Effects of Virtual Reality-Based Physical And Psychological Exercise On Depression In Stroke Patients : A Meta-Analysis

Abstract Background: Virtual Reality (VR) has been widely used in health-related fields. The aim of this study was to assess the effectiveness of virtual reality-based physical and psychological exercise on depression.Methods: A total of 752 patients with stroke from 11 randomized controlled trial (RCT) studies were included in this meta-analysis and the studies derived from 6 electronic databases searched from database inception to August 2021. For continuous results, the standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated to synthesize the effects.Results: The meta-analysis showed that compared with control group, VR-based interventions significantly decreased the depression scale score (SMD = −0.71, 95% CI: −1.32, −0.10) in the subjects. The results showed that the the patient age and total intervention time had a significant impact on the outcome of depression. The smaller the age and longer the intervention duration, the greater the impact on the outcome of depression.Conclusions: The current meta-analysis indicated the virtual reality-based physical and psychological exercise has a significant effect on depression in stroke patients compared to controls. The study showed an outstanding reduction in depression for aged under 60 participants and intervention longer than 8 weeks. At the same time, clinical studies of different ages and different intervention time also need further in-depth study.

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Enhancing Patient Experience in Office-Based Laryngology Procedures With Passive Virtual Reality

OTO Open ◽

10.1177/2473974x20975020 ◽

2021 ◽

Vol 5 (1) ◽

pp. 2473974X2097502

Author(s):

Joseph Chang ◽

Sen Ninan ◽

Katherine Liu ◽

Alfred Marc Iloreta ◽

Diana Kirke ◽

...

Keyword(s):

Virtual Reality ◽

Local Anesthesia ◽

Controlled Trial ◽

Care Center ◽

Tertiary Care ◽

Depression Scale ◽

Control Group ◽

Procedure Time ◽

Pain Scores ◽

Distress Scale

Objectives Virtual reality (VR) has been used as nonpharmacologic anxiolysis benefiting patients undergoing office-based procedures. There is little research on VR use in laryngology. This study aims to determine the efficacy of VR as anxiolysis for patients undergoing in-office laryngotracheal procedures. Study Design Randomized controlled trial. Setting Tertiary care center. Methods Adult patients undergoing office-based larynx and trachea injections, biopsy, or laser ablation were recruited and randomized to receive standard care with local anesthesia only or local anesthesia with adjunctive VR. Primary end point was procedural anxiety measured by the Subjective Units of Distress Scale (SUDS). Subjective pain, measured using a visual analog scale, satisfaction scores, and procedure time, and baseline anxiety, measured using the Hospital Anxiety and Depression Scale (HADS), were also collected. Results Eight patients were randomized to the control group and 8 to the VR group. SUDS scores were lower in the VR group than in the control group with mean values of 26.25 and 53.13, respectively ( P = .037). Baseline HADS scores did not differ between groups. There were no statistically significant differences in pain, satisfaction, or procedure time. Average satisfaction scores in VR and control groups were 6.44 and 6.25, respectively ( P = .770). Average pain scores were 3.53 and 2.64, respectively ( P = .434). Conclusion This pilot study suggests that VR distraction may be used as an adjunctive measure to decrease patient anxiety during office-based laryngology procedures. Procedures performed using standard local anesthesia resulted in low pain scores and high satisfaction scores even without adjunctive VR analgesia. Level of Evidence 1

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Evaluating the effectiveness of interventions to reducing screen time in children: meta-analysis of randomized controlled trials

Journal of Public Mental Health ◽

10.1108/jpmh-03-2021-0039 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Duygu Akçay ◽

Nuray Barış

Keyword(s):

