Pub Date : 2025-04-01Epub Date: 2024-08-07DOI: 10.1089/g4h.2023.0240
Hasan Sepehri Bonab, Soghra Ebrahimi Sani, Behzad Behzadnia
Introduction: Autistic children may encounter difficulties in managing emotions and executive functions (EFs), which can contribute to mental and health challenges. Recognizing physical activities as a potential strategy for enhancing emotion regulation (ER), this study aims to investigate the efficacy of a virtual reality (VR)-based physical exercise program in improving ER and EFs among children with autism spectrum disorder (ASD). Materials and Methods: Forty boys diagnosed with ASD, aged 7 to 10 years, were randomly assigned to two groups: a VR intervention group (n = 20) and a control group (n = 20). The intervention group participated in a VR program, while the control group solely concentrated on engaging in sedentary and inactive video gaming. EFs were evaluated through the utilization of both the flanker task and the Wisconsin card sorting task, both administered initially at baseline and subsequently after an 8-week interval. In addition, the parents of the children completed the Emotion Regulation Checklist to evaluate their ER skills. Results: According to the results, a significant difference was observed between the two groups in terms of EFs and the ability to regulate emotion (P < 0.05). The intervention group demonstrated a notable improvement in ER skills and exhibited superior executive functioning abilities compared with the control group. Conclusion: It appears that VR exercises can serve as a preliminary trial to enhance EFs and ER in children with autism. In addition, they may prove effective as complementary interventions to traditional educational strategies in preventing future challenges associated with ASD.
{"title":"The Impact of Virtual Reality Intervention on Emotion Regulation and Executive Functions in Autistic Children.","authors":"Hasan Sepehri Bonab, Soghra Ebrahimi Sani, Behzad Behzadnia","doi":"10.1089/g4h.2023.0240","DOIUrl":"10.1089/g4h.2023.0240","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Autistic children may encounter difficulties in managing emotions and executive functions (EFs), which can contribute to mental and health challenges. Recognizing physical activities as a potential strategy for enhancing emotion regulation (ER), this study aims to investigate the efficacy of a virtual reality (VR)-based physical exercise program in improving ER and EFs among children with autism spectrum disorder (ASD). <b><i>Materials and Methods:</i></b> Forty boys diagnosed with ASD, aged 7 to 10 years, were randomly assigned to two groups: a VR intervention group (<i>n</i> = 20) and a control group (<i>n</i> = 20). The intervention group participated in a VR program, while the control group solely concentrated on engaging in sedentary and inactive video gaming. EFs were evaluated through the utilization of both the flanker task and the Wisconsin card sorting task, both administered initially at baseline and subsequently after an 8-week interval. In addition, the parents of the children completed the Emotion Regulation Checklist to evaluate their ER skills. <b><i>Results:</i></b> According to the results, a significant difference was observed between the two groups in terms of EFs and the ability to regulate emotion (<i>P</i> < 0.05). The intervention group demonstrated a notable improvement in ER skills and exhibited superior executive functioning abilities compared with the control group. <b><i>Conclusion:</i></b> It appears that VR exercises can serve as a preliminary trial to enhance EFs and ER in children with autism. In addition, they may prove effective as complementary interventions to traditional educational strategies in preventing future challenges associated with ASD.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"146-158"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2024-08-07DOI: 10.1089/g4h.2024.0050
Emily M He, Faaizah Arshad, Brian S-K Li, Ryan Brinda, Avani Ganesan, Lijin Zhang, Sammy Fehr, Meghana Renavikar, Samuel T Rodriguez, Ellen Wang, Oswaldo Rosales, Thomas J Caruso
Background: Hospitalized pediatric patients and their caregivers often experience anxiety and fear, resulting in withdrawal and aggression. Despite virtual reality (VR) being a safe and effective anxiolytic, it is unknown what software design aspects contribute to its effectiveness. This prospective observational study evaluated which VR application elements increased awe, which is correlated with improved behavior and satisfaction. Methods: Patients aged 6 to 25 years and their caregivers at an academic pediatric hospital interacted with a custom VR application that compared design aspects, including environment, graphics fidelity, and presence of a motivational character. Outcomes investigated self-reported awe, vastness, accommodation, and engagement. Data were analyzed using repeated measure ANOVA tests and correlation analyses. Results: A total of 202 participants were enrolled, and 179 (88 pediatric patients, 91 adult caregivers) were included in the final analysis. A fictional environment was more effective at increasing awe in pediatric patients (P = 0.030) compared with a realistic environment. However, increased graphics fidelity was more effective at increasing awe in caregiver adults (P = 0.023) compared with low resolution graphics. Presence of a motivational character did not influence awe in either patients or caregivers (P = 0.432, P = 0.904, respectively). All measures of awe were positively correlated with application engagement (P < 0.005). Conclusion: In conclusion, when software developers design VR software for pediatric patients and their caregivers, fictional settings and increased graphic fidelity should be considered for pediatric patients and adults, respectively. Future studies will explore other VR elements in gameplay settings.
