scholarly journals Visual dependence after vestibular rehabilitation by virtual reality in individuals with unilateral peripheral vestibular dysfunction – one year of results

2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
B Cunha
Keyword(s):  
Virtual Reality ◽  
Visual Cues ◽  
Vestibular Rehabilitation ◽  
Vestibular Dysfunction ◽  
Dynamic Posturography ◽  
Velocity Parameter ◽  
Pressure Centre ◽  
Before And After ◽  
One Year ◽  
Visual Dependence

Abstract Introduction One of the most common approaches in individuals with unilateral peripheral vestibular dysfunction (UPVD) is vestibular rehabilitation (RV). Many factors can negatively affect the result of RV. Virtual reality based treatment may represent an important tool in the solution of these problems. In individuals with UPVD there is a decrease in the reception of vestibular stimuli and there is an adjustment in the reception of visual and proprioceptive stimuli. They use more visual cues to minimise the decrease in vestibular stimuli – visual dependence (VD). Although the importance and results of virtual reality as a tool in improving balance in individuals with UPVD have already been demonstrated, we intend to demonstrate that virtual reality allows significant improvements in the decrease in VD. Objectives The aim of the study is to compare VD levels in individuals with UPVD after RV program by virtual reality. Methodology For the evaluation of VD, dynamic posturography was performed with the Balance Rehabilition Unit equipment for 39 people with UPVD, before and after the RV program by virtual reality. Ten conditions were tested, with different visual and propriocetive stimuli. The parameters considered were the oscillation area of the pressure centre and the sway velocity. Results In the parameter of the oscillation area of the pressure centre, statistically significant results were found in the 10 conditions tested. In the sway velocity parameter, statistically significant results were found in the condition 1, 2, 3, 4, 5 e 10. Conclusion Virtual reality incorporated in the RV programs presents itself as an important tool in improving VD in individuals with UPVD.

scholarly journals Virtual Reality Vestibular Rehabilitation in 20 Patients with Vertigo Due to Peripheral Vestibular Dysfunction

2020 ◽  
Vol 26 ◽  
Author(s):  
Tomasz Stankiewicz ◽  
Mariusz Gujski ◽  
Artur Niedzielski ◽  
Lechosław P. Chmielik
Keyword(s):  
Virtual Reality ◽  
Vestibular Rehabilitation ◽  
Vestibular Dysfunction

scholarly journals The importance of computerized dynamic posturography in vestibular rehabilitation of patients with unilateral peripheral vestibular deficiency

2015 ◽  
Vol 5 (19) ◽  
pp. 173-178
Author(s):  
Anamaria Andreia Ulmeanu ◽  
Andreea Didilescu ◽  
Raluca Enache ◽  
Gabriela Musat ◽  
Codrut Sarafoleanu
Keyword(s):  
Maximum Amplitude ◽  
Vestibular Rehabilitation ◽  
Deficiency Syndrome ◽  
Rehabilitation Program ◽  
Time Interval ◽  
Dynamic Posturography ◽  
Eyes Closed ◽  
Computerized Dynamic Posturography ◽  
Before And After ◽  
Eyes Open

Abstract OBJECTIVE. To evaluate the importance of computerized dynamic posturography in vestibular rehabilitation of patients with unilateral peripheral vestibular deficiency syndrome. MATERIAL AND METHODS. The study was conducted on a group of 30 patients (33-78 years; mean age (± SD) = 55.8 ± 12.12) diagnosed with unilateral peripheral vestibular deficiency syndrome, which benefited from VR on a posturography platform. Assessment of the patients was made using the Sensory Organization Test before and after eight sessions of rehabilitation. We analyzed the results obtained with eyes open (EO) and eyes closed (EC) on static and foam platform. The following variables were evaluated: Romberg coefficient, statokinesigram (SKG), maximum amplitude of the degree of deviation in anterior/posterior and medial/lateral planes, SKG and the time interval of the game rehabilitation program. RESULTS. The statistical analysis of the data revealed a strong correlation (p<0.05) for the studied parameters, especially when the test was performed with the eyes closed on foam platform. The analysis of the Romberg coefficient did not show statistically significant results (p>0.05) and the measured values were outside the range of normality even at the end of the rehabilitation program. SKG and the time interval reference of the game showed significant improvement of the parameters (p<0.05); at the end of the rehabilitation sessions, 93.33% of the patients showed full recovery of their deficit. CONCLUSION. Computerized dynamic posturography has a particularly important role in the evaluation, monitoring and rehabilitation of the patients with peripheral vestibular deficiency.

scholarly journals Benefits of Virtual Reality Used in Vestibular Rehabilitation in Adult and Elderly Individuals with Dizziness

