Focus on Patient in Virtual Reality-Assisted Rehabilitation

2016 ◽  
pp. 85-113 ◽  
Author(s):  
Stefano Mottura ◽  
Luca Fontana ◽  
Sara Arlati ◽  
Claudia Redaelli ◽  
Andrea Zangiacomi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Emotional State ◽  
Models Of Care ◽  
Point Of View ◽  
Self Awareness ◽  
Patient Centered ◽  
Natural Interaction ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs

Since several years scientists are carrying on research about innovative systems, based on robotics, mechatronics devices and IT tools – especially the graphical ones – to support patients in rehabilitation programs for rescuing from various brain damages due to adverse events as stroke. Training sessions with a combination of robot and virtual reality (VR) lead to better rehabilitation outcomes than using only a robot and evidence from the field proved the importance of the use of VR interfaces in rehabilitation. The main aim of such a kind of environments is to monitor, motivate and drive the patient during the rehabilitation sessions. These systems mainly provide motor guidance and multimedia communication channels also measuring patients' performance and other observable variables. The approach implemented is usually based on gaming, where the patient has the key role to perform certain tasks or movements for controlling the game in the correct way and exercise the injured part. According to daily experience from physiotherapists, different aspects related to the physical and self-perceived patients' state revealed to have a fundamental role in influencing the rehabilitation session. Indeed, the treatment result depends not only on motor skills but also on patient's personal behavior and feelings that are not directly investigable, observable and measurable from outside. In other words this kind of elements can only be assessed by subjective measurements (as questions, interviews, narratives) revealing the point of view of the patient. Moreover, the emotional state has implications at different levels: on one hand, it is important to evaluate if the single rehabilitation session affects the emotional state of the patient, on the other, if the performance was influenced by this state. Some answers of a questionnaire administrated to post-stroke patients in a previous study underlined also the need for the patient to focus his/her attention on the trained body portion and the relevance of a visual feedback on movements to increase self-awareness on the action performed, avoiding any possible distraction derived from other kind of tasks and related visual/auditory stimuli. Patient-centered models of care are actually becoming increasingly common among rehabilitation clinical settings. They help to focus the therapy on improving the treatment of those deficiencies that most influence the quality of life of the patient. Another important aspect is represented by the relationship with the caregiver that in virtually assisted rehabilitation would not be direct anymore and will need to be mediated without completely loosing natural interaction. According to this patient centered vision, and in order to reduce possible side effects related to semi-automatic rehabilitation systems, it has been studied and developed a system which has not the aim of merely entertain the patient but to focalize the rehabilitation on him/her as a proactive character aware of what is happening and of the quality of the work performed.

Focus on Patient in Virtual Reality-Assisted Rehabilitation

2018 ◽  
pp. 1422-1450 ◽  
Author(s):  
Stefano Mottura ◽  
Luca Fontana ◽  
Sara Arlati ◽  
Claudia Redaelli ◽  
Andrea Zangiacomi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Emotional State ◽  
Models Of Care ◽  
Point Of View ◽  
Self Awareness ◽  
Patient Centered ◽  
Natural Interaction ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs

Since several years scientists are carrying on research about innovative systems, based on robotics, mechatronics devices and IT tools – especially the graphical ones – to support patients in rehabilitation programs for rescuing from various brain damages due to adverse events as stroke. Training sessions with a combination of robot and virtual reality (VR) lead to better rehabilitation outcomes than using only a robot and evidence from the field proved the importance of the use of VR interfaces in rehabilitation. The main aim of such a kind of environments is to monitor, motivate and drive the patient during the rehabilitation sessions. These systems mainly provide motor guidance and multimedia communication channels also measuring patients' performance and other observable variables. The approach implemented is usually based on gaming, where the patient has the key role to perform certain tasks or movements for controlling the game in the correct way and exercise the injured part. According to daily experience from physiotherapists, different aspects related to the physical and self-perceived patients' state revealed to have a fundamental role in influencing the rehabilitation session. Indeed, the treatment result depends not only on motor skills but also on patient's personal behavior and feelings that are not directly investigable, observable and measurable from outside. In other words this kind of elements can only be assessed by subjective measurements (as questions, interviews, narratives) revealing the point of view of the patient. Moreover, the emotional state has implications at different levels: on one hand, it is important to evaluate if the single rehabilitation session affects the emotional state of the patient, on the other, if the performance was influenced by this state. Some answers of a questionnaire administrated to post-stroke patients in a previous study underlined also the need for the patient to focus his/her attention on the trained body portion and the relevance of a visual feedback on movements to increase self-awareness on the action performed, avoiding any possible distraction derived from other kind of tasks and related visual/auditory stimuli. Patient-centered models of care are actually becoming increasingly common among rehabilitation clinical settings. They help to focus the therapy on improving the treatment of those deficiencies that most influence the quality of life of the patient. Another important aspect is represented by the relationship with the caregiver that in virtually assisted rehabilitation would not be direct anymore and will need to be mediated without completely loosing natural interaction. According to this patient centered vision, and in order to reduce possible side effects related to semi-automatic rehabilitation systems, it has been studied and developed a system which has not the aim of merely entertain the patient but to focalize the rehabilitation on him/her as a proactive character aware of what is happening and of the quality of the work performed.