{"title":"Awe Inducing Elements in Virtual Reality Applications: A Prospective Study of Hospitalized Children and Caregivers.","authors":"Emily M He, Faaizah Arshad, Brian S-K Li, Ryan Brinda, Avani Ganesan, Lijin Zhang, Sammy Fehr, Meghana Renavikar, Samuel T Rodriguez, Ellen Wang, Oswaldo Rosales, Thomas J Caruso","doi":"10.1089/g4h.2024.0050","DOIUrl":"10.1089/g4h.2024.0050","url":null,"abstract":"<p><p><b><i>Background:</i></b> Hospitalized pediatric patients and their caregivers often experience anxiety and fear, resulting in withdrawal and aggression. Despite virtual reality (VR) being a safe and effective anxiolytic, it is unknown what software design aspects contribute to its effectiveness. This prospective observational study evaluated which VR application elements increased awe, which is correlated with improved behavior and satisfaction. <b><i>Methods:</i></b> Patients aged 6 to 25 years and their caregivers at an academic pediatric hospital interacted with a custom VR application that compared design aspects, including environment, graphics fidelity, and presence of a motivational character. Outcomes investigated self-reported awe, vastness, accommodation, and engagement. Data were analyzed using repeated measure ANOVA tests and correlation analyses. <b><i>Results:</i></b> A total of 202 participants were enrolled, and 179 (88 pediatric patients, 91 adult caregivers) were included in the final analysis. A fictional environment was more effective at increasing awe in pediatric patients (<i>P</i> = 0.030) compared with a realistic environment. However, increased graphics fidelity was more effective at increasing awe in caregiver adults (<i>P</i> = 0.023) compared with low resolution graphics. Presence of a motivational character did not influence awe in either patients or caregivers (<i>P</i> = 0.432, <i>P</i> = 0.904, respectively). All measures of awe were positively correlated with application engagement (<i>P</i> < 0.005). <b><i>Conclusion:</i></b> In conclusion, when software developers design VR software for pediatric patients and their caregivers, fictional settings and increased graphic fidelity should be considered for pediatric patients and adults, respectively. Future studies will explore other VR elements in gameplay settings.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"159-166"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to evaluate the effect of somatosensory interactive games in combination with pulmonary rehabilitation programs (PRPs) on exercise tolerance, balance function, pulmonary function, inflammatory markers, and healthcare utilization in individuals with acute exacerbation of chronic obstructive pulmonary disease over 12 months. Design: In a randomized controlled trial, 80 patients were divided into two groups. The control group participated in a lasted 30 minutes daily program composed of postural training for 10 minutes, limb movement for 10 minutes, and breathing exercises for 10 minutes based on regular oxygen therapy and medication. The experimental group received a once-daily, 20-minute somatosensory interactive game session based on the control group. Patients began treatment within 48 hours after admission and lasted for 6 weeks. Results: The time × group interactions on 6-minute walk distance (6MWD) and Brief Balance Evaluation Systems Test (Brief-BESTest) between the two groups were significant (P < 0.001). At the postintervention and each time point of follow-up, the 6-minute walk distance (6MWD) and Brief-BESTest of the intervention group were significantly higher than those of the control group (P < 0.05). The effects of time factor on forced expiratory volume in one second and forced vital capacity were statistically significant (P < 0.05). The 6MWD and Brief-BESTest of the intervention group peaked 3 months after the intervention and were higher than the control group within 12 months. C-reactive protein and procalcitonin were similar between the groups before and after intervention (P > 0.05). The readmission rates and mean length of time spent in the hospital were comparable between the groups at 12 months (P > 0.05). Conclusions: The addition of somatosensory interactive games based on a PRP was safe and feasible, and this benefit persisted for 12 months, peaked at 3 months after the intervention, and then gradually decreased.