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Maria da Glória Canto de Sousa
Keyword(s):  
Quality Of Life ◽  
Virtual Reality ◽  
Video Game ◽  
The Elderly ◽  
Vestibular Rehabilitation ◽  
Language Intervention ◽  
Psychosocial Disorders ◽  
Gender And Age ◽  
Before And After

Introduction: Aging brings about several changes in health in the elderly. Dizziness is one of the symptoms most commonly found in this age group, causing psychosocial disorders in the daily activities. Objective: To assess the benefits of virtual reality by using the video game X-Box 360, in the vestibular rehabilitation of affected individuals of dizziness. Materials and Methods: The research consists of an observational study of the quantitative type of exploratory and descriptive character. The participants were five individuals of both genders, with a mean age of 59.6 year, subject to fulfillment of Kinect games and Kinect Sport Adventure the X-Box 360, and evaluated by comparing the scores of Dizzines Handicap interventory - DHI before and after intervention. Results: 80% of participants are female, the gender and age did not influence the improvement of quality of life, 80% had reduction of DHI in the physical, functional and emotional domain and consequently improved quality of life. Conclusion: The language intervention with patients with dizziness, through the video game X-Box 360, provided improvement in the quality of life of patients surveyed.

scholarly journals Back to reality: transition techniques from short HMD-based virtual experiences to the physical world

2021 ◽  
Author(s):  
Robin Horst ◽  
Ramtin Naraghi-Taghi-Off ◽  
Linda Rau ◽  
Ralf Dörner
Keyword(s):  
Virtual Reality ◽  
Virtual World ◽  
Visual Cues ◽  
User Study ◽  
Physical World ◽  
Direct Communication ◽  
Common Presentation ◽  
Presentation Media ◽  
Virtual Experiences ◽  
Short Times

AbstractEvery Virtual Reality (VR) experience has to end at some point. While there already exist concepts to design transitions for users to enter a virtual world, their return from the physical world should be considered, as well, as it is a part of the overall VR experience. We call the latter outro-transitions. In contrast to offboarding of VR experiences, that takes place after taking off VR hardware (e.g., HMDs), outro-transitions are still part of the immersive experience. Such transitions occur more frequently when VR is experienced periodically and for only short times. One example where transition techniques are necessary is in an auditorium where the audience has individual VR headsets available, for example, in a presentation using PowerPoint slides together with brief VR experiences sprinkled between the slides. The audience must put on and take off HMDs frequently every time they switch from common presentation media to VR and back. In a such a one-to-many VR scenario, it is challenging for presenters to explore the process of multiple people coming back from the virtual to the physical world at once. Direct communication may be constrained while VR users are wearing an HMD. Presenters need a tool to indicate them to stop the VR session and switch back to the slide presentation. Virtual visual cues can help presenters or other external entities (e.g., automated/scripted events) to request VR users to end a VR session. Such transitions become part of the overall experience of the audience and thus must be considered. This paper explores visual cues as outro-transitions from a virtual world back to the physical world and their utility to enable presenters to request VR users to end a VR session. We propose and investigate eight transition techniques. We focus on their usage in short consecutive VR experiences and include both established and novel techniques. The transition techniques are evaluated within a user study to draw conclusions on the effects of outro-transitions on the overall experience and presence of participants. We also take into account how long an outro-transition may take and how comfortable our participants perceived the proposed techniques. The study points out that they preferred non-interactive outro-transitions over interactive ones, except for a transition that allowed VR users to communicate with presenters. Furthermore, we explore the presenter-VR user relation within a presentation scenario that uses short VR experiences. The study indicates involving presenters that can stop a VR session was not only negligible but preferred by our participants.

scholarly journals Real-World Experience of the One-Year Efficacy of Rifaximin Add-On to Lactulose Is Superior to Lactulose Alone in Patients with Cirrhosis Complicated with Recurrent Hepatic Encephalopathy in Taiwan

2021 ◽  
Vol 11 (6) ◽  
pp. 478
Author(s):  
Ching Chang ◽  
Chien-Hao Huang ◽  
Hsiao-Jung Tseng ◽  
Fang-Chen Yang ◽  
Rong-Nan Chien
Keyword(s):  
Hepatic Encephalopathy ◽  
Real World ◽  
Ammonia Level ◽  
Decompensated Cirrhosis ◽  
Control Group ◽  
Multivariable Logistic Regression Model ◽  
Before And After ◽  
One Year ◽  
The One ◽  
Serum Ammonia

