scholarly journals A KinectTM-based, task-specific, virtual reality rehabilitation game for patients with stroke: A usability test and clinical trial (Preprint)

2020 ◽  
Author(s):  
Yangfan Xu ◽  
Qinzi Tongmei ◽  
Yangyang Lin ◽  
Wai-Kit Ming ◽  
Wangxiang Mai ◽  
...  

BACKGROUND The use of Virtual Reality (VR) is popular in clinical rehabilitation, but the effects of using commercial VR games in stroke patients have been mixed. OBJECTIVE Therefore, we developed a Kinect-based task-specific virtual reality game, “Stomp Joy”, for post-stroke rehabilitation of the lower extremities. This study aim to assess its feasibility and clinical efficacy. METHODS We carried out a feasibility test for “Stomp Joy” within representative user groups. Then, a clinical efficacy experiment was performed with a randomized controlled trial of 22 patients with stroke who received ten sessions (2 weeks) of conventional physical therapy only (control group) or conventional physical therapy plus 30 min of “Stomp Joy” intervention (experimental group). The Fugl-Meyer Assessment for lower extremity (FMA-LE), Modified Bathel Index (MBI), Berg Balance Scale Score (BBS), Single leg supporting time (SLS Time), drop-out rate, and adverse effects were recorded. RESULTS The feasibility test showed “Stomp Joy” improved interest, pressure, perceived competence, value, and effort by using intrinsic motivation scale (IMI). The clinical efficacy trial showed that a significant time-group interaction effect for FMA-LE (p = 0.006), MBI (p = 0.001), BBS (p = 0.004), and SLS Time (p = 0.001). A significant time effect was found in FMA-LE (p = 0.001), MBI (p < 0.001), BBS (p < 0.001), and SLS Time (p = 0.025). These indicate an improvement in LE motor ability, basic activities of daily living, balance ability, and single-leg supporting time in both groups after 2 weeks of intervention. However, no significant effects were found of group on FMA-LE (p = 0.06), MBI (p = 0.76), and BBS (p = 0.38), while a significant group interaction was detected for SLS Time (p < 0.001). These results indicate that the experimental group significantly improved more in SLS Time than the control group. No one left the trial, and no adverse effects were reported. CONCLUSIONS “Stomp Joy” is an effective Kinect-base VR game for replacing part of the conventional physiotherapy time, achieving equally effective improvement in LE function among stroke survivors.

2021 ◽  
Vol 10 (4) ◽  
pp. 682
Author(s):  
Bruno Porras-Garcia ◽  
Marta Ferrer-Garcia ◽  
Eduardo Serrano-Troncoso ◽  
Marta Carulla-Roig ◽  
Pau Soto-Usera ◽  
...  

In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image.


Author(s):  
Roxana Steliana Miclaus ◽  
Nadinne Roman ◽  
Ramona Henter ◽  
Silviu Caloian

More innovative technologies are used worldwide in patient’s rehabilitation after stroke, as it represents a significant cause of disability. The majority of the studies use a single type of therapy in therapeutic protocols. We aimed to identify if the association of virtual reality (VR) therapy and mirror therapy (MT) exercises have better outcomes in lower extremity rehabilitation in post-stroke patients compared to standard physiotherapy. Fifty-nine inpatients from 76 initially identified were included in the research. One experimental group (n = 31) received VR therapy and MT, while the control group (n = 28) received standard physiotherapy. Each group performed seventy minutes of therapy per day for ten days. Statistical analysis was performed with nonparametric tests. Wilcoxon Signed-Rank test showed that both groups registered significant differences between pre-and post-therapy clinical status for the range of motion and muscle strength (p < 0.001 and Cohen’s d between 0.324 and 0.645). Motor Fugl Meyer Lower Extremity Assessment also suggested significant differences pre-and post-therapy for both groups (p < 0.05 and Cohen’s d 0.254 for the control group and 0.685 for the experimental group). Mann-Whitney results suggested that VR and MT as a therapeutic intervention have better outcomes than standard physiotherapy in range of motion (p < 0.05, Cohen’s d 0.693), muscle strength (p < 0.05, Cohen’s d 0.924), lower extremity functionality (p < 0.05, Cohen’s d 0.984) and postural balance (p < 0.05, Cohen’s d 0.936). Our research suggests that VR therapy associated with MT may successfully substitute classic physiotherapy in lower extremity rehabilitation after stroke.


