Úvod a cíle: V rámci odborné přípravy mladých chirurgů je v České republice absolvování miniinvazivních laparoskopických simulačních kurzů dobrovolné. Cílem této práce je vyhodnotit 10leté pořádání simulačního laparoskopického miniinvazivního kurzu na boxových simulátorech a simulátorech virtuální reality z pohledu jeho absolventů a přiblížit současné využití simulace v erudici chirurgů. Typ studie: Observační, dotazníková (survey). Metodika: Z 26 kurzů, které probíhaly v letech 2014–2024, byla získána data pomocí anonymního dotazníku. Vyhodnocení proběhlo metodou deskriptivní statistiky. Zpracovávaly se odpovědi týkající se očekávání od kurzu, míry jejich naplnění, případného doporučení kurzu a finančních nákladů. Výsledky: Celkově se kurzů zúčastnilo 96 lékařů, z toho 55 mužů a 41 žen. Dotazníky vyplnili všichni. V 89 případech (92,7 %) účastníci očekávali naučení správné techniky, tipů a triků při laparoskopických operacích, ve 42 případech (43,8 %) očekávali zrychlení operačního času a ve 37 případech (38,5 %) uvedli prohloubení anatomických a teoretických znalostí. Kurz zcela naplnil očekávání u 92 % případů, u 6 % je naplnil s drobnými výhradami a u 2 % částečně. Kurz by povinně doporučilo 97 % účastníků, zatímco 3 % by jeho absolvování ponechala na uvážení jednotlivce. Celkem 28 (29,2 %) účastníků si kurz hradilo z vlastních prostředků, 5 (5,2 %) částečně a 63 (65,6 %) jej mělo hrazeno zaměstnavatelem. Závěr: Absolventi doporučují zařazení laparoskopického simulačního kurzu do povinného vzdělávacího kurikula chirurgie. Přibližně jedna třetina z nich projevila ochotu si nepovinné vzdělání sama uhradit. Přestože simulátory a simulace v chirurgii tvoří významný tréninkový nástroj, nelze jimi plně nahradit roli mentora – zkušeného atestovaného kolegy/ů.
Introduction and aims: The training of young surgeons in the Czech Republic includes the completion of mini-invasive, laparoscopic simulation courses on a voluntary basis. The aim of this study is to show how simulation is used now to train surgeons and to look back at 10 years of running a simulation, laparoscopic, mini-invasive course from the graduates’ points of view using box and virtual reality simulators. Type of study: Observational, survey. Methods: Data were collected from 26 courses (2014–2024) by an anonymous questionnaire. The questionnaires were completed by all graduates (100%). Their evaluation was done by the descriptive statistics method. Questions were asked about expectations and fulfilment of the expectations from the course with its possible recommendation and financial cost. Results: A total of 96 doctors, 55 men and 41 women, participated in the courses. The questionnaires were completed by all participants. In 89 cases (92.7%), the candidates wanted to learn the correct technique, tips, and tricks in laparoscopic surgery; in 42 cases (43.8%), they expected an increase in the operative time; and in 37 cases (38.5%), a deepening of anatomical and theoretical knowledge was mentioned. The course completely fulfilled the expectations in 92% of the cases, in 6.0% of the cases, it fulfilled them with minor reservations and in 2.0% it fulfilled them partially. Ninety seven percent of participants would recommend the course as compulsory; 3% would leave its recommendation to the discretion of the graduate. Twenty-eight participants (29.2%) fully paid for the course; 5 (5.2%) participants partially paid; and 63 (65.6%) participants received payment from their employer. Conclusion: The participants recommended the simulation course for compulsory inclusion in the surgical education curriculum, and about one-third of them also expressed willingness to pay for the optional education. Although simulators and simulations in surgery represent an important training potential, the subsequent role of mentor in the form of certified, experienced colleague(s) cannot be replaced by them.