scholarly journals Prevalence of Low-Value Care and Its Associations with Patient-Centered Outcomes in Dementia

2021 ◽  
pp. 1-13
Author(s):  
Moritz Platen ◽  
Steffen Flea ◽  
Anika Rädke ◽  
Diana Wucherer ◽  
Jochen René Thyrian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Models Of Care ◽  
Adverse Outcomes ◽  
Future Research ◽  
Patient Centered ◽  
Treatment Pathways ◽  
Patient Reported ◽  
Evidence Based Treatments ◽  
Related Quality

Background: Low-value care (LvC) is defined as care unlikely to provide a benefit to the patient regarding the patient’s preferences, potential harms, costs, or available alternatives. Avoiding LvC and promoting recommended evidence-based treatments, referred to as high-value care (HvC), could improve patient-reported outcomes for people living with dementia (PwD). Objective: This study aims to determine the prevalence of LvC and HvC in dementia and the associations of LvC and HvC with patients’ quality of life and hospitalization. Methods: The analysis was based on data of the DelpHi trial and included 516 PwD. Dementia-specific guidelines, the “Choosing Wisely” campaign and the PRISCUS list were used to indicate LvC and HvC treatments, resulting in 347 LvC and HvC related recommendations. Of these, 77 recommendations (51 for LvC, 26 for HvC) were measured within the DelpHi-trial and finally used for this analysis. The association of LvC and HvC treatments with PwD health-related quality of life (HRQoL) and hospitalization was assessed using multiple regression models. Results: LvC was highly prevalent in PwD (31%). PwD receiving LvC had a significantly lower quality of life (b = –0.07; 95%CI –0.14––0.01) and were significantly more likely to be hospitalized (OR = 2.06; 95%CI 1.26–3.39). Different HvC treatments were associated with both positive and negative changes in HRQoL. Conclusion: LvC could cause adverse outcomes and should be identified as early as possible and tried to be replaced. Future research should examine innovative models of care or treatment pathways supporting the identification and replacement of LvC in dementia.

The virtual railway station

2016 ◽  
Vol 22 (2) ◽  
pp. 116-126 ◽  
Author(s):  
Veronika Egger (is-design GmbH)
Keyword(s):  
Virtual Reality ◽  
Virtual Environment ◽  
Real World ◽  
Information Design ◽  
Point Of View ◽  
Immersive Virtual Environment ◽  
Real World Application ◽  
Partially Sighted ◽  
Central Station

In a fully immersive virtual environment that modeled the new Vienna Central Station this research project investigated to what extent virtual reality might serve to evaluate the quality of orientation signage. From an information design point of view, two questions were particularly relevant: (1) How applicable are results from a virtual environment to the real world? and (2) Is this type of virtual environment suitable for testing with elderly people and people who are partially sighted? The article describes evaluation methods, limits and strengths of the virtual environment and lessons for real world application of results.