Effect Size ◽

Subgroup Analysis ◽

Screen Time ◽

Meta Analysis ◽

Intervention Group ◽

Evidence Base ◽

Control Group ◽

Content Type ◽

Mean Differences ◽

The Impact

Purpose The purpose of this paper is to evaluate the impact of interventions focused on reducing screen time in children. Design/methodology/approach Studies that aim to investigate the effects of interventions aimed at reducing the time spent in front of the screen (i.e. screen time). A Random-effects model was used to calculate the pooled standard mean differences. The outcome was to evaluate the screen time in children in the 0–18 age range. A subgroup analysis was performed to reveal the extent to which the overall effect size varied by subgroups (participant age, duration of intervention and follow). Findings For the outcome, the meta-analysis included 21 studies, and the standard difference in mean change in screen time in the intervention group compared with the control group was −0.16 (95% confidence interval [CI], −0.21 to −0.12) (p < 0.001). The effect size was found to be higher in long-term (=7 months) interventions and follow-ups (p < 0.05). Originality/value Subgroup analysis showed that a significant effect of screen time reduction was observed in studies in which the duration of intervention and follow-up was =7 months. As the evidence base grows, future researchers can contribute to these findings by conducting a more comprehensive analysis of effect modifiers and optimizing interventions to reduce screen time.

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The Impact of a Stabilization Exercise on Neck Pain: A Systematic Review and Meta-analysis

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0039-3400953 ◽

2020 ◽

Vol 81 (04) ◽

pp. 342-347

Author(s):

Binbin Wu ◽

Hongyan Yuan ◽

Deyu Geng ◽

Liang Zhang ◽

Cheng Zhang

Keyword(s):

Systematic Review ◽

Neck Pain ◽

Meta Analysis ◽

Neck Disability Index ◽

Depression Scale ◽

Cochrane Library ◽

Control Group ◽

Stabilization Exercise ◽

Pain Scores ◽

The Impact

Abstract Introduction The efficacy of a stabilization exercise for the relief of neck pain remains controversial. We conducted a systematic review and meta-analysis to explore the effectiveness of a stabilization exercise on neck pain. Methods We searched Embase, Web of Science, EBSCO Information Services, and the Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the impact of a stabilization exercise on neck pain. This meta-analysis was performed using the random effects model. Results Six RCTs are included in the meta-analysis. Compared with the control group of patients with neck pain, a stabilization exercise can significantly reduce pain scores at 4 to 6 weeks (mean difference [MD]: −2.41; 95% confidence interval [CI], −4.46 to −0.35; p = 0.02), Neck Disability Index [NDI] at 10 to 12 weeks (MD:− 6.75; 95% CI, −11.71 to −1.79; p = 0.008), and depression scale at 4 to 6 weeks (MD: −4.65; 95% CI, −7.00 to −2.31; p = 0.02), but it has no obvious impact on pain scores at 10 to 12 weeks (MD: −1.07; 95% CI, −3.42 to 1.28; p = 0.37) or at 6 months (MD: −1.02; 95% CI, −3.43 to 1.39; p = 0.41). Conclusions A stabilization exercise can provide some benefits to control neck pain.

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The impact of virtual reality training on laparoscopic surgical skills; A prospective blinded controlled trial

10.25083/2559.5555/6.1.7 ◽

2021 ◽

Vol 6 (1) ◽

pp. 37-42

Author(s):

Prashanth A T ◽

Nishanth Lakshmikantha ◽

Krish Lakshman

Keyword(s):

Virtual Reality ◽

Controlled Trial ◽

Skills Training ◽

Surgical Skills ◽

Simulator Training ◽

Research Centre ◽

Controlled Study ◽

Control Group ◽

The Impact ◽

Vr Simulator

Background. Laparoscopic surgery has gained popularity in the last few decades replacing open standard techniques in several procedures. While its use and scope expand, a standardized method of training and assessment in laparoscopic skills is lacking. Aim. To assess the effect of virtual reality (VR) training on laparoscopic surgical skills. Materials and Methods. It is a prospective, controlled study conducted at Sagar Hospital’s skill lab and Shanthi Hospital and Research Centre (SHRC). We included 27 post graduates in general surgery. They were divided into two groups. One group underwent training in VR Simulator for one week, 30 minutes each day. The second group received no training. Their proficiency while mobilizing the Gallbladder from its liver bed was assessed using a validated scale by a single blinded observer. Results. The statistical analysis was done using a non-parametric test (Mann-Whitney U test). Residents who underwent training in VR simulator got better scores in Overall rating and also in individual parameters when compared with the control group (P = <0.05). Conclusions. Laparoscopic surgical skills can be increased by using proficiency-based VR simulator training and it can be transferred to actual operations. VR simulators are a valid tool for laparoscopic surgical skills training.

