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Macchi G, De Pisapia N. Virtual reality, face-to-face, and 2D video conferencing differently impact fatigue, creativity, flow, and decision-making in workplace dynamics. Sci Rep 2024; 14:10260. [PMID: 38704442 PMCID: PMC11069516 DOI: 10.1038/s41598-024-60942-6] [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: 10/05/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
Digital communication technologies are rapidly evolving, and understanding their impact on group dynamics and cognitive performance in professional settings becomes central. This study investigates the psychological impact of different interaction settings-two-dimensional Video Conferencing (VC), Face-To-Face (FTF), and Virtual Reality (VR)-on group dynamics, cognitive performance, and aspects of well-being in a professional context. Utilizing a sample of 40 participants from a large Italian electricity transmission company, the study employs a within-subjects design to explore various metrics, including flow, creativity, fatigue and aspects of interaction. The results indicate that FTF interactions are optimal for idea generation and task absorption. VR, although initially more fatiguing for first-time users, fosters a more collaborative and peaceful environment, encouraging participants to engage more openly with each other. VC was found to be the least fatiguing, but also the least engaging in terms of task absorption and idea generation. Additionally, age-related differences were observed, particularly in the perception of motivational and emotional fatigue in the VR setting. The study provides empirical evidence supporting the integration of VR in professional settings for specific types of meetings, while also highlighting the limitations and areas for future research. These findings have implications for organizational well-being, cognitive ergonomics, and the evolving landscape of remote work technologies.
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Affiliation(s)
- Gregorio Macchi
- Department of Psychology and Cognitive Science (DIPSCO), University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Nicola De Pisapia
- Department of Psychology and Cognitive Science (DIPSCO), University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy.
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Nguyen CM, Uy J, Serrada I, Hordacre B. Quantifying patient experiences with therapeutic neurorehabilitation technologies: a scoping review. Disabil Rehabil 2024; 46:1662-1672. [PMID: 37132669 DOI: 10.1080/09638288.2023.2201514] [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: 12/02/2022] [Accepted: 04/06/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Neurorehabilitation technologies are a novel approach to providing rehabilitation for patients with neurological conditions. There is a need to explore patient experiences. This study aimed; 1) To identify available questionnaires that assess patients' experiences with neurorehabilitation technologies, and 2) where reported, to document the psychometric properties of the identified questionnaires. MATERIALS AND METHODS Four databases were searched (Medline, Embase, Emcare and PsycInfo). The inclusion criteria were all types of primary data collection that included neurological patients of all ages who had experienced therapy with neurorehabilitation technologies and completed questionnaires to assess these experiences. RESULTS Eighty-eight publications were included. Fifteen different questionnaires along with many self-developed scales were identified. These were categorised as; 1) self-developed tools, 2) specific questionnaire for a particular technology, and 3) generic questionnaires originally developed for a different purpose. The questionnaires were used to assess various technologies, including virtual reality, robotics, and gaming systems. Most studies did not report any psychometric properties. CONCLUSION Many tools have been used to evaluate patient experiences, but few were specifically developed for neurorehabilitation technologies and psychometric data was limited. A preliminary recommendation would be use of the User Satisfaction Evaluation Questionnaire to evaluate patient experience with virtual reality systems.
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Affiliation(s)
- Chi Mai Nguyen
- University of South Australia, Allied Health and Human Performance, Adelaide, Australia
| | - Jeric Uy
- University of South Australia, Allied Health and Human Performance, Adelaide, Australia
| | - Ines Serrada
- University of South Australia, Allied Health and Human Performance, Adelaide, Australia
| | - Brenton Hordacre
- University of South Australia, Innovation, Implementation and Clinical Translation (IIMPACT), Health Allied Health and Human Performance, Adelaide, Australia
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Voinescu A, Petrini K, Stanton Fraser D. Presence and simulator sickness predict the usability of a virtual reality attention task. VIRTUAL REALITY 2023; 27:1-17. [PMID: 37360806 PMCID: PMC10038382 DOI: 10.1007/s10055-023-00782-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 02/26/2023] [Indexed: 06/28/2023]
Abstract
Attention is the ability to actively process specific information within one's environment over longer periods of time while disregarding other details. Attention is an important process that contributes to overall cognitive performance from performing every day basic tasks to complex work activities. The use of virtual reality (VR) allows study of the attention processes in realistic environments using ecological tasks. To date, research has focused on the efficacy of VR attention tasks in detecting attention impairment, while the impact of the combination of variables such as mental workload, presence and simulator sickness on both self-reported usability and objective attention task performance in immersive VR has not been examined. The current study tested 87 participants on an attention task in a virtual aquarium using a cross-sectional design. The VR task followed the continuous performance test paradigm where participants had to respond to correct targets and ignore non-targets over 18 min. Performance was measured using three outcomes: omission (failing to respond to correct targets), commission errors (incorrect responses to targets) and reaction time to correct targets. Measures of self-reported usability, mental workload, presence and simulator sickness were collected. The results showed that only presence and simulator sickness had a significant impact on usability. For performance outcomes, simulator sickness was significantly and weakly associated with omission errors, but not with reaction time and commission errors. Mental workload and presence did not significantly predict performance. Our results suggest that usability is more likely to be negatively impacted by simulator sickness and lack of presence than performance and that usability and attention performance are linked. They highlight the importance of considering factors such as presence and simulator sickness in attention tasks as these variables can impact usability. Supplementary Information The online version contains supplementary material available at 10.1007/s10055-023-00782-3.
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Affiliation(s)
- Alexandra Voinescu
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Karin Petrini
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
- Centre for the Analysis of Motion, Entertainment Research and Applications, University of Bath, Bath, UK
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Shah SHH, Karlsen AST, Solberg M, Hameed IA. A social VR-based collaborative exergame for rehabilitation: codesign, development and user study. VIRTUAL REALITY 2022; 27:1-18. [PMID: 36465891 PMCID: PMC9702607 DOI: 10.1007/s10055-022-00721-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 11/13/2022] [Indexed: 06/17/2023]
Abstract
Immersive virtual reality (VR)-based exercise video games (exergames) are increasingly being employed as a supportive intervention in rehabilitation programs to promote engagement in physical activity, especially for elderly users. A multifaceted and iterative codesign process is essential to develop sustainable exergaming solutions. The social aspect is considered one of the key motivating factors in exergames; however, research on the social aspect of VR exergames has been limited. Previous studies have relied on competitiveness in exergames, but research has shown that competition can lead to adverse effects on users. With the aim of motivating elderly individuals to participate in physical exercise and improving social connectedness during rehabilitation, this work presents a social VR-based collaborative exergame codesigned with elderly participants and therapists. This exergame stimulates full-body exercise and supports social collaboration among users through a collaborative game task. Furthermore, this article presents a user study based on a mixed-methods approach to gather user feedback on exergame design and the effect of social collaboration versus playing alone in a VR exergame in terms of physical exertion and motivation. This study spanned five weeks (99 exergaming sessions) with 14 elderly participants divided into two groups, one playing collaboratively and the other playing individually. Between-group comparisons were performed at baseline (first week) and in the fourth week, and within-group comparisons were performed in the fifth week, when the participants played the exergame in counterbalanced order. In contrast to the first week, the participants exergaming collaboratively in the fourth week reported significantly higher intrinsic motivation on all subscales (enjoyment: p < 0.02, effort: p < 0.002, usefulness: p < 0.01) and physical exertion (p < 0.001) than those playing alone. Thereafter, exergaming in counterbalanced order during the fifth week resulted in significant differences (medium to large effect size) within groups. The participants found the social VR gameplay enjoyable and agreed that collaboration played a vital role in their motivation. They reported various health benefits, a minimal increase in symptoms of simulator sickness, and excellent usability scores (83.75±13.3). In this work, we also identify various key design principles to support healthcare professionals, researchers and industrial experts in developing ergonomic and sustainable VR-based exergames for senior citizens.
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Affiliation(s)
- Syed Hammad Hussain Shah
- Department of ICT and Natural Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
| | - Anniken Susanne T. Karlsen
- Department of ICT and Natural Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
| | - Mads Solberg
- Department of Health Sciences, Faculty of Medicine and Health Science, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
| | - Ibrahim A. Hameed
- Department of ICT and Natural Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology (NTNU), Larsgårdsvegen 2, 6009 Ålesund, Norway
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Montoro-Cárdenas D, Cortés-Pérez I, Ibancos-Losada MDR, Zagalaz-Anula N, Obrero-Gaitán E, Osuna-Pérez MC. Nintendo ® Wii Therapy Improves Upper Extremity Motor Function in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12343. [PMID: 36231643 PMCID: PMC9566093 DOI: 10.3390/ijerph191912343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Nintendo® Wii-based therapy (NWT) is a non-immersive virtual reality therapy used to recover upper extremity (UE) motor function in children with cerebral palsy (CP). We aimed primarily to elucidate the effectiveness of NWT in improving UE motor and functional impaired abilities in children with CP, compared to conventional therapy or no intervention. The secondary aim was to assess if NWT is more effective when used alone or combined with conventional therapy. METHODS A systematic review with meta-analysis was conducted from a bibliographic search in PubMed, Scopus, PEDro, Web of Science, and CINHAL, ending in October 2021, in accordance with PRISMA guidelines. We included randomized controlled trials that compared NWT vs. conventional therapy or no intervention in terms of their impact on different UE impaired abilities (grip strength, tip grip strength, UE dissociated movements, functional capacity in daily living activities, gross and fine motor dexterity, and grasping ability) in children with CP. Effect size was calculated with standardized mean difference (SMD) and its 95% confidence interval (95% CI). RESULTS Nine studies (276 participants) were included. NWT is more effective than conventional therapy at improving grip strength (SMD = 0.5, 95% CI 0.08, 0.91), tip grip strength (SMD = 0.95, 95% CI 0.3, 1.61), and grasping ability (SMD = 0.72, 95%CI 0.14, 1.3). NWT is more effective than conventional therapy at improving functional capacity in daily living activities (SMD = 0.83, 95% CI 0.07, 1.56). For fine manual dexterity, NWT was better than no intervention (SMD = 3.12, 95% CI 1.5, 4.7). CONCLUSIONS Our results indicate that NWT is effective at improving various UE impaired motor skills in children with CP.
