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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Exercise and Health".

Deadline for manuscript submissions: closed (31 January 2023) | Viewed by 73283

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Special Issue Editors

Prof. José-Antonio Gil-Gómez

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Guest Editor

University Institute of Control Systems and Industrial Computing (ai2 Institute)， Universitat Politècnica de València， 46010 Valencia, Spain

Prof. Patricia Mesa Gresa

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Guest Editor

Psychobiology Department, Universitat de València, Avda. Blasco Ibáñez 21, 46010 Valencia, Spain

Dr. Sergio Albiol-Pérez

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Guest Editor

Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, 44003 Teruel, Spain
Interests: multimodal systems; virtual rehabilitation; augmented rehabilitation; neurodegenerative disorders; neurological disorders; clinical assessment
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Special Issue Information

Dear Colleagues,

In the last years, there has been increasing research interest in the application of Virtual Reality to rehabilitation, exercise and health promotion. Virtual Reality provides patients and users opportunities to engage in intensive, enjoyable and purposeful exercises and tasks related to their interest. Virtual Reality Technology is currently affordable and worldwide available, allowing researchers to provide solutions for professional environments (in clinical context and in exercise-related context) and for domestic environments. In the rehabilitation area, many different fields are currently the focus of Virtual Reality based systems: motor recovery, cognitive treatment, hemodialysis, mental health disorders, … The integration of Virtual Reality complements traditional rehabilitation programs and traditional exercise plans improving their effectiveness.This special issue of International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the application of Virtual Reality and ICTs to rehabilitation, exercise and health promotion. New research papers, reviews, case reports and conference papers are welcome to this issue. Other manuscript types accepted include methodological papers, position papers, brief reports, and commentaries.

We will accept manuscripts from different disciplines including motor and cognitive recovery, exercise for healthy subjects, exercise for improving physical condition in patients of different pathologies, health promotion, mental disorders treatment and socio-emotional intervention. Here are some examples of topics that could be addressed in this Special Issue:

Virtual Reality systems to track and to analyze motor disorders.
Multimodal systems to analyze of Kinematic and Kinetic parameters.
Novel Virtual Reality-based prototypes in health treatments for improved the quality of life.
Wearable technologies for improving patient rehabilitation.
Virtual Reality for health promotion.
Healthcare solutions by using Virtual Rehabilitation.
Virtual Reality and ICTs for socio-emotional intervention.
Model and algorithms to manage rehabilitation processes.
Training technologies in neurodegenerative disorders.
Virtual Reality systems for the treatment of mental health disorders.
Exercise for improving physical condition in patients of different pathologies.
Cognitive and motor rehabilitation.

Prof. José-Antonio Gil-Gómez
Dr. Sergio Albiol-Pérez
Prof. Patricia Mesa Gresa
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

Virtual Reality
Rehabilitation
Exercise
Health promotion
Mental Health disorders
Brain injury
Cognitive intervention
Socio-emotional intervention

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Published Papers (14 papers)

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Research

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12 pages, 4166 KiB

Open AccessArticle

Use of Virtual Reality and Videogames in the Physiotherapy Treatment of Stroke Patients: A Pilot Randomized Controlled Trial

by Francisco-Javier Peláez-Vélez, Martina Eckert, Mariano Gacto-Sánchez and Ángel Martínez-Carrasco

Int. J. Environ. Res. Public Health 2023, 20(6), 4747; https://doi.org/10.3390/ijerph20064747 - 8 Mar 2023