2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Shamekh Mohamed El-Shamy ◽  
Ehab Mohamed Abd El Kafy

Abstract Background TheraTogs promotes proprioceptive sense of a child with cerebral palsy and improves abnormal muscle tone, posture alignment, balance, and gait. Therefore, the aim of this study was to investigate the efficacy of TheraTogs orthotic undergarment on gait pattern in children with dyskinetic cerebral palsy. Thirty children with dyskinetic cerebral palsy were selected for this randomized controlled study. They were randomly assigned to (1) an experimental group that received TheraTogs orthotic undergarment (12 h/day, 3 days/week) plus traditional physical therapy for 3 successive months and (2) a control group that received only traditional physical therapy program for the same time period. Gait parameters were measured at baseline and after 3 months of intervention using Pro-Reflex motion analysis. Results Children in both groups showed significant improvements in the gait parameters (P < 0.05), with significantly greater improvements in the experimental group than in the control group. Conclusions The use of TheraTogs may have a positive effect to improve gait pattern in children with dyskinetic cerebral palsy. Trial registration This trial was registered in the ClinicalTrial.gov PRS (NCT03037697).


2021 ◽  
Vol 13 (13) ◽  
pp. 7092
Author(s):  
Yi-Chieh Chen ◽  
Kuo-Kuang Fan ◽  
Kwo-Ting Fang

Due to the emergence of computer education, AI education, the Internet of Things, big data, and technological wisdom, it is easy for students to be distracted when engaged in traditional education. Flipped teaching is a teaching strategy frequently used in colleges and universities. The focus of this research was conducted by a comparative analysis of the cognitive load between the experimental group and the control group through a quasi-experimental design for research with different learning methods and different classes. More specifically, flipped teaching was carried out with an experimental group, and traditional teaching a control group; they were observed at the same time, and 213 private university students participated in the experiment. The research proposes a practice of mixed teaching, carried out in a group communication behavior system, and enhancing the spirit of group interaction and learning through mobile devices. The core value of the research lies in (1) online learning, (2) group interaction, and (3) the learning load of the conceptual model. In addition, focus group interviews were used to provide feedback on participants’ cognition and emotions. The results indicate that there were differences in cognitive load between the two classes.


2021 ◽  
Vol 35 (2) ◽  
pp. 131-144
Author(s):  
Maijke van Bloemendaal ◽  
Sicco A. Bus ◽  
Frans Nollet ◽  
Alexander C. H. Geurts ◽  
Anita Beelen

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).


2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Huan-xia Li ◽  
Jing Cui ◽  
Jing-shi Fan ◽  
Jian-zhou Tong

Objective: To examine the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen therapy in treating thoracolumbar vertebral fracture-induced acute spinal cord injury (ASCI). Methods: From June 2015 to May 2018, 80 patients with thoracolumbar fractures and ASCI who were treated at Baoding First Central Hospital were selected. All patients underwent posterior laminectomy and screw fixation, and they were randomly divided into two groups using a random number table method. The control group received conventional postoperative treatment, while the experimental group was treated with riluzole combined with mannitol and hyperbaric oxygen on the basis of conventional treatment. The recovery of nerve function which included motor function and sensory function, and the changes of serum IL-6, CRP, BDNF, BFGF and other factors before treatment and four weeks after treatment of the two groups of patients were observed and evaluated. Results: After treatment, the motor function scores and sensory function scores of the two groups of patients were improved compared with those before treatment (p<0.05). Compared with the control group, the experimental group improved significantly, and the difference was statistically significant (p<0.05). The levels of IL-6, BDNF and NFGF in the experimental group were significantly lower than those in the control group (p<0.05). Conclusions: For patients with thoracolumbar fractures and ASCI undergoing laminar decompression and fixation, the comprehensive treatment plan of riluzole combined with mannitol and hyperbaric oxygen has certain advantages. Compared with the conventional therapy, it may significantly improve the movement and sensory functions of patients, relieve the inflammatory response of spinal cord, and promote recovery from the injury. doi: https://doi.org/10.12669/pjms.37.2.3418 How to cite this:Li H, Cui J, Fan J, Tong J. An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3418 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Pinger Li ◽  
Yinmei Lou

