Use of Virtual Reality to Improve the Quality of the Hospital Stay for Patients in Neurosurgery

Background: Virtual Reality (VR) technologies have numerous beneficial applications for patients during hospitalization (through complete immersion in a virtual, distant place allowing to “escape” from the context of hospitalization). Their positive effects in pain and anxiety management, neurorehabilitation and psychotherapy have been demonstrated. Here, we evaluated the effects of VR on the quality of hospitalization and postoperative pain after neurosurgery.Methods: Patients hospitalized in our department between 2019 and 2020 were prospectively enrolled and divided into a group that received a personal, 30-minutes-long, VR session using an Oculus Go ™ VR headset (VR group) or not (non-VR group). Surgeries were classified in simple or complex spinal and simple or complex cranial. Patient‘s overall satisfaction was considered as primary outcome, with secondary outcomes encompassing duration of hospitalization, pain reduction and patients’ opinion regarding VR.Results: 161 patients were enrolled (77 in the VR group and 84 in the non-VR group). There was no statistical difference between the two groups regarding satisfaction. The VR group presented with a significantly longer duration of hospitalization and higher maximal pain. Interestingly, pain reduction during hospitalization was significantly higher in the VR group, particularly in simple surgeries and spine surgeries. A vast majority of the VR group patients appreciated their VR experience (89.2%) and advocated for its systematic use (83.8%).Conclusion: VR can improve pain reduction during hospitalization after neurosurgery, particularly for simple spine surgeries. Furthermore, patients experiencing VR appear to appreciate it and advocate for its systematic use in neurosurgery. Further research is warranted to identify patients for whom addition of VR during hospitalization might bring the most benefit.

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Maintaining musculoskeletal health using a behavioural therapy approach: a population-based randomised controlled trial (the MAmMOTH Study)

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-219091 ◽

2021 ◽

pp. annrheumdis-2020-219091 ◽

Cited By ~ 1

Author(s):

Gary J Macfarlane ◽

Marcus Beasley ◽

Neil Scott ◽

Huey Chong ◽

Paul McNamee ◽

...

Keyword(s):

Quality Of Life ◽

High Risk ◽

Primary Outcome ◽

Population Based ◽

Behavioural Therapy ◽

Short Course ◽

Life Years ◽

Secondary Outcomes ◽

Randomised Controlled

ObjectiveCognitive–behavioural therapy (CBT) has been shown to be effective in the management of chronic widespread pain (CWP); we now test whether it can prevent onset among adults at high risk.MethodsA population-based randomised controlled prevention trial, with recruitment through UK general practices. A mailed screening questionnaire identified adults at high risk of CWP. Participants received either usual care (UC) or a short course of telephone CBT (tCBT). The primary outcome was CWP onset at 12 months assessed by mailed questionnaire. There were seven secondary outcomes including quality of life (EuroQol Questionnaire-five dimensions-five levels/EQ-5D-5L) used as part of a health economic assessment.Results996 participants were randomised and included in the intention-to-treat analysis of which 825 provided primary outcome data. The median age of participants was 59 years; 59% were women. At 12 months there was no difference in the onset of CWP (tCBT: 18.0% vs UC: 17.5%; OR 1.05; 95% CI 0.75 to 1.48). Participants who received tCBT were more likely to report better quality of life (EQ-5D-5L utility score mean difference 0.024 (95% CI 0.009 to 0.040)); and had 0.023 (95% CI 0.007 to 0.039) more quality-adjusted life-years at an additional cost of £42.30 (95% CI −£451.19 to £597.90), yielding an incremental cost-effectiveness ratio of £1828. Most secondary outcomes showed significant benefit for the intervention.ConclusionsA short course of tCBT did not prevent onset of CWP in adults at high risk, but improved quality of life and was cost-effective. A low-cost, short-duration intervention benefits persons at risk of CWP.Trial registration numberClinicalTrials.gov Registry (NCT02668003).

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A Virtual Reality-Based Self-Help Intervention for Dealing with the Psychological Distress Associated with the COVID-19 Lockdown: An Effectiveness Study with a Two-Week Follow-Up

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158188 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8188

Author(s):

Giuseppe Riva ◽

Luca Bernardelli ◽

Gianluca Castelnuovo ◽

Daniele Di Lernia ◽

Cosimo Tuena ◽

...