Cited by 14 | Viewed by 7511

Abstract

A stroke is a neurological condition with a high impact in terms of physical disability in the adult population, requiring specific and effective rehabilitative approaches. Virtual reality (VR), a technological approach in constant evolution, has great applicability in many fields of rehabilitation, including strokes. The aim of this study was to analyze the effects of a traditional neurological physiotherapy-based approach combined with the implementation of a specific VR-based program in the treatment of patients following rehabilitation after a stroke. Participants (n = 24) diagnosed with a stroke in the last six months were randomly allocated into a control group (n = 12) and an experimental group (n = 12). Both groups received one-hour sessions of neurological physiotherapy over 6 weeks, whilst the experimental group was, in addition, supplemented with VR. Patients were assessed through the Daniels and Worthingham Scale, Modified Ashworth Scale, Motor Index, Trunk Control Test, Tinetti Balance Scale, Berg Balance Scale and the Functional Ambulation Classification of the Hospital of Sagunto. Statistically significant improvements were obtained in the experimental group with respect to the control group on the Motricity Index (p = 0.005), Trunk Control Test (p = 0.008), Tinetti Balance Scale (p = 0.004), Berg Balance Scale (p = 0.007) and the Functional Ambulation Classification of the Hospital of Sagunto (p = 0.038). The use of VR in addition to the traditional physiotherapy approach is a useful strategy in the treatment of strokes. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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10 pages, 343 KiB

Open AccessArticle

Effects of Playing Exergames on Quality of Life among Young Adults: A 12-Week Randomized Controlled Trial

by Jiajun Yu, Han-Chung Huang, T. C. E. Cheng, May-Kuen Wong and Ching-I Teng

Int. J. Environ. Res. Public Health 2023, 20(2), 1359; https://doi.org/10.3390/ijerph20021359 - 11 Jan 2023

Cited by 6 | Viewed by 2388

Abstract

Objective: The purpose of this paper is to investigate whether playing exergames can enhance quality of life among young adults and it examines the potential moderators. Methods: A 12-week randomized controlled trial was conducted. Quality of life was measured using the short-form 36-item version (SF-36) scale. All the participants were between 20 and 24 years old in Taiwan. Participants in the intervention group (n = 55) were asked to play exergames for 12 weeks, three times a week and 30 minutes at a time, while participants in the control group (n = 62) did not play exergames. The changes in the scores on quality of life between the beginning and the end of the 12-week trial were calculated. Independent t-tests were used to analyze the differences. Results: The intervention group participants experienced an enhanced quality of life in terms of physical functioning, role-physical (role limitations due to physical health), general health, and social functioning. Moreover, the intervention group participants who were not enthusiastic about exercisers experienced an enhanced quality of life in physical functioning, role-physical, and general health. The intervention group participants who attempted to control their weight experienced enhanced general health, vitality, and mental health. Conclusion: Playing exergaming could contribute to users’ quality of life in terms of both physical and mental health. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

14 pages, 1669 KiB

Open AccessArticle

The Efficacy of an Immersive Virtual Reality Exergame Incorporating an Adaptive Cable Resistance System on Fitness and Cardiometabolic Measures: A 12-Week Randomized Controlled Trial

by Mitchell S. Mologne, Jonathan Hu, Erik Carrillo, David Gomez, Trent Yamamoto, Stevin Lu, Jonathan D. Browne and Brett A. Dolezal

Int. J. Environ. Res. Public Health 2023, 20(1), 210; https://doi.org/10.3390/ijerph20010210 - 23 Dec 2022

Cited by 6 | Viewed by 2812

Abstract

Exergaming, combining elements of video game into the realm of exercise, has recently incorporated immersive virtual reality (IVR) with resistance training. Thirty-two participants (14 females, mean age = 24.3) were randomized to IVR or self-directed control group (SELF) and worked out thrice weekly for 12 weeks (for 36 sessions). The IVR group spent 14 fewer minutes per session (p < 0.001) while reporting the sessions “enjoyable’. Compared to SELF, the IVR group had significantly greater improvement in changes from baseline to post-training in upper-and-lower muscular strength (1-RM) and muscular endurance (85% 1-RM) (14.3 kg vs. 10.0 kg for 1-RM upper, 28.6 kg vs. 22.5 kg for 1-RM lower, 2.6 reps vs. 1.9 reps for 85% 1-RM of upper, 2.7 vs. 2.0 reps for 85% 1-RM of lower, all p < 0.001), peak leg power (1424 vs. 865 W, p < 0.001), body fat% (−3.7% vs. −1.9%, p < 0.001), heart rate variability (4.3 vs. 1.8 ms, p < 0.001), rVO2max (3.28 vs. 0.89 mL/min/kg, p < 0.001) with decreased systolic BP (−0.4 vs. −2.3 mmHg, p < 0.001), and level of perceived exertion during workouts (RPE 14 vs. 16, p < 0.001). With its high-paced and action-filled gaming coupled with superior fitness and cardiometabolic outcomes, this IVR exergaming platform should be considered as another exercise modality for performance and health-related training. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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16 pages, 5122 KiB

