Virtual reality technology enhances the cognitive and social communication of children with autism spectrum disorder

Psychological effects of virtual reality intervention on breast cancer patients with different personalities: A randomized controlled trial

Objectives

To explore the efficacy and safety of virtual reality (VR) in relieving negative emotions in patients with breast cancer with different personalities.

Methods

A randomized controlled trial was conducted. Between April 2023 and October 2023, we enrolled patients with breast cancer treated in the Department of Breast Cancer and Oncology at Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Province. The patients were randomly divided into an intervention group (n = 118) and a control group (n = 119) using block randomization. The intervention group received the VR intervention 3 - 5 times over 5 ± 2 weeks using natural landscapes with music or relaxation guidance, and the duration of each VR intervention was 15 ± 3 min. The control group received routine nursing care, including disease education and psychological counseling. Patients were assessed using the Type D Scale, Positive and Negative Affect Scale, and Distress Thermometer, and adverse events during the intervention were recorded.

Results

Overall, 85 patients completed the study (44 in the intervention group and 41 in the control group). Patients with Type D personalities showed more negative emotions [25.0 (21.5, 27.5) vs. 19.0 (16.0, 24.0), P = 0.001] and distressed attitudes [4.0 (2.0, 5.0) vs. 3.0 (1.0, 4.0), P = 0.020] with fewer positive emotions (27.2 ± 5.6 vs. 31.0 ± 5.9, P = 0.014) than those with non-Type D personalities. Total population analysis revealed no significant differences between the groups. However, in the subgroup analysis, patients with Type D personalities in the intervention group showed greater relief from negative emotions than those in the control group [median difference, -5.0 (-9.0, -2.5) vs. -2.0 (-4.0, 2.0), P = 0.046]. No significant differences were found between groups of patients with non-Type D personality traits. The proportion of adverse events was not significantly different between groups (P = 0.110).

Conclusions

Breast cancer patients with Type D personalities suffer more severe negative emotions and distress, and more attention should be paid to them. VR intervention significantly and safely reduced negative emotions in patients with Type D personalities.

Effectiveness of Virtual Reality Technology Interventions in Improving the Social Skills of Children and Adolescents With Autism: Systematic Review

BACKGROUND

Virtual reality (VR) technology has shown significant potential in improving the social skills of children and adolescents with autism spectrum disorder (ASD).

OBJECTIVE

This study aimed to systematically review the evidence supporting the effectiveness of VR technology in improving the social skills of children and adolescents with ASD.

METHODS

The search for eligible studies encompassed 4 databases: PubMed, Web of Science, IEEE, and Scopus. Two (XY and JW) researchers independently assessed the extracted studies according to predefined criteria for inclusion and exclusion. These researchers also independently extracted information regarding gathered data on the sources, samples, measurement methods, primary results, and data related to the main results of the studies that met the inclusion criteria. The quality of the studies was further evaluated using the Physiotherapy Evidence Database scale.

RESULTS

This review analyzed 14 studies on using VR technology interventions to improve social skills in children and adolescents with ASD. Our findings indicate that VR interventions have a positive effect on improving social skills in children and adolescents with ASD. Compared with individuals with low-functioning autism (LFA), those with high-functioning autism (HFA) benefited more from the intervention. The duration and frequency of the intervention may also influence its effectiveness. In addition, immersive VR is more suitable for training complex skills in individuals with HFA. At the same time, nonimmersive VR stands out in terms of lower cost and flexibility, making it more appropriate for basic skill interventions for people with LFA. Finally, while VR technology positively enhances social skills, some studies have reported potential adverse side effects. According to the quality assessment using the Physiotherapy Evidence Database scale, of the 14 studies, 6 (43%) were classified as high quality, 4 (29%) as moderate quality, and 4 (29%) as low quality.

CONCLUSIONS

This systematic review found that VR technology interventions positively impact social skills in children and adolescents with ASD, with particularly significant effects on the enhancement of complex social skills in individuals with HFA. For children and adolescents with LFA, progress was mainly observed in basic skills. Immersive VR interventions are more suitable for the development of complex skills. At the same time, nonimmersive VR, due to its lower cost and greater flexibility, also holds potential for application in specific contexts. However, the use of VR technology may lead to side effects such as dizziness, eye fatigue, and sensory overload, particularly in immersive settings. These potential issues should be carefully addressed in intervention designs to ensure user comfort and safety. Future research should focus on optimizing individualized interventions and further exploring the long-term effects of VR interventions.

TRIAL REGISTRATION

International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202420079U1; https://inplasy.com/inplasy-2024-2-0079/.