Keyword(s):

Virtual Reality ◽

Psychological Distress ◽

Outcome Measures ◽

Perceived Stress ◽

Social Connectedness ◽

Primary Outcome ◽

Post Intervention ◽

Stress Levels ◽

Secondary Outcomes

The aim of this study is to investigate the effectiveness of a novel self-administered at-home daily virtual reality (VR)-based intervention (COVID Feel Good) for reducing the psychological burden experienced during the COVID-19 lockdown in Italy. A total of 40 individuals who had experienced at least two months of strict social distancing measures followed COVID Feel Good between June and July 2020 for one week. Primary outcome measures were depression, anxiety, and stress symptoms, perceived stress levels, and hopelessness. Secondary outcomes were the experienced social connectedness and the level of fear experienced during the COVID-19 pandemic. Linear mixed-effects models were fitted to evaluate the effectiveness of the intervention. Additionally, we also performed a clinical change analysis on primary outcome measures. As concerning primary outcome measures, participants exhibited improvements from baseline to post-intervention for depression levels, stress levels, general distress, and perceived stress (all p < 0.05) but not for the perceived hopelessness (p = 0.110). Results for the secondary outcomes indicated an increase in social connectedness from T0 to T1 (p = 0.033) but not a significant reduction in the perceived fear of coronavirus (p = 0.412). Among these study variables, these significant improvements were maintained from post-intervention to the 2-week follow-up (p > 0.05). Results indicated that the intervention was associated with good clinical outcomes, low-to-no risks for the treatment, and no adverse effects or risks. Globally, evidence suggests a beneficial effect of the proposed protocol and its current availability in 12 different languages makes COVID Feel Good a free choice for helping individuals worldwide to cope with the psychological distress associated with the COVID-19 crisis, although large scale trials are needed to evaluate its efficacy.

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Frailty and the Kidney Transplant Wait List: Protocol for a Multicenter Prospective Study

Canadian Journal of Kidney Health and Disease ◽

10.1177/2054358120957430 ◽

2020 ◽

Vol 7 ◽

pp. 205435812095743

Author(s):

Karthik K. Tennankore ◽

Lakshman Gunaratnam ◽

Rita S. Suri ◽

Seychelle Yohanna ◽

Michael Walsh ◽

...

Keyword(s):

Quality Of Life ◽

Kidney Transplant ◽

Repeated Measures ◽

Primary Outcome ◽

Frailty Index ◽

Wait List ◽

Relative Hazard ◽

Risk Of Death ◽

Secondary Outcomes

Background: Understanding how frailty affects patients listed for transplantation has been identified as a priority research need. Frailty may be associated with a high risk of death or wait-list withdrawal, but this has not been evaluated in a large multicenter cohort of Canadian wait-listed patients. Objective: The primary objective is to evaluate whether frailty is associated with death or permanent withdrawal from the transplant wait list. Secondary objectives include assessing whether frailty is associated with hospitalization, quality of life, and the probability of being accepted to the wait list. Design: Prospective cohort study. Setting: Seven sites with established renal transplant programs that evaluate patients for the kidney transplant wait list. Patients: Individuals who are being considered for the kidney transplant wait list. Measurements: We will assess frailty using the Fried Phenotype, a frailty index, the Short Physical Performance Battery, and the Clinical Frailty Scale at the time of listing for transplantation. We will also assess frailty at the time of referral to the wait list and annually after listing in a subgroup of patients. Methods: The primary outcome of the composite of time to death or permanent wait-list withdrawal will be compared between patients who are frail and those who are not frail and will account for the competing risks of deceased and live donor transplantation. Secondary outcomes will include number of hospitalizations and length of stay, and in a subset, changes in frailty severity over time, change in quality of life, and the probability of being listed. Recruitment of 1165 patients will provide >80% power to identify a relative hazard of ≥1.7 comparing patients who are frail to those who are not frail for the primary outcome (2-sided α = .05), whereas a more conservative recruitment target of 624 patients will provide >80% power to identify a relative hazard of ≥2.0. Results: Through December 2019, 665 assessments of frailty (inclusive of those for the primary outcome and all secondary outcomes including repeated measures) have been completed. Limitations: There may be variation across sites in the processes of referral and listing for transplantation that will require consideration in the analysis and results. Conclusions: This study will provide a detailed understanding of the association between frailty and outcomes for wait-listed patients. Understanding this association is necessary before routinely measuring frailty as part of the wait-list eligibility assessment and prior to ascertaining the need for interventions that may modify frailty. Trial Registration: Not applicable as this is a protocol for a prospective observational study.