{"title":"The Association of Conventional Therapy Associated with Somatosensory Interactive Game Enhances the Effects of Early Pulmonary Rehabilitation for Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.","authors":"Xiaoliang Jin, Mengni Jin, Beilei Zhang, Mei'e Niu, Yanxia Han, Jiale Qian","doi":"10.1089/g4h.2023.0095","DOIUrl":"10.1089/g4h.2023.0095","url":null,"abstract":"<p><p><b><i>Objective:</i></b> This study aimed to evaluate the effect of somatosensory interactive games in combination with pulmonary rehabilitation programs (PRPs) on exercise tolerance, balance function, pulmonary function, inflammatory markers, and healthcare utilization in individuals with acute exacerbation of chronic obstructive pulmonary disease over 12 months. <b><i>Design:</i></b> In a randomized controlled trial, 80 patients were divided into two groups. The control group participated in a lasted 30 minutes daily program composed of postural training for 10 minutes, limb movement for 10 minutes, and breathing exercises for 10 minutes based on regular oxygen therapy and medication. The experimental group received a once-daily, 20-minute somatosensory interactive game session based on the control group. Patients began treatment within 48 hours after admission and lasted for 6 weeks. <b><i>Results:</i></b> The time × group interactions on 6-minute walk distance (6MWD) and Brief Balance Evaluation Systems Test (Brief-BESTest) between the two groups were significant (<i>P</i> < 0.001). At the postintervention and each time point of follow-up, the 6-minute walk distance (6MWD) and Brief-BESTest of the intervention group were significantly higher than those of the control group (<i>P</i> < 0.05). The effects of time factor on forced expiratory volume in one second and forced vital capacity were statistically significant (<i>P</i> < 0.05). The 6MWD and Brief-BESTest of the intervention group peaked 3 months after the intervention and were higher than the control group within 12 months. C-reactive protein and procalcitonin were similar between the groups before and after intervention (<i>P</i> > 0.05). The readmission rates and mean length of time spent in the hospital were comparable between the groups at 12 months (<i>P</i> > 0.05). <b><i>Conclusions:</i></b> The addition of somatosensory interactive games based on a PRP was safe and feasible, and this benefit persisted for 12 months, peaked at 3 months after the intervention, and then gradually decreased.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"127-135"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2024-08-07DOI: 10.1089/g4h.2024.0039
Hina Faisal, Wesley Lim, Antara Dattagupta, Peter Lin, Rohan Gupta, Eugene C Lai, Jiaqiong Xu, Stephen T Wong, Faisal N Masud
Background: The aim of the current pilot study was to evaluate the usability, acceptability, and tolerability of virtual reality (VR)-based cognitive stimulation exercises (CSEs) in healthy young versus old populations before health care integration. A secondary aim was to assess the accuracy of VR games as a proxy for cognitive stimulation, specifically for attention. VR-based CSEs promise to improve attention and brain function through varied learning systems. Methods: This is a Phase 1 feasibility clinical trial at a single center. It involves 30 healthy volunteers randomly selected using the American Society of Anesthesiologists (ASA) physical status classification system. Participants fall into ASA 1 (age >18-35 years, n = 15) or ASA 2 (age >60 years, n = 15) categories. All participants tested the ReCognitionVR-based CSEs. Feasibility criterion: Participants in each group were monitored for completion of 20 minutes of VR-based CSEs. Acceptability criterion: Proportion of participants with system usability scale (SUS) >35 or SUS score of 87.5. Safety (tolerability) monitoring: Sessions were monitored for neurological, cardiovascular, or pulmonary adverse events (AEs). Safety criterion: No more than 10% of sessions stopped due to neurological, cardiovascular, or pulmonary AEs. Results: The primary outcome (feasibility) of ReCognitionVR-based CSEs was 100%. For the secondary outcome (acceptability), there was no group difference in SUS scores (ASA 1 = 88.17 ± 12.83 vs. ASA 2 = 88.39 ± 10.22, P = 0.81). For the tertiary outcome (safety), mild transient uneasiness was reported by two (13.4%) ASA 1 participants (resolved in 2 minutes), and one (6.67%) ASA 1 participant experienced a temporary >20% increase in blood pressure from baseline. No ASA 2 participants had AEs. Conclusion: The feasibility, acceptability, and safety of ReCognitionVR-based CSEs in healthy elderly volunteers are acceptable, indicating that the evaluation of the ReCognitionVR-based CSEs in hospitalized patients is reasonable.
{"title":"Usability and Tolerability of Virtual Reality-Based Cognitive Stimulation in Healthy Elderly Volunteers-A Feasibility Clinical Trial.","authors":"Hina Faisal, Wesley Lim, Antara Dattagupta, Peter Lin, Rohan Gupta, Eugene C Lai, Jiaqiong Xu, Stephen T Wong, Faisal N Masud","doi":"10.1089/g4h.2024.0039","DOIUrl":"10.1089/g4h.2024.0039","url":null,"abstract":"<p><p><b><i>Background:</i></b> The aim of the current pilot study was to evaluate the usability, acceptability, and tolerability of virtual reality (VR)-based cognitive stimulation exercises (CSEs) in healthy young versus old populations before health care integration. A secondary aim was to assess the accuracy of VR games as a proxy for cognitive stimulation, specifically for attention. VR-based CSEs promise to improve attention and brain function through varied learning systems. <b><i>Methods:</i></b> This is a Phase 1 feasibility clinical trial at a single center. It involves 30 healthy volunteers randomly selected using the American Society of Anesthesiologists (ASA) physical status classification system. Participants fall into ASA 1 (age >18-35 years, <i>n</i> = 15) or ASA 2 (age >60 years, <i>n</i> = 15) categories. All participants tested the ReCognitionVR-based CSEs. Feasibility criterion: Participants in each group were monitored for completion of 20 minutes of VR-based CSEs. Acceptability criterion: Proportion of participants with system usability scale (SUS) >35 or SUS score of 87.5. Safety (tolerability) monitoring: Sessions were monitored for neurological, cardiovascular, or pulmonary adverse events (AEs). Safety criterion: No more than 10% of sessions stopped due to neurological, cardiovascular, or pulmonary AEs. <b><i>Results:</i></b> The primary outcome (feasibility) of ReCognitionVR-based CSEs was 100%. For the secondary outcome (acceptability), there was no group difference in SUS scores (ASA 1 = 88.17 ± 12.83 vs. ASA 2 = 88.39 ± 10.22, <i>P</i> = 0.81). For the tertiary outcome (safety), mild transient uneasiness was reported by two (13.4%) ASA 1 participants (resolved in 2 minutes), and one (6.67%) ASA 1 participant experienced a temporary >20% increase in blood pressure from baseline. No ASA 2 participants had AEs. <b><i>Conclusion:</i></b> The feasibility, acceptability, and safety of ReCognitionVR-based CSEs in healthy elderly volunteers are acceptable, indicating that the evaluation of the ReCognitionVR-based CSEs in hospitalized patients is reasonable.