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Effects of Virtual Reality on Transtibial Amputation Rehabilitation Outcomes: A Randomized Study. 虚拟现实对经胫骨截肢康复效果的影响:一项随机研究。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-11-07 DOI: 10.1089/g4h.2023.0052
Tezel Yildirim Şahan, Fatih Erbahçeci

Purpose: Virtual reality is widely used in patients with chronic musculoskeletal problems. However, the short-term effects on individuals with transtibial (TT) amputation during this process remain unclear. This study aimed at investigating the effects of virtual reality on rehabilitation outcomes in TT amputees. Methods: The study included 20 TT amputees who were using TT prostheses. The participants were divided into two groups randomly as follows: physiotherapy (PT) and virtual reality (VR). Participants were treated 3 days a week, for 4 weeks, and evaluations were made before and after treatment; a 6-minute walk test was used for performance, a single-leg balance test for balance, Trinity Amputation Prosthesis Experience Scale for prosthesis satisfaction, a 10-meter walking test for gait speed, and a wearable smart t-shirt to determine cadence. Results: It was found that there was a statistically significant difference in performance, balance, prosthesis satisfaction, cadence, and gait speed before and after PT (P < 0.05). There were differences in terms of performance, prosthesis satisfaction, balance, cadence, and gait speed before and after VR (P < 0.05). There was no statistically significant difference between PT and VR (P > 0.05). Conclusion: The 4 weeks of VR training improved performance, prosthesis satisfaction, balance, cadence, and gait speed in TT amputation rehabilitation similar to physiotherapy methods. The addition of VR training to amputation rehabilitation will bring improvements since it is a fun and safe intervention. Clinical Trial Registration: The trial is registered at Clinical Trials.gov, Trial No: NCT03872193.

目的:虚拟现实广泛应用于慢性肌肉骨骼问题患者。然而,在此过程中对经胫骨(TT)截肢患者的短期影响尚不清楚。本研究旨在调查虚拟现实对TT截肢者康复结果的影响。方法:本研究包括20名使用TT假肢的TT截肢者。参与者被随机分为两组:物理疗法(PT)和虚拟现实(VR)。参与者每周接受3天、4周的治疗,并在治疗前后进行评估;6分钟步行测试用于表现,单腿平衡测试用于平衡,Trinity截肢假肢体验量表用于假肢满意度,10米步行测试用于步态速度,以及可穿戴智能t恤用于确定节奏。结果:PT前后患者的运动能力、平衡力、假体满意度、步频、步态速度差异有统计学意义(P P P > 结论:与物理治疗方法类似,4周的VR训练改善了TT截肢康复的表现、假肢满意度、平衡、节奏和步态速度。将VR训练加入截肢康复将带来改善,因为这是一种有趣且安全的干预措施。临床试验注册:该试验在Clinical Trials.gov上注册,试验编号:NCT03872193。
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引用次数: 0
Virtual Reality Game Selection for Traumatic Brain Injury Rehabilitation: A Therapist's Wish List for Game Developers. 创伤性脑损伤康复的虚拟现实游戏选择:治疗师对游戏开发者的愿望清单。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-07-25 DOI: 10.1089/g4h.2022.0174
Tonya L Rich, Timothy Truty, Katherine Muschler, Amy Gravely, Lindsay A Marth, Benjamin Barrett, Diane Mortimer, Andrew H Hansen

This project explored the selection process of commercially available virtual reality (VR) games for traumatic brain injury rehabilitation. Occupational therapy practitioners (OTPs) developed a classification framework that they used to evaluate VR games. The classification framework focused on movements required to effectively play the game, cognitive demand, position for game play, ease in menu navigation, and perceived therapeutic applications. OTPs used the ratings to aid in game selection and identified relevant game examples that allowed customizable settings and basic navigation with a game focus on functional activities. The OTPs and the research team identified the need for further work on accessibility and adaptability of game features (e.g., difficulty and limb usage) allowing for more individualization to optimize outcomes of VR-enhanced rehabilitation. The classification framework was useful in evaluating the potential therapeutic benefit of commercially available VR games. However, trial of the game by clinicians prior to use was still warranted.