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Restarting antiplatelet therapy after spontaneous intracerebral hemorrhage

Neurology ◽

10.1212/wnl.0000000000005742 ◽

2018 ◽

Vol 91 (1) ◽

pp. e26-e36 ◽

Cited By ~ 6

Author(s):

Ching-Jen Chen ◽

Dale Ding ◽

Thomas J. Buell ◽

Fernando D. Testai ◽

Sebastian Koch ◽

...

Keyword(s):

Quality Of Life ◽

Intracerebral Hemorrhage ◽

Functional Outcomes ◽

Primary Outcome ◽

Modified Rankin Scale ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Secondary Outcomes

ObjectiveTo compare the functional outcomes and health-related quality of life metrics of restarting vs not restarting antiplatelet therapy (APT) in patients presenting with intracerebral hemorrhage (ICH) in the ERICH (Ethnic/Racial Variations of Intracerebral Hemorrhage) study.MethodsAdult patients aged 18 years and older who were on APT before ICH and were alive at hospital discharge were included. Patients were dichotomized based on whether or not APT was restarted after hospital discharge. The primary outcome was a modified Rankin Scale score of 0–2 at 90 days. Secondary outcomes were excellent outcome (modified Rankin Scale score 0–1), mortality, Barthel Index, and health status (EuroQol–5 dimensions [EQ-5D] and EQ-5D visual analog scale scores) at 90 days.ResultsThe APT and no APT cohorts comprised 127 and 732 patients, respectively. Restarting APT was associated with lower rates of good functional outcome (36.5% vs 40.8%; p = 0.021) and lower Barthel Index scores at 90 days (p = 0.041). The 2 cohorts were then matched in a 1:1 ratio, and the matched cohorts each comprised 107 patients. No difference in primary outcome was observed between restarting vs not restarting APT (35.5% vs 43.9%; p = 0.105). There were also no differences between the secondary outcomes of the 2 cohorts.ConclusionRestarting APT in patients with ICH of mild to moderate severity after acute hospitalization is not associated with worse functional outcomes or health-related quality of life at 90 days. In patients with significant cardiovascular risk factors who experience an ICH, restarting APT remains the decision of the treating practitioner.

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PROFAST: A Randomized Trial Assessing the Effects of Intermittent Fasting and Lacticaseibacillus rhamnosus Probiotic among People with Prediabetes

Nutrients ◽

10.3390/nu12113530 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3530

Author(s):

Audrey Tay ◽

Hannah Pringle ◽

Elise Penning ◽

Lindsay D. Plank ◽

Rinki Murphy

Keyword(s):

Weight Loss ◽

Primary Outcome ◽

Synergistic Effects ◽

Gut Hormones ◽

Group Differences ◽

Intermittent Fasting ◽

Psychological Benefits ◽

Secondary Outcomes ◽

Double Blinded

Both intermittent fasting and specific probiotics have shown promise in improving glucose tolerance with a potential for synergistic effects through alterations to gut microbiota. In this randomized, double-blinded, two-arm feasibility study, we investigated whether intermittent fasting, supplemented with Lacticaseibacillus rhamnosus HN001 probiotic, reduces HbA1c in individuals with prediabetes. All participants with HbA1c 40–50 mmol/mol commenced intermittent fasting (2 days per week of calorie restriction to 600–650 kcal/day) and were randomized 1:1 to either daily probiotic (Lacticaseibacillus rhamnosus HN001) or placebo for 12 weeks. The primary outcome was a change in HbA1c. Secondary outcomes included changes in anthropometry, body composition, glucoregulatory markers, lipids, hunger hormones, liver enzymes, inflammatory markers, gut hormones, calorie and macronutrient intake, quality of life, hunger, mood and eating behavior. Of 33 participants who commenced the trial, 26 participants (mean age 52 years, body mass index (BMI) 34.7 kg/m2) completed the intervention (n = 11 placebo, n = 15 probiotic). HbA1c decreased from 43 ± 2.7 mmol/mol to 41 ± 2.3 mmol/mol, p < 0.001, with average of 5% weight loss. No significant between-group differences were seen in primary or secondary outcomes except for social functioning (p = 0.050) and mental health (p = 0.007) scores as improvements were seen in the probiotic group, but not in the placebo group. This study shows additional psychological benefits of probiotic supplementation during intermittent fasting to achieve weight loss and glycemic improvement in prediabetes.

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Effect of acupuncture on lung cancer-related fatigue: study protocol for a multi-center randomized controlled trial

Trials ◽

10.1186/s13063-019-3701-0 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Zhaoqin Wang ◽

Shanshan Li ◽

Luyi Wu ◽

Qin Qi ◽

Huirong Liu ◽

...

