scholarly journals Virtual Reality-based Vision Therapy Versus OBVAT in the Treatment of Convergence Insufficiency, Accommodative Dysfunction: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Shijin Li ◽  
Angcang Tang ◽  
Bi Yang ◽  
Jianglan Wang ◽  
Longqian Liu
Keyword(s):  
Virtual Reality ◽  
Young Adults ◽  
Therapy Group ◽  
Controlled Trial ◽  
Additional Treatment ◽  
Convergence Insufficiency ◽  
Significant Difference ◽  
Clinical Trials Registry ◽  
Vision Therapy ◽  
Accommodative Facility

Abstract Background: Virtual reality is being increasingly applied in vision therapy. However, the differences in effectiveness, optimal treatment cycle, and prognosis between virtual reality-based vision therapy and traditional therapies remain unknown. The purpose of this study was to compare the effectiveness of virtual reality-based vision therapy and office-based vergence/accommodative therapy in young adults with convergence insufficiency or accommodative dysfunction.Methods: The patients were randomly assigned to either the virtual reality-based vision therapy group or the office-based vergence/accommodative therapy group. The vision therapy lasted 12 weeks (1 h/week) in both groups. Binocular visual functions (vergence and accommodation) were measured and a subjective questionnaire-based assessment was performed at baseline and after 6 and 12 weeks of therapy.Results: In total, 33 patients with convergence insufficiency and 30 with accommodative dysfunction completed the study. After 12 weeks of treatment for convergence insufficiency, the Convergence Insufficiency Symptom Survey score (F2,31 = 13.704, P < 0.001), near point of convergence (F2,31 = 21.774, P < 0.001), positive fusional vergence (F2,31 = 71.766, P< 0.001), and near horizontal phoria (F2,31 = 16.482, P < 0.001) improved significantly in both groups. Moreover, the monocular accommodative amplitude (F2,25 = 22.154, P < 0.001) and monocular accommodative facility (F2,25 = 86.164, P < 0.001) improved significantly in both groups after 12 weeks of treatment. A statistically significant difference was observed in monocular accommodative facility (F1,25 = 8.140, P = 0.009) between the two groups, but not in other vergence and accommodative functions (0.098 < P < 0.687).Conclusion: Virtual reality-based vision therapy significantly improved binocular vision functions and symptoms in patients with convergence insufficiency and accommodative dysfunction, thereby suggesting its effectiveness as a new optional or additional treatment for young adults with these conditions.Trial registration: This study was registered at the Chinese Clinical Trials Registry on 16/04/2019 (identifier: ChiCTR1900022556).

scholarly journals Sitagliptin on carotid intima-media thickness in type 2 diabetes and hyperuricemia patients: a subgroup analysis of the PROLOGUE study

2021 ◽  
Vol 12 ◽  
pp. 204062232110269
Author(s):  
Yipin Zhao ◽  
Huawei Wang ◽  
Dazhi Ke ◽  
Wei Deng ◽  
Yingying Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Carotid Artery ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Controlled Trial ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Significant Difference

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.

scholarly journals Effects of Personal Low-Frequency Stimulation Device on Myalgia: A Randomized Controlled Trial

2022 ◽  
Vol 19 (2) ◽  
pp. 735
Author(s):  
Yong-Soon Yoon ◽  
Myoung-Hwan Ko ◽  
Il-Young Cho ◽  
Cheol-Su Kim ◽  
Johny Bajgai ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Short Form ◽  
Therapy Group ◽  
Controlled Trial ◽  
Low Frequency ◽  
Control Group ◽  
Mcgill Pain Questionnaire ◽  
Low Frequency Stimulation ◽  
Significant Difference ◽  
Frequency Stimulation

