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
- Anti-Bacterial Agents administration & dosage MeSH
- Adult MeSH
- Gentamicins * administration & dosage MeSH
- Injection, Intratympanic MeSH
- Quality of Life MeSH
- Middle Aged MeSH
- Humans MeSH
- Postoperative Care methods MeSH
- Preoperative Care methods MeSH
- Prospective Studies MeSH
- Aged MeSH
- Virtual Reality Exposure Therapy methods MeSH
- Vestibular Function Tests MeSH
- Neuroma, Acoustic * surgery MeSH
- Virtual Reality MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Comparative Study 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
- Cognition physiology MeSH
- Quality of Life * psychology MeSH
- Middle Aged MeSH
- Humans MeSH
- Parkinson Disease * psychology physiopathology therapy complications MeSH
- Postural Balance physiology MeSH
- Surveys and Questionnaires MeSH
- Aged MeSH
- Virtual Reality Exposure Therapy methods MeSH
- Virtual Reality * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article 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
- Adult MeSH
- Double-Blind Method MeSH
- Upper Extremity * physiopathology MeSH
- Quality of Life * MeSH
- Humans MeSH
- Magnetic Resonance Imaging * methods MeSH
- Posture MeSH
- Randomized Controlled Trials as Topic MeSH
- Multiple Sclerosis * diagnostic imaging MeSH
- Hand Strength MeSH
- Physical Therapy Modalities * MeSH
- Virtual Reality Exposure Therapy methods MeSH
- Virtual Reality MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial Protocol MeSH
The use of virtual reality (VR) in medicine is rapidly expanding, particularly in areas like pain management, surgical training, and mental health therapy. This study examines the implementation and effects of the Cold River VR application, a fully immersive tool designed to help manage pain and anxiety during dressing changes for burn trauma patients in a Czech hospital. The Cold River application immerses patients in a peaceful, interactive virtual environment, utilizing eye-tracking technology to engage them without the need for physical controllers, which could interfere with wound care. The study included 67 participants and found that Cold River effectively distracted patients, making the often painful and anxiety-provoking dressing changes more bearable. While stakeholder interviews indicated that the VR application was generally well-received and seen as a valuable tool in reducing patient discomfort, challenges such as lengthy calibration and occasional issues with nausea and headset discomfort were noted. Importantly, the Cold River application increased patient engagement and reduced the psychological burden associated with burn care, though it also highlighted the need for customization based on individual patient preferences and conditions. Overall, the experience with Cold River suggests that immersive VR holds significant potential for improving patient care during burn treatment, particularly when tailored to specific patient needs and contexts.
- Keywords
- Cold River,
- MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Pain Management methods MeSH
- Young Adult MeSH
- Patients psychology MeSH
- Burns * nursing psychology therapy MeSH
- Attitude of Health Personnel MeSH
- Aged MeSH
- Virtual Reality Exposure Therapy * methods instrumentation MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- MeSH
- Mental Disorders therapy MeSH
- Congresses as Topic MeSH
- Humans MeSH
- Virtual Reality Exposure Therapy * methods MeSH
- Artificial Intelligence MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- Interview MeSH
- News MeSH
- MeSH
- Adult MeSH
- Electrical Equipment and Supplies MeSH
- Ankle Joint * physiopathology MeSH
- Kinesiology, Applied methods MeSH
- Control Groups MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Joint Instability rehabilitation MeSH
- Telerehabilitation methods MeSH
- Exercise Therapy methods MeSH
- Virtual Reality Exposure Therapy * methods MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Young Adult MeSH
- Publication type
- Evaluation Study MeSH
- Comparative Study MeSH
BACKGROUND: A growing interest in non-pharmacological approaches aimed at cognitive rehabilitation and cognitive enhancement pointed towards the application of new technologies. The complex virtual reality (VR) presented using immersive devices has been considered a promising approach. OBJECTIVE: The article provides a systematic review of studies aimed at the efficacy of VR-based rehabilitation. First, we shortly summarize literature relevant to the role of immersion in memory assessment and rehabilitation. METHODS: We searched Web of Science, ScienceDirect, and PubMed with the search terms "memory rehabilitation", "virtual reality", "memory deficit". Only original studies investigating the efficacy of complex three-dimensional VR in rehabilitation and reporting specific memory output measures were included. RESULTS: We identified 412 citations, of which 21 met our inclusion criteria. We calculated appropriate effect sizes for 10 studies including control groups and providing descriptive data. The effect sizes range from large to small, or no effect of memory rehabilitation was present, depending on the control condition applied. Summarized studies with missing control groups point out to potential positive effects of VR but do not allow any generalization. CONCLUSIONS: Even though there are some theoretical advantages of immersive VE over non-immersive technology, there is not enough evidence yet to draw any conclusions.
- MeSH
- Humans MeSH
- Memory MeSH
- Stroke Rehabilitation methods trends MeSH
- Virtual Reality Exposure Therapy instrumentation methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Systematic Review MeSH
Objectives. Schizophrenia has a debilitating impact on patient‘s cognitive functioning and everyday activities. As a part of the treatment, schizophrenia patients attend sessions of cognitive remediation to restore impaired cognitive abilities. To combine cognitive and real life training, this study presents a virtual task to use in cognitive rehabilitation and assessment. Virtual Supermarket Shopping Task (VSST) simulates a shopping activity, in which participants have to memorize and collect items from a virtual supermarket. The aim of this study is to establish its validity for use in clinical practice. Sample and setting. Twenty patients suffering from chronic schizophrenia and twenty healthy controls were tested. Each participant completed the task and a battery of standard neuropsychological tests. Statistical analyses. Groups’ results were compared with Student’s t-tests. Validity of VSST was examined using correlations with standard neuropsychological measures. Several VSST metrics, such as trial difficulty, distances and times, and the effect the extraneous variables have on VSST measures were investigated using analyses of variance and mixed effect models. Results. The analyses demonstrate that patients perform worse in VSST than healthy controls and their performance corresponds to their mnemonic abilities measured by standard neuropsychological tests. VSST performance relates to the level of executive functioning only in patients. There was no effect of gaming experience on VSST performance. While potential gender effect has to be addressed in future studies, age seems to play a role in the additional VSST measures (trial time and distance). Study limitations.Subjects were tested only once and therefore long term benefits of using VSST in rehabilitation could not be investigated. Only schizophrenia patients were included in the sample which reduces generalizability of results to other psychiatric and neurologic conditions.
- MeSH
- Chronic Disease rehabilitation MeSH
- Persons with Psychiatric Disorders MeSH
- Cognitive Remediation methods MeSH
- Humans MeSH
- Psychiatric Rehabilitation methods MeSH
- Reproducibility of Results MeSH
- Schizophrenia * rehabilitation MeSH
- Supermarkets MeSH
- Virtual Reality Exposure Therapy * methods MeSH
- Check Tag
- Humans MeSH
- Publication type
- Evaluation Study MeSH
- Research Support, Non-U.S. Gov't MeSH