Open AccessArticle

Design to Assist Better Youthhood for Adolescents with Lower-Limb Disability through Virtual Reality Sports

by Xiaochen Zhang, Lanxin Hui, Muge Li, Jiajing Huang, Chengyuan Chen, Yunping Yang, Fuchuan Song, Fei Hu and Ding-Bang Luh

Int. J. Environ. Res. Public Health 2022, 19(7), 3985; https://doi.org/10.3390/ijerph19073985 - 27 Mar 2022

Cited by 4 | Viewed by 3264

Abstract

Background: Youths with lower limb dysfunction display low levels of sports participation, which limits their growth and self-development, both physically and mentally. Recently, VR technology has proven its profound value in the psychological evaluation and treatment, rehabilitation, and immersive training of people in need. We have proposed, designed, and developed a VR rock-climbing game for youths with lower-limb dysfunction that allows them to engage in enjoyable and purposeful in-game tasks that simultaneously bring about intensive real-world exercise. Methods: Pilot studies were conducted on college students whose lower limbs were fixed to chairs. Heart rate monitoring, a flow questionnaire, interviews, and observation were conducted for each participant to evaluate the impact of the VR rock-climbing game. The collected data were trimmed on the basis of Cronbach’s alpha and corrected item–total correlation (CITC) to guarantee the data’s reliability. Results: The average value of each flow experience dimension was greater than 4 (0.76 < SD < 0.91). According to the flow-based analysis and the whole-process feeling distribution (WPFD), the evaluated study brought about the participants’ happiness and a sense of mastery and achievement. Conclusions: By bringing about a deep and enjoyable immersion in VR, it remarkably promotes the participants’ intention to participate in exercises. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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20 pages, 3441 KiB

Open AccessArticle

Development and Testing of a Portable Virtual Reality-Based Mirror Visual Feedback System with Behavioral Measures Monitoring

by Beatriz Rey, Alejandro Oliver, Jose M. Monzo and Inmaculada Riquelme

Int. J. Environ. Res. Public Health 2022, 19(4), 2276; https://doi.org/10.3390/ijerph19042276 - 17 Feb 2022

Cited by 10 | Viewed by 2392

Abstract

Virtual Reality (VR) is a technology that has been used to provide the Mirror Visual Feedback (MVF) illusion to patients with promising results. In the present work, the goal is to design, develop and test a portable VR-based MVF system that monitors behavioral information about the performance of a simple motor task. The developed application runs in a stand-alone VR system and allows the researcher to select the real and virtual hands used to perform the motor task. The system was evaluated with a group of twenty healthy volunteers (12 men and 8 women) with ages between 18 and 66 years. Participants had to repetitively perform a motor task in four different experimental conditions: two mirror conditions (performing real movements with the dominant and with the non-dominant hand) and two non-mirror conditions. A significant effect of the experimental condition on embodiment score (p < 0.001), response time (p < 0.001), performance time (p < 0.001), trajectory length (p < 0.004) and trajectory maximum horizontal deviation (p < 0.001) was observed. Furthermore, a significant effect of the experimental moment (initial, middle and final parts of the training) on the performance time was observed (p < 0.001). These results show that the monitored parameters provide relevant information to evaluate the participant’s task performance in different experimental conditions. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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26 pages, 3376 KiB

Open AccessArticle

Virtual Reality Aided Therapy towards Health 4.0: A Two-Decade Bibliometric Analysis

by Zhen Liu, Lingfeng Ren, Chang Xiao, Ke Zhang and Peter Demian

Int. J. Environ. Res. Public Health 2022, 19(3), 1525; https://doi.org/10.3390/ijerph19031525 - 28 Jan 2022