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Chuang CS, Chen YW, Zeng BY, Hung CM, Tu YK, Tai YC, Wu YC, Hsu CW, Lei WT, Wu SL, Stubbs B, Carvalho AF, Su KP, Chen TY, Tseng PT, Wu MK, Tsai CH. Effects of modern technology (exergame and virtual reality)-assisted rehabilitation vs conventional rehabilitation in patients with Parkinson’s disease: a network meta-analysis of randomised controlled trials. Physiotherapy 2022; 117:35-42. [DOI: 10.1016/j.physio.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 06/04/2022] [Accepted: 07/12/2022] [Indexed: 01/08/2023]
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Zanatta F, Giardini A, Pierobon A, D'Addario M, Steca P. A systematic review on the usability of robotic and virtual reality devices in neuromotor rehabilitation: patients' and healthcare professionals' perspective. BMC Health Serv Res 2022; 22:523. [PMID: 35443710 PMCID: PMC9020115 DOI: 10.1186/s12913-022-07821-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/14/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The application of virtual reality (VR) and robotic devices in neuromotor rehabilitation has provided promising evidence in terms of efficacy, so far. Usability evaluations of these technologies have been conducted extensively, but no overviews on this topic have been reported yet. METHODS A systematic review of the studies on patients' and healthcare professionals' perspective through searching of PubMed, Medline, Scopus, Web of Science, CINAHL, and PsychINFO (2000 to 2021) was conducted. Descriptive data regarding the study design, participants, technological devices, interventions, and quantitative and qualitative usability evaluations were extracted and meta-synthetized. RESULTS Sixty-eight studies were included. VR devices were perceived as having good usability and as a tool promoting patients' engagement and motivation during the treatment, as well as providing strong potential for customized rehabilitation sessions. By contrast, they suffered from the effect of learnability and were judged as potentially requiring more mental effort. Robotics implementation received positive feedback along with high satisfaction and perceived safety throughout the treatment. Robot-assisted rehabilitation was considered useful as it supported increased treatment intensity and contributed to improved patients' physical independence and psychosocial well-being. Technical and design-related issues may limit the applicability making the treatment difficult and physically straining. Moreover, cognitive and communication deficits were remarked as potential barriers. CONCLUSIONS Overall, VR and robotic devices have been perceived usable so far, reflecting good acceptance in neuromotor rehabilitation programs. The limitations raised by the participants should be considered to further improve devices applicability and maximise technological rehabilitation effectiveness. TRIAL REGISTRATION PROSPERO registration ref. CRD42021224141 .
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Affiliation(s)
- Francesco Zanatta
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Anna Giardini
- Information Technology Department, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Antonia Pierobon
- Psychology Unit of Montescano Institute, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Italy.
| | - Marco D'Addario
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Steca
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
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A pilot randomised control trial of the efficacy of stability-based training with visualisation for people with chronic ankle instability. Med Biol Eng Comput 2022; 60:1199-1209. [PMID: 35247167 PMCID: PMC8933360 DOI: 10.1007/s11517-022-02533-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 02/14/2022] [Indexed: 11/23/2022]
Abstract
Chronic ankle instability (CAI) is associated with recurring symptoms that inhibit daily activity. Stability-based rehabilitative training is recommended for CAI. Visualisation (VIS) produces real-time feedback using motion capture and virtual reality. This pilot study aimed to determine the feasibility, adherence, safety, and efficacy of incorporating VIS into stability training for people with CAI. Efficacy was examined through effect of VIS training on dynamic stability, perception of stability, and rehabilitative experience. Individuals with CAI completed a 4-week stability-based training programme with VIS, or without visualisation (NO-VIS). Participants completed the Star Excursion Balance Test (SEBT) and Cumberland Ankle Instability Tool (CAIT) prior to, and after training. Enjoyment of training was recorded using the Physical Activity Enjoyment Scale (PACES-8). Of 17 participants (VIS = 10, NO-VIS = 7), there were 2 drop outs (VIS = 1, NO-VIS = 1). No adverse events were reported, and participant drop-out was due to injury unrelated to the study. The VIS group showed a significantly greater increase in average SEBT reach distance (d = 1.7, p = 0.02). No significant differences were reported for the CAIT or PACES-8. This study supports the feasibility and safety of stability-based training with VIS in those with CAI. The enhanced performance outcome on the SEBT suggests VIS may enhance stability-based training.
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Wu J, Zhang H, Chen Z, Fu R, Yang H, Zeng H, Ren Z. Benefits of Virtual Reality Balance Training for Patients With Parkinson Disease: Systematic Review, Meta-analysis, and Meta-Regression of a Randomized Controlled Trial. JMIR Serious Games 2022; 10:e30882. [PMID: 35230242 PMCID: PMC8924777 DOI: 10.2196/30882] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/07/2021] [Accepted: 12/11/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Virtual reality (VR) balance training is increasingly being pursued in biomedical research, specifically with respect to investigating balance ability with VR. However, existing systematic reviews have found inconsistent conclusions about the efficacy of VR in improving balance in Parkinson disease (PD) patients. OBJECTIVE The goal of the research was to evaluate the impact of VR balance training on the balance ability of patients with PD. METHODS All major databases, including Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, and Wanfang, were searched to identify all relevant studies published in English or Chinese since September 15, 2010. Two researchers independently conducted document retrieval, study selection, data extraction, and methodological quality evaluation. RESULTS A total of 16 randomized controlled trials were analyzed (n=583 patients with PD), with the methodological quality evaluation score ranging from 5 to 8 points. A random effects model was selected to combine effect sizes. Meta-analysis showed that the balance ability of PD was significantly improved after VR training compared with the control group (standardized mean difference [SMD] 2.127, 95% CI 1.202 to 3.052, P<.001, I2=95.1, df=15). It is worth noting that the intervention platform may be the main reason for heterogeneity. Meta regression analysis showed that no training program could predict the impact of VR training (P=.57 to .94) on PD balance ability. Subgroup result showed that a single training time of 0 to 20 minutes (SMD 6.446), 4 to 6 times per week (SMD 4.067), training for 3 to 5 weeks (SMD 62.478), training course reached more than 30 times (SMD 4.405), and 201 to 300 minutes per week (SMD 4.059) maybe have more benefit. CONCLUSIONS A systematic review and meta-analysis confirmed that VR balance training is a highly effective means to improve balance performance with large effects in PD. In addition, we preliminarily extracted dose-effect relationships for training volume, informing clinicians and practitioners to design effective VR balance training for balance ability. Further research is needed to reveal optimal dose-response relationships following VR balance training.
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Affiliation(s)
- Jinlong Wu
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Hui Zhang
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Ziyan Chen
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Ruijia Fu
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Hao Yang
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Hongfa Zeng
- Department of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- Department of Physical Education, Shenzhen University, Shenzhen, China
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García-Muñoz C, Casuso-Holgado MJ, Hernández-Rodríguez JC, Pinero-Pinto E, Palomo-Carrión R, Cortés-Vega MD. Feasibility and safety of an immersive virtual reality-based vestibular rehabilitation programme in people with multiple sclerosis experiencing vestibular impairment: a protocol for a pilot randomised controlled trial. BMJ Open 2021; 11:e051478. [PMID: 34810187 PMCID: PMC8609940 DOI: 10.1136/bmjopen-2021-051478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 10/22/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Vestibular system damage in patients with multiple sclerosis (MS) may have a central and/or peripheral origin. Subsequent vestibular impairments may contribute to dizziness, balance disorders and fatigue in this population. Vestibular rehabilitation targeting vestibular impairments may improve these symptoms. Furthermore, as a successful tool in neurological rehabilitation, immersive virtual reality (VRi) could also be implemented within a vestibular rehabilitation intervention. METHODS AND ANALYSIS This protocol describes a parallel-arm, pilot randomised controlled trial, with blinded assessments, in 30 patients with MS with vestibular impairment (Dizziness Handicap Inventory ≥16). The experimental group will receive a VRi vestibular rehabilitation intervention based on the conventional Cawthorne-Cooksey protocol; the control group will perform the conventional protocol. The duration of the intervention in both groups will be 7 weeks (20 sessions, 3 sessions/week). The primary outcomes are the feasibility and safety of the vestibular VRi intervention in patients with MS. Secondary outcome measures are dizziness symptoms, balance performance, fatigue and quality of life. Quantitative assessment will be carried out at baseline (T0), immediately after intervention (T1), and after a follow-up period of 3 and 6 months (T2 and T3). Additionally, in order to further examine the feasibility of the intervention, a qualitative assessment will be performed at T1. ETHICS AND DISSEMINATION The study was approved by the Andalusian Review Board and Ethics Committee, Virgen Macarena-Virgen del Rocio Hospitals (ID 2148-N-19, 25 March 2020). Informed consent will be collected from participants who wish to participate in the research. The results of this research will be disseminated by publication in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER NCT04497025.
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Affiliation(s)
| | | | | | | | - Rocío Palomo-Carrión
- Department of Nursery, Physiotherapy and Occupational Therapy, University of Castilla-La Mancha, Toledo, Spain
- GIFTO, Physiotherapy Research Group, Toledo, Spain
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Ebrahimi N, Rojhani-Shirazi Z, Yoosefinejad AK, Nami M. The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial. BMC Musculoskelet Disord 2021; 22:900. [PMID: 34696764 PMCID: PMC8544183 DOI: 10.1186/s12891-021-04785-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/08/2021] [Indexed: 11/10/2022] Open
Abstract
Background Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment. Methods Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses. Results Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group. Conclusion This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP. Trial registration IRCT, IRCT20090831002391N40. Registered 23 / 10 / 2019.
