A Scoping Review of The Efficacy of Virtual Reality and Exergaming on Patients of Musculoskeletal System Disorder

To assess the effects of virtual reality on patients with musculoskeletal disorders by means of a scoping review of randomized controlled trials (RCTs). The databases included PubMed, IEEE, and the MEDLINE database. Articles involving RCTs with higher than five points on the Physiotherapy Evidence Database (PEDro) scale were reviewed for suitability and inclusion. The methodological quality of the included RCT was evaluated using the PEDro scale. The three reviewers extracted relevant information from the included studies. Fourteen RCT articles were included. When compared with simple usual care or other forms of treatment, there was significant pain relief, increased functional capacity, reduced symptoms of the disorder, and increased joint angles for the virtual reality treatment of chronic musculoskeletal disorders. Furthermore, burn patients with acute pain were able to experience a significant therapeutic effect on pain relief. However, virtual reality treatment of patients with non-chronic pain such as total knee replacement, ankle sprains, as well as those who went through very short virtual reality treatments, did not show a significant difference in parameters, as compared with simple usual care and other forms of treatment. Current evidence supports VR treatment as having a significant effect on pain relief, increased joint mobility, or motor function of patients with chronic musculoskeletal disorders. VR seems quite effective in relieving the pain of patients with acute burns as well.

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Antibiotic prophylaxis for surgical procedures: a scoping review

Revista Panamericana de Salud Pública ◽

10.26633/rpsp.2021.62 ◽

2021 ◽

Vol 45 ◽

pp. 1

Author(s):

Eva Brocard ◽

Ludovic Reveiz ◽

Jean-Philippe Régnaux ◽

Veronica Abdala ◽

Pilar Ramón-Pardo ◽

...

Keyword(s):

Antibiotic Prophylaxis ◽

Systematic Reviews ◽

Scoping Review ◽

First Generation ◽

Evidence Base ◽

Current Evidence ◽

Cochrane Library ◽

Antibiotic Administration ◽

Significant Difference ◽

Surgical Antibiotic Prophylaxis

Objectives. To map the current evidence on surgical antibiotic prophylaxis (SAP) administration and identify knowledge gaps in the literature available in this field. Methods. The PubMed, Cochrane Library, Epistemonikos, and Health Systems Evidence databases were searched from January 2015 to March 2020 for systematic reviews published in English, French, Portuguese, and Spanish. Results. Eighty-three systematic reviews were included, the quality of the reviews was assessed using AMSTAR 2, and data were extracted for all primary outcomes. Perioperative antibiotic administration, the use of first generation cephalosporins, and surgical site infection (SSI) were the most commonly reported for timing of antibiotic administration, drug class, and primary outcome, respectively. Findings showed that, overall, SAP may reduce SSIs compared with a placebo or with no SAP. Results suggested that intraoperative SAP may lower SSI, while postoperative SAP did not show a statistically significant difference. Conclusions. Findings have confirmed the role of SAP in reducing postoperative SSI across various surgeries and do not support the use of antibiotics after surgery to prevent infections. The findings of this scoping review have enhanced the evidence base that can inform decisions regarding the development of global guidelines for the prevention of SSI. However, high-quality systematic reviews and research reflecting diverse populations and settings are needed.

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Safety and effectiveness of dose-sparing strategies for seasonal influenza vaccine: a rapid scoping review of fractional dosing of the intramuscular influenza vaccine

10.1101/2020.07.31.20163717 ◽

2020 ◽

Author(s):

Jesmin Antony ◽

Patricia Rios ◽

Chantal Williams ◽

Naveeta Ramkissoon ◽

Sharon E Straus ◽

...

Keyword(s):