OBJECTIVE: Resection of the vestibular schwannoma causes acute peripheral vestibular loss. The process of central compensation starts immediately afterward. The rehabilitation goal is to support this process and restore the quality of life. MATERIALS AND METHODS: In this prospective single-center study, 67 consecutive patients underwent vestibular schwannoma resection (40 females, mean age 52 ± 12 years). The patients were divided into three groups: the prehabilitation with intratympanic gentamicin group, the virtual reality group (optokinetic stimulation via virtual reality goggles in the first ten days after the surgery), and the control group. All patients were examined with objective methods and completed questionnaires before the prehabilitation, before the surgery, at the hospital discharge, and after three months. RESULTS: Intratympanic gentamicin prehabilitation leads ipsilaterally to a significant aVOR reduction in all semicircular canals (p < 0.050), the increase of the unilateral weakness in air calorics (p = 0.026), and loss of cVEMPs responses (p = 0.017). Prehabilitation and postoperative exposure to virtual reality scenes improved the patient's perception of vertigo problems according to Dizziness Handicap Inventory (p = 0.039 and p = 0.076, respectively). These findings conform with the optokinetic testing results, which showed higher slow phase velocities at higher speeds (40 deg/s) in both targeted groups compared to the control group. CONCLUSION: Preoperative intratympanic gentamicin positively affects peripheral vestibular function, influencing balance perception after VS resection. In long-term follow-up, prehabilitation and postoperative exposure to virtual reality improve patients' quality of life in the field of vertigo problems.
- MeSH
- antibakteriální látky aplikace a dávkování MeSH
- dospělí MeSH
- gentamiciny * aplikace a dávkování MeSH
- intratympanická injekce MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- pooperační péče metody MeSH
- předoperační péče metody MeSH
- prospektivní studie MeSH
- senioři MeSH
- terapie pomocí virtuální reality metody MeSH
- vestibulární funkční testy MeSH
- vestibulární schwannom * chirurgie MeSH
- virtuální realita MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
BACKGROUND: The increasing complexity of mass casualty incidents (MCIs) necessitates highly effective training for emergency responders. Traditional training methods, while effective in teaching core skills, often fail to replicate the dynamic, high-pressure environments responders face in real-world crises. Virtual reality (VR) offers a novel approach to emergency training, providing an immersive, controlled setting that can simulate real-life scenarios. This study explores the effectiveness of VR in training paramedic students for MCIs and compares the outcomes to those from conventional training methods. METHODS: A comparative study was conducted with 37 paramedic students who underwent either VR-based training or conventional training using mannequins and real-world equipment. The VR application simulated a mass casualty car accident, focusing on triage and patient management. Both groups were assessed based on their performance in key areas, including the accuracy of situational reporting (METHANE), patient triage, heart rate monitoring, and perceived demand using the NASA Task Load Index (NASA-TLX). RESULTS: The VR group demonstrated significantly lower mental demand (p < 0.001) and frustration levels (p = 0.021) compared to traditional training. However, task completion times were slower in the VR setting (p < 0.001), likely due to the interface's unfamiliarity. Accuracy in situational reporting was higher in VR (p = 0.002), while heart rate monitoring did not reveal a significant difference between the groups (p = 0.516). Although VR did not reduce temporal demand (p = 0.057), it showed potential for improving focus and precision in training. Error rates in triage were similar across both training methods (p = 0.882), indicating comparable performance levels in patient classification. CONCLUSIONS: VR presents a promising tool for training emergency responders, particularly in situations that require rapid upskilling, such as crises or wars. The ability to simulate realistic, high-pressure scenarios in a controlled environment can enhance both cognitive and emotional preparedness. Further research is necessary to optimize VR systems and interfaces, making them more efficient for real-time decision-making. As VR technology advances, it holds potential as a key component in future emergency preparedness strategies.