Background: Hepatic encephalopathy (HE), a neuropsychiatric complication of decompensated cirrhosis, is associated with high mortality and high risk of recurrence. Rifaximin add-on to lactulose for 3 to 6 months is recommended for the prevention of recurrent episodes of HE after the second episode. However, whether the combination for more than 6 months is superior to lactulose alone in the maintenance of HE remission is less evident. Therefore, the aim of this study is to evaluate the one-year efficacy of rifaximin add-on to lactulose for the maintenance of HE remission in Taiwan. Methods: We conducted a real-world single-center retrospective cohort study to compare the long-term efficacy of rifaximin add-on to lactulose (group R + L) versus lactulose alone (group L, control group). Furthermore, the treatment efficacy before and after rifaximin add-on to lactulose was also analyzed. The primary endpoint of our study was time to first HE recurrence (Conn score ≥ 2). All patients were followed up every three months until death, and censored at one year if still alive. Results and Conclusions: 12 patients were enrolled in group R + L. Another 31 patients were stratified into group L. Sex, comorbidity, ammonia level, and ascites grade were matched while age, HE grade, and model for end-stage liver disease (MELD) score were adjusted in the multivariable logistic regression model. Compared with group L, significant improvement in the maintenance of HE remission and decreased episodes and days of HE-related hospitalizations were demonstrated in group R + L. The serum ammonia levels were significantly lower at the 3rd and 6th month in group 1. Concerning changes before and after rifaximin add-on in group R + L, mini-mental status examination (MMSE), episodes of hospitalization, and variceal bleeding also improved at 6 and 12 months. Days of hospitalization, serum ammonia levels also improved at 6th month. Except for concern over price, no patients discontinued rifaximin due to adverse events or complications. The above results provide evidence for the one-year use of rifaximin add-on to lactulose in reducing HE recurrence and HE-related hospitalization for patients with decompensated cirrhosis.

scholarly journals Gamification and Hazard Communication in Virtual Reality: A Qualitative Study

Sensors ◽  
2021 ◽  
Vol 21 (14) ◽  
pp. 4663
Author(s):  
Janaina Cavalcanti ◽  
Victor Valls ◽  
Manuel Contero ◽  
David Fonseca
Keyword(s):  
Virtual Reality ◽  
New Technologies ◽  
Training Environment ◽  
Hazard Communication ◽  
Head Mounted Display ◽  
Compliance Behavior ◽  
Before And After ◽  
Recorded Data ◽  
The Impact ◽  
Different Levels

An effective warning attracts attention, elicits knowledge, and enables compliance behavior. Game mechanics, which are directly linked to human desires, stand out as training, evaluation, and improvement tools. Immersive virtual reality (VR) facilitates training without risk to participants, evaluates the impact of an incorrect action/decision, and creates a smart training environment. The present study analyzes the user experience in a gamified virtual environment of risks using the HTC Vive head-mounted display. The game was developed in the Unreal game engine and consisted of a walk-through maze composed of evident dangers and different signaling variables while user action data were recorded. To demonstrate which aspects provide better interaction, experience, perception and memory, three different warning configurations (dynamic, static and smart) and two different levels of danger (low and high) were presented. To properly assess the impact of the experience, we conducted a survey about personality and knowledge before and after using the game. We proceeded with the qualitative approach by using questions in a bipolar laddering assessment that was compared with the recorded data during the game. The findings indicate that when users are engaged in VR, they tend to test the consequences of their actions rather than maintaining safety. The results also reveal that textual signal variables are not accessed when users are faced with the stress factor of time. Progress is needed in implementing new technologies for warnings and advance notifications to improve the evaluation of human behavior in virtual environments of high-risk surroundings.

scholarly journals SURG-03. IMMERSIVE VIRTUAL REALITY APPLICATIONS IN NEUROSURGICAL ONCOLOGY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii461-iii461
Author(s):  
Andrea Carai ◽  
Angela Mastronuzzi ◽  
Giovanna Stefania Colafati ◽  
Paul Voicu ◽  
Nicola Onorini ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Real Time ◽  
New Technologies ◽  
Young Patients ◽  
Spatial Relationship ◽  
3D Models ◽  
Immersive Virtual Reality ◽  
Global Improvement ◽  
3D Rendering ◽  
Before And After