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"136-145"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141898642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2024-08-12DOI: 10.1089/g4h.2024.0026
Julia Amaral Teixeira, Eduarda Bitencourt, Viviane Derhon, Brendon Stubbs, Felipe Barreto Schuch
Virtual reality (VR) exercise aims to offer positive affective and sensory experiences through an immersive experience rich in audiovisual stimuli. Notwithstanding, there is a paucity of large sample size studies comparing the acute effects of VR exercise compared with a matched exercise performed in a non-VR environment. The study compared the acute effects of a VR exercise session versus a matched non-VR exercise session in effect, pleasure, enjoyment, perceived exertion, and heart rate. This is a crossover randomized clinical trial. The time, difficulty, and exercise type of the non-VR exercise were matched to VR exercise. Before and immediately after each session, participants responded to the Borg's Perceived Exertion Scale, the Feeling Scale and the Felt Arousal Scale, and the Physical Activity Enjoyment Scale. The analyses were conducted with Generalized Linear Models, Wilcoxon's, and T-test for paired samples. A total of 83 adults (40 females) aged 35.46 years were included in the study. Participants in the VR condition had a greater increase in affect (mean change difference = 0.95, 95% confidence interval [CI] = 0.83-1.06, P < 0.001), arousal (mean change difference = 0.37, 95% CI = 0.23-9.50, P < 0.001). The pleasure and enjoyment median after the VR session were higher. In conclusion, the immersive VR exercise was more strenuous, but resulted in a better affective response, greater pleasure, and enjoyment.
{"title":"Acute Affective Responses to Virtual Reality Exercise: A Crossover Randomized Clinical Trial.","authors":"Julia Amaral Teixeira, Eduarda Bitencourt, Viviane Derhon, Brendon Stubbs, Felipe Barreto Schuch","doi":"10.1089/g4h.2024.0026","DOIUrl":"10.1089/g4h.2024.0026","url":null,"abstract":"<p><p>Virtual reality (VR) exercise aims to offer positive affective and sensory experiences through an immersive experience rich in audiovisual stimuli. Notwithstanding, there is a paucity of large sample size studies comparing the acute effects of VR exercise compared with a matched exercise performed in a non-VR environment. The study compared the acute effects of a VR exercise session versus a matched non-VR exercise session in effect, pleasure, enjoyment, perceived exertion, and heart rate. This is a crossover randomized clinical trial. The time, difficulty, and exercise type of the non-VR exercise were matched to VR exercise. Before and immediately after each session, participants responded to the Borg's Perceived Exertion Scale, the Feeling Scale and the Felt Arousal Scale, and the Physical Activity Enjoyment Scale. The analyses were conducted with Generalized Linear Models, Wilcoxon's, and T-test for paired samples. A total of 83 adults (40 females) aged 35.46 years were included in the study. Participants in the VR condition had a greater increase in affect (mean change difference = 0.95, 95% confidence interval [CI] = 0.83-1.06, <i>P</i> < 0.001), arousal (mean change difference = 0.37, 95% CI = 0.23-9.50, <i>P</i> < 0.001). The pleasure and enjoyment median after the VR session were higher. In conclusion, the immersive VR exercise was more strenuous, but resulted in a better affective response, greater pleasure, and enjoyment.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"103-109"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01Epub Date: 2025-02-05DOI: 10.1089/g4h.2023.0193
Beatriz Brea-Gómez, Laura Pérez-Gisbert, Ibán Fernández-Castro, Marie Carmen Valenza, Irene Torres-Sánchez
The aim was to analyze the effects of virtual reality-based rehabilitation (VRBR) in patients with fibromyalgia syndrome (FMS). This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search was conducted in CINAHL, Medline (via PubMed), Scopus, and Web of Science up to January 2023. Eligibility criteria were defined with Participants, Interventions, Comparisons, Outcomes, and Study design. To assess the methodological quality, the modified Downs and Black scale was used. The risk of bias was assessed through The Cochrane Collaboration's tool. Meta-analysis was performed using RevMan software. Seventeen studies were included in the systematic review and 11 in the meta-analysis. We obtained significant differences in favor of VRBR for FMS impact (standardized mean difference or SMD: -0.49; 95% confidence interval or CI: -0.72 to -0.26), pain intensity (SMD: -0.50; 95% CI: -0.87 to -0.12), fatigue (SMD: -0.55, 95% CI: -0.89 to -0.22), depression (SMD: -0.39; 95% CI: -0.55 to -0.23), anxiety (SMD: -0.36; 95% CI: -0.57 to -0.14), health-related quality of life (SMD: 0.56; 95% CI: 0.29 to 0.83), health perception (mean difference or MD:10.56; 95% CI: 6.23 to 14.88), functional exercise capacity (SMD: 0.60; 95% CI: 0.33 to 0.87), and physical function (MD: 10.90; 95% CI: 7.04 to 14.77). No significant differences were found for kinesiophobia. VRBR significantly improves FMS symptoms, quality of life, and physical condition. VRBR applied alone or combined with other interventions shows good results. VRBR was superior to treatment as usual. Better results were obtained when specialized VRBR was used. More research is needed to determine how to implement this treatment and to study VRBR effects on follow-up.