Influenza Vaccine ◽

Scoping Review ◽

Seasonal Influenza ◽

Clinical Effectiveness ◽

Influenza Vaccines ◽

Current Evidence ◽

Cochrane Library ◽

Full Dose ◽

Significant Difference ◽

Dose Sparing

Background: The objective of this rapid scoping review was to identify potentially safe and effective dose-sparing strategies for intramuscular administration of seasonal influenza vaccines in healthy individuals of all ages. Methods: Comprehensive literature searches were developed and executed in MEDLINE, EMBASE, and the Cochrane library, and grey literature was searched via international clinical trial registries for relevant studies published in English in the last 20 years. References of relevant systematic reviews and included studies were also scanned. Title/abstract and full-text screening were carried out by pairs of reviewers independently and data charting conducted by a single reviewer and verified by a second reviewer. Results were presented narratively. Results: A total of 13 studies with 10,351 participants were included in the review and all studies were randomized control trials conducted between 2006 and 2019. The most common interventions were the trivalent influenza vaccine (n=10), followed by quadrivalent influenza vaccine (n=4). Nine studies included infants/toddlers 6-36 months old and one of these studies also included children and adolescents. In these nine studies, no clinical effectiveness outcomes were reported and no difference was found in local and systemic reactogenicity between dosing strategies. Of the four adult studies (≥ 18 years), the two studies that reported on effectiveness outcomes found similar results between the half-dose and full-dose vaccination groups and all four studies reported no differences in safety outcomes between groups. Conclusion: The current evidence for the administration of intramuscular influenza vaccines suggests there is no significant difference in safety and clinical effectiveness with the use of low-dose compared to full-dose vaccines, which is promising given the predicted resource constraints in the upcoming influenza season due to the 2019 novel coronavirus. Due to the low number of studies in adults and the lack of studies assessing confirmed influenza and influenza-like illness, there remains a need for further evaluation.

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Diagnosis and Treatment of Snapping Scapula Syndrome: A Scoping Review

Sports Health A Multidisciplinary Approach ◽

10.1177/19417381211029211 ◽

2021 ◽

pp. 194173812110292

Author(s):

Hassan Baldawi ◽

Kyle Gouveia ◽

Chetan Gohal ◽

Latifah Almana ◽

Ryan Paul ◽

...

Keyword(s):

Pain Relief ◽

Physical Examination ◽

Operative Treatment ◽

Study Design ◽

Scoping Review ◽

Nonoperative Management ◽

Diagnosis And Treatment ◽

Current Evidence ◽

Diagnostic Process ◽

Snapping Scapula

Context: Snapping scapula syndrome (SSS) is commonly misdiagnosed and underreported due to lack of awareness. Objective: This scoping review aims to summarize the current evidence related to SSS diagnosis and treatment to aid clinicians in managing the condition more effectively. Data Sources: PubMed, Medline, and Embase databases were searched for studies related to the etiology, diagnosis, or treatment of SSS (database inception to March 2020). Study Selection: Databases were searched for available studies related to the etiology, diagnosis, or treatment of SSS. Study Design: A scoping review study design was selected to explore the breadth of knowledge in the literature regarding SSS diagnosis and treatment. Level of Evidence: Level 4. Data Extraction: Primary outcomes abstraction included accuracy of diagnostic tests, functional outcomes, and pain relief associated with various nonoperative and operative treatment options for SSS. Results: A total of 1442 references were screened and 40 met the inclusion criteria. Studies commonly reported SSS as a clinical diagnosis and relied heavily on a focused history and physical examination. The most common signs reported were medial scapular border tenderness, crepitus, and audible snapping. Three-dimensional computed tomography had high interrater reliability of 0.972, with a 100% success rate in identifying symptomatic incongruity of the scapular articular surface. Initial nonoperative treatment was reported as successful in most symptomatic patients, with improved visual analogue scale (VAS) scores (7.7 ± 0.5 pretreatment, to 2.4 ± 0.6). Persistently symptomatic patients underwent surgical intervention most commonly involving bursectomy, superomedial angle resection, or partial scapulectomy. High satisfaction rates of surgery were reported in VAS (6.9 ± 0.7 to 1.9 ± 0.9), American Shoulder and Elbow Surgeons scores (50.3 ± 12.2 to 80.6 ± 14.9), and mean simple shoulder test scores (5.6 ± 1.0 to 10.2 ± 1.1). Conclusion: Focused history and physical examination is the most crucial initial step in the diagnostic process, with supplemental imaging used to assess for structural etiologies when nonoperative management fails. Nonoperative management is as effective as surgical management in pain relief and is advised for 3 to 6 months before operative treatment.

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Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review

10.21007/con.dnp.2021.0010 ◽

2021 ◽

Author(s):

Gregory Harris ◽

Brooke Hatchell ◽

Davelin Woodard ◽

Dwayne Accardo

Keyword(s):

Risk Factors ◽

Scoping Review ◽

Elderly Population ◽

Postoperative Delirium ◽

Significant Risk ◽

The Elderly ◽

Current Evidence ◽

Opioid Use ◽

Significant Difference ◽

Opioid Administration

Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.

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Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study

Journal of Neurosurgery ◽

10.3171/2019.1.jns183093 ◽

2020 ◽

Vol 132 (5) ◽

pp. 1405-1413 ◽

Cited By ~ 1

Author(s):

Michael D. Staudt ◽

Holger Joswig ◽

Gwynedd E. Pickett ◽

Keith W. MacDougall ◽

Andrew G. Parrent

Keyword(s):

Multiple Sclerosis ◽

Pain Relief ◽

Trigeminal Neuralgia ◽

Retrospective Chart Review ◽

Medication Usage ◽

Free Response ◽

Free Survival ◽

Time To Recurrence ◽

Significant Difference

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.