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Impact of virtual reality anatomy training on ultrasound competency development: A randomized controlled trial

PLoS ONE ◽

10.1371/journal.pone.0242731 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0242731

Author(s):

Kai-Chun Hu ◽

Daniel Salcedo ◽

Yi-No Kang ◽

Che-Wei Lin ◽

Chin-Wang Hsu ◽

...

Keyword(s):

Virtual Reality ◽

Controlled Trial ◽

Group Analysis ◽

Intervention Group ◽

Spatial Relationship ◽

Control Group ◽

Psychomotor Skills ◽

Anatomical Structures ◽

Image Identification ◽

The Impact

Purpose The use of Virtual Reality (VR) in health professions education has increased dramatically in recent years, yet there is limited evidence of its impact on educational outcomes. The purpose of the study was to assess the impact of VR anatomy instruction on the ultrasound competency of novice learners participating in a ultrasonography workshop. Method We designed a VR-enhanced ultrasonography training program and utilized a plane transection tool to interact with a three-dimensional (3D) VR model of the human body which facilitated the 3D conceptualization of the spatial relationship of anatomical structures, leading to faster and better development of ultrasonographic competency. This was a randomized control study which enrolled third-year medical students (n = 101) without previous exposure to formal or informal ultrasonography training. The participants were randomly divided into an intervention and control group. We assessed participants’ competency through ultrasound performance stations on live subjects, we also measured anatomical and ultrasound image identification ability using multiple choice tests. Result Participants in the intervention group (median = 16; interquartile 13 to 19) had significantly higher scores in ultrasonography task performance tests than the control group (median = 10; interquartile 7 to 14; Mann-Whitney U = 595; P < 0.01). In sub-group analysis, the intervention group performed significantly better in the six out of ten ultrasound tasks. Participants in the intervention group also had greater improvement in ultrasonographic image identification MCQ tests than the control group (Mann-Whitney U = 914; P < 0.05). Conclusion This study suggests that VR-enhanced anatomical training could be of significant benefit in ultrasonography training by promoting a better understanding of the spatial relationships of anatomical structures and the development of early psychomotor skills transferable to the handling of ultrasonographic probes.

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The Impact of Immersive and Non-Immersive Virtual Reality Trends in Sensorimotor Recovery of Post-Stroke Patients-A Meta-Analysis

Journal of Intellectual Disability - Diagnosis and Treatment ◽

10.6000/2292-2598.2021.09.05.14 ◽

2021 ◽

Vol 9 (5) ◽

pp. 555-564

Author(s):

Jaza Rizvi ◽

◽

Abid Khan ◽

Sumaira Imran Farooqui ◽

Bashir Ahmed Soomro ◽

...

Keyword(s):

Virtual Reality ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Stroke Patients ◽

Post Stroke ◽

Randomized Controlled ◽

Sensorimotor Recovery ◽

The Impact

Virtual Reality (VR) is an approach in stroke rehabilitation with ever-improving technological advancement for targeted motor rehabilitation by providing a user interface in a simulated environment with proprioceptive and visual feedback. This meta-analysis intended to evaluate the impact of immersive and non-immersive VR-based interventions compared to conventional rehabilitation in sensorimotor recovery following stroke. Randomized Controlled Trials based on the impact of VR, either immersive or non-immersive type in comparison to conventional rehabilitation on post-stroke patients (>18 years) sensorimotor recovery were searched on six databases including Google Scholar, PEDro, MEDLINE, Cochrane Library, EMBASE, and Web of Science from August to November 2020. A total of 17 randomized controlled trials on VR based intervention showed significant improvement in sensorimotor recovery following a stroke in overall FMA outcomes in comparison to the control group with pool effects in terms of SMD in a random effect model showed an impact of 0.498 at 95% CI (p<0.001) depicts a moderate effect size. An immersive and non-immersive emerging VR trend appears to be a promising therapeutic tool in sensorimotor recovery following stroke.