Cited by 76 | Viewed by 10838

Abstract

Health 4.0 aligns with Industry 4.0 and encourages the application of the latest technologies to healthcare. Virtual reality (VR) is a potentially significant component of the Health 4.0 vision. Though VR in health care is a popular topic, there is little knowledge of VR-aided therapy from a macro perspective. Therefore, this paper was aimed to explore the research of VR in aiding therapy, thus providing a potential guideline for futures application of therapeutic VR in healthcare towards Health 4.0. A mixed research method was adopted for this research, which comprised the use of a bibliometric analysis (a quantitative method) to conduct a macro overview of VR-aided therapy, the identification of significant research structures and topics, and a qualitative review of the literature to reveal deeper insights. Four major research areas of VR-aided therapy were identified and investigated, i.e., post-traumatic stress disorder (PTSD), anxiety and fear related disorder (A&F), diseases of the nervous system (DNS), and pain management, including related medical conditions, therapies, methods, and outcomes. This study is the first to use VOSviewer, a commonly used software tool for constructing and visualizing bibliometric networks and developed by Center for Science and Technology Studies, Leiden University, the Netherlands, to conduct bibliometric analyses on VR-aided therapy from the perspective of Web of Science core collection (WoSc), which objectively and visually shows research structures and topics, therefore offering instructive insights for health care stakeholders (particularly researchers and service providers) such as including integrating more innovative therapies, emphasizing psychological benefits, using game elements, and introducing design research. The results of this paper facilitate with achieving the vision of Health 4.0 and illustrating a two-decade (2000 to year 2020) map of pre-life of the Health Metaverse. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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20 pages, 6016 KiB

Open AccessArticle

Design and Validation of Virtual Reality Task for Neuro-Rehabilitation of Distal Upper Extremities

by Debasish Nath, Neha Singh, Megha Saini, M. V. Padma Srivastava and Amit Mehndiratta

Int. J. Environ. Res. Public Health 2022, 19(3), 1442; https://doi.org/10.3390/ijerph19031442 - 27 Jan 2022

Cited by 7 | Viewed by 3174

Abstract

Stroke, affecting approximately 15 million people worldwide, has long been a global cause of death and disability. Virtual Reality (VR) has shown its potential as an assistive tool for post-stroke rehabilitation. The objective of this pilot study was to define the task-specific performance metrics of VR tasks to assess the performance level of healthy subjects and patients quantitatively and to obtain their feedback for improving the developed framework. A pilot prospective study was designed. We tested the designed VR tasks on forty healthy right-handed subjects to evaluate its potential. Qualitative trajectory plots and three quantitative performance metrics—time taken to complete the task, percentage relative error, and trajectory smoothness—were computed from the recorded data of forty healthy subjects. Two patients with stroke were also enrolled to compare their performance with healthy subjects. Each participant received one VR session of 90 min. No adverse effects were noticed throughout the study. Performance metrics obtained from healthy subjects were used as a reference for patients. Relatively higher values of task completion time and trajectory smoothness and lower values of relative % error was observed for the affected hands w.r.t the unaffected hands of both the patients. For the unaffected hands of both the patients, the performance levels were found objectively closer to that of healthy subjects. A library of VR tasks for wrist and fingers were designed, and task-specific performance metrics were defined in this study. The evaluation of the VR exercises using these performance metrics will help the clinicians to assess the patient’s progress quantitatively and to design the rehabilitation framework for a future clinical study. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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10 pages, 831 KiB

Open AccessArticle

Assessment of Wheelchair Propulsion Performance in an Immersive Virtual Reality Simulator

by Yu-Sheng Yang, Alicia M. Koontz, Yu-Hsuan Hsiao, Cheng-Tang Pan and Jyh-Jong Chang

Int. J. Environ. Res. Public Health 2021, 18(15), 8016; https://doi.org/10.3390/ijerph18158016 - 29 Jul 2021