Electrotherapy is commonly used for myalgia alleviation. Low-frequency stimulation (LFS) is primarily used for controlling acute and chronic pain and is a non-invasive therapy that can be easily performed with electric stimulation applied on the skin. However, little evidence exists regarding the pain alleviation effects of personal low-frequency stimulation device for home use. Moreover, no studies have compared myalgia alleviation effects between personal low-frequency stimulation (PLS) and physical therapy (PT), which are most commonly used for patients with myalgia in hospitals and clinics. Therefore, we aimed to investigate the pain alleviation effects of PLS in patients with myalgia and compare these effects with those of conventional PT (transcutaneous electrical nerve stimulation + ultrasound). In total, 39 patients with myalgia in the neck, shoulder, back, and waist areas were randomly assigned to the personal low-frequency stimulation group (PLSG: n = 20) and physical therapy group (PTG: n = 19). Both groups were treated for 3 weeks (20 min per session and 5 sessions per week). Patients were assessed for pain intensity by surface electromyography (sEMG), visual analogue scale (VAS) and a short-form McGill pain questionnaire (SF-MPQ) before and after the intervention period. Our results showed that PLSG showed a tendency of muscle relaxation with a significant decrease in sEMG in the neck (p = 0.0425), shoulder (p = 0.0425), and back (p = 0.0046) areas compared to the control group. However, there was no significant difference in waist area. Additionally, VAS scores significantly decreased between pre- and post-treatment in both PTG (p = 0.0098), and PLSG (p = 0.0304) groups, but there was no significance difference between the groups. With respect to SF-MPQ, the PLSG showed greater pain alleviation (5.23 ± 0.25) effects than the PTG (6.23 ± 0.25). Accordingly, our results suggest that PLS treatment using a home device might offer positive assistance in pain alleviation for patients with myalgia that is as equally effective as conventional PT treatment. However, further detailed studies are required considering larger samples to fully claim the effectiveness of this device.

scholarly journals Efficacy and Safety of an Herbal Therapy in Patients with Amnestic Mild Cognitive Impairment: A 24-Week Randomized Phase III Trial

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Jinzhou Tian ◽  
Jing Shi ◽  
Tao Li ◽  
Lin Li ◽  
Zhiliang Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Therapy Group ◽  
Controlled Trial ◽  
Amnestic Mild Cognitive Impairment ◽  
Phase Iii ◽  
Disease Assessment ◽  
Herbal Therapy ◽  
Modest Improvement ◽  
Significant Difference

Objective. In the 24-week randomized, double-blind, double-placebo, parallel-controlled trial, we aimed to test the effects of herbal therapy with amnestic mild cognitive impairment (aMCI). Methods. A total of 324 patients with aMCI entered a 2-week placebo run-in period followed by 24 weeks’ treatment of either (a) herbal capsule (5 shenwu capsules/administration, 3 times/day) and placebo identical to donepezil tablets (n=216) or (b) donepezil (5 mg/day) and placebo identical to herbal capsule (n=108). Results. Herbal therapy showed a significant improvement on the primary efficacy measure, measured by Alzheimer Disease Assessment Scale-cognitive subscale (ADAS-cog), and showed a mean decrease from baseline of 4.23 points at the endpoint, without a significant difference from the donepezil group. Secondary efficacy measurement of the Logical Memory II Delayed Story Recall subtest (DSR) showed modest improvement in those taking herbal capsule compared to baseline, and there was no significant difference from donepezil group. The frequency of adverse events was much less in the herbal therapy group than the donepezil. Conclusion. Herbal therapy demonstrated a significant improvement in cognition and memory, which were similar to the donepezil in patients with aMCI. Herbal therapy was safe and well tolerated. Trial Registration. This study is registered with clinicaltrials.gov NCT01451749.

scholarly journals A Brief Intervention to Increase Uptake and Adherence of an Internet-Based Program for Depression and Anxiety (Enhancing Engagement With Psychosocial Interventions): Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Philip J Batterham ◽  
Alison L Calear ◽  
Matthew Sunderland ◽  
Frances Kay-Lambkin ◽  
Louise M Farrer ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Psychosocial Interventions ◽  
P Uptake ◽  
Depression And Anxiety ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Difference ◽  
Clinical Trials Registry