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Affiliation(s)
- Naghmeh Ebrahimi
- Student Research Committee, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abiverdi 1Street, P.O. Box: 71345-1733, Shiraz, Iran
| | - Zahra Rojhani-Shirazi
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abiverdi 1Street, P.O. Box: 71345-1733, Shiraz, Iran.,Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amin Kordi Yoosefinejad
- Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Chamran Blvd., Abiverdi 1Street, P.O. Box: 71345-1733, Shiraz, Iran. .,Rehabilitation Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Nami
- Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Panama City, 084301103, Panama.,Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, 71348-14336, Iran.,Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, 71364-76172, Iran.,Academy of Health, Senses Cultural Foundation, Sacramento, CA, 66006, USA.,Department of Cognitive Neuroscience, Institute for Cognitive Science Studies (ICSS), Pardis, Tehran, 1658344575, Iran
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Rodríguez-Mansilla J, Mejías-Gil A, Garrido-Ardila EM, Jiménez-Palomares M, Montanero-Fernández J, González-López-Arza MV. Effects of Non-Pharmacological Treatment on Pain, Flexibility, Balance and Quality of Life in Women with Fibromyalgia: A Randomised Clinical Trial. J Clin Med 2021; 10:jcm10173826. [PMID: 34501274 PMCID: PMC8432021 DOI: 10.3390/jcm10173826] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/18/2021] [Accepted: 08/25/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The functional deficits in people with fibromyalgia can be related to the level of physical activity performed. This study investigated the effectiveness of an active exercise programme versus exercise for well-being improving pain, flexibility, static balance, perceived exertion and quality of life of women with fibromyalgia; Methods: A randomised, single-blind, controlled trial was conducted. A total of 141 of women diagnosed with fibromyalgia were enrolled and randomised to an active exercise program group (n = 47), where they performed physical active exercises, an exercise for well-being group (n = 47), which performed the Qi Gong exercises named ‘the twenty Wang Ziping figures for health and longevity’, and a control group (n = 47), which did not receive any intervention, for a period of 4 weeks. Measures were taken at baseline and after the treatment. The primary outcome measures were static balance and centre of gravity (Wii-Fit Nintendo ©), flexibility (test de Wells and Dillon), pain (Visual Analogue Scale) and quality of life (Spanish-Fibromyalgia Impact Questionnaire). The secondary outcome measure was the perceived exertion during activity (BORG Scale). Results: In total, 93 participants completed the study. The mean value of the age was 52.24 ± 6.19. The post intervention results showed statistically significant improvements in the exercise for well-being and the active exercise programme groups vs. the control group in relation to pain (p = 0.006 active exercise programme group, p = 0.001 exercise for well-being group), static balance (p < 0.001 active exercise programme group) and quality of life (p < 0.001 active exercise programme group, p = 0.002 exercise for well-being group). In addition, the mean scores related to perceived fatigue during the sessions were 6.30 ± 1.88 for the active exercise programme group and 5.52 ± 1.55 for the exercise for well-being group. These differences were not significant. Conclusions: The active exercise program and exercise for well-being improved flexibility, static balance, pain and quality of life of women with fibromyalgia. The participants of the active exercise programme achieved better results that those of the exercise for well-being.
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Affiliation(s)
- Juan Rodríguez-Mansilla
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (J.R.-M.); (A.M.-G.); (M.J.-P.); (M.V.G.-L.-A.)
| | - Abel Mejías-Gil
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (J.R.-M.); (A.M.-G.); (M.J.-P.); (M.V.G.-L.-A.)
| | - Elisa María Garrido-Ardila
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (J.R.-M.); (A.M.-G.); (M.J.-P.); (M.V.G.-L.-A.)
- Correspondence: ; Tel.: +34-653369655
| | - María Jiménez-Palomares
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (J.R.-M.); (A.M.-G.); (M.J.-P.); (M.V.G.-L.-A.)
| | - Jesús Montanero-Fernández
- Mathematics Department, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain;
| | - María Victoria González-López-Arza
- ADOLOR Research Group, Department of Medical-Surgical Therapy, Faculty of Medicine and Health Sciences, Extremadura University, 06006 Badajoz, Spain; (J.R.-M.); (A.M.-G.); (M.J.-P.); (M.V.G.-L.-A.)
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13
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Kuroda Y, Young M, Shoman H, Punnoose A, Norrish AR, Khanduja V. Advanced rehabilitation technology in orthopaedics-a narrative review. INTERNATIONAL ORTHOPAEDICS 2021; 45:1933-1940. [PMID: 33051693 PMCID: PMC8338874 DOI: 10.1007/s00264-020-04814-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/15/2020] [Indexed: 12/29/2022]
Abstract
INTRODUCTION As the demand for rehabilitation in orthopaedics increases, so too has the development in advanced rehabilitation technology. However, to date, there are no review papers outlining the broad scope of advanced rehabilitation technology used within the orthopaedic population. The aim of this study is to identify, describe and summarise the evidence for efficacy for all advanced rehabilitation technologies applicable to orthopaedic practice. METHODS The relevant literature describing the use of advanced rehabilitation technology in orthopaedics was identified from appropriate electronic databases (PubMed and EMBASE) and a narrative review undertaken. RESULTS Advanced rehabilitation technologies were classified into two groups: hospital-based and home-based rehabilitation. In the hospital-based technology group, we describe the use of continuous passive motion and robotic devices (after spinal cord injury) and their effect on improving clinical outcomes. We also report on the use of electromagnetic sensor technology for measuring kinematics of upper and lower limbs during rehabilitation. In the home-based technology group, we describe the use of inertial sensors, smartphones, software applications and commercial game hardware that are relatively inexpensive, user-friendly and widely available. We outline the evidence for videoconferencing for promoting knowledge and motivation for rehabilitation as well as the emerging role of virtual reality. CONCLUSIONS The use of advanced rehabilitation technology in orthopaedics is promising and evidence for its efficacy is generally supportive.
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Affiliation(s)
- Yuichi Kuroda
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Matthew Young
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Haitham Shoman
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Anuj Punnoose
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK
| | - Alan R Norrish
- Department of Academic Orthopaedics, Trauma and Sports Medicine, Queens Medical Centre, University of Nottingham, Nottingham, UK
| | - Vikas Khanduja
- Young Adult Hip Service, Department of Trauma and Orthopaedic Surgery, Addenbrooke's-Cambridge University Hospitals NHS Foundation Trust, Hills Road, Box 37, Cambridge, CB2 0QQ, UK.
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14
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Roh CH, Kim DS, Kim GW, Won YH, Park SH, Seo JH, Ko MH. Efficacy of an Integrated Training Device in Improving Muscle Strength, Balance, and Cognitive Ability in Older Adults. Ann Rehabil Med 2021; 45:314-324. [PMID: 34496474 PMCID: PMC8435467 DOI: 10.5535/arm.21072] [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: 04/07/2021] [Revised: 06/09/2021] [Accepted: 06/14/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To determine the effects of an integrated training device for strength and balance on extremity muscle strength, postural balance, and cognition in older adults using a combination with various rehabilitation training games, in which balance, strength, and cognitive training were configured in a single device. METHODS This prospective study included 20 healthy participants aged 65-85 years. Participants trained for 30 minutes daily, 3 days weekly, for 6 weeks with an integrated training device for strength and balance (SBT-120; Man&Tel Inc., Gumi, Korea). Main outcomes were measured using the Korean Mini-Mental State Examination (K-MMSE), Korean version of the Montreal Cognitive Assessment (K-MoCA), Timed Up and Go Test (TUG), Functional Reach Test (FRT), Berg Balance Scale (BBS), and Manual Muscle Test. Measurements were taken at three time points: T0 (pretreatment), T1 (immediately after treatment), and T2 (4 weeks after treatment). RESULTS All 20 patients completed the training, and TUG, FRT, and BBS scores significantly improved at T1 and T2 compared to T0. Mean TUG scores decreased by 0.99±2.00 at T1 and 1.05±1.55 at T2 compared to T0. Mean FRT scores increased by 6.13±4.26 at T1 and 6.75±4.79 at T2 compared to T0. BBS scores increased by 0.60±0.94 at T1 and 0.45±1.15 at T2 compared to T0. Moreover, muscle strength and cognition (K-MMSE and K-MoCA scores) increased after training. CONCLUSION Our findings suggest that an integrated training device for strength and balance can be a safe and useful tool for older adults.
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Affiliation(s)
- Choong-Hee Roh
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
| | - Da-Sol Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
| | - Gi-Wook Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- Translational Research & Clinical Trial Center for Medical Device, Jeonbuk National University Hospital, Jeonju, Korea
| | - Yu-Hui Won
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Sung-Hee Park
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Jeong-Hwan Seo
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University–Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
- Translational Research & Clinical Trial Center for Medical Device, Jeonbuk National University Hospital, Jeonju, Korea
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15
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Moon S, Huang CK, Sadeghi M, Akinwuntan AE, Devos H. Proof-of-Concept of the Virtual Reality Comprehensive Balance Assessment and Training for Sensory Organization of Dynamic Postural Control. Front Bioeng Biotechnol 2021; 9:678006. [PMID: 34395396 PMCID: PMC8358300 DOI: 10.3389/fbioe.2021.678006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/10/2021] [Indexed: 12/03/2022] Open
Abstract
Accurate quantification of the impact of visual, somatosensory, and vestibular systems on postural control may inform tailor-made balance intervention strategies. The aim of this proof-of-concept study was to determine the safety, sense of presence, system usability, and face validity of a newly developed Virtual Reality Comprehensive Balance Assessment and Training (VR-ComBAT) in healthy young individuals. The VR-ComBAT included six balance condition: (1) stable surface with fixed virtual reality (VR) surroundings; (2) stable surface with blacked out VR surroundings; (3) stable surface with VR visual conflict; (4) unstable surface with fixed VR surroundings; (5) unstable surface with blacked out VR surroundings; and (6) unstable surface with VR visual conflict. Safety was evaluated using the number of adverse events, including scores on the Simulator Sickness Questionnaire. Sense of presence was evaluated using the igroup Presence Questionnaire (iPQ). System usability was assessed using the Systems Usability Scale (SUS). Friedman analyses with post hoc Wilcoxon Signed Rank tests were employed to demonstrate face validity by quantifying center of pressure (COP) changes in mean distance, mean velocity, and mean frequency in the anteroposterior (AP) and mediolateral (ML) direction across the six conditions. Twenty-three participants (27.4 ± 8.0 years old; 13 women) reported no adverse events. Participants scores on average 44.9 ± 9.6 on the iPQ and 79.7 ± 9.9 on the SUS. Post hoc analyses showed significant changes in COP-based measures when compared to baseline. The mean frequency change of COP showed direction-dependence in which increased frequency change in AP was observed while decreased change in ML was noted. The VR-ComBAT provides a safe, feasible, and cost-effective VR environment that demonstrates consistent sensory re-weighting between visual, somatosensory, and vestibular systems. Future studies should investigate whether VR-ComBAT can be used to inform precision rehabilitation of balance and fall prevention in older adults without and with neurological conditions.