Evaluating the patient-centered quality of cancer survivorship care models.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 48-48
Author(s):  
Holly Mead ◽  
Mandi Pratt-Chapman ◽  
Sean Cleary ◽  
Sarah Raskin
Keyword(s):  
Cancer Survivorship ◽  
Organizational Context ◽  
Models Of Care ◽  
Survivorship Care ◽  
Coordinated Care ◽  
Patient Centered ◽  
High Quality ◽  
Full Spectrum ◽  
Better Than

48 Background: With 15.5 million cancer survivors in the U.S., cancer is increasingly viewed as a chronic illness that requires systematic, coordinated care. Yet research has not determined what models of survivorship are most effective in providing high quality, patient-centered care. This study evaluates the quality of three models of cancer survivorship care using a newly developed patient-centered measure. Methods: We conducted a comparative effectiveness study with 32 cancer programs distributed across 3 distinct models of survivorship care: 1) Consultative Specialized Survivorship Clinic; 2) Longitudinal Specialized Survivorship Clinic; and 3) Oncology-Embedded Survivorship Clinic with Referrals. We developed the Patient-Prioritized Measure of High Quality Survivorship Care (PPM), a scale comprising 9 patient-prioritized components of survivorship care. We enrolled 991 survivors of breast, colorectal and prostate cancer across these programs and followed them over 6 months collecting self-reported data on quality of survivorship services. Results: Preliminary results suggest statistically significant differences across models of care for six PPM components. Model 1 is more likely than the other two models to provide a full spectrum of services (p=0.0001), mental health and social support (p<0.0001), and information and resources for patients in survivorship (p=0.0002). Model 2 is better than model 3 at providing a medical home (0.04), and outperforms both other models at coordinating care and transitions (p=0.0059). Both Models 1 and 2 are better than model 3 in ensuring productive patient-provider interactions (p=0.006). Conclusions: It appears that certain models of survivorship care are better at specific domains of patient-centered quality, suggesting cancer centers should consider their organizational context and their patients’ needs before committing to a particular model of care.

scholarly journals The Influence of Comorbidities on Outcomes of Pulmonary Rehabilitation Programs in Patients with COPD: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Miek Hornikx ◽  
Hans Van Remoortel ◽  
Heleen Demeyer ◽  
Carlos Augusto Marcal Camillo ◽  
Marc Decramer ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiovascular Disease ◽  
Exercise Capacity ◽  
Pulmonary Rehabilitation ◽  
Chronic Obstructive ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs ◽  
Functional Exercise ◽  
Functional Exercise Capacity

Introduction. Chronic obstructive pulmonary disease (COPD) is associated with comorbidities such as cardiovascular disease, metabolic disease, osteoporosis, and anxiety and/or depression. Although pulmonary rehabilitation programs are proven to be beneficial in patients with COPD, it is unclear whether comorbidities influence pulmonary rehabilitation outcomes. The aim of the present review was to investigate to what extent the presence of comorbidities can affect pulmonary rehabilitation outcomes.Methods. The systematic literature search (Pubmed, EMBASE, and PEDro) resulted in 4 articles meeting the inclusion criteria. The odds ratios (95% confidence intervals) of the logistic regression analyses, with comorbidities as independent variables and pulmonary rehabilitation outcomes (dyspnea, functional exercise capacity, and quality of life) as dependent variables, were used for data extraction.Results. Patients with anxiety and/or depression less likely improve in dyspnea. Osteoporosis is associated with less improvements in functional exercise capacity, while cardiovascular disease does not seem to negatively impact on this outcome. Patients with cardiovascular comorbidity will experience less positive changes in quality of life.Conclusion. Evidence from literature suggests that comorbidities can have a negative influence on pulmonary rehabilitation outcomes. Screening for comorbidities in pulmonary rehabilitation settings seems useful to readdress the right patients for individually tailored pulmonary rehabilitation.

scholarly journals Rehabilitation of Rheumatic Patients in Primary Care

2020 ◽  
pp. 8-13
Author(s):  
Liudmyla Khimion ◽  
Oleksandr Burianov ◽  
Oksana Yashchenko ◽  
Svitlana Danylyuk ◽  
Tetiana Sytyuk ◽  
...  
Keyword(s):  
Social Life ◽  
Positive Impact ◽  
Evidence Base ◽  
Functional Abilities ◽  
Patient Centered ◽  
Rehabilitation Programs ◽  
Methods Of Evaluation ◽  
The Given ◽  
Rheumatic Patients

