Search Results (472)

Background: Serious games (SGs) are primarily aimed at promoting learning, skills training, and rehabilitation. Artificial intelligence, immersive technologies, the metaverse, and neurotechnologies promise the next revolution in gaming. Meta-skills are considered the “must-have” skills for thriving in the era of rapid change, complexity, and innovation. Μeta-skills can be defined as a set of higher-order skills that incorporate metacognitive, meta-emotional, and meta-motivational attributes, enabling one to be mindful, self-motivated, self-regulated, and flexible in different circumstances. Skillfulness, and more specifically meta-skills development, is recognized as a predictor of optimal performance along with mental and emotional wellness. Nevertheless, there is still limited knowledge about the effectiveness of integrating cutting-edge technologies in serious games, especially in the field of meta-skills training. Objectives: The current systematic review aims to collect and synthesize evidence concerning the effectiveness of advanced technologies in serious gaming for promoting meta-skills development. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was employed to identify experimental studies conducted in the last 10 years. Four different databases were employed: Web of Science, PubMed, Scopus, and Google Scholar. Results: Forty-nine studies were selected. Promising outcomes were identified in AI-based SGs (i.e., gamified chatbots) as they provided realistic, adaptive, personalized, and interactive environments using natural language processing, player modeling, reinforcement learning, GPT-based models, data analytics, and assessment. Immersive technologies, including the metaverse, virtual reality, augmented reality, and mixed reality, provided realistic simulations, interactive environments, and sensory engagement, making training experiences more impactful. Non-invasive neurotechnologies were found to encourage players’ training by monitoring brain activity and adapting gameplay to players’ mental states. Healthy participants (n = 29 studies) as well as participants diagnosed with anxiety, neurodevelopmental disorders, and cognitive impairments exhibited improvements in a wide range of meta-skills, including self-regulation, cognitive control, attention regulation, meta-memory skills, flexibility, self-reflection, and self-evaluation. Players were more self-motivated with an increased feeling of self-confidence and self-efficacy. They had a more accurate self-perception. At the emotional level, improvements were observed in emotional regulation, empathy, and stress management skills. At the social level, social awareness was enhanced since they could more easily solve conflicts, communicate, and work in teams. Systematic training led to improvements in higher-order thinking skills, including critical thinking, problem-solving skills, reasoning, decision-making ability, and abstract thinking. Discussion: Special focus is given to the potential benefits, possible risks, and ethical concerns; future directions and implications are also discussed. The results of the current review may have implications for the design and implementation of innovative serious games for promoting skillfulness among populations with different training needs. Full article

Background and aim: Cerebral palsy (CP) is a nonprogressive neurological disorder characterized by permanent developmental disorders of movement and posture. One of the most common goals of rehabilitation is the treatment of gait disorders. Ataxic gait disorder tends to worsen in the adolescent period. Research indicates a positive therapeutic effect of the combined application of conventional rehabilitation, robotic neurorehabilitation (RNR) and virtual reality, but there is no consensus on the length of treatment and frequency of application. The aim of this case report was to contribute to the definition of the RNR protocol for the treatment of ataxic gait disorder in adolescents with CP. Case report: In a female child with an ataxic form of CP who was on regular conventional kinesitherapy in the age period between 13 to 15 years, robotic-assisted gait training (RAGT) was applied for the treatment of gait disorders. The rehabilitation protocol lasted 10 weeks, 5 times a week, and included individual, conventional kinesitherapy for 30 min and RAGT for 30 min. Combined RNR treatment was conducted once a year in the period between July and September. The results of the therapeutic evaluation revealed that the functional motor level remained unchanged, while the improved functional motor status for the category of standing and gait was maintained during treatment between the patient’s 13 and 15 years age. In their 15th year, independent gait over a shorter distance (14 m) was achieved, as well as a normal gait frequency (83 steps/minute), with a desirable duration of the left leg support phase of 65% and 70% for the right leg support phase. Conclusions: The results of our research indicate that the application of conventional kinesitherapy and RAGT, over the period of 10 weeks a year, can have a positive effect on improving the postural and locomotor functions of ataxic gait in adolescents with CP. Full article