{"title":"Effects of Virtual Reality-Based Rehabilitation in the Treatment of Patients with Fibromyalgia Syndrome: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.","authors":"Beatriz Brea-Gómez, Laura Pérez-Gisbert, Ibán Fernández-Castro, Marie Carmen Valenza, Irene Torres-Sánchez","doi":"10.1089/g4h.2023.0193","DOIUrl":"10.1089/g4h.2023.0193","url":null,"abstract":"<p><p>The aim was to analyze the effects of virtual reality-based rehabilitation (VRBR) in patients with fibromyalgia syndrome (FMS). This systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search was conducted in CINAHL, Medline (via PubMed), Scopus, and Web of Science up to January 2023. Eligibility criteria were defined with Participants, Interventions, Comparisons, Outcomes, and Study design. To assess the methodological quality, the modified Downs and Black scale was used. The risk of bias was assessed through The Cochrane Collaboration's tool. Meta-analysis was performed using RevMan software. Seventeen studies were included in the systematic review and 11 in the meta-analysis. We obtained significant differences in favor of VRBR for FMS impact (standardized mean difference or SMD: -0.49; 95% confidence interval or CI: -0.72 to -0.26), pain intensity (SMD: -0.50; 95% CI: -0.87 to -0.12), fatigue (SMD: -0.55, 95% CI: -0.89 to -0.22), depression (SMD: -0.39; 95% CI: -0.55 to -0.23), anxiety (SMD: -0.36; 95% CI: -0.57 to -0.14), health-related quality of life (SMD: 0.56; 95% CI: 0.29 to 0.83), health perception (mean difference or MD:10.56; 95% CI: 6.23 to 14.88), functional exercise capacity (SMD: 0.60; 95% CI: 0.33 to 0.87), and physical function (MD: 10.90; 95% CI: 7.04 to 14.77). No significant differences were found for kinesiophobia. VRBR significantly improves FMS symptoms, quality of life, and physical condition. VRBR applied alone or combined with other interventions shows good results. VRBR was superior to treatment as usual. Better results were obtained when specialized VRBR was used. More research is needed to determine how to implement this treatment and to study VRBR effects on follow-up.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"79-102"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Preclinical studies suggested the exposure to environmental enrichment (EE) as an intervention able to prevent or reduce nicotine-taking and nicotine-seeking behaviors. Virtual reality (VR) may help to test the effects of EE in smokers in a reproducible and feasible manner. Materials and Methods: In the present study, 31 smokers (14 women) were divided into two groups: (1) exposure to a virtual EE (VR-EE) and (2) exposure to a virtual neutral environment (VR-NoEE). Cigarette craving was assessed as basal and evoked, at different timepoints during the session. Behavior activity during VR exposure, mood, and subjective measures were also collected. Results: EE exposure in VR significantly reduced craving scores from basal timepoint. This was not observed in the VR-NoEE group, which significantly increased craving compared with values at neutral scenario. When both groups were exposed to smoking-related VR scenario, the VR-EE group showed an increased craving compared with previous timepoint up to score values not different from those in the VR-NoEE group. A significant positive correlation between basal craving scores and interactive behavior with virtual smoking cues was observed in the VR-NoEE but not in the VR-EE group. Conclusion: These findings suggest that virtual EE might have an inhibitory effect in smokers on basal, but not on evoked cigarette craving. Noteworthily, the interactive activity correlation to craving scores in the VR-NoEE participants was not observed in the VR-EE group, adding further evidence that the enrichment simulation was nonetheless able to modify behavior in the smoking-related scenario.