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Affiliation(s)
- Sanghee Moon
- Department of Physical Therapy, Ithaca College, Ithaca, NY, United States.,Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
| | - Chun-Kai Huang
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
| | - Maryam Sadeghi
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
| | - Abiodun E Akinwuntan
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States.,Office of the Dean, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, United States
| | - Hannes Devos
- Laboratory for Advanced Rehabilitation Research in Simulation, Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
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16
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Ertunc Gulcelik G, Tarakci D, Gedik Soyuyuce O, Gence Gumus Z, Korkut N, Algun ZC. Research on the Effects of a Web-Based System With Oculomotor and Optokinetic Stimuli on Vestibular Rehabilitation. Am J Phys Med Rehabil 2021; 100:555-562. [PMID: 32889859 DOI: 10.1097/phm.0000000000001584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The variety and use of technologies used in vestibular rehabilitation are very limited. The purpose of this study was to investigate the effects of a Web-based system on vestibular rehabilitation in patients with vestibular hypofunction. DESIGN A total of 20 patients with unilateral vestibular hypofunction were randomly assigned to two groups. Conventional vestibular rehabilitation was applied to the control group, whereas the study group received treatment with the Web-based system supporting the vestibulo-ocular reflex with oculomotor and optokinetic stimulus (Simulation of Vestibulo-Ocular Reflex Exercises). Vestibular and balance tests, oculomotor level, the Tampa Kinesiophobia Scale, and the Dizziness Handicap Inventory were used to evaluate the treatment's efficacy. RESULTS Vestibular symptoms and findings, balance tests, oculomotor functions, Tampa Kinesiophobia Scale, and Dizziness Handicap Inventory improved significantly in both groups after the interventions (P < 0.05). In the intergroup analysis, improvement was found in eyes closed Romberg, semitandem, and left one-foot position balance tests in favor of the study group (P < 0.05). CONCLUSION The new vestibular technology, Simulation of Vestibulo-Ocular Reflex Exercises, was found to be effective in vestibular rehabilitation.
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Affiliation(s)
- Gonul Ertunc Gulcelik
- From the Physical Therapy and Rehabilitation PhD Program, Graduate School of Health Sciences (GEG), and Division of Ergotherapy, School of Health Science (DT), Istanbul Medipol University, Istanbul, Turkey; Physiotherapy and Rehabilitation, Istanbul Gedik University Health Science Faculty, Istanbul, Turkey (GEG); Departments of Audiology (OGS, ZGG) and Ear, Nose, and Throat (NK), Acıbadem Maslak Hospital, Istanbul, Turkey; and Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Turkey (ZCA)
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17
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Bhattacharjya S, Cavuoto LA, Reilly B, Xu W, Subryan H, Langan J. Usability, Usefulness, and Acceptance of a Novel, Portable Rehabilitation System (mRehab) Using Smartphone and 3D Printing Technology: Mixed Methods Study. JMIR Hum Factors 2021; 8:e21312. [PMID: 33749608 PMCID: PMC8080267 DOI: 10.2196/21312] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/24/2020] [Accepted: 02/19/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Smart technology use in rehabilitation is growing and can be used remotely to assist clients in self-monitoring their performance. With written home exercise programs being the commonly prescribed form of rehabilitation after discharge, mobile health technology coupled with task-oriented programs can enhance self-management of upper extremity training. In the current study, a rehabilitation system, namely mRehab, was designed that included a smartphone app and 3D-printed household items such as mug, bowl, key, and doorknob embedded with a smartphone. The app interface allowed the user to select rehabilitation activities and receive feedback on the number of activity repetitions completed, time to complete each activity, and quality of movement. OBJECTIVE This study aimed to assess the usability, perceived usefulness, and acceptance of the mRehab system by individuals with stroke and identify the challenges experienced by them when using the system remotely in a home-based setting. METHODS A mixed-methods approach was used with 11 individuals with chronic stroke. Following training, individuals with stroke used the mRehab system for 6 weeks at home. Each participant completed surveys and engaged in a semistructured interview. Participants' qualitative reports regarding the usability of mRehab were integrated with their survey reports and quantitative performance data. RESULTS Of the 11 participants, 10 rated the mRehab system between the 67.5th and 97.5th percentile on the System Usability Scale, indicating their satisfaction with the usability of the system. Participants also provided high ratings of perceived usefulness (mean 5.8, SD 0.9) and perceived ease of use (mean 5.3, SD 1.5) on a 7-point scale based on the Technology Acceptance Model. Common themes reported by participants showed a positive response to mRehab with some suggestions for improvements. Participants reported an interest in activities they perceived to be adequately challenging. Some participants indicated a need for customizing the feedback to be more interpretable. Overall, most participants indicated that they would like to continue using the mRehab system at home. CONCLUSIONS Assessing usability in the lived environment over a prolonged duration of time is essential to identify the match between the system and users' needs and preferences. While mRehab was well accepted, further customization is desired for a better fit with the end users. TRIAL REGISTRATION ClinicalTrials.gov NCT04363944; https://clinicaltrials.gov/ct2/show/NCT04363944.
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Affiliation(s)
- Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, United States
| | - Lora Anne Cavuoto
- Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
| | - Brandon Reilly
- Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
| | - Wenyao Xu
- Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
| | - Heamchand Subryan
- Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
| | - Jeanne Langan
- Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
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18
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Kravtsova EN, Meigal AY. [Virtual reality technologies in the rehabilitation of patients with peripheral vestibular dysfunction]. Vestn Otorinolaringol 2021; 86:103-107. [PMID: 33720661 DOI: 10.17116/otorino202186011103] [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: 11/17/2022]
Abstract
Review of articles published in peer-reviewed international journals devoted to the issues of rehabilitation of patients with peripheral vestibular dysfunction using virtual reality conditions. IN the review provides a neurophysiological rationale for the use of virtual reality techniques for rehabilitation, the technical methods used to recreate the virtual environment, as well as the published results of their clinical application. It is concluded that the application of virtual reality methods in clinical vestibulology is promising. The search was carried out using the search engines Google Scholar, PubMed, PMC, CrossRef, Science Direct.
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Affiliation(s)
| | - A Yu Meigal
- Petrozavodsk State University, Petrozavodsk, Russia
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19
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Karabulut M, Bas B, Müjdeci B. Evaluation of dual-task performance with Nintendo Wii-Fit plus in children with specific learning disabilities. HEARING, BALANCE AND COMMUNICATION 2021. [DOI: 10.1080/21695717.2020.1870822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Mustafa Karabulut
- Department of Audiology, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Banu Bas
- Department of Audiology, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Banu Müjdeci
- Department of Audiology, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Turkey
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20
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Monardo G, Pavese C, Giorgi I, Godi M, Colombo R. Evaluation of Patient Motivation and Satisfaction During Technology-Assisted Rehabilitation: An Experiential Review. Games Health J 2021; 10:13-27. [DOI: 10.1089/g4h.2020.0024] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Giulia Monardo
- Service of Psychology and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Chiara Pavese
- Neurorehabilitation and Spinal Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
- Department of Clinical-Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Ines Giorgi
- Service of Psychology and Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy
| | - Marco Godi
- Division of Physical Medicine and Rehabilitation and Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
| | - Roberto Colombo
- Service of Bioengineering, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy
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21
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Abbas RL, Cooreman D, Al Sultan H, El Nayal M, Saab IM, El Khatib A. The Effect of Adding Virtual Reality Training on Traditional Exercise Program on Balance and Gait in Unilateral, Traumatic Lower Limb Amputee. Games Health J 2021; 10:50-56. [DOI: 10.1089/g4h.2020.0028] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Rami L. Abbas
- Physical Therapy Department, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Didier Cooreman
- International Committee of the Red Cross (ICRC), Geneva, Switzerland
| | - Hala Al Sultan
- International Committee of the Red Cross (ICRC), Geneva, Switzerland
| | - Mayssah El Nayal
- Department of Psychology, Faculty of Human Sciences, Beirut Arab University, Beirut, Lebanon
| | - Ibtissam M. Saab
- Physical Therapy Department, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Ayman El Khatib
- Physical Therapy Department, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
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22
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Morse H, Biggart L, Pomeroy V, Rossit S. Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke. Neuropsychol Rehabil 2020; 32:707-731. [PMID: 32942950 DOI: 10.1080/09602011.2020.1819827] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Spatial neglect is a common and severe cognitive consequence of stroke, yet there is currently no effective rehabilitation tool. Virtual Reality (VR) telerehabilitation tools have the potential to provide multisensory and enjoyable therapies and remotely monitor adherence without the presence of a therapist at all times. Researchers and industry need to better understand end-user perspectives about these technologies to ensure these are acceptable and, ultimately, optimize adherence and efficacy. This study aims to explore end-user perspectives on the use of self-administered VR for spatial neglect in a university environment to identify barriers and facilitators prior to extending its use remotely as a telerehabilitation tool. We used a mixed-method design including focus groups, self-administered questionnaires and interviews with stroke survivors (N = 7), their carers (N = 3) and stroke clinicians (N = 6). End-user perspectives identified clarity of instructions, equipment (cost, available resources) and for some, level of experience with technology as barriers of use. Perceived facilitators were performance feedback, engagement and enjoyment, and psychological benefits associated with self-administered VR telerehabilitation. Overall, end-users were positive and interested in using VR telerehabilitation for spatial neglect. These perspectives enabled us to produce practical recommendations to inform development, enhance engagement and uptake of VR telerehabilitation and inform future studies.
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Affiliation(s)
- Helen Morse
- School of Psychology, University of East Anglia, Norwich, UK.,Acquired Brain Injury Rehabilitaion Alliance, University of East Anglia, Norwich, UK
| | - Laura Biggart
- School of Psychology, University of East Anglia, Norwich, UK
| | - Valerie Pomeroy
- Acquired Brain Injury Rehabilitaion Alliance, University of East Anglia, Norwich, UK.,School of Health Sciences, University of East Anglia, Norwich, UK.,National Institute for Health Research (NIHR) Brain Injury MedTech Co-operative, Cambridge, UK
| | - Stéphanie Rossit
- School of Psychology, University of East Anglia, Norwich, UK.,Acquired Brain Injury Rehabilitaion Alliance, University of East Anglia, Norwich, UK
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Nehrujee A, Vasanthan L, Lepcha A, Balasubramanian S. A Smartphone-based gaming system for vestibular rehabilitation: A usability study. J Vestib Res 2020; 29:147-160. [PMID: 31356221 DOI: 10.3233/ves-190660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUNDVestibular dysfunctions result in a wide range of impairments and can have debilitating consequences on a person's day-to-day activities. Conventional vestibular rehabilitation is effective but suffers from poor therapy compliance due to boredom. Virtual reality technology can make training more engaging and allow precise quantification of the training process. However, most existing technologies for vestibular rehabilitation are expensive and not suitable for use in patients' homes and most clinics. In this pilot study, we developed and evaluated the usability of a smartphone-based head-mounted display (HMD) for vestibular rehabilitation and quantified the simulator sickness induced by the system.METHODSTwo adaptive training games were developed to train discrete and rhythmic head movements in the pitch and yaw planes. The usability and simulator sickness associated with the system were evaluated in a single testing session on healthy subjects and patients with unilateral vestibular dysfunction. Additionally, the head movement kinematics measured during training was also analyzed using different movement quality measures.RESULTSA total of 15 healthy subjects and 15 patients underwent testing with the system. Both groups found the system to be highly usable (>80 score on the system usability scale). Following 20-30 min training with the system, healthy subjects reported minimal simulator sickness symptoms. On the other hand, patients reported a higher incidence rate for symptoms, which could have been the result of their vestibular condition.CONCLUSIONThe current study demonstrated the usability and safety of a smartphone-based system for vestibular rehabilitation. The system is compact, and affordable thus has the potential to become an excellent tool for home-based vestibular rehabilitation.