本项目探讨了商用虚拟现实(VR)游戏在创伤性脑损伤康复中的选择过程。职业治疗从业者(otp)开发了一个分类框架,用于评估VR游戏。分类框架侧重于有效玩游戏所需的动作、认知需求、游戏位置、菜单导航的便利性以及感知到的治疗应用。otp使用评级来帮助游戏选择,并确定相关的游戏示例,这些示例允许自定义设置和基本导航,并将游戏重点放在功能活动上。OTPs和研究团队确定需要进一步研究游戏功能的可访问性和适应性(例如,难度和肢体使用),允许更多个性化以优化vr增强康复的结果。该分类框架有助于评估商用VR游戏的潜在治疗效益。然而,临床医生在使用前对游戏进行试验仍然是有保证的。
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引用次数: 0
Adaptation and Validation of a Serious Game for Motor Learning Training in Children with Cerebral Palsy. 脑性麻痹儿童运动学习训练中严肃游戏的适应与验证。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-07-14 DOI: 10.1089/g4h.2023.0082
Juan D Bautista, Francisco J Perales, Silvia Ramis, Pedro Montoya, Inmaculada Riquelme

Objective: Children with cerebral palsy (CP) present motor learning disorders and somatosensory dysfunction. Although many protocols use videogames in children with CP, few apply or examine motor learning principles. This study aims at (1) implementing therapist-user-designer collaboration in adapting a videogame to the principles of motor learning and the characteristics of users with CP, and (2) piloting the effectiveness of these adaptations by analyzing the achievement of motor learning parameters (learning rate acquisition, retention, and transfer to motor and somatosensory function). Materials and Methods: Periodical interprofessional meetings conducted to the adaptation of a videogame, requiring the control of a joystick for traveling through a maze, to motor learning principles. In a pilot validation, effects in unilateral upper limb function, gross manual dexterity, and somatosensory thresholds were assessed before and after 10-week training in 13 children with CP. Results: After 10-week training with the adapted serious game, children showed learning rates above 90% and improvement in motor learning parameters along the sessions. Manual dexterity and pronation-supination of the dominant hand improved after training. No significant effects were found on somatosensory thresholds. Conclusion: Serious games are useful as motor learning tools for improving motor function in children with PC. Cooperative work among professionals and users is advisable for designing efficient videogames according to rehabilitation best practices.

目的:探讨脑瘫患儿的运动学习障碍和躯体感觉功能障碍。尽管许多协议使用视频游戏治疗CP儿童,但很少应用或检查运动学习原理。本研究旨在(1)实现治疗师-用户-设计师的合作,使电子游戏适应运动学习的原则和CP用户的特征,以及(2)通过分析运动学习参数的实现(学习率获得、保留和向运动和体感功能的转移)来试验这些适应的有效性。材料和方法:定期召开专业间会议,讨论视频游戏的改编,需要控制通过迷宫的操纵杆,运动学习原理。在试点验证中,对13名CP儿童进行了为期10周的训练前后对单侧上肢功能、总手灵活性和体感阈值的影响进行了评估。结果:经过10周的适应性严肃游戏训练后,儿童的学习率超过90%,运动学习参数也有所改善。训练后,手的灵巧性和优势手的旋前、旋后均有提高。在体感觉阈值上没有发现明显的影响。结论:严肃游戏是改善PC患儿运动功能的有效运动学习工具。专业人员和用户之间的合作对于根据康复最佳实践设计高效的电子游戏是可取的。
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引用次数: 0
Virtual Reality Intervention and Its Impact on Upper Extremity Function in the Stroke Population: A Scoping Review. 虚拟现实干预及其对脑卒中人群上肢功能的影响:范围界定综述。
IF 2.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-11-10 DOI: 10.1089/g4h.2022.0239
Kylee Bedar, Cara Bubanovich, Jordan Rosemore, Kayley Radford, Kelly L Taylor

The aim of this scoping review was to examine virtual reality (VR) interventions used within rehabilitation and their effect on the functional outcomes of individuals with stroke. Specifically, this study sought to determine the impact of VR on the upper extremity (UE) use of participants as it relates to body function, occupational participation, and overall UE function (UEfxn). Twenty-six articles were selected for inclusion and results were extracted to determine common themes of outcomes among the effects of VR intervention (VRI). Thematic analysis included details about the VRIs used, as well as the change in UE outcomes post-VRI. Overall, positive change in UEfxn was found across many of the studies, indicating that VR technologies may be an effective intervention technique for individuals, poststroke. Findings of this review encourage clinicians to conduct further research regarding VR technology for UE rehabilitation poststroke.