Cited by 9 | Viewed by 3342

Abstract

Maneuvering a wheelchair is an important necessity for the everyday life and social activities of people with a range of physical disabilities. However, in real life, wheelchair users face several common challenges: articulate steering, spatial relationships, and negotiating obstacles. Therefore, our research group has developed a head-mounted display (HMD)-based intuitive virtual reality (VR) stimulator for wheelchair propulsion. The aim of this study was to investigate the feasibility and efficacy of this VR stimulator for wheelchair propulsion performance. Twenty manual wheelchair users (16 men and 4 women) with spinal cord injuries ranging from T8 to L2 participated in this study. The differences in wheelchair propulsion kinematics between immersive and non-immersive VR environments were assessed using a 3D motion analysis system. Subjective data of the HMD-based intuitive VR stimulator were collected with a Presence Questionnaire and individual semi-structured interview at the end of the trial. Results indicated that propulsion performance was very similar in terms of start angle (p = 0.34), end angle (p = 0.46), stroke angle (p = 0.76), and shoulder movement (p = 0.66) between immersive and non-immersive VR environments. In the VR episode featuring an uphill journey, an increase in propulsion speed (p < 0.01) and cadence (p < 0.01) were found, as well as a greater trunk forward inclination (p = 0.01). Qualitative interviews showed that this VR simulator made an attractive, novel impression and therefore demonstrated the potential as a tool for stimulating training motivation. This HMD-based intuitive VR stimulator can be an effective resource to enhance wheelchair maneuverability experiences. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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13 pages, 2737 KiB

Open AccessArticle

A Velostat-Based Pressure-Sensitive Mat for Center-of-Pressure Measurements: A Preliminary Study

by Javier Martinez-Cesteros, Carlos Medrano-Sanchez, Inmaculada Plaza-Garcia, Raul Igual-Catalan and Sergio Albiol-Pérez

Int. J. Environ. Res. Public Health 2021, 18(11), 5958; https://doi.org/10.3390/ijerph18115958 - 2 Jun 2021

Cited by 14 | Viewed by 4975

Abstract

Center-of-pressure (CoP) displacements play a key role in studies assessing postural stability. The accepted instrument to measure CoP trajectories is the force platform, but pressure-sensitive mats (PSMs) are an alternative composed of a matrix of sensitive cells. A typical cell comprises two electrodes with piezoresistive material in between, while a force platform has a force sensor at each of its corners. In this paper, we compare a homemade Velostat-based PSM and an affordable commercial mat with a commercial force platform in a test series with 42 healthy volunteers in single-legged trials (29 males, 13 females; height 1.74 (0.09) m, weight 74.3 (16.34) kg, age 31.21 (12.66) years). The aim of the research was to perform a preliminary study of the performance of our prototype to measure CoP, and more specifically, the standard deviation of the CoP path on both axes, the medial–lateral and anterior–posterior. We could thus discover several improvements for future clinical applications. The intraclass correlation coefficient (ICC) for agreement in the base experiment showed a moderate value for the prototype (0.38 to 0.63) and lower values for the commercial mat (0.11 to 0.12). However, we identified several factors that were relevant to improve ICC and reduce error by considering several processing options: (i) the known crosstalk problem between cells that appears in this kind of mats must be eliminated; (ii) the response time of the sensor has to be taken into account; and (iii) increasing the mat resolution also improves agreement. Therefore, as future work, we plan to test the improved version of the prototype in a clinical environment. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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12 pages, 3082 KiB

Open AccessArticle

The Effects of Exergaming Training on Balance in Healthy Elderly Women—A Pilot Study

by Anna Brachman, Wojciech Marszałek, Anna Kamieniarz, Justyna Michalska, Michał Pawłowski, Anna Akbaş and Grzegorz Juras

Int. J. Environ. Res. Public Health 2021, 18(4), 1412; https://doi.org/10.3390/ijerph18041412 - 3 Feb 2021