Purpose: Over the past decade, tele-neurorehabilitation (TNR) has emerged as a vital and effective tool for delivering continuous care to stroke patients, playing a key role in enhancing functional recovery and ensuring consistent access to rehabilitation services. In the field of TNR, various protocols are utilized to ensure effective cognitive stimulation at home. Recent preliminary studies highlight the employment of multidomain cognitive interventions, which would seem to induce more stable and relevant cognitive recovery in stroke patients. A randomized controlled trial (RCT) study was conducted to compare the effectiveness of a TNR multidomain cognitive approach to conventional face-to-face cognitive treatment. Methods: A total of 30 patients with stroke were equally enrolled and randomly assigned to the experimental and control groups. In the experimental group, patients received sessions of home-based cognitive virtual reality rehabilitation system (VRRS) training. The control group underwent traditional face-to-face cognitive multidomain treatment at the hospital. The therapy was given for one hour every day for four weeks in both groups. Specific cognitive domains, including memory, praxis skills, executive functions, and speech therapy, were stimulated in the procedure. Neuropsychological evaluations were performed at three timepoints: at baseline (T0), at the end of TNR (T1), and six months later (T2). Results: The TNR group demonstrated significant improvements in working memory and language abilities, as well as in depressive symptoms and caregiver burden, with an average decrease of 2.07. Most of this improvement persisted 6 months after treatment. The group that received face-to-face cognitive treatment showed improvements (not persisting at T2) after treatment in a task measuring constructive apraxia and alternating attention with the cognitive skill of set-shifting. Conclusions: According to our findings, multidomain cognitive TNR may be useful in enhancing cognitive outcomes in stroke populations (even six months after treatment concludes). TNR may also be a viable way to deliver these interventions since it boosts people’s motivation to train and, consequently, their adherence to treatment while also having a positive effect on caregivers’ distress management. Full article

Virtual reality (VR) can play an important role in supporting remote care for cancer patients. The purpose of this study is to explore the possible applications of VR in-home cancer care to support patients and healthcare practitioners. We conducted a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched for peer-reviewed publications in PubMed, Web of Science, and IEEE Xplore for research articles published in the last two decades. After the final list of relevant articles was identified, we adopted an inductive approach to categorize and report our findings. We identified 15 relevant research articles and categorized them into three themes: medical treatment, emotional support, and education and training. Six articles leveraged VR to support medical treatment such as outpatient physical therapy and rehabilitation, and pain management. Five used VR to provide emotional support to patients by uplifting their feelings or providing psychological guidance. Lastly, four leveraged VR for education and training purposes. Overall, all studies reported positive outcomes of VR for home cancer care. Our review advocates for VR integration in in-home cancer care. The findings of this review acknowledge the potential of VR in augmenting medical treatment, providing emotional support to patients, and facilitating the education and training of patients and clinicians. VR in-home cancer care can provide patients with a better quality of care. However, just like any other technological integration, VR can also introduce different challenges, including usability, affordability, and acceptance. Therefore, more studies evaluating VR’s usability and acceptance should be conducted. Additionally, stakeholders such as regulatory bodies, patients, and payors should be involved in ensuring VR’s affordability and developing protocols for its safe use. Full article

Background: The evolution of technology has continuously redefined the landscape of rehabilitation medicine. Researchers have long incorporated virtual reality (VR) as a promising intervention, providing immersive therapeutic environments for patients. The emergence of the metaverse has recently further expanded the potential applications of VR to augment the possibilities in rehabilitation. Rehabilitation is a crucial aspect of healthcare, and technological advancements have allowed new approaches to aid in this process. One such approach is the metaverse, a virtual world where users can interact with each other and their surroundings in a simulated environment. This comprehensive review aimed to analyze the scientific evidence using the term “metaverse” in rehabilitation and its potential patient benefits. Methods: We conducted a comprehensive literature search from the inception to September 2024 in PubMed, Scopus, Web of Science, and Cochrane Database to identify studies investigating the term “metaverse” and its role in rehabilitation. We then assessed these studies based on their methodology, patient population, technology used, and therapeutic outcomes. Results: Out of 81 articles, 55 remained after removing duplicates. After screening the title, abstract, and full text, we included five articles. Conclusions: Results from these studies suggested potential benefits in various rehabilitative areas, such as cerebral palsy, intellectual disabilities, pain management, and physical performance improvement among the elderly. The metaverse presents promising avenues for enhancing rehabilitation outcomes. While VR’s effectiveness is well established, the metaverse, being a newer concept, necessitates further studies for a more comprehensive understanding. Full article