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Affiliation(s)
- Aravind Nehrujee
- Department of Bioengineering, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
| | - Lenny Vasanthan
- Department of Physical Medicine and Rehabilitation, Physiotherapy Unit, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
| | - Anjali Lepcha
- Department of Ear, Nose and Throat, Audiovestibular Unit, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
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Objective evaluation of Nintendo Wii Fit Plus balance program training on postural stability in Multiple Sclerosis patients: a pilot study. Int J Rehabil Res 2020; 43:199-205. [DOI: 10.1097/mrr.0000000000000408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Rosiak O, Krajewski K, Woszczak M, Jozefowicz-Korczynska M. Evaluation of the effectiveness of a Virtual Reality-based exercise program for Unilateral Peripheral Vestibular Deficit. J Vestib Res 2019; 28:409-415. [PMID: 30714985 PMCID: PMC9249289 DOI: 10.3233/ves-180647] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recently, two types of movement sensors have been introduced into Virtual Reality (VR) therapy: motion trackers and force-plate platforms. Combining these two methods could produce better rehabilitation outcomes. Such devices, encompassing motion trackers and force platforms, are referred to as "hybrid" VR units. OBJECTIVE To assess the effectiveness of a low-cost hybrid VR based vestibular rehabilitation programMETHODS: A prospective, non-randomized, controlled group study comparing training using a hybrid VR unit (Group 1 n = 25) vs. static posturography with visual feedback (Group 2 n = 25) in patients with peripheral vestibular dysfunction was conducted. The subjects underwent 10 training sessions over 10 days (30 minute sessions). All were examined on a posturography platform at the start and 1 month after rehabilitation and completed the Vertigo Symptom Scale - Short Form (VSS-SF) questionnaire. RESULTS Both groups demonstrated improvement in posturographic parameters, which were statistically significant, but when comparing results between both groups there were no differences. The patients reported improvement in their subjective perception of symptoms on the VSS-SF scale, which were statistically significant in both groups, but greater in the VR group. CONCLUSIONS Both methods reduce postural sway, however subjective reduction of symptoms was greater in the VR group.
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Affiliation(s)
- Oskar Rosiak
- Department of Otolaryngology, Balance Disorders Unit, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
| | - Krzysztof Krajewski
- Department of Otolaryngology, Balance Disorders Unit, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
| | - Marek Woszczak
- Department of Rehabilitation, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
| | - Magdalena Jozefowicz-Korczynska
- Department of Otolaryngology, Balance Disorders Unit, Medical University of Lodz, The Norbert Barlicki Memorial Teaching Hospital, Lodz, Poland
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Feasibility of a Home-Based Balance Intervention in Middle-Aged Women Using Wii Fit Plus®. J Phys Act Health 2019; 16:736-744. [PMID: 31310993 DOI: 10.1123/jpah.2018-0265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 04/09/2019] [Accepted: 05/12/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study evaluated the feasibility and effectiveness of a home-based exercise intervention using the Wii Fit Plus®. METHODS A randomized, controlled trial of 24 women (age 53.6 [5.4] y) was used to assess compliance and changes in balance over 12 weeks. Balance was measured via the Berg Balance Scale and Frailty and Injuries: Cooperative Studies of Intervention Techniques-4 Scale at baseline and week 6 and week 12. Participant compliance to the intervention was captured via paper logs and the electronic record collected by the Wii Fit Plus®. RESULTS Participants in the intervention group were 95% compliant based on electronic records. There were no significant differences between groups for total score on either balance scale. There was a significant group × time interaction in favor of the intervention for maximum velocity y (P < .05), average velocity (P < .05), and was trending for maximum velocity x (P = .05) in the tandem step, eyes closed position. CONCLUSIONS The results suggest that the Wii Fit Plus® is appropriate for home-based interventions in middle-aged women. Modest improvements in balance indicate that this may be an effective means to improve or maintain balance in older women. More research is needed to determine compliance and benefits to reducing fall risk in durations exceeding 12 weeks.
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Ni Y, Bermudez M, Kennebeck S, Liddy-Hicks S, Dexheimer J. A Real-Time Automated Patient Screening System for Clinical Trials Eligibility in an Emergency Department: Design and Evaluation. JMIR Med Inform 2019; 7:e14185. [PMID: 31342909 PMCID: PMC6685132 DOI: 10.2196/14185] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 01/23/2023] Open
Abstract
Background One critical hurdle for clinical trial recruitment is the lack of an efficient method for identifying subjects who meet the eligibility criteria. Given the large volume of data documented in electronic health records (EHRs), it is labor-intensive for the staff to screen relevant information, particularly within the time frame needed. To facilitate subject identification, we developed a natural language processing (NLP) and machine learning–based system, Automated Clinical Trial Eligibility Screener (ACTES), which analyzes structured data and unstructured narratives automatically to determine patients’ suitability for clinical trial enrollment. In this study, we integrated the ACTES into clinical practice to support real-time patient screening. Objective This study aimed to evaluate ACTES’s impact on the institutional workflow, prospectively and comprehensively. We hypothesized that compared with the manual screening process, using EHR-based automated screening would improve efficiency of patient identification, streamline patient recruitment workflow, and increase enrollment in clinical trials. Methods The ACTES was fully integrated into the clinical research coordinators’ (CRC) workflow in the pediatric emergency department (ED) at Cincinnati Children’s Hospital Medical Center. The system continuously analyzed EHR information for current ED patients and recommended potential candidates for clinical trials. Relevant patient eligibility information was presented in real time on a dashboard available to CRCs to facilitate their recruitment. To assess the system’s effectiveness, we performed a multidimensional, prospective evaluation for a 12-month period, including a time-and-motion study, quantitative assessments of enrollment, and postevaluation usability surveys collected from the CRCs. Results Compared with manual screening, the use of ACTES reduced the patient screening time by 34% (P<.001). The saved time was redirected to other activities such as study-related administrative tasks (P=.03) and work-related conversations (P=.006) that streamlined teamwork among the CRCs. The quantitative assessments showed that automated screening improved the numbers of subjects screened, approached, and enrolled by 14.7%, 11.1%, and 11.1%, respectively, suggesting the potential of ACTES in streamlining recruitment workflow. Finally, the ACTES achieved a system usability scale of 80.0 in the postevaluation surveys, suggesting that it was a good computerized solution. Conclusions By leveraging NLP and machine learning technologies, the ACTES demonstrated good capacity for improving efficiency of patient identification. The quantitative assessments demonstrated the potential of ACTES in streamlining recruitment workflow and improving patient enrollment. The postevaluation surveys suggested that the system was a good computerized solution with satisfactory usability.
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Affiliation(s)
- Yizhao Ni
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Monica Bermudez
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Stephanie Kennebeck
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Stacey Liddy-Hicks
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Judith Dexheimer
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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Tsai TH, Tseng KC, Wong AM, Chang HJ. A study exploring the usability of an exergaming platform for senior fitness testing. Health Informatics J 2019; 26:963-980. [PMID: 31264499 DOI: 10.1177/1460458219853369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study proposes a structural usability model to identify the relationship between the user interface design and the usability of an exergame system that includes a software system and a separate hardware device. The model consisted of two dimensions: the interface design, which was evaluated using Nielsen's heuristic evaluation method, and the usability, as defined by ISO 9241-11. An empirical study used the iFit exergame system to test the physical fitness of 101 seniors in order to evaluate the model's validity. The results showed a strong correlation between the interface design and the usability of the exergame system. An improved interface enabled users to interact with the system better, and the usability of the whole system was enhanced, including the device and the system itself. The results show that the proposed usability model can be used to evaluate other exergame systems.
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Affiliation(s)
- Tsai-Hsuan Tsai
- Chang Gung University; Chang Gung Memorial Hospital; Ming Chi University of Technology
| | - Kevin C Tseng
- National Taiwan Normal University; Product Design and Development Laboratory
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Nehrujee A, Vasanthan L, Lepcha A, Balasubramanian S. A Smartphone-based gaming system for vestibular rehabilitation: A usability study. J Vestib Res 2019. [DOI: 10.3233/ves-180660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Aravind Nehrujee
- Department of Bioengineering, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
| | - Lenny Vasanthan
- Department of Physical Medicine and Rehabilitation, Physiotherapy Unit, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
| | - Anjali Lepcha
- Department of Ear, Nose and Throat, Audiovestibular Unit, Christian Medical College, Bagayam, Vellore, Tamil Nadu, India
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Text Input in Virtual Reality: A Preliminary Evaluation of the Drum-Like VR Keyboard. TECHNOLOGIES 2019. [DOI: 10.3390/technologies7020031] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The drum-like virtual reality (VR) keyboard is a contemporary, controller-based interface for text input in VR that uses a drum set metaphor. The controllers are used as sticks which, through downward movements, “press” the keys of the virtual keyboard. In this work, a preliminary feasibility study of the drum-like VR keyboard is described, focusing on the text entry rate and accuracy as well as its usability and the user experience it offers. Seventeen participants evaluated the drum-like VR keyboard by having a typing session and completing a usability and a user experience questionnaire. The interface achieved a good usability score, positive experiential feedback around its entertaining and immersive qualities, a satisfying text entry rate (24.61 words-per-minute), as well as moderate-to-high total error rate (7.2%) that can probably be further improved in future studies. The work provides strong indications that the drum-like VR keyboard can be an effective and entertaining way to type in VR.