- MeSH
- dospělí MeSH
- first responder * výchova psychologie MeSH
- hromadné neštěstí * MeSH
- lidé MeSH
- plánování postupu v případě katastrof metody MeSH
- třídění pacientů metody MeSH
- virtuální realita * MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND AND OBJECTIVES: Individuals with acrophobia (fear of heights) can experience severe anxiety or panic attacks when they are located at height. This randomized controlled study aimed to verify the effects of a novel scalable virtual reality-based exposure (VR exposure) tool in individuals with acrophobia, by exposing them to a predefined set of situations they usually tend to avoid. METHODS: Forty-three adults were randomly assigned to one of the two groups: the experimental group or the waitlist group. Both groups attended initial short online education. The experimental group consecutively attended three VR-based exposure therapy (VRET) intervention sessions over 3-5 weeks during which the therapist encouraged participants to enter the predefined feared situations, while the control group on the waitlist had no additional intervention. RESULTS: The findings show that a 3-session VR exposure intervention with a standardized set of tasks effectively reduces the level of experienced height intolerance and particularly avoidance behavior compared to the control waitlist group limited to psychoeducation only. Results were maintained at the 2 months follow-up. The higher the sense of presence after the VR exposure was, the lower the avoidance level rated in the follow-up. LIMITATIONS: Our study has some limitations, such as potential sample selection bias and tracking of only medium-term effects in the 2-month follow-up. CONCLUSIONS: The findings show that three sessions of VR exposure intervention with a standardized set of VR-based scenarios are effective in reducing the level of height intolerance and associated avoidance behavior and led to improvement of the outcome measures two months after the procedure. The role of presence was implicated in the prolonged outcome of the VR exposure intervention.
- MeSH
- dospělí MeSH
- fobie * terapie psychologie MeSH
- implozivní terapie * metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- následné studie MeSH
- terapie pomocí virtuální reality * metody MeSH
- virtuální realita * MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
According to recent research, many family caregivers lack the necessary knowledge and skills to provide effective care for individuals who have survived a stroke. Interventions such as psychoeducational training have demonstrated the potential to enhance caregiver competence and patient outcomes. Utilizing virtual reality to deliver educational content to family caregivers represents a novel approach to addressing the challenges encountered by caregivers of post-stroke survivors. In a quasi-experimental study employing a one-group, pre-test and post-test design, we recruited a cohort of 30 family caregivers responsible for providing care to stroke survivors within their homes. The study sample was drawn from a hospital in Surabaya, Indonesia. Participating family caregivers of stroke survivors completed a four-week psychoeducational program, following which data on effectiveness and feasibility were collected. The findings revealed a statistically significant reduction in the DASS-42 score after the program (t = 31.22, p < 0.001), indicating that the psychoeducational program was perceived as beneficial for family caregivers of stroke patients. Subsequently, the next phase will involve the implementation of the psychoeducational program with a broader group of family caregivers of stroke survivors.
- Klíčová slova
- psychoedukace,
- MeSH
- cévní mozková příhoda ošetřování MeSH
- duševní zdraví MeSH
- lidé MeSH
- osoby pečující o pacienty * psychologie výchova MeSH
- pilotní projekty MeSH
- rodina psychologie MeSH
- virtuální realita * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
The human mind, trying to perceive events coherently, creates the illusion of continuous time passage. Empirical evidence suggests distortions in subjectively perceived time flow associated with well-studied neural responses to sensory stimuli. This study aimed to investigate whether visually uncomfortable patterns, causing exceptionally strong brain activation, affect short time estimates and whether these estimates vary based on the overall reported sensory sensitivity and cortical excitability of individuals. Two experiments in virtual reality testing our assumptions at different levels of complexity of timed stimuli provided initial insight into the studied processes in highly controlled and realistic conditions. Data analysis results did not support our hypotheses, but showed that subjectively most visually uncomfortable simple patterns, i.e., achromatic gratings, cause more variable temporal judgments. Supposedly, this inaccuracy depends on the currently perceived visual comfort and thus the current visual system sensitivity, which cannot be satisfactorily derived from trait-based measures. The exploration of the effect of complex stimuli, i.e., virtual exteriors, suggested that their visual comfort does not affect time perception at all. Biological sex was an important variable across experiments, as males experienced temporal compression of stimuli compared to females. Neuroimaging research is needed for a deeper investigation of the origin of these results.Protocol registration: The Stage 1 manuscript associated with this Registered Report was in-principle accepted on 4 March 2024 prior to data collection for hypothesis testing. The accepted version of the manuscript can be found in the publicly available OSF repository at https://doi.org/ https://doi.org/10.17605/OSF.IO/K3YZE .