背景:临床前研究表明,接触丰富环境(EE)是一种能够预防或减少尼古丁吸食和尼古丁寻求行为的干预措施。虚拟现实(VR)有助于以可重复和可行的方式测试 EE 对吸烟者的影响。材料与方法:在本研究中,31 名吸烟者(14 名女性)被分为两组:(1) 接触虚拟 EE(VR-EE);(2) 接触虚拟中性环境(VR-NoEE)。在测试过程中的不同时间点,对吸烟者的烟瘾进行基础和诱发评估。此外,还收集了暴露于虚拟环境期间的行为活动、情绪和主观测量结果。研究结果在 VR 中暴露于 EE 会明显降低渴求程度在基础时间点上的得分。而在 VR-NoEE 组则没有观察到这种情况,与中性情景下的数值相比,该组的渴望程度明显增加。当两组人都暴露在与吸烟相关的 VR 情景中时,VR-EE 组的渴求度与之前的时间点相比都有所提高,最高得分与 VR-NoEE 组的得分相差不大。在 VR-NoEE 组和 VR-EE 组,基础渴求得分和与虚拟吸烟线索的互动行为之间存在明显的正相关。结论:这些研究结果表明,虚拟 EE 可能对吸烟者的基础吸烟渴求有抑制作用,但对诱发的吸烟渴求没有抑制作用。值得注意的是,VR-NoEE 参与者的互动活动与渴求得分之间的相关性在 VR-EE 组中没有观察到,这进一步证明了增强模拟能够改变吸烟相关情景中的行为。
{"title":"Virtual Reality Environmental Enrichment Effects on Craving for Cigarettes in Smokers.","authors":"Giulia Benvegnù, Samuele Perotti, Alessia Vegher, Cristiano Chiamulera","doi":"10.1089/g4h.2023.0188","DOIUrl":"10.1089/g4h.2023.0188","url":null,"abstract":"<p><p><b><i>Background:</i></b> Preclinical studies suggested the exposure to environmental enrichment (EE) as an intervention able to prevent or reduce nicotine-taking and nicotine-seeking behaviors. Virtual reality (VR) may help to test the effects of EE in smokers in a reproducible and feasible manner. <b><i>Materials and Methods:</i></b> In the present study, 31 smokers (14 women) were divided into two groups: (1) exposure to a virtual EE (VR-EE) and (2) exposure to a virtual neutral environment (VR-NoEE). Cigarette craving was assessed as basal and evoked, at different timepoints during the session. Behavior activity during VR exposure, mood, and subjective measures were also collected. <b><i>Results:</i></b> EE exposure in VR significantly reduced craving scores from basal timepoint. This was not observed in the VR-NoEE group, which significantly increased craving compared with values at neutral scenario. When both groups were exposed to smoking-related VR scenario, the VR-EE group showed an increased craving compared with previous timepoint up to score values not different from those in the VR-NoEE group. A significant positive correlation between basal craving scores and interactive behavior with virtual smoking cues was observed in the VR-NoEE but not in the VR-EE group. <b><i>Conclusion:</i></b> These findings suggest that virtual EE might have an inhibitory effect in smokers on basal, but not on evoked cigarette craving. Noteworthily, the interactive activity correlation to craving scores in the VR-NoEE participants was not observed in the VR-EE group, adding further evidence that the enrichment simulation was nonetheless able to modify behavior in the smoking-related scenario.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"21-28"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-08-02DOI: 10.1089/g4h.2023.0210
Francisco José Lobato-Camacho, Juan Pedro Vargas, Juan Carlos López
Introduction: The cognitive effects of video games have garnered increasing attention due to their potential applications in cognitive rehabilitation and evaluation. However, the underlying mechanisms driving these cognitive modifications remain poorly understood. Objectives: This study investigates the fundamental mnemonic processes of spatial navigation, pattern separation, and recognition memory, closely associated with the hippocampus. Our objective is to elucidate the interaction of these cognitive processes and shed light on rehabilitation mechanisms that could inform the design of video games aimed at stimulating the hippocampus. Method: In this study, we assessed 48 young adults, including both video game players and non-players. We utilized virtual reality and cognitive tasks such as the Lobato Virtual Water Maze and the Mnemonic Similarity Task to evaluate their cognitive abilities. Results: Our key findings highlight that gamers exhibit heightened pattern separation abilities and demonstrate quicker and more accurate spatial learning, attributed to the cognitive stimulation induced by video games. Additionally, we uncovered a significant relationship between spatial memory, guided by environmental cues, and pattern separation, which serves as the foundation for more efficient spatial navigation. Conclusions: These results provide valuable insights into the cognitive impact of video games and offer potential for monitoring changes in rehabilitation processes and early signs of cognitive decline through virtual reality-based assessments. Ultimately, we propose that examining the relationships between cognitive processes represents an effective method for evaluating neurodegenerative conditions, offering new possibilities for early diagnosis and intervention.