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VR Locomotion in the New Era of Virtual Reality: An Empirical Comparison of Prevalent Techniques. ADVANCES IN HUMAN-COMPUTER INTERACTION 2019. [DOI: 10.1155/2019/7420781] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The latest technical and interaction advancements within the virtual reality (VR) field have marked a new era, not only for VR, but also for VR locomotion. In this era, well-established, prevalent VR locomotion techniques are mostly used as points of comparison for benchmarking of new VR locomotion designs. At the same time, there is the need for more exploratory, comparative studies of contemporary VR locomotion techniques, so that their distinguished interaction aspects can be documented and guide the design process of new techniques. This article presents a comparative, empirical evaluation study of contemporary and prevalent VR locomotion techniques, examining the user experience (UX) they offer. First, the prevalent VR locomotion techniques are identified based on literature, i.e., walking-in-place, controller/joystick, and teleportation. Twenty-six adults are enrolled in the study and perform a game-like task using the techniques. The study follows a mixed methods approach, utilising the System Usability Scale survey, the Game Experience Questionnaire, and a semistructured interview to assess user experiences. Results indicate that the walking-in-place technique offers the highest immersion but also presents high levels of psychophysical discomfort. Controller/joystick VR locomotion is perceived as easy-to-use due to the users’ familiarity with controllers, whereas teleportation is considered to be effective due to its fast navigation, although its visual ‘jumps’ do break the users’ sense of immersion. Based on the interviews, the users focused on the following interaction dimensions to describe their VR locomotion experiences: (i) immersion and flow, (ii) ease-of-use and mastering, (iii) competence and sense of effectiveness, and (iv) psychophysical discomfort. The study implications for VR locomotion are discussed, along with the study limitations and the future direction for research.
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Cipresso P, Giglioli IAC, Raya MA, Riva G. The Past, Present, and Future of Virtual and Augmented Reality Research: A Network and Cluster Analysis of the Literature. Front Psychol 2018; 9:2086. [PMID: 30459681 PMCID: PMC6232426 DOI: 10.3389/fpsyg.2018.02086] [Citation(s) in RCA: 215] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 10/10/2018] [Indexed: 12/19/2022] Open
Abstract
The recent appearance of low cost virtual reality (VR) technologies - like the Oculus Rift, the HTC Vive and the Sony PlayStation VR - and Mixed Reality Interfaces (MRITF) - like the Hololens - is attracting the attention of users and researchers suggesting it may be the next largest stepping stone in technological innovation. However, the history of VR technology is longer than it may seem: the concept of VR was formulated in the 1960s and the first commercial VR tools appeared in the late 1980s. For this reason, during the last 20 years, 100s of researchers explored the processes, effects, and applications of this technology producing 1000s of scientific papers. What is the outcome of this significant research work? This paper wants to provide an answer to this question by exploring, using advanced scientometric techniques, the existing research corpus in the field. We collected all the existent articles about VR in the Web of Science Core Collection scientific database, and the resultant dataset contained 21,667 records for VR and 9,944 for augmented reality (AR). The bibliographic record contained various fields, such as author, title, abstract, country, and all the references (needed for the citation analysis). The network and cluster analysis of the literature showed a composite panorama characterized by changes and evolutions over the time. Indeed, whether until 5 years ago, the main publication media on VR concerned both conference proceeding and journals, more recently journals constitute the main medium of communication. Similarly, if at first computer science was the leading research field, nowadays clinical areas have increased, as well as the number of countries involved in VR research. The present work discusses the evolution and changes over the time of the use of VR in the main areas of application with an emphasis on the future expected VR's capacities, increases and challenges. We conclude considering the disruptive contribution that VR/AR/MRITF will be able to get in scientific fields, as well in human communication and interaction, as already happened with the advent of mobile phones by increasing the use and the development of scientific applications (e.g., in clinical areas) and by modifying the social communication and interaction among people.
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Affiliation(s)
- Pietro Cipresso
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | | | - Mariano Alcañiz Raya
- Instituto de Investigación e Innovación en Bioingeniería, Universitat Politècnica de València, Valencia, Spain
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
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Golla A, Müller T, Wohlfarth K, Jahn P, Mattukat K, Mau W. Home-based balance training using Wii Fit™: a pilot randomised controlled trial with mobile older stroke survivors. Pilot Feasibility Stud 2018; 4:143. [PMID: 30155268 PMCID: PMC6109315 DOI: 10.1186/s40814-018-0334-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/15/2018] [Indexed: 11/10/2022] Open
Abstract
Background Several studies have reported that using the Wii™ Balance Board can provide added value regarding balance (re-)training in neurological diseases. However, for the large group of mobile older stroke survivors, there is no evidence regarding the feasibility of an unsupervised Wii™ Balance Board training in the home setting. The aim of this study was to investigate the feasibility of a home-based Wii™ balance training for these patients and to identify methodological challenges for randomised controlled trials in the future. Methods We conducted a pilot randomised controlled trial with two intervention arms in participants' homes. Mobile stroke survivors (aged 60 years or above; 12 weeks after discharge from hospital) received a 6-week (once per week) supervised balance training at the study centre, followed by a 6-week (three times per week) unsupervised balance training at home. We used the Nintendo Wii™ Balance Board for one intervention arm and conventional balance exercises for the other intervention arm. Feasibility was assessed by recruiting rates, appropriateness of assessments regarding sensitivity to changes and acceptance of the intervention by the participants. Results In two German hospital stroke units, 349 stroke survivors were screened over a period of 6 months, 91 were eligible and 52 were interested. Twelve weeks after discharge, 14 participants agreed and 11 completed the intervention (7 men and 4 women, mean age 74 years). The Berg Balance Scale and Dynamic Gait Index showed ceiling effects already at baseline measure. The participants in both intervention arms evaluated the unsupervised training positively and feasible for self-application. No falls or injuries occurred over the intervention period, while the required scope of the exercises could largely be achieved. Conclusions In this pilot study, the recruitment of participants and the chosen assessments were not satisfactory due to selection bias and corresponding ceiling effects. However, the two home-based balance interventions proved feasible for mobile older stroke survivors with low functional limitations. Trial registration ClinicalTrials.gov, NCT02251470. Registered 29 September 2014.
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Affiliation(s)
- André Golla
- 1Institute of Rehabilitation Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
| | - Tobias Müller
- 2Department of Neurology, University Hospital Halle (Saale), Ernst-Grube-Str. 40, 06097 Halle (Saale), Germany
| | - Kai Wohlfarth
- Clinic of Neurology, BG Hospital Bergmannstrost Halle (Saale), Merseburger Str. 165, 06112 Halle (Saale), Germany
| | - Patrick Jahn
- 4Nursing Research Unit, University Hospital Halle (Saale), Ernst-Grube-Str. 30, 06120 Halle (Saale), Germany
| | - Kerstin Mattukat
- 1Institute of Rehabilitation Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
| | - Wilfried Mau
- 1Institute of Rehabilitation Medicine, Medical Faculty, Martin Luther University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
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Deacon M, Parsons J, Mathieson S, Davies TC. Can Wii Balance? Evaluating a Stepping Game for Older Adults. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1783-1793. [PMID: 30072333 DOI: 10.1109/tnsre.2018.2862146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Decline in balance control is an issue for older adults as it leads to an increased risk of falling which may result in serious injury. Mitigating this risk may be achieved through balance training and exercise, but lack of adherence to an exercise program often occurs. Improvement in balance control may be difficult to quantify in an unbiased manner given the therapist providing the treatment also assesses the patient. We developed a gamified system using an off-the-shelf technology through an iterative feedback with therapists and clients to evaluate a response time during stepping as a measure of balance control. The game was designed using serious game strategies to increase participant engagement. This game included two Nintendo Wii balance boards between which the individual was required to step while the times were recorded. To provide evidence that the system could be used in a clinical environment, we conducted a cross-sectional study collecting data for five minutes at the beginning of a physiotherapy assessment. One hundred and four individuals older than 50 years of age were recruited who were able to step forward with or without an aid. The response time for a step using the system was negatively correlated to the Berg balance score.
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Martel D, Lauzé M, Agnoux A, Fruteau de Laclos L, Daoust R, Émond M, Sirois MJ, Aubertin-Leheudre M. Comparing the effects of a home-based exercise program using a gerontechnology to a community-based group exercise program on functional capacities in older adults after a minor injury. Exp Gerontol 2018; 108:41-47. [DOI: 10.1016/j.exger.2018.03.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/06/2018] [Accepted: 03/18/2018] [Indexed: 11/27/2022]
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Jahn K, Saul AK, Elstner M, Sapa K, Kellerer S. Vestibular rehabilitation therapy and Nintendo Wii balance board training both improve postural control in bilateral vestibulopathy. J Neurol 2018; 265:70-73. [DOI: 10.1007/s00415-018-8882-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/23/2018] [Accepted: 04/24/2018] [Indexed: 11/24/2022]
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Lee MM, Lee KJ, Song CH. Game-Based Virtual Reality Canoe Paddling Training to Improve Postural Balance and Upper Extremity Function: A Preliminary Randomized Controlled Study of 30 Patients with Subacute Stroke. Med Sci Monit 2018; 24:2590-2598. [PMID: 29702630 PMCID: PMC5944399 DOI: 10.12659/msm.906451] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background Virtual reality (VR) training with motion-controlled console games can be incorporated into stroke rehabilitation programs. The use of a variety of gaming software can provide the patient with an opportunity to perform activities that are exciting, entertaining, and that may not be feasible in clinical environments. The aim of this preliminary randomized controlled study was to investigate the effects of game-based VR canoe paddling training, when combined with conventional physical rehabilitation programs, on postural balance and upper extremity function in 30 patients with subacute stroke. Material/Methods Thirty patients, who were within six months following the diagnosis of stroke, were randomly allocated to either the experimental group (n=15) or the control group (n=15). All participants participated in a conventional rehabilitation program. Also, the experimental group (n=15) performed the VR canoe paddling training for 30 minutes each day, three times per week, for five weeks. After five weeks, outcomes of changes in postural balance and upper extremity function were evaluated and compared between the two groups. Results At five weeks, postural balance and upper extremity function showed significant improvements in both patients groups when compared with the baseline measurements (p<0.05). However, postural balance and upper extremity function were significantly improved in the experimental group when compared with the control group (p<0.05). Conclusions Game-based VR canoe paddling training is an effective rehabilitation therapy that enhances postural balance and upper extremity function in patients with subacute stroke when combined with conventional physical rehabilitation programs.