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Primary Outcome ◽

Acupuncture Treatment ◽

Acupuncture Group ◽

Randomized Controlled ◽

Link Type ◽

Cancer Related Fatigue ◽

Secondary Outcomes

Abstract Background Fatigue is one of the primary symptoms in lung cancer, with a prevalence of 88.0% in survivors of cancer, and an even higher prevalence post resection surgery. Effective fatigue control after lung cancer surgery is important for patient recovery and quality of life. Some studies have shown that acupuncture might be effective in treating cancer-related fatigue; however, randomized controlled trials (RCTs) of suitable sample size are limited. Method/design This is a multi-center, patient-blinded RCT. A total of 320 eligible patients will be recruited in four centers and randomly assigned to either the acupuncture group or the sham acupuncture group in a 1:1 ratio. Treatment will be given twice per week for 12 sessions. Treatment will be given at acupoints GV20, GV29, CV12, CV6, CV4, and bilateral LI4, LR3, SP6, ST36. The primary outcome will be assessed using the Chinese version of The Brief Fatigue Inventory. The secondary outcomes will be measured using The European Organization for Research and The Treatment of Cancer Quality of Life Questionnaire, and the Hamilton Rating Scale for Depression. The primary outcome will be assessed at all main points (baseline, the 3rd week, the 6th week, and at follow up time points) and the secondary outcomes will be assessed at baseline and the 6th week. Intention-to-treat analysis will be used in this RCT. Discussion This trial protocol provides an example of the clinical application acupuncture treatment in the management of lung cancer-related fatigue. If the acupuncture treatment protocol confirms that acupuncture is an effective and safe option for lung cancer-related fatigue, it can be adopted as a standardized treatment. Trial registration Chinese Clinical Trial Registry, ChiCTR1900022831. Registered on 27 April 2019. URL: http://www.chictr.org.cn/showproj.aspx?proj=37823

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Self-concept in poor readers: a systematic review and meta-analysis

PeerJ ◽

10.7717/peerj.8772 ◽

2020 ◽

Vol 8 ◽

pp. e8772 ◽

Cited By ~ 2

Author(s):

Genevieve M. McArthur ◽

Nicola Filardi ◽

Deanna A. Francis ◽

Mark E. Boyes ◽

Nicholas A. Badcock

Keyword(s):

Systematic Review ◽

Primary Outcome ◽

Strong Association ◽

Physical Appearance ◽

Self Concept ◽

Poor Reading ◽

Quality Of Evidence ◽

Secondary Outcomes ◽

Meta Analyses

Background The aims of this systematic review and meta-analyses were to determine if there is a statistically reliable association between poor reading and poor self-concept, and if such an association is moderated by domain of self-concept, type of reading impairment, or contextual factors including age, gender, reading instruction, and school environment. Methodology We searched 10 key databases for published and unpublished studies, as well as reference lists of included studies, and studies that cited included studies. We calculated standardised mean differences (SMDs) and 95% confidence intervals for one primary outcome (average self-concept) and 10 secondary outcomes (10 domains of self-concept). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. Results Thirteen studies with 3,348 participants met our selection criteria. Meta-analyses revealed statistically significant SMDs for average self-concept (−0.57) and five domains of self-concept (reading/writing/spelling: −1.03; academic: −0.67; math: −0.64; behaviour: −0.32; physical appearance: −0.28). The quality of evidence for the primary outcome was moderate, and for secondary outcomes was low, due to lack of data. Conclusions These outcomes suggest a probable moderate association between poor reading and average self-concept; a possible strong association between poor reading and reading-writing-spelling self-concept; and possible moderate associations between poor reading and self-concept in the self-concept domains of academia, mathematics, behaviour, and physical appearance.