{"title":"Effects of the Regular Use of Virtual Environments on Spatial Navigation and Memory.","authors":"Francisco José Lobato-Camacho, Juan Pedro Vargas, Juan Carlos López","doi":"10.1089/g4h.2023.0210","DOIUrl":"10.1089/g4h.2023.0210","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The cognitive effects of video games have garnered increasing attention due to their potential applications in cognitive rehabilitation and evaluation. However, the underlying mechanisms driving these cognitive modifications remain poorly understood. <b><i>Objectives:</i></b> This study investigates the fundamental mnemonic processes of spatial navigation, pattern separation, and recognition memory, closely associated with the hippocampus. Our objective is to elucidate the interaction of these cognitive processes and shed light on rehabilitation mechanisms that could inform the design of video games aimed at stimulating the hippocampus. <b><i>Method:</i></b> In this study, we assessed 48 young adults, including both video game players and non-players. We utilized virtual reality and cognitive tasks such as the Lobato Virtual Water Maze and the Mnemonic Similarity Task to evaluate their cognitive abilities. <b><i>Results:</i></b> Our key findings highlight that gamers exhibit heightened pattern separation abilities and demonstrate quicker and more accurate spatial learning, attributed to the cognitive stimulation induced by video games. Additionally, we uncovered a significant relationship between spatial memory, guided by environmental cues, and pattern separation, which serves as the foundation for more efficient spatial navigation. <b><i>Conclusions:</i></b> These results provide valuable insights into the cognitive impact of video games and offer potential for monitoring changes in rehabilitation processes and early signs of cognitive decline through virtual reality-based assessments. Ultimately, we propose that examining the relationships between cognitive processes represents an effective method for evaluating neurodegenerative conditions, offering new possibilities for early diagnosis and intervention.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"49-56"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Several health games have been developed for pediatric patients in recent years but few for children with atopic dermatitis (AD). As this chronic disease requires changes in daily habits, this study aimed to develop and validate the content of a board health game for children with AD. Material and Methods: This is a content development and validation study of DermatrilhaTM, a board health game about AD. The instrument aims to promote interactions between children with AD and health care providers and offers the exchange of experiences, feelings, and knowledge about the disease in a playful way. The five stages of development of the board game were (a) planning, (b) development, (c) preparation of content validation questionnaires, (d) evaluation by a committee of experts, and (e) pretest with the target audience. Results: The expert committee group consisted of 20 professionals: 5 physicians specialized in pediatric dermatology, 5 psychologists specialized in health psychology, 5 designers with experience in illustration, and 5 early childhood educators. The target audience consisted of 25 children aged 7-12 years with AD. The evaluation of the expert committee found 0.95 in the general content validity index and 0.92 in the target audience, thus exceeding 0.80 in all items. Conclusion: The board health game Dermatrilha has proven to be a psychoeducational tool for the therapeutic education of children with AD, enabling the exchange of experiences, feelings, and knowledge about the disease among peers and health care providers.
{"title":"Let's Play! A Board Health Game Development and Validation for Children with Atopic Dermatitis.","authors":"Mariana Muzzolon, Mariana Morgan, Izabella Reis, Renata Imoto, Vânia Oliveira de Carvalho","doi":"10.1089/g4h.2023.0218","DOIUrl":"10.1089/g4h.2023.0218","url":null,"abstract":"<p><p><b><i>Objective:</i></b> Several health games have been developed for pediatric patients in recent years but few for children with atopic dermatitis (AD). As this chronic disease requires changes in daily habits, this study aimed to develop and validate the content of a board health game for children with AD. <b><i>Material and Methods:</i></b> This is a content development and validation study of Dermatrilha<sup>TM</sup>, a board health game about AD. The instrument aims to promote interactions between children with AD and health care providers and offers the exchange of experiences, feelings, and knowledge about the disease in a playful way. The five stages of development of the board game were (a) planning, (b) development, (c) preparation of content validation questionnaires, (d) evaluation by a committee of experts, and (e) pretest with the target audience. <b><i>Results:</i></b> The expert committee group consisted of 20 professionals: 5 physicians specialized in pediatric dermatology, 5 psychologists specialized in health psychology, 5 designers with experience in illustration, and 5 early childhood educators. The target audience consisted of 25 children aged 7-12 years with AD. The evaluation of the expert committee found 0.95 in the general content validity index and 0.92 in the target audience, thus exceeding 0.80 in all items. <b><i>Conclusion:</i></b> The board health game Dermatrilha has proven to be a psychoeducational tool for the therapeutic education of children with AD, enabling the exchange of experiences, feelings, and knowledge about the disease among peers and health care providers.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"29-34"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-08-02DOI: 10.1089/g4h.2024.0034