这项范围界定综述的目的是研究康复中使用的虚拟现实(VR)干预措施及其对中风患者功能结果的影响。具体而言,本研究试图确定VR对参与者上肢(UE)使用的影响,因为它与身体功能、职业参与和整体UE功能(UEfxn)有关。选择26篇文章进行纳入,并提取结果,以确定VR干预(VRI)效果中的共同结果主题。专题分析包括所使用的VRI的详细信息,以及VRI后UE结果的变化。总体而言,在许多研究中都发现UEfxn发生了积极变化,这表明VR技术可能是中风后个体的有效干预技术。这篇综述的发现鼓励临床医生对脑卒中后UE康复的VR技术进行进一步研究。
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引用次数: 0
Go Across Immersive Technology: A Preliminary Study of the Design and Development of a System for Gait Training Using Virtual Reality. 跨越沉浸式技术:基于虚拟现实的步态训练系统设计与开发的初步研究。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-07-06 DOI: 10.1089/g4h.2023.0101
Patrícia M M Silva, Léon W M Silva, Edgar R Vieira, Fabrícia A C Cavalvanti, Edgard Morya

Virtual reality (VR) allows visuotactile interaction in a virtual environment. VR has several potential applications such as surgical training, phobia treatments, and gait rehabilitation. However, further interface development is required. Therefore, the objective of this study was to develop a noninvasive wearable device control to a VR gait training program. It consists of custom-made insoles with vibratory actuators, and plantar pressure sensor-based wireless interface with a VR game. System usability testing involved a habituation period and three gaming sessions. Significant gait improvement was associated with game scores (P < 0.05). This VR gait training system allowed real-time virtual immersive interaction with anticipatory stimulus and feedback during gait.

虚拟现实(VR)允许在虚拟环境中进行视觉互动。VR有几个潜在的应用,如外科训练、恐惧症治疗和步态康复。然而,需要进一步的接口开发。因此,本研究的目的是开发一种无创可穿戴设备来控制VR步态训练计划。它由带有振动执行器的定制鞋垫和基于足底压力传感器的无线接口组成,并带有VR游戏。系统可用性测试包括一个习惯期和三个游戏环节。显著的步态改善与游戏得分相关(P
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引用次数: 0
Immersive Virtual Reality Fitness Games to Improve Recovery After Colorectal Surgery: A Randomized Single Blind Controlled Pilot Trial. 沉浸式虚拟现实健身游戏提高结肠直肠癌手术后的恢复:一项随机单盲对照试验。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-07-10 DOI: 10.1089/g4h.2023.0004
Matthias C Schrempf, Johannes Zanker, Tim Tobias Arndt, Dmytro Vlasenko, Matthias Anthuber, Gernot Müller, Florian Sommer, Sebastian Wolf

Introduction: Early mobilization after surgery is crucial for reducing postoperative complications and restoring patients' fitness and ability to care for themselves. Immersive, activity-promoting fitness games in virtual reality (VR) can be used as a low-cost motivational adjunct to standard physiotherapy to promote recovery after surgery. In addition, they have potentially positive effects on mood and well-being, which are often compromised after colorectal surgery. The purpose of this pilot study was to evaluate the feasibility and clinical outcomes of a VR-based intervention that provides additional mobilization. Methods: Patients undergoing curative surgery for colorectal cancer were randomly assigned to an intervention group or a control group. Participants in the intervention group (VR group) received daily bedside fitness exercises using immersive, activity-promoting, virtual reality fitness games in addition to standard care during their postoperative hospital stay. Results: A total of 62 patients were randomized. The feasibility outcomes were in line with the predefined goals. In the VR group, an improvement in overall mood (+0.76 points; 95% confidence interval [CI] 0.39 to 1.12; P < 0.001) and a shift toward positive feelings were observed. The median length of hospital stay was 7.0 days in the VR group compared with 9.0 days in the control group, but the difference (2.0 days) did not reach statistical significance (95% CI -0.0001 to 3.00; P = 0.076). Surgical outcomes, health status, and measures of distress did not differ between groups. Conclusions: The study demonstrated the feasibility of a VR intervention that improved overall mood and showed a desirable effect on feelings and length of hospital stay after colorectal surgery. The results should stimulate further research investigating the potential of VR as an adjunct to physiotherapy to enhance mobilization after surgery.