Extended reality (XR) technologies—encompassing virtual reality (VR), augmented reality (AR), and mixed reality (MR)—are transforming cognitive assessment and training by offering immersive, interactive environments that simulate real-world tasks. XR enhances ecological validity while enabling real-time, multimodal data collection through tools such as galvanic skin response (GSR), electroencephalography (EEG), eye tracking (ET), hand tracking, and body tracking. This allows for a more comprehensive understanding of cognitive and emotional processes, as well as adaptive, personalized interventions for users. Despite these advancements, current XR applications often underutilize the full potential of multimodal integration, relying primarily on visual and auditory inputs. Challenges such as cybersickness, usability concerns, and accessibility barriers further limit the widespread adoption of XR tools in cognitive science and clinical practice. This review examines XR-based cognitive assessment and training, focusing on its advantages over traditional methods, including ecological validity, engagement, and adaptability. It also explores unresolved challenges such as system usability, cost, and the need for multimodal feedback integration. The review concludes by identifying opportunities for optimizing XR tools to improve cognitive evaluation and rehabilitation outcomes, particularly for diverse populations, including older adults and individuals with cognitive impairments. Full article

Background/Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder, characterised by cardinal motor features and a multitude of non-motor manifestations. Among them, cognitive impairment in PD has been recognised as a defined clinical entity, and it might lead to an increased risk of developing dementia. Consequently, the present review aimed to ascertain the available interventions for the training of cognitive abilities in persons with PD (PwPD). Methods: PRISMA guidelines were followed to select studies in the following databases: PubMed, PsycINFO, and Web of Science. Two independent reviewers conducted the different phases of the review, and a third expert was called in to address any doubts/conflicts. Randomised controlled trials and randomised clinical trials concerning cognitive training with cognitive outcomes in PwPD were selected. Results: A total of 28 articles were included. The considered studies applied various experimental interventions for the training of cognitive functions in PwPD: computer-based platforms, exergames, paper-and-pencil programmes, dual-task or treadmill training with action observation therapy, motor imagery, and virtual reality components, interventions targeting precise cognitive domain, tele-rehabilitation, transcranial direct current stimulation, structured cognitive training, and multimodal treatments. Cognitive functions were assessed employing neuropsychological tests, self-report questionnaires, and computerised batteries. Conclusions: Overall, the review reported better performances in the experimental groups compared to the control groups, in several cognitive domains. Structured cognitive training emerged as the most effective strategy to enhance cognitive functioning in PwPD. However, further studies are necessary to determine the most appropriate and useful training and to develop interventions that also consider patients’ quality of life. Full article

The purpose of this study is to investigate Greek physical therapists’ perceptions of therapeutic approaches, assessment tools, and the use of technology in the treatment of Parkinson’s disease. A cross-sectional survey was conducted using an online questionnaire consisting of 26 questions. The questionnaire was addressed to Greek physiotherapists who were registered with the Panhellenic Physical Therapy Association (PPTA) at the time of the survey and practiced their profession in Greece. A total of 203 physical therapists who met the inclusion criteria participated in the study. Out of all the participants, 65% had over 10 years of work experience and treated 1–9 patients with PD per year. Additionally, 84.7% of participants communicated with health scientists as part of the interdisciplinary collaboration, and 23.2% used assessment tools/scales frequently. New technologies were only used by 24.6% of participants despite a positive view of their benefits (70.9%). Physiotherapists who attended a lifelong educational program or adult neurological physiotherapy seminars or held a master’s or doctoral degree in physiotherapy used new technologies at higher rates of 64% and 68%, respectively. Finally, the use of new technologies was related to the acquisition of a master’s degree or lifelong training specialization. Full article

Background: With technological advancements, virtual versions of the Box and Block Test (BBT) employing the Leap Motion Controller have been developed for evaluating hand dexterity. Currently, there are no studies about the usefulness of this system in children with unilateral cerebral palsy (UCP). Thus, our main objective is to apply a virtual BBT based on the Leap Motion Controller in children with UCP compared with the real BTT for assessing upper limb function within a pilot study. Methods: Seven children between the ages of 4 and 8 years who were diagnosed with UCP were assessed three times using the real and virtual BBT. Results: For all the participants, performance was greater in the real BBT than in the virtual BBT. During the last assessment, the participants reached 28.17 (SD:6.31) blocks in the real test and 9.00 (SD:5.90) in the virtual test. The correlation index between the two modalities of the BBT was moderate (r = 0.708). Conclusions: The results obtained in this study suggest that the application of the virtual BBT in children with UCP is feasible. Future studies are needed to validate the application of the virtual BBT in children with UCP. Full article