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Acupuncture for tinnitus: a systematic review and meta-analysis of randomized controlled trials

Acupuncture in Medicine ◽

10.1177/0964528420938380 ◽

2020 ◽

pp. 096452842093838 ◽

Cited By ~ 1

Author(s):

Kaiyu Huang ◽

Shuang Liang ◽

Lei Chen ◽

Antoine Grellet

Keyword(s):

Randomized Controlled Trials ◽

Primary Outcome ◽

Meta Analysis ◽

Small Sample ◽

Controlled Trials ◽

Control Groups ◽

Positive Effects ◽

Randomized Controlled ◽

Vas Score ◽

Secondary Outcomes

Objective: To evaluate the efficacy/effectiveness of acupuncture for the treatment of tinnitus. Methods: Four English and four Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture for tinnitus published before 30 September 2018. RCTs applying acupuncture alone compared with conventional treatments, sham acupuncture, or no treatment, as well as acupuncture plus conventional treatments compared with conventional treatments alone, were included. The primary outcome was the visual analogue scale (VAS). Secondary outcomes included tinnitus handicap inventory (THI) and tinnitus severity index (TSI) scores. Meta-analysis was conducted using RevMan V5.3 software. The protocol was registered in the PROSPERO database (ref. CRD42018108692). Results: Eight studies involving 504 participants were included. Meta-analysis showed no significant differences in the VAS score (mean difference (MD) = −1.81, 95% confidence interval (CI) = −3.69 to 0.07; p = 0.06) between the acupuncture and control groups. However, favorable effects of acupuncture on changes in THI score (MD = −10.11, 95% CI = −12.74 to −7.48; p < 0.001) and TSI score (MD = −8.36, 95% CI = −8.87 to −7.86; p < 0.001) were found. Conclusion: Acupuncture had no significant effect on the primary outcome of VAS score compared with control treatment; however, positive effects on secondary outcomes (THI and TSI score) were observed in acupuncture versus control groups. Due to the low quality and small sample size of the included trials, the level of evidence was insufficient to draw any definitive conclusions. Further rigorous and high-quality studies with larger sample sizes should be conducted to confirm the efficacy/effectiveness of acupuncture for tinnitus.

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Virtual Reality as Analgesia

International Journal of Creative Interfaces and Computer Graphics ◽

10.4018/ijcicg.2014070105 ◽

2014 ◽

Vol 5 (2) ◽

pp. 75-86 ◽

Cited By ~ 1

Author(s):

Mark Nazemi ◽

Diane Gromala ◽

Mehdi Karamnejad

Keyword(s):

Chronic Pain ◽

Virtual Reality ◽

Pain Management ◽

Interface Design ◽

Pain Reduction ◽

Self Management ◽

Sound Design ◽

Interactive Approach ◽

Pharmacological Method

This paper introduces a multidisciplinary and interactive approach to self-management of chronic pain using Virtual Reality (VR). This approach is meant to reduce the reliance on heavy use of medication and provide a non-pharmacological method for pain management. In addition, the paper discusses additional technologies that deal with issues surrounding immersion, presence, and interface design that directly impact the quality of treatment patients can obtain through VR therapy. A set of guidelines are also included that signify the importance of using biofeedback and interactive sound design to help improve rehabilitation and meditation practices for pain reduction.

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Trends in use in a Canadian pediatric emergency department

CJEM ◽

10.2310/8000.2013.131280 ◽

2014 ◽

Vol 16 (05) ◽

pp. 405-410 ◽

Cited By ~ 9

Author(s):

Quynh Doan ◽

Emerson D. Genuis ◽

Alvis Yu

Keyword(s):

Emergency Department ◽

Patient Outcomes ◽

Primary Outcome ◽

Tertiary Care ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Ed Overcrowding ◽

Secondary Outcomes ◽

Ed Crowding

ABSTRACTIntroduction:Emergency department (ED) crowding is a significant problem in Canada and has been associated with decreased quality of care in general and pediatric emergency departments (PEDs). Although boarding of admitted patients in the ED is the main contributor to adult ED overcrowding, factors involved in PED crowding may be different. The objective of this study was to report the trend in PED services use and to document the degree of overcrowding experienced in a Canadian PED.Methods:A retrospective cohort study was conducted using administrative data from a tertiary care PED from 2002 to 2011. The primary outcome was PED use (total volume of visits and case severity per triage levels using the Canadian Triage and Acuity Scale [CTAS] score and admissions). Secondary outcomes included measures of PED overcrowding, such as rates of patients leaving without being seen (LWBS) and length of stay (LOS).Results:Total volumes increased by 30% over the 10-year study period, whereas hospitalizations remained stable at approximately 10%. Trends in CTAS levels did not indicate meaningful changes in the severity of cases treated at our PED. LWBS proportions among CTAS 3, CTAS 4, and CTAS 5 groups and LOS for all CTAS groups progressively and statistically increased from year to year.Conclusions:Over the course of the study period, there was a substantial increase in PED visits,which likely contributed to the worsening markers of PED flow outcomes. Further study into the effects of PED crowding on patient outcomes is warranted.

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