Chandler A Godfrey, Jennifer Flynn Oody, Scott A Conger, Jeremy A Steeves
Objective: The purpose of this study was to (1) quantify the oxygen consumption (VO2) and heart rate (HR) of virtual reality (VR) exergaming in youth, (2) compare the physical activity intensity of VR gaming to moderate-intensity thresholds, and (3) quantify the game experience and cybersickness of VR gaming, compared with traditional gaming. Material and Methods: Youth (N = 28; age, 9.4 ± 1.2 years) completed 10-minute conditions: seated rest, seated videogame Katamari Forever (SVG-KF), treadmill walking (TW) (5.6 km/h, 0% grade), and VR exergames Beat Saber (BS) and Thrill of the Fight (TOF) while VO2 and HR were collected. Game experience and Child Simulator Sickness Questionnaires were collected after gameplay. Results: VO2 and HR for BS (9.1 ± 3.0 mL/kg/min and 119 ± 15 bpm), TW (17.1 ± 2.4 mL/kg/min and 135 ± 15 bpm), and TOF (16.9 ± 5.4 mL/kg/min and 145 ± 19 bpm) were significantly higher than that at rest (4.2 ± 1.5 mL/kg/min and 94 ± 12 bpm) and for SVG-KF (4.3 ± 1.3 mL/kg/min and 94 ± 12 bpm). BS was light-to-moderate, whereas TW and TOF were of moderate intensity based on HR and metabolic equivalents (METs). For game experience, SVG-KF (1.6 ± 1.6) was less challenging than BS (3.3 ± 1.0) and TOF (3.1 ± 1.1). BS was more visually satisfying (3.5 ± 0.7 vs 2.7 ± 0.9) and required more concentration than SVG-KF (3.6 ± 0.7 vs 3.1 ± 1.1). TOF (3.4 ± 0.8) was more fun than SVG-KF (2.8 ± 0.7). Two youths (7%) experienced cybersickness symptoms, but neither requested to stop play. Oculomotor symptoms (0.6 ± 0.9), although minimal, were significantly greater than nausea (0.2 ± 0.5) and disorientation (0.3 ± 0.6) in both games. Conclusions: VR exergames provided light- to moderate-intensity exercise, challenge, visual stimulation, attention, and fun with minimal cybersickness symptoms, compared with conventional gameplay in youth.
{"title":"Active Virtual Reality Games: Comparing Energy Expenditure, Game Experience, and Cybersickness to Traditional Gaming and Exercise in Youth Aged 8-12.","authors":"Chandler A Godfrey, Jennifer Flynn Oody, Scott A Conger, Jeremy A Steeves","doi":"10.1089/g4h.2024.0034","DOIUrl":"10.1089/g4h.2024.0034","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The purpose of this study was to (1) quantify the oxygen consumption (VO<sub>2</sub>) and heart rate (HR) of virtual reality (VR) exergaming in youth, (2) compare the physical activity intensity of VR gaming to moderate-intensity thresholds, and (3) quantify the game experience and cybersickness of VR gaming, compared with traditional gaming. <b><i>Material and Methods:</i></b> Youth (<i>N</i> = 28; age, 9.4 ± 1.2 years) completed 10-minute conditions: seated rest, seated videogame Katamari Forever (SVG-KF), treadmill walking (TW) (5.6 km/h, 0% grade), and VR exergames Beat Saber (BS) and Thrill of the Fight (TOF) while VO<sub>2</sub> and HR were collected. Game experience and Child Simulator Sickness Questionnaires were collected after gameplay. <b><i>Results:</i></b> VO<sub>2</sub> and HR for BS (9.1 ± 3.0 mL/kg/min and 119 ± 15 bpm), TW (17.1 ± 2.4 mL/kg/min and 135 ± 15 bpm), and TOF (16.9 ± 5.4 mL/kg/min and 145 ± 19 bpm) were significantly higher than that at rest (4.2 ± 1.5 mL/kg/min and 94 ± 12 bpm) and for SVG-KF (4.3 ± 1.3 mL/kg/min and 94 ± 12 bpm). BS was light-to-moderate, whereas TW and TOF were of moderate intensity based on HR and metabolic equivalents (METs). For game experience, SVG-KF (1.6 ± 1.6) was less challenging than BS (3.3 ± 1.0) and TOF (3.1 ± 1.1). BS was more visually satisfying (3.5 ± 0.7 vs 2.7 ± 0.9) and required more concentration than SVG-KF (3.6 ± 0.7 vs 3.1 ± 1.1). TOF (3.4 ± 0.8) was more fun than SVG-KF (2.8 ± 0.7). Two youths (7%) experienced cybersickness symptoms, but neither requested to stop play. Oculomotor symptoms (0.6 ± 0.9), although minimal, were significantly greater than nausea (0.2 ± 0.5) and disorientation (0.3 ± 0.6) in both games. <b><i>Conclusions:</i></b> VR exergames provided light- to moderate-intensity exercise, challenge, visual stimulation, attention, and fun with minimal cybersickness symptoms, compared with conventional gameplay in youth.</p>","PeriodicalId":47401,"journal":{"name":"Games for Health Journal","volume":" ","pages":"42-48"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}