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Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis

Journal of Medical Internet Research ◽

10.2196/16255 ◽

2020 ◽

Vol 22 (10) ◽

pp. e16255

Author(s):

Amika Shah ◽

Michael Chaiton ◽

Dolly Baliunas ◽

Robert Schwartz

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Passive Control ◽

Controlled Trial ◽

Meta Analysis ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

The Impact

Background The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. Objective The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. Methods Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. Results A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25). Conclusions The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.

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Use of Mobile Phone App Interventions to Promote Weight Loss: Meta-Analysis (Preprint)

10.2196/preprints.17039 ◽

2019 ◽

Author(s):

Md.Mohaimenul Islam ◽

Tahmina Nasrin Poly ◽

Bruno Andres Walther ◽

Yu-Chuan (Jack) Li

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Body Weight ◽

Mobile Phone ◽

Controlled Trial ◽

Meta Analysis ◽

Mobile App ◽

Control Group ◽

Promote Weight Loss ◽

The Impact

BACKGROUND Obesity and lack of physical activity are major health risk factors for many life-threatening diseases, such as cardiovascular diseases, type 2 diabetes, and cancer. The use of mobile app interventions to promote weight loss and boost physical activity among children and adults is fascinating owing to the demand for cutting-edge and more efficient interventions. Previously published studies have examined different types of technology-based interventions and their impact on weight loss and increase in physical activity, but evidence regarding the impact of only a mobile phone app on weight loss and increase in physical activity is still lacking. OBJECTIVE The main objective of this study was to assess the efficacy of a mobile phone app intervention for reducing body weight and increasing physical activity among children and adults. METHODS PubMed, Google Scholar, Scopus, EMBASE, and the Web of Science electronic databases were searched for studies published between January 1, 2000, and April 30, 2019, without language restrictions. Two experts independently screened all the titles and abstracts to find the most appropriate studies. To be included, studies had to be either a randomized controlled trial or a case-control study that assessed a mobile phone app intervention with body weight loss and physical activity outcomes. The Cochrane Collaboration Risk of Bias tool was used to examine the risk of publication bias. RESULTS A total of 12 studies involving a mobile phone app intervention were included in this meta-analysis. Compared with the control group, the use of a mobile phone app was associated with significant changes in body weight (−1.07 kg, 95% CI −1.92 to −0.21, P=.01) and body mass index (−0.45 kg/m2, 95% CI −0.78 to −0.12, P=.008). Moreover, a nonsignificant increase in physical activity was observed (0.17, 95% CI −2.21 to 2.55, P=.88). CONCLUSIONS The findings of this study demonstrate the promising and emerging efficacy of using mobile phone app interventions for weight loss. Future studies are needed to explore the long-term efficacy of mobile app interventions in larger samples.

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Use of Mobile Phone App Interventions to Promote Weight Loss: Meta-Analysis

JMIR mhealth and uhealth ◽

10.2196/17039 ◽

2020 ◽

Vol 8 (7) ◽

pp. e17039

Author(s):