Cited by 13 | Viewed by 3838

Abstract

Our aim was to observe, through objective testing using an assessment module incorporated in a new exergaming system, whether elderly people’s static and functional balance is improved by a balance exergaming training program based on movements performed in everyday life. Thirteen healthy elderly women participated in 12 sessions of balance-based exergaming training (three times a week, 30 min per session). All objective outcomes, the quiet standing test, functional balance test (FBT), and limit of stability (LOS) test, were measured on three occasions: before intervention, after six training sessions, and after the completion of the four-week program. The results showed a significant improvement in LOS performance after the intervention. In FBT, participants exhibited a significant decrease (p < 0.01; Kendall’s W = 0.5) in the average time to target hit after six trainings. The average center of pressure velocity increased after six and 12 sessions, however did not reach significance (p = 0.053); nevertheless the size of the effect was large (η_p2 = 0.22). The parameters of the quiet standing test were not significantly affected by the training. The results support the need for more definite and objective studies assessing exergaming for balance in elderly. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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9 pages, 588 KiB

Open AccessArticle

Training Using a Commercial Immersive Virtual Reality System on Hand–Eye Coordination and Reaction Time in Young Musicians: A Pilot Study

by Sebastian Rutkowski, Mateusz Adamczyk, Agnieszka Pastuła, Edyta Gos, Carlos Luque-Moreno and Anna Rutkowska

Int. J. Environ. Res. Public Health 2021, 18(3), 1297; https://doi.org/10.3390/ijerph18031297 - 1 Feb 2021

Cited by 26 | Viewed by 7331

Abstract

The implementation of virtual reality (VR) opens up a wide range of possibilities for the development of dexterity, speed and precision of movements. The aim of this study was to investigate whether immersive VR training affected the hand–eye coordination and reaction time in students of the state music school. This study implemented a single-group pre-post study design. This study enrolled 14 individuals, submitted to a 15 min training session of the immersive music game “Beat Saber”, once a day for 5 consecutive days. The plate-tapping test (PTT) and the ruler-drop test (Ditrich’s test) were used to assess the reaction time. Trial-making test (TMT) A and TMT B were used to assess coordination and visual attention. Analysis of the results showed a statistically significant improvement in hand–eye coordination and reaction time of music school students using the TMT-A (p < 0.002), TMT-B (p < 0.001), Ditrich’s test for the non-dominant hand (0.025) and PTT (0.0001) after applying a week-long training period in immersive VR. The results obtained in the present study show that the VR system, along with the immersive music game, has the potential to improve hand–eye coordination and reaction time in young musicians, which may lead to the faster mastering of a musical instrument. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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Review

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18 pages, 894 KiB

Open AccessReview

Virtual Reality-Based Immersive Rehabilitation for Cognitive- and Behavioral-Impairment-Related Eating Disorders: A VREHAB Framework Scoping Review

by Bryan Pak-Hei So, Derek Ka-Hei Lai, Daphne Sze-Ki Cheung, Wing-Kai Lam, James Chung-Wai Cheung and Duo Wai-Chi Wong

Int. J. Environ. Res. Public Health 2022, 19(10), 5821; https://doi.org/10.3390/ijerph19105821 - 10 May 2022

Cited by 19 | Viewed by 5268

Abstract

Virtual reality (VR) technology is one of the promising directions for rehabilitation, especially cognitive rehabilitation. Previous studies demonstrated successful rehabilitation in motor, cognitive, and sensorial functions using VR. The objective of this review is to summarize the current designs and evidence on immersive rehabilitation interventions using VR on cognitive- or behavioral-related eating disorders, which was mapped using a VREHAB framework. Two authors independently searched electronic databases, including PubMed, Web of Science, Scopus, CINAHL, EMBASE, and Cochrane Library. Ten (n = 10) articles were eligible for review. Treatments for anorexia nervosa and binge eating disorder/bulimia nervosa were reported through enhanced/experimental cognitive behavior therapy (ECT), cue exposure therapy (CET), and body exposure therapy (BET) via the virtual environment. Some studies reported that the VR effects were superior or comparable to traditional treatments, while the effects may last longer using VR technology. In addition, VR was perceived as acceptable and feasible among patients and therapists and could be valuable for supplementing existing therapies, relieving manpower and caregiver burdens. Future studies may consider incorporating haptic, smell, and biofeedback to improve the experience, and thus the effects of the treatments for the users. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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15 pages, 2447 KiB