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The application of virtual reality in health professions� digital education: a narrative review (Preprint)

10.2196/preprints.12220 ◽

2018 ◽

Author(s):

Lorraine Tudor Car ◽

Bhone Myint Kyaw ◽

Josip Car

Keyword(s):

Virtual Reality ◽

Professional Education ◽

Health Professions ◽

Health Professions Education ◽

Narrative Review ◽

Current Evidence ◽

Future Research ◽

Educational Content ◽

Potential Applications

BACKGROUND Digital technology called Virtual Reality (VR) is increasingly employed in health professions’ education. Yet, based on the current evidence, its use is narrowed around a few most applications and disciplines. There is a lack of an overview that would capture the diversity of different VR applications in health professions’ education and inform its use and research. OBJECTIVE This narrative review aims to explore different potential applications of VR in health professions’ education. METHODS The narrative synthesis approach to literature review was used to analyse the existing evidence. RESULTS We outline the role of VR features such as immersion, interactivity and feedback and explain the role of VR devices. Based on the type and scope of educational content VR can represent space, individuals, objects, structures or their combination. Application of VR in medical education encompasses environmental, organ and micro level. Environmental VR focuses on training in relation to health professionals’ environment and human interactions. Organ VR educational content targets primarily human body anatomy; and micro VR microscopic structures at the level of cells, molecules and atoms. We examine how different VR features and health professional education areas match these three VR types. CONCLUSIONS We conclude by highlighting the gaps in the literature and providing suggestions for future research.

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Upskilling health and care workers with augmented and virtual reality: protocol for a realist review to develop an evidence-informed programme theory

BMJ Open ◽

10.1136/bmjopen-2021-050033 ◽

2021 ◽

Vol 11 (7) ◽

pp. e050033

Author(s):

Norina Gasteiger ◽

Sabine N van der Veer ◽

Paul Wilson ◽

Dawn Dowding

Keyword(s):

Virtual Reality ◽

Grey Literature ◽

Healthcare Providers ◽

Realist Review ◽

Relevant Information ◽

Care Providers ◽

Programme Theory ◽

Clinical Educators ◽

Continued Learning ◽

Search Quality

IntroductionAugmented reality (AR) and virtual reality (VR) are increasingly used to upskill health and care providers, including in surgical, nursing and acute care settings. Many studies have used AR/VR to deliver training, providing mixed evidence on their effectiveness and limited evidence regarding contextual factors that influence effectiveness and implementation. This review will develop, test and refine an evidence-informed programme theory on what facilitates or constrains the implementation of AR or VR programmes in health and care settings and understand how, for whom and to what extent they ‘work’.Methods and analysisThis realist review adheres to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) standards and will be conducted in three steps: theory elicitation, theory testing and theory refinement. First, a search will identify practitioner, academic and learning and technology adoption theories from databases (MEDLINE, Scopus, CINAHL, Embase, Education Resources Information Center, PsycINFO and Web of Science), practitioner journals, snowballing and grey literature. Information regarding contexts, mechanisms and outcomes will be extracted. A narrative synthesis will determine overlapping configurations and form an initial theory. Second, the theory will be tested using empirical evidence located from the above databases and identified from the first search. Quality will be assessed using the Mixed Methods Appraisal Tool (MMAT), and relevant information will be extracted into a coding sheet. Third, the extracted information will be compared with the initial programme theory, with differences helping to make refinements. Findings will be presented as a narrative summary, and the MMAT will determine our confidence in each configuration.Ethics and disseminationEthics approval is not required. This review will develop an evidence-informed programme theory. The results will inform and support AR/VR interventions from clinical educators, healthcare providers and software developers. Upskilling through AR/VR learning interventions may improve quality of care and promote evidence-based practice and continued learning. Findings will be disseminated through conference presentations and peer-reviewed journal articles.

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A novel approach utilizing laser acupuncture teletherapy for management of elderly-onset rheumatoid arthritis: A randomized clinical trial

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211009861 ◽

2021 ◽

pp. 1357633X2110098

Author(s):

Aya Sedky Adly ◽

Afnan Sedky Adly ◽

Mahmoud Sedky Adly ◽

Mohammad F Ali

Keyword(s):