Examining Virtual Reality Interventions for Social Skills in Children with Autism Spectrum Disorder: A Systematic Review

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is characterized by limitations in social communication and interaction, self-repetitive behaviors, and the presence of limited interests. The prevalence of ASD, which typically emerges in the first years of life, is increasing at an alarming rate due to multiple factors, including the broadening of diagnostic criteria, heightened public awareness, and more frequent diagnoses among women and adults. Over the years, experts have invested considerable time and effort in developing educational scenarios for children with ASD. However, they have faced challenges replicating certain scenarios-such as emergencies, crowded public transportation, or restaurant environments-because recreating these exact conditions in real-world settings is difficult or cost-prohibitive. This has consequently compelled experts to seek out supplementary intervention methods that are more suitable and accessible. Virtual reality (VR), which has the capacity to integrate the physical and virtual realms, represents one such alternative intervention method. In this study, a systematic review of studies employing VR technology in social skills interventions for individuals with ASD was conducted, and 31 studies were included. The findings indicate the potential benefits of VR applications focusing on the social skills of individuals with ASD. Additionally, this research elucidates the limitations of the studies and offers suggestions for future research.

Current virtual reality-based rehabilitation interventions in neuro-developmental disorders at developmental ages

This mini-review examines the available papers about virtual reality (VR) as a tool for the diagnosis or therapy of neurodevelopmental disorders, focusing on Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Specific Learning Disorders (SLD). Through a search on literature, we selected 62 studies published between 1998 and 2024. After exclusion criteria, our synoptic table includes 32 studies on ADHD (17 were on diagnostic evaluation and 15 were on therapeutic interventions), 2 on pure ASD, and 2 on pure SLD. These cover a total of 8,139 participants with ADHD (ages 3-19), 458 with ASD (ages 4-19), and 162 with SLD (ages 7-11). Results show that VR offers high ecological validity and enables improvements in cognitive and social skills. Specifically, in individuals with ADHD, VR showed benefits in attention and executive function, with optimal results when combined with pharmacological treatments. For ASD kids, VR proved effective in enhancing social skills and emotional regulation through personalized virtual scenarios. However, the literature on SLD remains limited, suggesting an evolving area of research. Despite limitations related to small sample sizes and technology costs, VR presents a promising outlook for clinical intervention in neuro-developmental disorders, supporting enhanced skills in a safe and controlled environment. We conclude that both immersive and non-immersive VR represents a valuable supplement to traditional therapies, allowing for personalized approaches.

Design Considerations for Virtual Reality Intervention for People with Intellectual and Developmental Disabilities: A Systematic Review

OBJECTIVES

This systematic review aims to explore virtual reality (VR) applications for rehabilitation purposes among people with intellectual and developmental disabilities (IDD), identify their effects on rehabilitation outcomes, explore themes to consider in VR intervention design, and provide guidance for designers and researchers in creating therapeutic environments using VR technology.

BACKGROUND

VR has gained increasing attention in healthcare settings to assist in achieving rehabilitation goals for people with IDD. VR is particularly advantageous since it simulates the real world while providing controllable, safe, and versatile environments. It is necessary to expand the current body of knowledge on VR intervention's outcomes by synthesizing further information on VR application characteristics as well as identifying design considerations regarding feasibility, usability, safety, and other aspects that will benefit future VR intervention design and research.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framed the current review. Multiple databases were searched to identify studies published between 2001 and 2023. The review qualitatively organized VR environment design considerations according to three themes: feasibility, usability, and safety.

RESULTS

This review included 27 articles and included 868 participants. The overall findings indicated that VR interventions are promising in enhancing rehabilitation outcomes among people with IDD, such as physical, cognitive, emotional, and functional independence domains.

CONCLUSION

This review provides design recommendations to create effective, usable, and safe VR interventions for individuals with IDD. The suggested design implications should be applied with the awareness that VR is a relatively emerging technology with rapidly evolving features.

Opportunities and challenges in leveraging digital technology for mental health system strengthening: a systematic review to inform interventions in the United Arab Emirates

Digital technology offers scalable, real-time interventions for mental health promotion and treatment. This systematic review explores the opportunities and challenges associated with the use of digital technology in mental health, with a focus on informing mental health system strengthening interventions in the United Arab Emirates (UAE). Following PRISMA guidelines, a systematic search of databases was conducted up to August 2023 and identified a total of 8479 citations of which 114 studies were included in the qualitative analysis. The included studies encompass diverse digital interventions, platforms, and modalities used across various mental health conditions. The review identifies feasible, acceptable, and efficacious interventions, ranging from telehealth and mobile apps to virtual reality and machine learning models. Opportunities for improving access to care, reducing patients' transfers, and utilizing real-world interaction data for symptom monitoring are highlighted. However, challenges such as digital exclusion, privacy concerns, and potential service replacement caution policymakers. This study serves as a valuable evidence base for policymakers and mental health stakeholders in the UAE to navigate the integration of digital technology in mental health services effectively.