BACKGROUND Psychosocial, self-guided, internet-based programs are effective in treating depression and anxiety. However, the community uptake of these programs is poor. Recent approaches to increasing engagement (defined as both uptake and adherence) in internet-based programs include brief engagement facilitation interventions (EFIs). However, these programs require evaluation to assess their efficacy. OBJECTIVE The aims of this hybrid implementation effectiveness trial are to examine the effects of a brief internet-based EFI presented before an internet-based cognitive behavioral therapy self-help program (<i>myCompass 2</i>) in improving engagement (uptake and adherence) with that program (primary aim), assess the relative efficacy of the <i>myCompass 2</i> program, and determine whether greater engagement was associated with improved efficacy (greater reduction in depression or anxiety symptoms) relative to the control (secondary aim). METHODS A 3-arm randomized controlled trial (N=849; recruited via social media) assessed the independent efficacy of the EFI and <i>myCompass 2</i>. The <i>myCompass 2</i> program was delivered with or without the EFI; both conditions were compared with an attention control condition. The EFI comprised brief (5 minutes), tailored audio-visual content on a series of click-through linear webpages. RESULTS Uptake was high in all groups; 82.8% (703/849) of participants clicked through the intervention following the pretest survey. However, the difference in uptake between the EFI + <i>myCompass 2</i> condition (234/280, 83.6%) and the <i>myCompass 2</i> alone condition (222/285, 77.9%) was not significant (n=565; <i>χ</i><sup>2</sup><sub>1</sub>=29.2; <i>P=</i>.09). In addition, there was no significant difference in the proportion of participants who started any number of modules (1-14 modules) versus those who started none between the EFI + <i>myCompass 2</i> (214/565, 37.9%) and the <i>myCompass 2</i> alone (210/565, 37.2%) conditions (n=565; <i>χ</i><sup>2</sup><sub>1</sub><0.1; <i>P=</i>.87). Finally, there was no significant difference between the EFI + <i>myCompass 2</i> and the <i>myCompass 2</i> alone conditions in the number of modules started (<i>U</i>=39366.50; <i>z</i>=−0.32; <i>P=</i>.75) or completed (<i>U</i>=39494.0; <i>z</i>=−0.29; <i>P=</i>.77). The <i>myCompass 2</i> program was not found to be efficacious over time for symptoms of depression (<i>F</i><sub>4,349.97</sub>=1.16; <i>P=</i>.33) or anxiety (<i>F</i><sub>4,445.99</sub>=0.12; <i>P=</i>.98). However, planned contrasts suggested that <i>myCompass 2</i> may have been effective for participants with elevated generalized anxiety disorder symptoms (<i>F</i><sub>4,332.80</sub>=3.50; <i>P=</i>.01). CONCLUSIONS This brief internet-based EFI did not increase the uptake of or adherence to an existing internet-based program for depression and anxiety. Individuals’ motivation to initiate and complete internet-based self-guided interventions is complex and remains a significant challenge for self-guided interventions. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12618001565235; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375839

scholarly journals Effects of Caloric Restriction and Rope-Skipping Exercise on Cardiometabolic Health: A Pilot Randomized Controlled Trial in Young Adults

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3222
Author(s):  
Zhaoxie Tang ◽  
Yingan Ming ◽  
Miao Wu ◽  
Jiajia Jing ◽  
Suhua Xu ◽  
...  
Keyword(s):  
Young Adults ◽  
Body Fat ◽  
Calorie Restriction ◽  
Controlled Trial ◽  
Interleukin 8 ◽  
Inflammatory Factors ◽  
Cardiometabolic Health ◽  
Model Assessment ◽  
Significant Difference ◽  
Rope Skipping