- MeSH
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mozek fyziologie diagnostické zobrazování MeSH
- světelná stimulace metody MeSH
- virtuální realita MeSH
- vnímání času * fyziologie MeSH
- zraková percepce * fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Background and Objectives: The aim of this study was to determine the effect of immersive virtual reality used as a short-term multifaceted activity with a focus on motor and cognitive function in patients with Parkinson's Disease. The sub-objective focused on quality of life in the study group of patients. Materials and Methods: Nineteen patients (64.2 ± 12.8 years) were included in this study. Inclusion criteria for this study: adult patients in Hoehn and Yahr's stage 1-3, cooperative, with stable health status, independent and mobile. IVR therapy was performed twice a week for 20 min for one month. Input and output measurements were taken within 14 days of starting or ending therapy. The 10 Meter Walk test was used to examine and assess both comfortable and fast walking, and the Timed Up and Go (TUG) + s dual task was applied to quickly assess the highest possible level of functional mobility. The Berg Balance Scale test (BBS) was used to assess balance with a 14-item balance scale containing specific movement tasks. The standardized Parkinson's Disease Questionnaire (PDQ-39) was used to assess quality of life. Data were processed in the PAST program using a nonparametric paired Wilcoxon test. The significance level was set at α = 0.05. The value of the r score was used to evaluate the effect size. Results: A significant reduction in the time in the fast walk 10MWT (p = 0.006; r = 0.63) and TUG (p < 0.001; r = 0.80) parameter were found after therapy. Significant improvement in the BBS score was found after applied therapy (p = 0.016; r = 0.55). In the PDQ-39 questionnaire, significant improvements were found in the study group after therapy in the domains of mobility (p = 0.027; r = 0.51) and emotional well-being (p = 0.011; r = 0.58). Conclusions: The results of this study indicate a positive effect of virtual reality therapy on balance and gait, which is also good in terms of reducing the risk of falls in the study group. Therapy also promoted quality of life in the study group.
- MeSH
- kognice fyziologie MeSH
- kvalita života * psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- Parkinsonova nemoc * psychologie patofyziologie terapie komplikace MeSH
- posturální rovnováha fyziologie MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- terapie pomocí virtuální reality metody MeSH
- virtuální realita * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: Upper limb (UL) impairment is common in people with multiple sclerosis (pwMS), and functional recovery of the UL is a key rehabilitation goal. Technology-based approaches, like virtual reality (VR), are increasingly promising. While most VR environments are task-oriented, our clinical approach integrates neuroproprioceptive 'facilitation and inhibition' (NFI) principles. To advance this, we developed immersive VR software based on NFI principles targeting UL function and sit-to-stand ability. This study aims to evaluate the effectiveness of this VR therapy compared with conventional NFI-based physical therapy in pwMS. Our study uniquely applies advanced imaging techniques, along with biological molecular assessments, to explore adaptive processes induced by VR rehabilitation. METHODS AND ANALYSIS: This double-arm, randomised, assessor-blinded, controlled trial runs over 2 months (1 hour, 2 times per week). PwMS with mild to severe disability will receive either VR therapy or real-world physical therapy. Primary outcomes include the nine-hole peg test, box and block test, handgrip strength, tremor and five times sit-to-stand test. Secondary measures include the Multiple Sclerosis Impact Scale, the 5-level EQ-5D questionnaire and kinematic analysis. Adaptive processes will be monitored using imaging techniques (functional MRI and tractography), molecular genetic methods (long non-coding RNAs) and immune system markers (leukocytes, dendritic cells). The International Classification of Functioning, Disability and Health brief set for MS will map the bio-psycho-social context of participants. ETHICS AND DISSEMINATION: This project and its amendments were approved by the Ethics Committee of the Institute for Clinical and Experimental Medicine and Thomayer Hospital (1983/21+4772/21 (G-21-02) and the Ethics Committee of Kralovske Vinohrady University Hospital (EK-VP/38/0/2021) in Prague, Czechia (with single enrolment). The findings of this project will be disseminated through scientific publications, conferences, professional networks, public engagement, educational materials and stakeholder briefings to ensure a broad impact across clinical, academic and public domains. TRIAL REGISTRATION NUMBER: clinicaltrials.gov (NCT04807738).
- MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- horní končetina * patofyziologie MeSH
- kvalita života * MeSH
- lidé MeSH
- magnetická rezonanční tomografie * metody MeSH
- postura těla MeSH
- randomizované kontrolované studie jako téma MeSH
- roztroušená skleróza * diagnostické zobrazování MeSH
- síla ruky MeSH
- techniky fyzikální terapie * MeSH
- terapie pomocí virtuální reality metody MeSH
- virtuální realita MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- protokol klinické studie MeSH
Úvod: Efektivní preprocedurální edukace je klíčová pro spolupráci a následnou compliance pacientů. V současnosti se v medicíně stále více používá virtuální realita (VR). Cílem naší studie bylo prokázat non-inferioritu VR v edukaci pacientů před elektivní koronarografií ve srovnání s klasickou edukací zdravotnickým personálem. Metodika: V této prospektivní studii bylo zařazeno 386 pacientů před elektivní koronarografií, kteří byli randomizováni do dvou skupin. Pacienti ve skupině VR (n = 193) sledovali 360° video o plánovaném výkonu s použitím VR brýlí Oculus Meta Quest 2 a pacienti v konvenční skupině (n = 193) byli před výkonem edukováni lékařem. Pacienti následně vyplnili dotazník, který hodnotil kvalitu edukace, porozumění plánovanému výkonu a spokojenost pacientů. Výsledky: Edukace ve VR byla ve srovnání s klasickou edukací non-inferiorní, se statisticky podobným výsledkem při hodnocení porozumění plánovanému výkonu po edukaci v nemocnici (93,8 % vs. 90,2 %, p = 0,19) a subjektivní evaluací kvality edukace s použitím Likertovy stupnice (77,2 % vs. 68,4 % pacientů hodnotilo edukaci známkou 1, p = 0,261). Edukace VR prokázala lepší zapamatování poskytunutých informací, kdy 34,7 % pacientů dosáhlo nejlepšího možného skóre (4 ze 4 možných bodů) v dotazníku ve srovnání s 18,8 % pacientů v konvenční skupině (p < 0,001). V následné subanalýze se ukázalo, že horší výsledky měli starší pacienti (p = 0,028). Závěr: Edukace s použitím virtuální reality se ukázala být stejně efektivní jako klasická edukace lékařem a prokázala lepší následné zapamatování poskytnutých informací, zejména u mladších pacientů. Potvrdil se tak potenciál virtuální reality jako užitečného edukačního nástroje.
Background: Effective pre-procedural education is crucial for patients' cooperation and adherence to treat- ment plans. Virtual reality (VR) has recently been expanding in clinical medicine. This study aimed to prove the non-inferiority of VR education compared to conventional education in patients prior to invasive coronary angiography. Methods: In this prospective study, 386 participants undergoing elective coronary angiography were randomized into a VR group (n = 193) that watched a 360° video about the procedure using VR headset Oculus Meta Quest 2 and a conventional group (n = 193) educated by a physician. Patients completed question- naires assessing educational quality, knowledge of the procedure, and satisfaction.
- MeSH
- chytré brýle MeSH
- koronární angiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- pochopení MeSH
- předoperační péče metody MeSH
- průzkumy a dotazníky MeSH
- senioři MeSH
- statistika jako téma MeSH
- úzkost terapie MeSH
- virtuální realita * MeSH
- vzdělávání pacientů jako téma * metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- randomizované kontrolované studie MeSH