The translatability of communication interventions in paediatric autism: A scoping review

PURPOSE

Translation of research is requisite for speech-language pathologists; however, barriers have been reported. This review aimed to identify the extant literature published on communication for autistic children, and examine the replicability and translatability of communication interventions for speech-language pathologists providing services to children with autism.

METHOD

A scoping review was conducted using a six-stage protocol. Following initial database searching and screening, data were extracted from included studies for demographic characteristics and Template for Intervention Description and Replication (TIDieR) checklist elements. Stakeholder consultation interviews with 13 speech-language pathologists who work with autistic children were also undertaken.

RESULT

The database search revealed 4719 studies on the topic of communication in autistic children, of which 762 were communication intervention studies. Of these included intervention studies, 30% were considered replicable according to the TIDieR checklist. Stakeholder consultation revealed that poorly described intervention studies hindered translation efforts.

CONCLUSION

The vast amount of autism communication intervention literature and the variable quality of intervention description reporting are barriers to accessing high quality literature for translation to practice. Improved reporting of intervention descriptions in autism communication intervention studies would support research translation into clinical settings.

Digital interventions for autism spectrum disorders: A systematic review and meta-analysis

Importance

Digital technology is now widely available for the interventions of autism, but its validity and feasibility remain to be proved.

Objective

This study aimed to investigate the effectiveness of digital health interventions (DHIs) in improving core symptoms or intelligence quotient in patients with autism spectrum disorder (ASD).

Methods

Three databases including PubMed, Cochrane, and Scopus, were searched on November 15, 2022. Randomized clinical trials that enrolled patients with ASD who received DHIs and a control group without DHI treatment were included. Cochrane risk of bias tool (RoB 2) was applied to assess the risk of bias.

Results

A total of 33 studies, involving 1285 participants (658 [51.2%] in DHI groups and 627 [48.8%] in control groups), were analyzed to investigate the differences between DHI groups and control groups. Significantly greater improvements in the overall performance of ASD were observed in the DHI groups compared to the control groups (including active, waitlist, treatment-as-usual, and no treatment) with an effect size of 1.89 (Cohen's d 95% confidence interval [CI]: 1.26-2.52). Studies with treatment-as-usual, waitlist, and no treatment control demonstrated large effect sizes of Cohen's d 3.41 (95% CI: 0.84-5.97), Cohen's d 4.27 (95% CI: 1.95-6.59), and Cohen's d 4.52 (95% CI: 2.98-6.06) respectively. In contrast, studies with active control revealed insignificant effect sizes (Cohen's d 0.73, 95% CI: 0.12-1.33).

Interpretation

This meta-analysis found significantly greater improvements in core symptoms or intelligence quotient in ASD patients receiving DHIs compared to those in control conditions. ASD patients may benefit from the DHIs and reduce the economic burden.

Effect of immersive virtual reality-based training on cognitive, social, and emotional skills in children and adolescents with autism spectrum disorder: A meta-analysis of randomized controlled trials

BACKGROUND

Virtual Reality (VR) based diagnostic and therapeutic interventions have opened up new possibilities for addressing the challenges in identifying and treating individuals with Autism Spectrum Disorders (ASD).

AIM

To conduct a systematic review and meta-analysis of Randomized Controlled Trials to investigate the impact of Immersive VR techniques on the cognitive, social, and emotional skills of under-18 children and adolescents with ASD.

METHODS AND PROCEDURES

Four databases were systematically searched as per "Preferred Reporting Items for Systematic Reviews and Meta-analyses" guidelines and assessed six RCTs for further analysis. The Cochrane Risk of Bias tool was used to assess the methodological quality of the studies.

OUTCOMES

Pooled results favoured VR and reported significant differences between experimental and control groups concerning social skills (SMD:1.43; 95 % CI: 0.01-2.84; P: 0.05), emotional skills (SMD: 2.45; 95 % CI: 0.21-4.18; P: 0.03) and cognitive skills.

CONCLUSION

VR offers an array of benefits that make it a promising tool for children and adolescents with ASD to improve their cognitive, social and emotional skills in a safe and supportive setting. However, accessibility, affordability, customization, and cost are also significant aspects to consider when developing and implementing VR-based interventions for ASD.