The evidence base for use of different rehabilitation programs is discussed in the article. The most effective approaches to the rehabilitation organization and patients education are presented together with the different types of physical rehabilitation, ergotherapy and physical activities useful for the development of the maximum functional ability and social integration of rheumatic patients. The positive impact of the motivational interview in work with rheumatic patients, the results of the clinical studies on evaluation of the patients education influence on their functional abilities and psychologic status; recommendations on ortheses use are discussed in the article. The recommendations of the leading international expert groups about exercises, physiotherapy, ergotherapy prescribing to the patients with rheumatoid arthritis, osteoarthritis and connective tissue systemic diseases are given; the attention is drown to the methods of evaluation of patients physical status; patients education about energy saving technologies use for maximum possible functional and physical loads and patients autonomy at hom aend social life realization. Implementation of the given rehabilitation algorithms can help to realize holistic patient-centered approach, improve patients quality of life and functional capacity.

scholarly journals Formação para a integralidade no cuidado: potencialidades de um projeto interprofissional / Training for integrality in Health Care Careers: Potential for an Interprofessional Project

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Rosana Rossit ◽  
Sylvia Helena Batista ◽  
Nildo Alves Batista
Keyword(s):  
Health Care ◽  
Interprofessional Education ◽  
Professional Training ◽  
Sao Paulo ◽  
Point Of View ◽  
São Paulo ◽  
Patient Centered ◽  
Centered Care ◽  
Development Of Competencies

ABSTRACTThis study highlights the importance of interprofessional education in health for the learning process of the teamwork and integrality in care to expand effectiveness of services and quality of care. Former students from undergraduate health courses in Federal University of São Paulo/UNIFESP, Brazil (physical education, physical therapy, nursing and occupational therapy) responded to the questionnaire RIPLS to assess attitudes and readiness to three factors: teamwork and collaboration, professional identity and patient-centered care. The results showed the following development of competencies, which are essential for health professionals - problem solving, decision making, leadership, trust and respect to each other, communication with patients and other professionals, understanding the nature of the problems, understanding the clinical cases from the patient´s point of view. These are recognized on the global scenario as components of quality of professional training and attention to health care. Eighty -four percent of the former students of the undergraduate courses were satisfied with the training received and provided contributions to the analysis of health education in the perspective of interprofessional education.RESUMOPesquisa de abordagem quantitativa para avaliar a formação para a integralidade no cuidado em carreiras da saúde. Destaca-se a importância da educação interprofissional em saúde para o aprendizado do trabalho em equipe e da integralidade no cuidado para ampliar a resolutividade dos serviços e a qualidade da atenção à saúde. Egressos da graduação em saúde da Universidade Federal de São Paulo/UNIFESP-Brasil (educação física, fisioterapia, nutrição e terapia ocupacional) responderam ao Questionário RIPLS para avaliação de atitudes e prontidão para três fatores: trabalho de equipe e colaboração, identidade profissional e atenção centrada no paciente. Os resultados indicam o desenvolvimento de competências essenciais para as profissões da saúde - resolução de problemas, tomada de decisão, liderança, confiança e respeito uns aos outros, comunicação com pacientes e outros profissionais, compreensão da natureza dos problemas, entendimento dos casos clínicos na perspectiva do paciente - as quais são reconhecidas no cenário global como componentes da qualidade da formação profissional e da atenção à saúde. Oitenta e quatro por cento dos egressos mostram-se satisfeitos com a formação recebida e fornecem contribuições para a análise da forma-ção em saúde, na perspectiva da educação interprofissional.

scholarly journals The Virtual Reality Experience and Leisure Experience of Screen Horse Riding Participants: from the ‘Simulation’ point of view by Boudrillard

2018 ◽  
Vol 7 (3.33) ◽  
pp. 229
Author(s):  
Lim Jeong Mi ◽  
Lim Soo Woen ◽  
Oh Hyun Ok
Keyword(s):  
Virtual Reality ◽  
Leisure Activities ◽  
Point Of View ◽  
Horseback Riding ◽  
Sensory Stimuli ◽  
Horse Riding ◽  
Study Participants ◽  
Simulation Point ◽  
Leisure Experience