前言:术后早期活动对于减少术后并发症,恢复患者健康和自理能力至关重要。虚拟现实(VR)中的沉浸式、促进活动的健身游戏可以作为标准物理治疗的低成本激励辅助手段,以促进手术后的恢复。此外,它们对情绪和健康有潜在的积极影响,而这些在结直肠癌手术后往往会受到损害。这项初步研究的目的是评估基于vr的干预的可行性和临床结果,以提供额外的动员。方法:将接受根治性大肠癌手术的患者随机分为干预组和对照组。干预组(VR组)的参与者在术后住院期间除了接受标准护理外,还使用沉浸式、活动促进式、虚拟现实健身游戏进行每日床边健身锻炼。结果:共纳入62例患者。可行性结果符合预定目标。在VR组中,整体情绪的改善(+0.76分;95%置信区间[CI] 0.39 ~ 1.12;p = 0.076)。手术结果、健康状况和痛苦程度在两组之间没有差异。结论:该研究证明了VR干预的可行性,可以改善整体情绪,并在结直肠癌术后的感觉和住院时间方面显示出理想的效果。该结果应刺激进一步研究VR作为物理治疗辅助的潜力,以增强手术后的活动能力。
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引用次数: 0
Acknowledgment of Reviewers: 2023. 审稿人致谢:2023。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 DOI: 10.1089/g4h.2023.1111.ack
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引用次数: 0
Player 2 Has Entered the Game: Extended Reality and Games for Health. 玩家2已经进入游戏:扩展现实和健康游戏。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 DOI: 10.1089/g4h.2023.0215
Kimberly Hieftje, Asher Marks
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引用次数: 0
Gamification of Cervical Spine Physiotherapy by Virtual Reality Software: Is This Real Rehabilitation? 虚拟现实软件对颈椎物理治疗的游戏化:这是真正的康复吗?
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-01 Epub Date: 2023-07-25 DOI: 10.1089/g4h.2023.0036
Lilach Gavish, Omer Weissberger, Yair Barzilay

Objective: Physical rehabilitation by virtual reality (VR) gamification is gaining acceptance. This study was designed to verify whether neck movements invoked by a fully immersive VR game environment may be physiotherapist-prescribed rehabilitation exercise. Methods: This was a single-visit prospective clinical trial (NCT03104647). Healthy participants put on VR headsets and entered a fully immersive game environment (VRPhysio, XRHealth, Tel Aviv, Israel) that prompted neck movement (flexion, extension, rotation, lateral bend, and combinations repeated twice in random order) accompanied by feedback encouraging correct performance. Four board-certified physiotherapists independently viewed videotapes recorded during the session, identified movements, and determined whether they were recommended as neck rehabilitation exercises. Results: Twenty (n = 20) participants (male-female ratio = 13:7; age = 38 ± 14 years old) completed the training session (16 movements per participant). All movements were identified correctly and determined to be appropriate for neck rehabilitation. No adverse events were reported. Conclusions: The VRPhysio software invoked movements identified by board-certified physiotherapists as appropriate for neck rehabilitation. The potential advantage of home-based VR gamification of cervical spine rehabilitation programs over common practice in motivating patient adherence warrants evaluation by randomized controlled trials.