Abstract Tridimensional (3D) rendering of volumetric neuroimaging is increasingly been used to assist surgical management of brain tumors. New technologies allowing immersive virtual reality (VR) visualization of obtained models offer the opportunity to appreciate neuroanatomical details and spatial relationship between the tumor and normal neuroanatomical structures to a level never seen before. We present our preliminary experience with the Surgical Theatre, a commercially available 3D VR system, in 60 consecutive neurosurgical oncology cases. 3D models were developed from volumetric CT scans and MR standard and advanced sequences. The system allows the loading of 6 different layers at the same time, with the possibility to modulate opacity and threshold in real time. Use of the 3D VR was used during preoperative planning allowing a better definition of surgical strategy. A tailored craniotomy and brain dissection can be simulated in advanced and precisely performed in the OR, connecting the system to intraoperative neuronavigation. Smaller blood vessels are generally not included in the 3D rendering, however, real-time intraoperative threshold modulation of the 3D model assisted in their identification improving surgical confidence and safety during the procedure. VR was also used offline, both before and after surgery, in the setting of case discussion within the neurosurgical team and during MDT discussion. Finally, 3D VR was used during informed consent, improving communication with families and young patients. 3D VR allows to tailor surgical strategies to the single patient, contributing to procedural safety and efficacy and to the global improvement of neurosurgical oncology care.

Changes In Prothrombin And Activated Partial Thromboplastin Time During Replacement Therapy With Human Recombinant Growth Hormone In Growth Hormone Deficient Adults

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Y S Kamel
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Healthy Subjects ◽  
Recombinant Growth Hormone ◽  
Gh Replacement ◽  
Coagulation Tests ◽  
Before And After ◽  
Human Recombinant Growth Hormone ◽  
Male Patients ◽  
One Year

Abstract Introduction/Objective The aim of this study was to investigate the effects of GH administration on basic coagulation parameters: PT, aPTT and fibrinogen concentrations in adult GHD patients before and during one year of GH replacement. Methods Twenty-one adult patients with severe GHD (mean age +/- SE: 38.6 +/- 2.8 years) were included in this hospital based, prospective, interventional study. All patients were treated with rhGH for 12 months (GH dose: 0.4 mg/day for male and 0.6 mg/day for female patients). IGF-1 concentrations were determined using RIA-INEP kits. Basic coagulation tests, i.e. aPTT and fibrinogen concentrations, were measured before and after 3, 6 and 12 months of treatment with rhGH. Control values were obtained from fourteen “healthy” subjects matched by age, sex and body mass index (BMI). Results At baseline, we observed no significant differences in PT, aPTT and fibrinogen values between GHD and healthy subjects. IGF-1 concentrations increased significantly within 3 months of GH therapy (8.2 +/- 1.5 vs. 24.2 +/- 2.9 nmol/l, p &lt;0.05) and remained stable thereafter. A significant increase in PT values, which was more pronounced in female subjects, was noted after 6 and 12 months of treatment with GH. aPTT values increased significantly after 12 months of treatment only in male patients (28.8 +/- 4.6 vs. 39.7 +/- 2.1 s.; p &lt;0.05). No significant changes in fibrinogen concentrations were found during the study. Conclusion Twelve months of GH replacement therapy led to a significant increase in PT and aPTT values in adult GHD patients, while fibrinogen concentrations did not change. Changes in PT were more pronounced in female GHD patients, while an increase in aPTT values was observed only in male patients with GHD. The clinical significance of these changes needs further evaluation.

scholarly journals 19 Colectomy Rate for Moderate to Severe Ulcerative Colitis with Biologics

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J W H Koh ◽  
C H Ng ◽  
M H Lee ◽  
Y H Chin ◽  
Z H Ong ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Current Literature ◽  
Biologic Therapy ◽  
Meta Analysis ◽  
Severe Ulcerative Colitis ◽  
Before And After ◽  
Arcsine Transformation ◽  
One Year

Abstract Introduction Biologics are recommended by both the ACG and ECCO community for the treatment of ulcerative colitis. Yet, current literature has yet to estimate the rate of colectomies after biologic therapy, and thus a pooled meta-analysis was conducted the rate of colectomies in 1month, 6 months, 1 year, 2years and five years after biologics. Method Medline and Embase were searched for articles examining biologics use in moderate to severe UC or acute severe UC (ASUC) from inception to 21st May 2020. Analysis of proportions were undertaken after a freeman-tukey double arcsine transformation. Results The pooled overall colectomy rates of ASUC and moderate to severe UC were 9% (CI: 4% - 14%) at one month, 18% (CI: 13% - 25%) at six months, 21% (CI:16% - 27%) at one year, 29% (CI:24% - 34%) at two years and 38% (CI:30% - 45%) at five years. Additionally, colectomy rates were consistently lower comparing between articles before and after 2010. At one-year, overall colectomy rate following infliximab use was at 25%, golimumab at 15%, vedolizumab at 14%, and adalimumab at 3%. Conclusions Colectomy rates in the era of biologics ranged from 8% to 38% and lower post-2010 showing significant improvement in management and supporting the utility of biologics in Ulcerative colitis management.

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