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Affiliation(s)
- Myung Mo Lee
- Department of Physical Therapy, Daejeon University, Daejeon, South Korea
| | - Kyeong Jin Lee
- Department of Physical Therapy, Kyungdong University, Gangwon, South Korea
| | - Chang Ho Song
- Department of Physical Therapy, Sahmyook University, Seoul, South Korea
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Ku J, Kang YJ. Novel Virtual Reality Application in Field of Neurorehabilitation. BRAIN & NEUROREHABILITATION 2018. [DOI: 10.12786/bn.2018.11.e5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Jeonghun Ku
- Department of Biomedical Engineering, College of Medicine, Keimyung University, Daegu, Korea
| | - Youn Joo Kang
- Department of Rehabilitation Medicine, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
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Lauzé M, Martel DD, Agnoux A, Sirois MJ, Émond M, Daoust R, Aubertin-Leheudre M. Feasibility, Acceptability and Effects of a Home-Based Exercise Program Using a Gerontechnology on Physical Capacities after a Minor Injury in Community-Living Older Adults: A Pilot Study. J Nutr Health Aging 2018; 22:16-25. [PMID: 29300417 DOI: 10.1007/s12603-017-0938-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
CONTEXT Several studies have demonstrated that physical activity can help limit decline in functional capacities of older adults. Nevertheless, many adults aged 65 and over are inactive. OBJECTIVE To explore the feasibility, the acceptability and the effects of a home-based exercise program (HEP) using a motion capture gerontechnology in independent community-living older adults at risk of function decline. DESIGN Interventionnal clinical trial. PARTICIPANTS Sixteen previously independent individuals aged 65 and older recruited at the Emergency Department after being treated for a minor injury and discharged home were assigned to a home-based exercise program group (HEP=8) or to a control group (CONTR=8). Twelve participants completed the study, 6 in each group Setting: Canadian Community-dwelling in Montreal area. INTERVENTION The HEP group engaged in a twelve-week physical activity intervention using a gerontechnology while the CONTR group continued with discharge plan from ED. MEASUREMENTS Participants were evaluated for functional status using validated questionnaires and objective physical measures at baseline, three and six months later. Feasibility and acceptability of the HEP was assessed using data reports from the gerontechnology and from self-reported assessments. RESULTS There was no differences between groups at baseline except for the fallrelated self-efficacy: HEP=8.33/28±1.51 vs CONTR=7/28±0 p=0.022. The HEP was found to be feasible and acceptable (adherence rate at 86% and average quality of movements at 87.5%). Significant improvement in walking speed on 4m was observed three months after baseline for HEP vs CONTR group (+0.25 vs +0.05 m/sec, p=0.025). Effects remained at follow-up. Only CONTR group resulted in a significant increase in SF-36 global score. CONCLUSION This twelve-week HEP intervention using the Jintronix® gerontechnology is feasible, acceptable and safe for community-living older adults who sustained a minor injury. This intervention could increase walking speed, the most important predictor of adverse events in the elderly population, and that the improvement could be maintained over time.
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Affiliation(s)
- M Lauzé
- Mylène Aubertin-Leheudre, Département des Sciences de l'activité physique, Université du Québec à Montréal, 141 avenu Président-Kennedy, SB-4615, Montréal (Québec) Canada H3C 3P8,
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Zavala J, Fitace F, León M, Ponce F, Gutiérrez H. Resultados funcionales tras entrenamiento fisioterapéutico que incluye la realidad virtual en mayores de 60 años con artroplastia total de cadera: estudio descriptivo. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.ft.2017.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Tripette J, Murakami H, Ryan KR, Ohta Y, Miyachi M. The contribution of Nintendo Wii Fit series in the field of health: a systematic review and meta-analysis. PeerJ 2017; 5:e3600. [PMID: 28890847 PMCID: PMC5590553 DOI: 10.7717/peerj.3600] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/29/2017] [Indexed: 12/22/2022] Open
Abstract
Background Wii Fit was originally designed as a health and fitness interactive training experience for the general public. There are, however, many examples of Wii Fit being utilized in clinical settings. This article aims to identify the contribution of Wii Fit in the field of health promotion and rehabilitation by: (1) identifying the health-related domains for which the Wii Fit series has been tested, (2) clarifying the effect of Wii Fit in those identified health-related domains and (3) quantifying this effect. Method A systematic literature review was undertaken. The MEDLINE database and Games for Health Journal published content were explored using the search term “Wii-Fit.” Occurrences resulting from manual searches on Google and material suggested by experts in the field were also considered. Included articles were required to have measurements from Wii Fit activities for at least one relevant health indicator. The effect of Wii Fit interventions was assessed using meta-analyses for the following outcomes: activity-specific balance confidence score, Berg balance score (BBC) and time-up-and-go test (TUG). Findings A total of 115 articles highlighted that the Wii Fit has been tested in numerous healthy and pathological populations. Out of these, only a few intervention studies have focused on the prevention of chronic diseases. A large proportion of the studies focus on balance training (N = 55). This systematic review highlights several potential benefits of Wii Fit interventions and these positive observations are supported by meta-analyses data (N = 25). For example, the BBC and the TUG respond to a similar extend to Wii Fit interventions compared with traditional training. Conclusion Wii Fit has the potential to be used as a rehabilitation tool in different clinical situations. However, the current literature includes relatively few randomized controlled trials in each population. Further research is therefore required.
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Affiliation(s)
- Julien Tripette
- Ochanomizu University, Bunkyo, Tokyo, Japan.,Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Haruka Murakami
- Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Katie Rose Ryan
- Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
| | - Yuji Ohta
- Ochanomizu University, Bunkyo, Tokyo, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institutes of Biomedical innovation, Health and Nutrition, Shinjuku, Tokyo, Japan
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Gil-Gómez JA, Manzano-Hernández P, Albiol-Pérez S, Aula-Valero C, Gil-Gómez H, Lozano-Quilis JA. USEQ: A Short Questionnaire for Satisfaction Evaluation of Virtual Rehabilitation Systems. SENSORS 2017; 17:s17071589. [PMID: 28686174 PMCID: PMC5539644 DOI: 10.3390/s17071589] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 11/16/2022]
Abstract
New emerging technologies have proven their efficacy in aiding people in their rehabilitation. The tests that are usually used to evaluate usability (in general) or user satisfaction (in particular) of this technology are not specifically focused on virtual rehabilitation and patients. The objective of this contribution is to present and evaluate the USEQ (User Satisfaction Evaluation Questionnaire). The USEQ is a questionnaire that is designed to properly evaluate the satisfaction of the user (which constitutes part of usability) in virtual rehabilitation systems. Forty patients with balance disorders completed the USEQ after their first session with ABAR (Active Balance Rehabilitation), which is a virtual rehabilitation system that is designed for the rehabilitation of balance disorders. Internal consistency analysis and exploratory factor analysis were carried out to identify the factor structure of the USEQ. The six items of USEQ were significantly associated with each other, and the Cronbach alpha coefficient for the questionnaire was 0.716. In an analysis of the principal components, a one-factor solution was considered to be appropriate. The findings of the study suggest that the USEQ is a reliable questionnaire with adequate internal consistency. With regard to patient perception, the patients found the USEQ to be an easy-to-understand questionnaire with a convenient number of questions.
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Affiliation(s)
- José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
| | | | - Sergio Albiol-Pérez
- Aragón Health Research Institute (IIS Aragón), Universidad de Zaragoza, Ciudad Escolar, 44003 Teruel, Spain.
| | | | - Hermenegildo Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
| | - José-Antonio Lozano-Quilis
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022 Valencia, Spain.
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Chanpimol S, Seamon B, Hernandez H, Harris-Love M, Blackman MR. Using Xbox kinect motion capture technology to improve clinical rehabilitation outcomes for balance and cardiovascular health in an individual with chronic TBI. Arch Physiother 2017; 7:6. [PMID: 28824816 PMCID: PMC5560163 DOI: 10.1186/s40945-017-0033-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 05/09/2017] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Motion capture virtual reality-based rehabilitation has become more common. However, therapists face challenges to the implementation of virtual reality (VR) in clinical settings. Use of motion capture technology such as the Xbox Kinect may provide a useful rehabilitation tool for the treatment of postural instability and cardiovascular deconditioning in individuals with chronic severe traumatic brain injury (TBI). The primary purpose of this study was to evaluate the effects of a Kinect-based VR intervention using commercially available motion capture games on balance outcomes for an individual with chronic TBI. The secondary purpose was to assess the feasibility of this intervention for eliciting cardiovascular adaptations. METHODS A single system experimental design (n = 1) was utilized, which included baseline, intervention, and retention phases. Repeated measures were used to evaluate the effects of an 8-week supervised exercise intervention using two Xbox One Kinect games. Balance was characterized using the dynamic gait index (DGI), functional reach test (FRT), and Limits of Stability (LOS) test on the NeuroCom Balance Master. The LOS assesses end-point excursion (EPE), maximal excursion (MXE), and directional control (DCL) during weight-shifting tasks. Cardiovascular and activity measures were characterized by heart rate at the end of exercise (HRe), total gameplay time (TAT), and time spent in a therapeutic heart rate (TTR) during the Kinect intervention. Chi-square and ANOVA testing were used to analyze the data. RESULTS Dynamic balance, characterized by the DGI, increased during the intervention phase χ2 (1, N = 12) = 12, p = .001. Static balance, characterized by the FRT showed no significant changes. The EPE increased during the intervention phase in the backward direction χ2 (1, N = 12) = 5.6, p = .02, and notable improvements of DCL were demonstrated in all directions. HRe (F (2,174) = 29.65, p = < .001) and time in a TTR (F (2, 12) = 4.19, p = .04) decreased over the course of the intervention phase. CONCLUSIONS Use of a supervised Kinect-based program that incorporated commercial games improved dynamic balance for an individual post severe TBI. Additionally, moderate cardiovascular activity was achieved through motion capture gaming. Further studies appear warranted to determine the potential therapeutic utility of commercial VR games in this patient population. TRIAL REGISTRATION Clinicaltrial.gov ID - NCT02889289.