Open AccessReview

Virtual Reality Assisted Non-Pharmacological Treatments in Chronic Pain Management: A Systematic Review and Quantitative Meta-Analysis

by Simone Grassini

Int. J. Environ. Res. Public Health 2022, 19(7), 4071; https://doi.org/10.3390/ijerph19074071 - 29 Mar 2022

Cited by 40 | Viewed by 9247

Abstract

Virtual reality (VR) is a developing technology that has recently attracted the attention of healthcare practitioners. Recently, VR systems have been used to treat pain symptoms. The present study aims to evaluate the VR effectiveness on chronic pain management. A systematic literature search was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Keywords were used to discover the potentially eligible studies. The primary focus of the present investigation was to evaluate the possible effect of VR-assisted treatments on chronic pain, especially in the commonly occurring low back and neck pain. Nine studies reporting randomized controlled trials were included in the present study. VR-mediated interventions demonstrated significant improvement for pain symptoms in patients experiencing chronic pain. In addition, VR-mediated therapy decreased pain intensity and disability in the case of chronic neck pain compared to control conditions. However, the VR interventions showed a statistically non-significant improvement in chronic low back pain when experimental groups were compared with controls. VR therapy positive effect on chronic pain did not differ from the one reported for other types of interventions for pain management, as physical exercise and laser therapy. Taken together, these findings showed that currently available lines of evidence on the effect of VR-mediated therapy in chronic pain management, despite pointing towards possible therapeutical benefits of the VR-based intervention, are overall inconclusive and that more research on VR-assisted therapy for chronic pain is needed. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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Other

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21 pages, 1079 KiB

Open AccessSystematic Review

Addressing Cognitive Function and Psychological Well-Being in Chronic Kidney Disease: A Systematic Review on the Use of Technology-Based Interventions

by Alexandra-Elena Marin, Rosa Redolat, José-Antonio Gil-Gómez and Patricia Mesa-Gresa

Int. J. Environ. Res. Public Health 2023, 20(4), 3342; https://doi.org/10.3390/ijerph20043342 - 14 Feb 2023

Cited by 2 | Viewed by 2948

Abstract

Patients with chronic kidney disease (CKD) are at risk of both a gradual decline in cognitive function and an increase in psychological distress. This includes symptoms of anxiety, depression, and sleep disturbances, all of which are factors that have been associated with increased morbidity and mortality. In response, we are now seeing that interventions based on new digital technologies are increasingly used in order to optimize patients’ quality of life. Systematic research of the literature on electronic databases (MEDLINE/PubMed, Scopus, Web of Science, and PsycInfo/ProQuest) covering the period from 2012 to 2022 was conducted in order to methodically review the existing evidence regarding the implementation and effectiveness of technology-based interventions in the management of cognitive and psychological well-being symptoms in patients with CKD. A total of 739 articles were retrieved, 13 of which are included in the present review. All the studies focused on the usability, acceptability, and feasibility of technology-based interventions aimed at psychological symptoms, with no studies targeting cognitive functioning. Technology-based interventions offer feelings of safety, fun, and satisfaction, and they also have the potential to improve CKD patients’ health outcomes regarding their psychological well-being. The diverseness of technologies allows an approximation towards the identification of those types of technologies most frequently used, as well as the symptoms targeted. There was considerable heterogeneity in the types of technologies used for interventions in so few studies, making it difficult to draw conclusive findings with regard to their efficiency. In order to adequately assess the technology-based health interventions effect, future lines of research should consider designing non-pharmacological treatments for the improvement of cognitive and psychological symptoms in this type of patient. Full article

(This article belongs to the Special Issue Virtual Reality Rehabilitation, Exercise and Health Promotion)

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