Using Virtual Reality to Reduce Anxiety and Improve Hospital Experience in Paediatric Orthopaedic Patients and Their Parents

The hospital environment can be a stressful environment for paediatric patients and their parents, which is often characterised by heightened levels of pain and anxiety. To address these challenges, many innovative intervention methods has been explored. For example, immersive virtual reality (VR) headsets as a distraction method has become an increasingly popular intervention in recent years. This study aimed to evaluate the effectiveness of VR using 'Rescape DR.VR Junior' in reducing pain, anxiety, and enhancing the overall hospital experience for paediatric orthopaedic patients and their parents. A total of 64 patients aged 4-18 years were included in this study, which utilised a control group (interacting with a play specialist) and a VR intervention group (including pre-operative patients and fracture clinic patients). Anxiety and pain levels were measured using a 10-point Likert scale before and after the intervention, and validated questionnaires were used to assess parental anxiety and overall hospital experience. The results indicated that VR intervention significantly reduced patient and parental anxiety both before surgery and in the fracture clinic setting (p < 0.5). However, no significant reduction in pain scores was observed in either environments. Comparatively, VR intervention was found to be comparable to traditional play methods in terms of reducing anxiety in the pre-operative environment. All patients and parents agreed that the use of VR distraction methods significantly improved their hospital experience. In conclusion, VR is an effective method for reducing child and parental anxiety and enhancing the hospital experience and can be used alone or in conjunction with a play specialist.

Virtual reality rehabilitation program on executive functions of children with specific learning disorders: a pilot study

Background

The application of Virtual Reality (VR) in the field of rehabilitation has been widely studied, because it has already proven to be an effective intervention for a variety of physical and cognitive conditions. Nevertheless, its application in pediatric rehabilitation is more recent. This pilot study aims to examine whether a VR-rehabilitation program may have positive effects on the Executive Functions (EFs) of children with Specific Learning Disorders (SLD).

Materials and methods

Twenty-four children with diagnosis of SLD participated to the study (range 7-11 years) and performed the VR-training across 6 weeks in the CARE Lab, that was designed with appropriate structural measures and ad hoc fittings, to hide the sophisticated technology necessary to allow the child to experience a rehabilitative setting with recreational and semi-immersive features. Children were evaluated across three main time-points: T0, assessment of cognitive level and EFs immediately before the start of the intervention; T1, assessment of EFs immediately after the end of VR intervention; T2, follow-up of EFs after 6 months from the end of the VR intervention. The rehabilitation programs were customized according to clinical needs and/or single patient's characteristics, proposing different games with variable complexity levels.

Results

Results showed that scores for visual attention, inhibition, flexibility, and planning abilities were significantly higher than before the intervention, and the most part of these ameliorations were maintained after 6 months.

Conclusion

These findings provide important inputs for the development of new innovative rehabilitation interventions for children with SLD that must be founded in ecological and evidence-based approaches.

Areas of Research Focus and Trends in the Research on the Application of VR in Rehabilitation Medicine

OBJECTIVE

To establish the areas of research focus in the application of VR in rehabilitation medicine, analyze its themes and trends, and offer a reference for future related research in this field.

METHODS

This paper provides an in-depth analysis of the development process, areas of research focus, and research trends in the field of the application of VR in rehabilitation medicine, using the Web of Science core dataset as the source and using a bibliometric analysis with CiteSpace.

RESULTS

The application of VR in rehabilitation medicine was composed of three stages, and the research topics were reviewed from five perspectives: neurological rehabilitation, psychological treatment, pain distraction, cardiopulmonary rehabilitation, and visual-spatial disorder.

LIMITATIONS

The research data were sourced from the Web of Science core dataset only, and the data-sample size was not comprehensive.

CONCLUSIONS

Overcoming VR-technology-induced vertigo, mental disorders from the overuse of VR, individualized treatments, and integration with traditional therapy are all challenges in the application of VR in rehabilitation medicine that require research. In addition, developing VR products with better experiences, constructing standardized guidelines, and conducting more high-quality clinical studies are all future research topics related to the application of VR in rehabilitation medicine.

The perspective of allergy and immunology specialists on the innovations of metaverse: A survey study

BACKGROUND

New technologies have resulted in dramatic shifts in the field of medicine, and it stands to reason that metaverse will also affect the practice of allergy and immunology. This study aimed to determine the attitudes of allergists and raise awareness about metaverse applications in allergy and immunology.

METHODS

A nationwide survey-based study was conducted in Turkey. First, a 28-item questionnaire was developed and sent to Turkish allergists. After completing the first questionnaire, the participants were asked to watch a 5-min informative video about the metaverse. Lastly, a second survey was conducted to evaluate the changes in the views of the participants.

RESULTS

A total of 148 allergy doctors in Turkey participated in the survey. After watching a video containing updated information about the metaverse, there was a significant increase in the importance that participants attributed to the use of virtual reality and augmented reality applications in the field of immunology and allergy (P < 0.05). Additionally, there was a significant increase in the percentage of participants who thought that Metaverse applications could be integrated into the existing system and said that this possibility excited them (P < 0.05). There was also a significant increase in the percentage of participants who thought this innovative technology could be helpful in patient examination, student and physician education, allergy testing, and patient education (P < 0.05).

CONCLUSIONS

Our results demonstrate that providing information to professionals working in the field can positively influence physicians' views on the potential of the metaverse, which is a valuable tool in the field of immunology and allergy.