Md Mohaimenul Islam ◽

Tahmina Nasrin Poly ◽

Bruno Andres Walther ◽

Yu-Chuan (Jack) Li

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Body Weight ◽

Mobile Phone ◽

Controlled Trial ◽

Meta Analysis ◽

Mobile App ◽

Control Group ◽

Promote Weight Loss ◽

The Impact

Background Obesity and lack of physical activity are major health risk factors for many life-threatening diseases, such as cardiovascular diseases, type 2 diabetes, and cancer. The use of mobile app interventions to promote weight loss and boost physical activity among children and adults is fascinating owing to the demand for cutting-edge and more efficient interventions. Previously published studies have examined different types of technology-based interventions and their impact on weight loss and increase in physical activity, but evidence regarding the impact of only a mobile phone app on weight loss and increase in physical activity is still lacking. Objective The main objective of this study was to assess the efficacy of a mobile phone app intervention for reducing body weight and increasing physical activity among children and adults. Methods PubMed, Google Scholar, Scopus, EMBASE, and the Web of Science electronic databases were searched for studies published between January 1, 2000, and April 30, 2019, without language restrictions. Two experts independently screened all the titles and abstracts to find the most appropriate studies. To be included, studies had to be either a randomized controlled trial or a case-control study that assessed a mobile phone app intervention with body weight loss and physical activity outcomes. The Cochrane Collaboration Risk of Bias tool was used to examine the risk of publication bias. Results A total of 12 studies involving a mobile phone app intervention were included in this meta-analysis. Compared with the control group, the use of a mobile phone app was associated with significant changes in body weight (−1.07 kg, 95% CI −1.92 to −0.21, P=.01) and body mass index (−0.45 kg/m2, 95% CI −0.78 to −0.12, P=.008). Moreover, a nonsignificant increase in physical activity was observed (0.17, 95% CI −2.21 to 2.55, P=.88). Conclusions The findings of this study demonstrate the promising and emerging efficacy of using mobile phone app interventions for weight loss. Future studies are needed to explore the long-term efficacy of mobile app interventions in larger samples.

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Tailored Web-Based Smoking Interventions and Reduced Attrition: Systematic Review and Meta-Analysis (Preprint)

10.2196/preprints.16255 ◽

2019 ◽

Author(s):

Amika Shah ◽

Michael Chaiton ◽

Dolly Baliunas ◽

Robert Schwartz

Keyword(s):

Systematic Review ◽

Smoking Cessation ◽

Passive Control ◽

Controlled Trial ◽

Meta Analysis ◽

Intervention Group ◽

Control Group ◽

Web Based ◽

The Impact

BACKGROUND The increasing number of internet users presents an opportunity to deliver health interventions to large populations. Despite their potential, many web-based interventions, including those for smoking cessation, face high rates of attrition. Further consideration of how intervention features impact attrition is needed. OBJECTIVE The aim of this systematic review is to investigate whether tailored web-based smoking cessation interventions for smokers are associated with reduced rates of attrition compared with active or passive untailored web-based interventions. The outcomes of interest were dropout attrition at 1-, 3-, 6-, and 12-month follow-ups. METHODS Literature searches were conducted in May 2018 and updated in May 2020 on MEDLINE (Medical Literature Analysis and Retrieval System Online), PsycINFO (Psychological Information), EMBASE (Excerpta Medica dataBASE), CINAHL (Cumulated Index to Nursing and Allied Health Literature), Scopus, and the Cochrane Tobacco Addiction Group Specialized Register with the following search terms: smoking cessation, tailored, or web- or internet-based. Included studies were published in English before or in May 2020 using a randomized controlled trial design. Studies were restricted to those with web-based delivery, a tailored intervention group, an untailored control group, and a reported outcome of smoking cessation. Studies were assessed for methodological quality using the Cochrane Risk of Bias tool. Two reviewers independently extracted the study characteristics and the number of participants lost to follow-up for each treatment group. RESULTS A total of 13 studies were included in the systematic review, of which 11 (85%) were included in the meta-analysis. Tailoring had no statistically significant effect on dropout attrition at 1-month (risk ratio [RR]=1.02, 95% CI 0.95-1.09; P=.58; I2=78%), 3-month (RR=0.99, 95% CI 0.95-1.04; P=.80; I2=73%), 6-month (RR=1.00, 95% CI 0.95-1.05; P=.90; I2=43%), or 12-month (RR=0.97, 95% CI 0.92-1.02; P=.26; I2=28%) follow-ups. Subgroup analyses suggested that there was a statistically significant effect of tailoring between the active and passive subgroups at 1-month (P=.03), 3-month (P<.001), and 6-month (P=.02) follow-ups but not at 12-month follow-up (P=.25). CONCLUSIONS The results suggest that tailoring of web-based smoking cessation interventions may not be associated with reduced rates of dropout attrition at 1-, 3-, 6-, or 12-month follow-ups. Significant differences between studies that include untailored active and passive control groups suggest that the role of tailoring may be more prominent when studies include a passive control group. These findings may be because of variability in the presence of additional features, the definition of smokers used, and the duration of smoking abstinence measured. Future studies should incorporate active web-based controls, compare the impact of different tailoring strategies, and include populations outside of the Western countries.

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