Rheumatoid Arthritis ◽

Virtual Reality ◽

Elderly Patients ◽

Aerobic Exercise ◽

Health Professionals ◽

Post Treatment ◽

Laser Acupuncture ◽

Virtual Reality Training ◽

Significant Difference ◽

Elderly Onset

Introduction Rheumatoid arthritis (RA) disease is a systemic progressive inflammatory autoimmune disorder. Elderly-onset RA can be assumed as a benign form of RA. Until recently, face-to-face therapeutic sessions between health professionals and patients are usually the method of its treatment. However, during pandemics, including coronavirus disease 2019 (COVID-19), teletherapeutic sessions can extensively increase the patient safety especially in elderly patients who are more vulnerable to these infections. Thus, the aim of this study was to evaluate a novel teletherapy approach for management of elderly patients suffering from RA by utilizing laser acupuncture. Methods A teletherapy system was used for management of elderly patients suffering from RA. Sixty participants were allocated randomly into two groups and the ratio was 1:1. Patients in the first group were treated with laser acupuncture and telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Patients in the second group received telerehabilitation sessions, which consisted of aerobic exercise and virtual reality training. Evaluation of patients was done by using the Health Assessment questionnaire (HAQ), the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire, and the analysis of interleukin-6 (IL-6), serum C-reactive protein (CRP), plasma adenosine triphosphate (ATP) concentration and plasma malondialdehyde (MDA). Results A statistically significant difference was found in CRP, RAQoL, IL-6 and MDA between the pre- and post-treatments in the first group ( p < 0.05) favouring the post-treatment group, while the HAQ showed a statistically significant difference between pre- and post-treatments ( p < 0.05) in both groups. Statistically significant post-treatment differences were also observed between the two groups ( p < 0.05) in RAQoL, CRP, ATP and MDA, favouring the first group. Discussion Laser acupuncture teletherapy could be suggested as a reliable treatment method for elderly patients suffering from RA, as it can provide a safe and effective therapeutic approach. Teletherapy provided safer access to health professionals and patients while giving a high patient satisfaction value with a relatively lower cost (ClinicalTrials.gov Identifier: NCT04684693).

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Adolescents’ pain and distress during peripheral intravenous cannulation in a paediatric emergency setting

European Journal of Pediatrics ◽

10.1007/s00431-021-04169-x ◽

2021 ◽

Author(s):

Giorgio Cozzi ◽

Marta Cognigni ◽

Riccardo Busatto ◽

Veronica Grigoletto ◽

Manuela Giangreco ◽

...

Keyword(s):

Emergency Department ◽

Pain Relief ◽

Local Anaesthesia ◽

Cross Sectional Study ◽

Emergency Setting ◽

Older Children ◽

Cross Sectional ◽

Paediatric Emergency Department ◽

Paediatric Emergency ◽

Significant Difference

AbstractThe objective of the study is to investigate pain and distress experienced by a group of adolescents and children during peripheral intravenous cannulation in a paediatric emergency department. This cross-sectional study was performed between November 2019 and June 2020 at the paediatric emergency department of the Institute for Maternal and Child Health of Trieste, Italy. Eligible subjects were patients between 4 and 17 years old undergoing intravenous cannulation, split into three groups based on their age: adolescents (13–17 years), older children (8–12 years), and younger children (4–7 years). Procedural distress and pain scores were recorded through validated scales. Data on the use of topical anaesthesia, distraction techniques, and physical or verbal comfort during procedures were also collected. We recruited 136 patients: 63 adolescents, 48 older children, and 25 younger children. There was no statistically significant difference in the median self-reported procedural pain found in adolescents (4; IQR = 2–6) versus older and younger children (5; IQR = 2–8 and 6; IQR = 2–8, respectively). Furthermore, no significant difference was observed in the rate of distress between adolescents (79.4%), older (89.6%), and younger (92.0%) children. Adolescents received significantly fewer pain relief techniques.Conclusion: This study shows that adolescents experience similar pain and pre-procedural distress as younger children during peripheral intravenous cannulation. What is Known:• Topical and local anaesthesia, physical and verbal comfort, and distraction are useful interventions for pain and anxiety management during intravenous cannulation in paediatric settings. • No data is available on pain and distress experienced by adolescents in the specific setting of the emergency department. What is New:• Adolescents experienced high levels of pre-procedural distress in most cases and similar levels of pain and distress when compared to younger patients• The number of pain relief techniques employed during procedures was inversely proportional to patient’s age, topical or local anaesthesia were rarely used

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Effectiveness of Virtual Reality-Based Exercise Therapy in Rehabilitation: A Scoping Review

Informatics in Medicine Unlocked ◽

10.1016/j.imu.2021.100562 ◽

2021 ◽

pp. 100562

Author(s):

Afsoon Asadzadeh ◽

Taha Samad-Soltani ◽

Zahra Salahzadeh ◽

Peyman Rezaei-Hachesu

Keyword(s):

Virtual Reality ◽

Exercise Therapy ◽

Scoping Review

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