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Affiliation(s)
- Shane Chanpimol
- Neurology Service, Veterans Affairs Medical Center, Washington, DC USA
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC USA
| | - Bryant Seamon
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC USA
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center, Washington, DC USA
| | - Haniel Hernandez
- Physical Medicine and Rehabilitation Service, Veterans Affairs Medical Center, Washington, DC USA
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center, Washington, DC USA
| | - Michael Harris-Love
- Muscle Morphology, Mechanics and Performance Laboratory, Clinical Research Center - Human Performance Research Unit, Veterans Affairs Medical Center, Washington, DC USA
- Geriatrics and Extended Care Service/Research Service, Veterans Affairs Medical Center, Washington, DC USA
- Department of Exercise and Nutritional Sciences, Milken Institute School of Public Health, The George Washington University, Washington, DC USA
| | - Marc R. Blackman
- Research Service, Veterans Affairs Medical Center, Washington, DC USA
- Departments of Medicine, Biochemistry and Molecular Medicine, George Washington University School of Medicine, Washington, DC USA
- Departments of Medicine and Rehabilitation Medicine, Georgetown University School of Medicine, Washington, DC USA
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Sousa VEC, Dunn Lopez K. Towards Usable E-Health. A Systematic Review of Usability Questionnaires. Appl Clin Inform 2017; 8:470-490. [PMID: 28487932 PMCID: PMC6241759 DOI: 10.4338/aci-2016-10-r-0170] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/26/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen. OBJECTIVES To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality. METHODS We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table. RESULTS Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7). CONCLUSIONS Existing questionnaires provide a foundation for research on e-health usability. However, future research is needed to broaden the coverage of the usability attributes and psychometric properties of the available questionnaires.
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Affiliation(s)
- Vanessa E C Sousa
- Vanessa E. C. Sousa, PhD, MSN, University of Illinois at Chicago, College of Nursing, Department of Health Systems Science, 845 South Damen St., Chicago, IL 60612, , Phone: 773-814-0517
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Glännfjord F, Hemmingsson H, Larsson Ranada Å. Elderly people's perceptions of using Wii sports bowling - A qualitative study. Scand J Occup Ther 2016; 24:329-338. [PMID: 27960603 DOI: 10.1080/11038128.2016.1267259] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The Nintendo Wii is a gaming console with motion-sensitive controls that is making inroads into health care and rehabilitation. However, there is still limited knowledge on how elderly people perceive the use of such a product. The aim of this study was to examine how the use of the Wii Sports Bowling in an activity group was perceived by elderly people. The data consisted of observations and interviews with participants who used Wii Sports Bowling and was analysed with content analysis. The findings are described in three themes; 'The use of the Wii Sports game', 'Engagement in the game' and 'Social interaction around the activity'. Wii Sports Bowling was described as easier to play compared to real-life bowling and was enjoyable and a social activity. The opportunity to meet the group each week was important for the participants. Playing the game resulted in signs of immersion and a flow-like state. The Wii was perceived to be easy to use, to provide a way to socialize with peers and to give opportunities to participate in activities in a new way. More studies regarding elderly people's experiences and apprehensions regarding new technology such as gaming consoles and virtual reality are needed.
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Affiliation(s)
- Fredrik Glännfjord
- a Department of Social and Welfare studies , Linköping University , Norrköping , Sweden
| | - Helena Hemmingsson
- a Department of Social and Welfare studies , Linköping University , Norrköping , Sweden
| | - Åsa Larsson Ranada
- a Department of Social and Welfare studies , Linköping University , Norrköping , Sweden
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Dexheimer JW, Kurowski BG, Anders SH, McClanahan N, Wade SL, Babcock L. Usability evaluation of the SMART application for youth with mTBI. Int J Med Inform 2016; 97:163-170. [PMID: 27919376 DOI: 10.1016/j.ijmedinf.2016.10.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 05/13/2016] [Accepted: 10/06/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE There is a dearth of evidence-based treatments available to address the significant morbidity associated with mild traumatic brain injury (mTBI). To address this gap, we designed a novel user-friendly, web-based application. We describe the preliminary evaluation of feasibility and usability of the application to promote recovery following mTBI in youth, the Self-Monitoring Activity-Restriction and Relaxation Treatment (SMART). SMART incorporates real-time recommendations for individualized symptom management and activity restriction along with training in cognitive-behavioral coping strategies. METHODS We conducted a usability evaluation to assess and modify the SMART system prior to further study and deployment. Children ages 11-18 years presenting to the emergency department were recruited after symptoms resolved. Usability was assessed using a 60-min think-aloud protocol of teens and parents describing their interaction with the application. Upon completion of the tasks, each participant also completed the system usability scale (SUS). RESULTS We performed tests with 4 parent/child dyads. The average age of the children was 13 years (standard deviation=1.8). The parents were an average of 41.5 years old (standard deviation=6.2). Research revealed that the participants were enthusiastic about the interactive portions of the tool particularly the video based sessions. Parents were concerned about the speed at which their child might move through the program and the children thought that the system required large amounts of reading. Based on user feedback, researchers modified SMART to include an audio file in every module and improved the system's aesthetic properties. The mean SUS score was 85, with high SUS scores (>68) indicating satisfactory usability. CONCLUSION High initial usability and favorable user feedback provide a foundation for further iterative development and testing of the SMART application as a tool for managing recovery from concussion.
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Affiliation(s)
- Judith W Dexheimer
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
| | - Brad G Kurowski
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Shilo H Anders
- Department of Biomedical Informatics, Vanderbilt University, Nashville, TN, United States
| | - Nicole McClanahan
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Shari L Wade
- Division of Physical Medicine and Rehabilitation, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Lynn Babcock
- Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
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Atasavun Uysal S, Baltaci G. Effects of Nintendo Wii™Training on Occupational Performance, Balance, and Daily Living Activities in Children with Spastic Hemiplegic Cerebral Palsy: A Single-Blind and Randomized Trial. Games Health J 2016; 5:311-317. [DOI: 10.1089/g4h.2015.0102] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Songül Atasavun Uysal
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Gül Baltaci
- Department of Physical Therapy and Rehabilitation, Private Güven Hospital, Ankara, Turkey
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Lee SH, Yeh SC, Chan RC, Chen S, Yang G, Zheng LR. Motor Ingredients Derived from a Wearable Sensor-Based Virtual Reality System for Frozen Shoulder Rehabilitation. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7075464. [PMID: 27642600 PMCID: PMC5011756 DOI: 10.1155/2016/7075464] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/30/2016] [Accepted: 07/26/2016] [Indexed: 11/17/2022]
Abstract
Objective. This study aims to extract motor ingredients through data mining from wearable sensors in a virtual reality goal-directed shoulder rehabilitation (GDSR) system and to examine their effects toward clinical assessment. Design. A single-group before/after comparison. Setting. Outpatient research hospital. Subjects. 16 patients with frozen shoulder. Interventions. The rehabilitation treatment involved GDSR exercises, hot pack, and interferential therapy. All patients first received hot pack and interferential therapy on the shoulder joints before engaging in the exercises. The GDSR exercise sessions were 40 minutes twice a week for 4 weeks. Main Measures. Clinical assessments included Constant and Murley score, range of motion of the shoulder, and muscle strength of upper arm as main measures. Motor indices from sensor data and task performance were measured as secondary measures. Results. The pre- and posttest results for task performance, motor indices, and the clinical assessments indicated significant improvement for the majority of the assessed items. Correlation analysis between the task performance and clinical assessments revealed significant correlations among a number of items. Stepwise regression analysis showed that task performance effectively predicted the results of several clinical assessment items. Conclusions. The motor ingredients derived from the wearable sensor and task performance are applicable and adequate to examine and predict clinical improvement after GDSR training.
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Affiliation(s)
- Si-Huei Lee
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Shih-Ching Yeh
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Rai-Chi Chan
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital and National Yang-Ming University, Taipei, Taiwan
| | - Shuya Chen
- Department of Physical Therapy, China Medical University, Taichung, Taiwan
| | - Geng Yang
- School of Information Science and Technology, Fudan University, Shanghai, China
| | - Li-Rong Zheng
- School of Information Science and Technology, Fudan University, Shanghai, China
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Lee MM, Shin DC, Song CH. Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study. J Phys Ther Sci 2016; 28:2019-24. [PMID: 27512255 PMCID: PMC4968497 DOI: 10.1589/jpts.28.2019] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 04/07/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.
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Affiliation(s)
- Myung-Mo Lee
- Department of Physical Therapy, Daejeon University, Republic of Korea
| | - Doo-Chul Shin
- Department of Physical Therapy, Sahmyook University, Republic of Korea
| | - Chang-Ho Song
- Department of Physical Therapy, Sahmyook University, Republic of Korea
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50
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Imam B, Miller WC, Finlayson H, Eng JJ, Jarus T. A randomized controlled trial to evaluate the feasibility of the Wii Fit for improving walking in older adults with lower limb amputation. Clin Rehabil 2016; 31:82-92. [DOI: 10.1177/0269215515623601] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To assess the feasibility of Wii.n.Walk for improving walking capacity in older adults with lower limb amputation. Design: A parallel, evaluator-blind randomized controlled feasibility trial. Setting: Community-living. Participants: Individuals who were ⩾50 years old with a unilateral lower limb amputation. Intervention: Wii.n.Walk consisted of Wii Fit training, 3x/week (40 minute sessions), for 4 weeks. Training started in the clinic in groups of 3 and graduated to unsupervised home training. Control group were trained using cognitive games. Main Measures: Feasibility indicators: trial process (recruitment, retention, participants’ perceived benefit from the Wii.n.Walk intervention measured by exit questionnaire), resources (adherence), management (participant processing, blinding), and treatment (adverse event, and Cohen’s d effect size and variance). Primary clinical outcome: walking capacity measured using the 2 Minute Walk Test at baseline, end of treatment, and 3-week retention. Results: Of 28 randomized participants, 24 completed the trial (12/arm). Median (range) age was 62.0 (50-78) years. Mean (SD) score for perceived benefit from the Wii.n.Walk intervention was 38.9/45 (6.8). Adherence was 83.4%. The effect sizes for the 2 Minute Walk Test were 0.5 (end of treatment) and 0.6 (3-week retention) based on intention to treat with imputed data; and 0.9 (end of treatment) and 1.2 (3-week retention) based on per protocol analysis. The required sample size for a future larger RCT was deemed to be 72 (36 per arm). Conclusions: The results suggested the feasibility of the Wii.n.Walk with a medium effect size for improving walking capacity. Future larger randomized controlled trials investigating efficacy are warranted.
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Affiliation(s)
- Bita Imam
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
| | - William C Miller
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - Heather Finlayson
- Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, Canada
| | - Janice J Eng
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Tal Jarus
- Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
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