The aim of this study is to investigate the effects of calorie restriction (CR), rope-skipping (RS) exercise, and their joint effects on cardiometabolic health in young adults. An 8-week randomized trial was conducted on 46 undergraduates aged 19–21 y from South China. The participants were randomized into the following three groups: Calorie restriction (CR) group (n = 14), Rope-skipping (RS) group (n = 14), and CR plus RS (CR–RS) group (n = 12). At both allocation and the end of the intervention, data on anthropometry, serum metabolic, and inflammatory markers were collected. A total of 40 participants completed the intervention and were included in the analysis. After the 8-week intervention, the participants from the CR group and the CR–RS group reduced in body weight (−1.1 ± 1.7 kg, −1.3 ± 2.0 kg), body mass index (−0.4 ± 0.6 kg/m2, −0.5 ± 0.7 kg/m2), body fat percentage (−1.2 ± 1.6%, −1.7 ± 1.8%), and body fat mass (−1.1 kg (−2.2, −0.3), −1.1 kg (−2.5, −0.4)) compared to the baseline (p < 0.05 or p = 0.051). For metabolic and inflammatory factors, the participants in the CR–RS group showed significant decreases in low density lipoprotein cholesterol (−0.40 mmol/L) and interleukin-8 (−0.73 mmol/L). While all the above markers showed no significant difference among the groups after intervention, in the subgroup of overweight/obese participants (n = 23), the CR–RS group had significantly lower blood pressure, fasting insulin, homeostatic model assessment of insulin resistance, tumor necrosis factor-α, and interleukin-8 levels than the CR or RS groups (p < 0.05). In conclusion, both CR and CR–RS could reduce weight and improve body composition in young adults. More importantly, in those with overweight or obesity, CR–RS intervention might be superior to either CR or RS in improving cardiometabolic health.

scholarly journals Effects Of Home-Based Convergence Insufficiency Vision Therapy On Accommodation Among School Going Children

2020 ◽  
Vol 7 (06) ◽  
pp. 4848-4853
Author(s):  
Andrew Wekesa ◽  
Mazximila Wanzala
Keyword(s):  
Mean Value ◽  
Mean Values ◽  
Convergence Insufficiency ◽  
Home Based ◽  
Before And After ◽  
The Mean ◽  
Home Based Therapy ◽  
Vision Therapy ◽  
The Town ◽  
Accommodative Facility

Effects of home-based convergence insufficiency vision therapy on accommodation among school going children Wekesa Andrew1, Wanzala Maximilla1 1Masinde Muliro University of Science and Technology Kakamega, Kenya.   Abstract Background: Convergence and accommodation are always yoked together and any adjustment on the former affects the later. The most effective treatment for convergence insufficiency (CI) is vision therapy. Aim/Purpose: To determine the effects of home-based vision therapy on accommodation in school-going with CI attending the Masinde Muliro University Academic Vision Center in Kenya. Methods: A clinical experimental design involving 23 participants with the mean age of 14±2.4 years, were recruited into the study, however, only 18 were assessed after the therapy. The study took 9 weeks thus majority lost contact while others moved out of the town. Home-based vision therapy which is undertaken at home using a pencil or broke strings. During the therapy, accommodative values were monitored which were; negative relative accommodation, positive relative accommodation, dynamic accommodation, accommodative facility and near point of accommodation. Paired t-test used to compare mean values before and after the therapy. Results: The mean value of negative relative accommodation (NRA) before (mention what the mean values were here) and after (mention what the mean values were here) home-based therapy was statistically significant (p=0.01). However, the mean values before and after home-based therapy for the near point of accommodation (NPA), dynamic (Lag), relativity (PRA) and facility (MAF) showed no difference (p> 0.05). The mean value of the NRA before and after office-based vision therapy was statistically significant (p=0.01). Conclusion: The use of home-based vision therapy for the patients with CI had significant effects on accommodation changing from a lower limit to average after the therapy.   Keywords: Convergence insufficiency, Accommodation, Home-based vision therapy.