This study aims to gain depth understanding of the virtual reality experience experienced by screen riding, to analyze in depth and interpret from the perspective of Boudrillard through a subjective and subjective perspective of leisure users. In this study, after learning about the experience of virtual reality symbols built into them through screen riding, the leisure experience of screen riding participants was further identified. The double-checking results are as follows. First, experience in the virtual reality of screen riding can be described as a fusion of virtual reality symbols and experiences. The virtual reality symbols inherent in screen riding are expressed as spatial symbols, behavioral symbols, and contents, and the fusion of experience means a transcendental and a transformative environment. Second, screen riding was a derivative of the study that enabled participants to enter horseback riding more easily and to continue with leisure activities, also to help with posture correction, constipation, diet, and Kegel exercise. thereby enhancing fun and desire for horseback riding. In the study, participants were focusing on subjective feelings arising from the experience of horseback riding, and they stated that the body's sensory stimuli increased the quality of life and felt happy. In this study, the leisure activities are satisfied with the simulacra which can replace reality according to the subjective viewpoint of the leisure experiencer and the reflection of personal circumstances in the virtual reality of screen riding sports which is IT fusion. In the future, It is necessary to study the consumption patterns and the popularity of the emerging virtual reality sports since various virtual reality sports are becoming popular and are being built into the culture of life. 

scholarly journals Self-Transformations of Health Professionals in the Field

2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Josée Lachance ◽  
Richard B. Hovey ◽  
Jean-François Desbiens
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Professionals ◽  
Sense Of Self ◽  
Transformation Process ◽  
Point Of View ◽  
Self Awareness ◽  
Concept Of Health ◽  
The Individual

 Health does not arise from health care. Perhaps we are facing an impasse and should we reconsider and reconceptualize the mandate of the health system. In order to improve our influence on the culture that often prevails in our institutions as well as the health of those institutions. This article examines the changes to the mandate of the health system seen in the light of self-transformations. This vision is based on a model that illustrates the transformations experienced by physicians following a mind-body training, i.e. Awakening the Sensible Being (ASB). The model shows the transformation process reported by physicians, after experiencing self-awareness of what they are doing, through experiencing the ASB, while developing a closer relationship with themselves. As it turned out, the training was beneficial for their health. Their expanded sense of self-awareness and quality of “savoir-être” brought on by the training contributes to their impression of “feeling whole” and provides them with a quality of presence that influences the type of care they can provide to their patients by considering the individual as a whole. This point of view could bring about a shift in the mandate of the health system and improve the health of caregivers and care-receivers as well, while contributing to widen the concept of health.

Results of osteopathic correction of patients with post-traumatic coccygodynia

2019 ◽  
pp. 19-27
Author(s):  
Yu. V. Antonova ◽  
A. M. Iskandarov ◽  
I. B. Mizonova
Keyword(s):  
Quality Of Life ◽  
Emotional State ◽  
Pain Syndrome ◽  
Control Group ◽  
Life Questionnaire ◽  
Treatment Area ◽  
Diffi Cult ◽  
Osteopathic Treatment ◽  
Post Traumatic

Introduction.Coccygodynia is a multidisciplinary disease which is diffi cult to treat. It seriously limits the ability to work and signifi cantly affects the quality of life of patients. The study of somatic dysfunctions in patients with coccygodynia and the analysis of the results of osteopathic treatment of such patients makes it possible to justify the necessity of osteopathic correction of coccygodynia.Goal of the study— to determine the structure of the leading somatic dysfunctions in patients with coccygodynia and to study the effectiveness of osteopathic treatment of this pathology.Materials and methods.The study involved 44 patients from 25 to 65 years old, randomly divided into two groups. The main group of 24 people (20 women and 4 men) received osteopathic treatment, in accordance with the identifi ed leading somatic dysfunctions. Patients of the control group (16 women and 4 men) were treated locally with soft manual techniques (the treatment area was limited by the pelvic region). In order to assess the results of the treatment, we examined the intensity of the pain syndrome and the psycho-emotional state of patients. The severity of the pain syndrome was assessed in accordance with the visual analogue scale (VAS). The psycho-emotional state (with physical and mental components) was assessed with the help of the SF-36 quality of life questionnaire.Results.Somatic dysfunctions typical for patients with coccygodynia have been identifi ed. Osteopathic treatment has proven to be more effective in comparison with local manual therapy of coccygodynia both in early periods and in 3 months after the end of the treatment course.Conclusion.Osteopathic treatment of post-traumatic coccygodynia is effective, and can be recommended for treatment of such patients.

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