目的:虚拟现实(VR)游戏化的物理康复正在获得认可。本研究旨在验证完全沉浸式VR游戏环境引发的颈部运动是否可能是物理治疗师规定的康复运动。方法:这是一项单次前瞻性临床试验(NCT03104647)。健康的参与者戴上VR头显,进入一个完全沉浸式的游戏环境(VRPhysio, XRHealth, Tel Aviv, Israel),该环境促使颈部运动(弯曲、伸展、旋转、侧向弯曲和随机重复两次的组合),并伴有鼓励正确表现的反馈。四名委员会认证的物理治疗师独立观看了会议期间录制的录像带,确定了动作,并确定它们是否被推荐为颈部康复练习。结果:20名参与者(n = 20),男女比例为13:7;年龄= 38±14岁)完成训练(每个参与者16个动作)。所有动作均被正确识别并确定为适合颈部康复。无不良事件报告。结论:VRPhysio软件调用由委员会认证的物理治疗师识别的适合颈部康复的运动。基于家庭的虚拟现实游戏化颈椎康复计划在激励患者依从性方面的潜在优势值得通过随机对照试验进行评估。
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引用次数: 0
Feasibility and Effects of Cognitive Training with the COGNIPLAT Game Platform in Elderly with Mild Cognitive Impairment: Pilot Randomized Controlled Trial. COGNIPLAT游戏平台对轻度认知障碍老年人进行认知训练的可行性和效果:试点随机对照试验。
IF 3.5 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-10-01 Epub Date: 2023-06-05 DOI: 10.1089/g4h.2023.0029
Christos Goumopoulos, Georgios Skikos, Maria Frounta

This study examines the effectiveness of a new multi-domain multimodal cognitive training game platform, COGNIPLAT, in improving cognitive performance in elderly with mild cognitive impairment (MCI). The platform combines standard serious games and cognitive stimulation leveraging virtual and augmented reality technologies. A double-arm, evaluator-blinded randomized controlled trial was conducted with 21 elderly participants in the MCI spectrum, with 11 in the intervention group (INT) and 10 in the control group (CTL). Feasibility was assessed in terms of adherence, effective learning, and perceived usefulness. The INT attended 24 training sessions, 60 minutes long, twice a week, whereas the CTL engaged in normal daily activities and usual care. Results showed that the INT had a statistically significant change in the Montreal Cognitive Assessment score, stages List B Recall, Short-term delayed Recall, and Long-term delayed Recall of the Rey Auditory Verbal Learning Test (RAVLT), Trail Making Test-A and B test scores, Digit Span Test (DST) Forward Span, and Functional Activities Questionnaire score. A trend level difference was also found for the RAVLT Recognition and the DST Backward Span. No significant differences were found for the CTL in any of the metrics. The completion rate of the INT was 91%, and the attendance rate was 100% for participants who completed the follow-up segment of the study. The engagement level was high, and effective learning was observed between the participants. The perceived usability and usefulness of the game platform was assessed as high. This study provides evidence of a positive effect of a multi-domain multimodal-based cognitive training program in elderly with MCI, with broader benefits on cognition by inducing more cooperative transfer effects over different domains.

本研究考察了一种新的多领域多模式认知训练游戏平台COGNIPLAT在改善轻度认知障碍(MCI)老年人认知表现方面的有效性。该平台结合了标准的严肃游戏和利用虚拟和增强现实技术的认知刺激。对21名MCI谱中的老年参与者进行了一项双臂、评估者盲法随机对照试验,其中11人在干预组(INT),10人在对照组(CTL)。从依从性、有效学习和感知有用性方面评估了可行性。INT参加了24次训练,每次60分钟,每周两次,而CTL则进行正常的日常活动和日常护理。结果显示,INT在蒙特利尔认知评估得分、雷伊听觉言语学习测试(RAVLT)的列表B回忆、短期延迟回忆和长期延迟回忆阶段、追踪测试a和B测试得分、数字跨度测试(DST)前向跨度和功能活动问卷得分方面有统计学显著变化。RAVLT识别和DST后向跨度也存在趋势水平差异。CTL在任何指标中均未发现显著差异。INT的完成率为91%,完成研究后续部分的参与者的出勤率为100%。参与者的参与度很高,并观察到他们之间的有效学习。游戏平台的可用性和有用性被评估为很高。这项研究提供了证据,证明基于多领域多模式的认知训练计划对患有MCI的老年人有积极影响,通过在不同领域诱导更多的合作转移效应,对认知有更广泛的益处。
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引用次数: 1
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