P-750 Clinical efficacy of virtual reality for acute pain and anxiety management during outpatient hysteroscopy and endometrial biopsy in subfertile patients

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
V Schutyser ◽  
R Buyl ◽  
M De Vos ◽  
H Tournaye ◽  
C Blockeel
Keyword(s):  
Virtual Reality ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Cochrane Review ◽  
Endometrial Biopsy ◽  
Cognitive Capacity ◽  
Control Group ◽  
Preliminary Results ◽  
Pain Scores ◽  
Significant Difference

Abstract Study question Does the use of virtual reality (VR) headsets in diagnostic office hysteroscopy (HSC) with endometrial biopsy (EB) reduce anxiety and pain scores in the patient? Summary answer Virtual reality during office HSC do not seem to improve relaxation, anxiety, or pain scores. Physicians have a good perception of patients’ pain. What is known already Women undergoing outpatient HSC experience high levels of preoperative anxiety, which increase pain and discomfort during the procedure. The experience of pain is a complex phenomenon, which simultaneously occurs on cognitive, emotional, and behavioural levels, and is influenced by many factors. A Cochrane review failed to show a significant difference between different types of pain relief (analgesics, local anaesthetic and verbal support techniques …). VR is a multisensory immersion providing an interactive high level distraction, occupying a large portion of humans’ finite attentional resources (vision and audio), and leaving less cognitive capacity available to process pain. Study design, size, duration The sample size for this prospective randomized controlled trial was calculated at 196 patients (98 per group), considering a power of at least 80% to detect superiority of adding a VR headset versus standard care, standard deviation (SD = 2.0), using a two-sided, t-test, at significance level alpha of 0.05. The preliminary results after 1 month include a sample of 48 patients 25 in the VR group and 23 controls. Participants/materials, setting, methods All 48 patients suffer subfertility and underwent HSC with EB at our tertiary-care fertility center. We used Oncomfort®, a commercially available VR autohypnosis relaxation program designed for perioperative settings. The headmounted smartphone display with headphones provides image sound distraction with suggestive hypnosis techniques incorporated. Before and immediately after the exam, both patients and surgeons fill out a questionnaire using the 10.0cm visual analog scale (VAS). Main results and the role of chance The mean duration of HSC was 3min43sec in the VR group, (range 2-6min), compared to 4min50 in the control group (range 1-12minutes), which was not significantly different (p = 0.09). Subjective variables of stress, anxiety and pain were evaluated at four different time points, i.e. before, during, immediately after HSC and one week later. According to VAS, stress levels did not differ significantly (p &gt; 0.05) between the VR group and the control group, or within time 5.08 to 5.36 to 3.08 vs 4.48 to 4.83 to 2.48 before, during and after HSC respectively. Fear levels prior to HSC at 4.28 for VR patients and 3.52 for controls did not increase significantly during HSC in both groups: 4.44 vs 4.17. During HSC, pain levels increased from 1.40 to 4.720 in the VR group vs 0.65 to 4.109 (NS) in the controls, to decrease again afterwards to 2.60 vs 2.17 (NS) respectively. Physicians rated the average pain levels of VR patients as 3.32 compared to 3.0 for controls, which was significantly correlated to patients’ perception (p &lt; 0,005). Patients gave a positive rating to the VR experience (satisfaction score 7.17). Limitations, reasons for caution These are preliminary results, evaluating only a fourth of the required sample. A population selection bias could exist, as recruited patients were willing to accept VR. The very short induction period of 2 minutes could influence the effect of (immersiveness into) VR. Wider implications of the findings Pain management in ambulatory procedures should be multimodal and should include both pharmacological and non-pharmacological interventions. Introducing VR might increase patient tolerance for longer or more painful procedures. Offering a range of options will increase the spectrum of successful procedures in the outpatient setting and improve patient experience. Trial registration number B.U.N. 1432020000050

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