Background/Objectives: Dementia leads to cognitive decline, affecting memory, reasoning, and daily activities, often requiring full-time care. Multisensory stimulation (MSS), combined with cognitive tasks, can slow this decline, improving mood, communication, and overall quality of life. This systematic review aims to explore methods that utilize MSS in the rehabilitation of patients with dementia. Its clinical value is rooted in its ability to offer a deep comprehension of how MSS can be successfully incorporated into rehabilitation treatments. Methods: Studies were identified from an online search of PubMed, EBSCOhost, Cochrane Library, Web of Science, Embase, and Scopus databases with a search time frame from 2014 to 2024. This review has been registered on Open OSF (n) 3KUQX. Results: Pilot studies investigating MSS interventions, encompassing Cognitive Stimulation Therapy (CST), Sonas therapy, and combined physical–cognitive exercise programs, have yielded mixed findings in individuals with dementia. CST has demonstrated significant improvements in general cognitive function, particularly in language skills, offering a promising approach for cognitive enhancement. Sonas therapy, while showing positive trends in some studies, does not consistently achieve statistically significant outcomes across all cognitive domains. Conversely, combined exercise programs have shown efficacy in improving dual-task performance, suggesting benefits for motor–cognitive integration. MSS delivered within specialized environments like Snoezelen rooms consistently produces positive effects on mood, reducing agitation and promoting relaxation. Conclusions: This review emphasizes how MSS can enhance cognitive, emotional, and behavioral results for individuals with dementia. It is essential for future research to standardize protocols, incorporate advanced technologies such as virtual reality, and rectify diversity gaps. Collaboration between different fields will improve the effectiveness and usefulness of MSS in caring for individuals with dementia. Full article

Virtual reality (VR) has gained significant attention in various fields including healthcare and industrial applications. Within healthcare, an interesting application of VR can be found in the field of physiotherapy. The conventional methodology for rehabilitating upper limb lesions is often perceived as tedious and uncomfortable. The manual nature of the process, performed by physicians, leaves patients in an environment lacking motivation and engagement. This presents an opportunity for implementing VR as a tool to enhance the rehabilitation process and improve the quality, efficiency, and evolution of recovery. However, physiotherapy often lacks relevant data to track the recovery process effectively, further compounding concerns about its efficacy. To address this, we propose the development of a posture control system using the Oculus Quest 2, a VR device. Our primary objective was to validate the performance aspects of this device and assess its potential as a rehabilitation tool, providing valuable support to healthcare professionals. Through a series of tests, we evaluated the effectiveness of our VR solution by integrating it into specific therapeutic exercises. This approach enhances patient involvement by offering real-time feedback on exercise execution and providing clear instructions for posture correction. The results demonstrate a notable impact on exercise performance, highlighting the feasibility of developing physiotherapeutically adapted solutions utilizing VR technology. By leveraging the Oculus Quest 2 system and the proposed framework, our research contributes to the advancement of VR-based rehabilitation practices. The findings offer valuable insights into the potential benefits of integrating immersive technologies into the field of physiotherapy, empowering healthcare professionals in their treatment approaches. Full article

Total hip arthroplasty (THA) is a widely performed surgical procedure that has evolved significantly due to advancements in artificial intelligence (AI) and robotics. As demand for THA grows, reliable tools are essential to enhance diagnosis, preoperative planning, surgical precision, and postoperative rehabilitation. AI applications in orthopedic surgery offer innovative solutions, including automated hip osteoarthritis (OA) diagnosis, precise implant positioning, and personalized risk stratification, thereby improving patient outcomes. Deep learning models have transformed OA severity grading and implant identification by automating traditionally manual processes with high accuracy. Additionally, AI-powered systems optimize preoperative planning by predicting the hip joint center and identifying complications using multimodal data. Robotic-assisted THA enhances surgical precision with real-time feedback, reducing complications such as dislocations and leg length discrepancies while accelerating recovery. Despite these advancements, barriers such as cost, accessibility, and the steep learning curve for surgeons hinder widespread adoption. Postoperative rehabilitation benefits from technologies like virtual and augmented reality and telemedicine, which enhance patient engagement and adherence. However, limitations, particularly among elderly populations with lower adaptability to technology, underscore the need for user-friendly platforms. To ensure comprehensiveness, a structured literature search was conducted using PubMed, Scopus, and Web of Science. Keywords included “artificial intelligence”, “machine learning”, “robotics”, and “total hip arthroplasty”. Inclusion criteria emphasized peer-reviewed studies published in English within the last decade focusing on technological advancements and clinical outcomes. This review evaluates AI and robotics’ role in THA, highlighting opportunities and challenges and emphasizing further research and real-world validation to integrate these technologies into clinical practice effectively. Full article

