambulation.• Innovations in human machine interfaces may help advance the control of mobility devices and robots with the brain, eye movements, facial gesture recognition or other systems.• Development of new smart devices is needed for better control of the environment, monitoring activity and promoting healthy behaviours.
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Affiliation(s)
- Brad E Dicianno
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.,c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - James Joseph
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA
| | - Stacy Eckstein
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA
| | - Christina K Zigler
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Eleanor J Quinby
- b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Mark R Schmeler
- c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - Richard M Schein
- c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - Jon Pearlman
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - Rory A Cooper
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.,c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
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Kelleher A, Dicianno BE, Eckstein S, Schein R, Pearlman J, Cooper RA. Consumer Feedback to Steer the Future of Assistive Technology Research and Development: A Pilot Study. Top Spinal Cord Inj Rehabil 2018; 23:89-97. [PMID: 29339885 DOI: 10.1310/sci2302-89] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: The overall objective of this project was to identify consumers' opinions of their needs and wants related to assistive technology (AT) in a systematic and quantitative manner via a questionnaire that can be used to validate existing and establish new research priorities. Methods: This pilot study describes questionnaire development, online implementation, and revisions considered to the questionnaire in preparation for conducting a nationwide survey. Data from a sample (N = 112) are presented. The pilot study was critical to refine the questions and ensure that meaningful information was being collected. Results: It was identified that revisions were warranted to provide more structure and allow for consumers to prioritize AT research efforts. Conclusion: The questionnaire results, although positively in favor of many of the technologies presented, are inconclusive to identify generalizable research priorities, thus expansion to a nationwide population is warranted.
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Affiliation(s)
- Annmarie Kelleher
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Stacy Eckstein
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Richard Schein
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan Pearlman
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania.,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania
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Dietrich WD. Protection and Repair After Spinal Cord Injury: Accomplishments and Future Directions. Top Spinal Cord Inj Rehabil 2015; 21:174-87. [PMID: 26364287 DOI: 10.1310/sci2102-174] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
It was an honor for me to present the 2014 G. Heiner Sell Memorial Lecture at the annual American Spinal Injury Association (ASIA) meeting in San Antonio. For this purpose, I provided a comprehensive review of the scope of research targeting discovery and translational and clinical investigations into spinal cord injury (SCI) research. Indeed, these are exciting times in the area of spinal cord research and clinical initiatives. Many laboratories and clinical programs throughout the world are publishing data related to the pathophysiology of SCI and new strategies for protecting and promoting recovery in both animal models and humans. For this lecture, several topics were discussed including neuroprotective and reparative strategies, neurorehabilitation, quality of life issues, and future directions. In the area of neuroprotection, pathophysiological events that may be targeted with therapeutic strategies, including pharmacological and targeted temperature management were reviewed. For reparative approaches, the importance of both intrinsic and extrinsic mechanisms of axonal regeneration was highlighted. Various cell therapies currently being tested in preclinical and clinical arenas were reviewed as well as ongoing US Food and Drug Administration approved trials for SCI patients. Neurorehabilitation is an evolving research field with locomotive training strategies, electrical stimulation, and brain-machine interface programs targeting various types of SCI. The importance of testing combination approaches including neuroprotective, reparative, and rehabilitative strategies to maximize recovery mechanisms was therefore emphasized. Finally, quality of life issues that affect thousands of individuals living with paralysis were also presented. Future directions and specific obstacles that require attention as we continue to move the SCI field forward were discussed.
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Affiliation(s)
- W Dalton Dietrich
- The Miami Project to Cure Paralysis and the Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida
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