Objective. To investigate the clinical value of Fuzheng Guben anticancer decoction combined with taxol in treating ovarian carcinoma (OC). Methods. The medical records of 80 OC patients treated in the First People’s Hospital of Fuyang Hangzhou (January 2018–January 2021) were retrospectively analyzed, and the patients were split into the control group and the experimental group according to the treatment regimen, with 40 cases each. Those in the control group accepted the taxol chemotherapy, and on this basis, those in the experimental group took the Fuzheng Guben anticancer decoction, so as to compare its clinical efficacy and complication incidence. Results. No statistical between-group differences in patients’ general information were observed P > 0.05 ; compared with the control group, the disease objective remission rate of the experimental group was greatly higher P < 0.05 ; before and after treatment, the changes in CD8+ were not significant, indicating no statistically significant between-group differences P > 0.05 , and after treatment, CD3+, CD4+, and CD4+/CD8+ were obviously higher than before and were obviously higher in the experimental group than in the control group P < 0.05 ; after treatment, the CA125, CA199, and CEA levels were obviously lower than before and were significantly lower in the experimental group than in the control group P < 0.05 ; the mean survival of the experimental group was significantly higher than that of the control group (19.80 ± 5.84 vs. 14.075 ± 5.12 months, P < 0.05 ); and between the two groups, the incidence rate of adverse reactions of the experimental group was remarkably lower P < 0.05 . Conclusion. On the basis of taxol chemotherapy, jointly applying Fuzheng Guben anticancer decoction can significantly improve the clinical efficacy of OC, help to improve patients’ immune function, lower the complication incidence rate, and prolong the mean survival.


2021 ◽  
Vol 28 (4) ◽  
pp. 458-469
Author(s):  
Eun Ju Lee ◽  
Min Jung Ryu

Purpose: This study was conducted to develop and examine the effects of a nursing education program using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care by assessing students’ confidence in performance, clinical decision-making ability, practice flow, class evaluations, and simulation design evaluations.Methods: This study was developed based on the Jeffries simulation model and 5E learning cycle model, blending a virtual reality simulation and high-fidelity simulation. The participants were 41 third-year nursing students with no virtual reality and simulation education experience. The experimental group (n=21) received the virtual reality program, while the control group (n=20) received traditional simulation education. Data were collected from March 8 to May 28, 2021 and analyzed using SPSS version 27 for Windows.Results: Statistically significant differences were found between the experimental group and the control group post-intervention in confidence in performance (F=4.88, p=.33) and clinical decision-making ability (F=18.68, p<.001). The experimental group showed significant increases in practice flow (t=2.34, p=.024) and class evaluations (t=2.99, p=.005) compared to the control group.Conclusion: Nursing education programs using virtual reality to enhance clinical decision-making ability in respiratory disease nursing care can be an effective educational strategy in the clinical context.


2020 ◽  
pp. 104687812094456
Author(s):  
Panos Kostakos ◽  
Paula Alavesa ◽  
Mikko Korkiakoski ◽  
Mario Monteiro Marques ◽  
Victor Lobo ◽  
...  

Background Wayfinding has been adopted in several intense evacuation and navigation simulations; however, the use of biometric measurements for characterizing physiological outcomes has been somewhat overlooked and applied only under limited laboratory conditions. Methods Twenty-four participants took part in a virtual reality (VR) experiment using a wayfinding installation with the Oculus Rift S head-mounted display (HMD). They were immersed in a simulation of a burning underground parking lot and tasked to navigate to the exit. The purpose of this research was to investigate the high-level effect of wayfinding assistive lights on behavioral, physiological, and psychological outcomes. Participants were split into two groups: the control group was exposed to a scene without assistive lights, and the experimental group was exposed to the same scene with assistive lights. Results Results indicate there was no statistically significant difference between the groups in traveled distance, pauses, turns, or game completion time. Curiously, differences between the two groups in heart rate (HR) outcomes were found to be statistically significant, with subjects in the control group displaying an increasing HR trend during simulation. Conclusions This finding, in accordance with previous studies that have shown the efficacy of landmarks and wayfinding affordances in reducing cognitive demands, suggests that assistive lights might contribute to improved brain wiring connectivity during the game. We discuss these findings in the context of a rich wayfinding affordances literature.


2020 ◽  
pp. 003329412093744
Author(s):  
Lobna Chérif ◽  
Valerie M. Wood ◽  
Christian Watier

This study assessed the effectiveness of a strengths-based randomized controlled trial focused on fostering all 24 character strengths in a group of 75 participants from a University in Tunisia. Participants randomly assigned to the challenge condition (n = 40) received an email each day for 24 days, that highlighted a particular strength of the day including why the strength is valuable, how to implement the strength behaviourally, and a motto related to that strength. Those in the control condition (n = 35) simply received emails containing the motto for each strength daily for 24 days. We assessed all participants’ levels of happiness before the experiment (T0), the day following the experiment (T1), and one-month following the experiment (T2). Results from a 2 (group) X 3 (time) split plot ANOVA revealed a significant group-by-time interaction, such that at T2 the experimental group had greater happiness scores than the control group. These findings provide some evidence that even “minimalist” interventions (involving the receipt of emails encouraging character-strength development), might be effective for promoting gains in happiness even one month after the intervention.


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