Virtual reality (VR) sports games are increasingly becoming important tools for enhancing cognitive and physical health among older adults. However, current research faces several challenges. Many experimental studies utilize existing games designed for general populations, lacking those specifically tailored for older adults; small sample sizes limit the generalizability of results; and issues such as cybersickness and technology adaptability remain challenges, although progress has been made. This literature review employs the PRISMA method to assess the latest research findings on the impact of VR sports games in improving cognitive and physical functions in older adults. We conducted a search in the Web of Science and SCOPUS databases, selecting literature related to VR interventions for balance, muscle strength, memory, and concentration enhancement. From an initial pool of 1705 articles, 12 studies met the inclusion criteria. Results indicate that VR sports games significantly enhance older adults’ exercise motivation through immersive experiences, while real-time feedback promotes the simultaneous improvement of cognitive and physical abilities. Furthermore, the social interaction elements within the VR environment effectively alleviate feelings of loneliness and enhance engagement longevity. Future research should focus on developing personalized and collaborative VR game designs and exploring their applications in home rehabilitation and community care to enhance accessibility and long-term effects. This review provides theoretical and practical support for the innovative application of VR technology in promoting healthy aging. It will benefit technology developers and researchers focused on the cognitive and physical health of older adults. Full article

Background: Parkinson’s disease is a neurodegenerative disorder affecting the central and peripheral nervous systems. Its treatment combines pharmacological and rehabilitative approaches, aimed at improving motor symptoms and preventing cognitive decline. Virtual reality emerges as a complementary rehabilitative option, showing efficacy in enhancing motor and cognitive aspects. This study systematically reviews the effectiveness of virtual reality in the rehabilitation of individuals with Parkinson’s disease. Methods: A systematic review was carried out. The Jadad scale was used to assess the methodological quality of the included studies, and the Oxford Center for Evidence-Based Medicine criteria were applied to determine the level of evidence and recommendation. The review followed PRISMA guidelines, with a literature search conducted in databases such as Cochrane and PubMed. Results: The studies indicate improvements in gait, balance, and overall motor function in Parkinson’s patients using virtual reality, though limitations such as small sample sizes and the lack of control groups in some studies are noted. Conclusions: Virtual reality proves to be an effective tool in Parkinson’s rehabilitation, enhancing balance and motor function. However, more studies with adequate methodological quality and larger sample sizes are needed to validate these findings. Full article

Donor site morbidity remains a significant concern in free flap microsurgery, with implications that extend beyond immediate postoperative outcomes to affect patients’ long-term quality of life. This review explores the multi-faceted impact of donor site morbidity on physical, psychological, social, and occupational well-being, synthesizing findings from the existing literature. Particular attention is given to the functional limitations, sensory deficits, aesthetic outcomes, and chronic pain associated with commonly utilized free flaps. Advancements in surgical techniques, including nerve-sparing and muscle-sparing methods, as well as innovations, like perforator flaps, have demonstrated the potential to mitigate these morbidities. Furthermore, the integration of regenerative medicine strategies, such as stem cell therapy and fat grafting, and technological innovations, including virtual reality rehabilitation and biofeedback devices, has shown promise in enhancing recovery and minimizing long-term complications. Despite these advances, challenges persist in standardizing QoL assessments and optimizing donor site management. This review emphasizes the need for a holistic, patient-centered approach in reconstructive microsurgery, advocating for further research to refine current strategies, improve long-term outcomes, and develop robust tools for QoL evaluation. By addressing these gaps, reconstructive surgeons can better align surgical objectives with the comprehensive well-being of their patients. Full article