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virtual reality Enhanced Exercise Training in Upper Limb Function of Patients With Stroke: Meta-Analytic Study

JOURNAL OF MEDICAL INTERNET RESEARCH 2025年 27卷 e66802页

作者： Xu, Shiqi Xu, Yanwen Wen, Ruyi Wang, Jun Qiu, Yuyu Chan, Chetwyn C. H. Soochow Univ Wuxi Ninth Peoples Hosp Dept Rehabil Med Wuxi Jiangsu Peoples R China Jiangnan Univ Wuxi Sch Med Wuxi Jiangsu Peoples R China Nanjing Med Univ Sch Rehabil Med Nanjing Peoples R China Educ Univ Hong Kong Dept Psychol Lo Ping Rd Hong Kong Peoples R China

Background: Recovery of upper limb function after stroke secondary to ischemia or hemorrhage is crucial for patients' independence in daily living and quality of life. virtual reality (VR) is a promising computer-based technology designed to enhance the effects of rehabilitation;however, the results of VR-based interventions remain equivocal. Objective: This study aims to review the plausible factors that may have influenced VR's therapeutic effects on improving upper limb function in patients with stroke, with the goal of synthesizing an optimal VR intervention protocol. Methods: The databases PubMed, EMBASE, Web of Science, and Cochrane Library were queried for English-language papers published from May 2022 onward. Two reviewers independently extracted data from the included papers, and discrepancies in their findings were resolved through consensus during joint meetings. The risk of bias was assessed using the Physiotherapy Evidence Database Scale and the Methodological Index for Non-Randomized Studies. Outcome variables included the Action Research Arm Test, Box-Block Test, Functional Independence Measure, Upper Extremity Fugl-Meyer Assessment, and Wolf Motor Function Test. The plausible factors examined were age, total dosage (hours), trial length (weeks), session duration (hours/session), frequency (sessions/week), and VR content design. The Bonferroni adjustment was applied to P values to prevent data from being incorrectly deemed statistically significant. Results: The final sample included 15 articles with a total of 1243 participants (age range 48.6-75.59 years). Participants in the VR therapy (VRT) group (n=455) demonstrated significantly greater improvements in upper limb function and independence in activities of daily living compared with those in the conventional therapy group (n=301). Significant factors contributing to improved outcomes in upper limb function were younger age (mean difference [MD] 5.34, 95% CI 2.18-8.5, P P<.001;I2=0%), interventio

关键词： virtual reality stroke upper limb function exercise training meta-analysis

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virtual reality High-Intensity Interval Training Exergaming Compared to Traditional High-Intensity Circuit Training Among Medical Students: Pilot Crossover Study

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JMIR SERIOUS GAMES 2025年 13卷 e63461页

作者： Merola, Pietro Cardoso, Marcos Barros Barreto, Gabriel Chagas, Matheus Carvalho Saunders, Luana Farias Oliveira Saunders, Bryan Berton, Danilo Cortozi Hosp Clin Porto Alegre Move Sapiens St Ramiro Barcelos 2350 BR-90410000 Porto Alegre Brazil Hosp Clin Porto Alegre Porto Alegre Brazil Univ Fed Rio Grande do Sul Postgrad Program Pulm Sci Porto Alegre Brazil Univ Fed Rio Grande do Sul Sch Med Porto Alegre Brazil Univ Sao Paulo Fac Med Appl Physiol & Nutr Res Grp Sao Paulo Brazil Fed Univ ABC Biomed Engn Sao Bernardo Do Campo Brazil Univ Sao Paulo Fac Med Ctr Lifestyle Med Sao Paulo Brazil Univ Sao Paulo Sch Phys Educ & Sport Appl Physiol & Nutr Res Grp Sao Paulo Brazil Univ Sao Paulo Fac Med Brazii SP Brazil

Background: This study evaluated the effectiveness of a virtual reality (VR) high-intensity interval training (HIIT) boxing protocol compared to traditional high-intensity circuit training (HICT) in improving exercise motivation, engagement, and physiological responses among 30 healthy medical students. Objective: The purpose was to compare the VR HIIT protocol, which involved using an Oculus Quest 2 for a futuristic exoskeleton game experience, with a traditional 12-exercise HICT. Methods: In total, 30 medical students engaged in both VR HIIT, using an Oculus Quest 2 for a futuristic exoskeleton game experience, and a traditional 12-exercise HICT. Metrics included heart rate (HR) and blood lactate levels before and after exercise alongside ratings of perceived exertion and the Situational Motivation Scale. Results: VR HIIT showed significantly higher mean HR (mean 161, SD 15 vs mean 144, SD 11 bpm;d =1.5;P <.001), peak HR (mean 182, SD 15 vs mean 176, SD 11 bpm;d =0.8;P =.001), and ratings of perceived exertion (mean 16, SD 2 vs mean 15, SD 2;d =0.4;P =.03). Postexercise lactate levels were higher in HICT (mean 8.8, SD 4.5 vs mean 10.6, SD 3.0 mmol/L;d =0.6;P =.006). Intrinsic motivation and other psychological measures showed no significant differences, except for lower fatigue in HICT (d=0.5;P =.02). Conclusions: VR HIIT significantly enhances physiological parameters while maintaining intrinsic motivation, making it a viable alternative to traditional HICT. However, the short-term nature of this study is a limitation, and future research should explore the long-term engagement and therapeutic impacts of VR exercise in diverse and clinical populations.

关键词： virtual reality VR high-intensity interval training exercise motivation exergame physical activity exercise heart rate

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virtual reality Interventions and Chronic Pain: Scoping Review

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JOURNAL OF MEDICAL INTERNET RESEARCH 2025年 27卷 e59922页

作者： Ding, Michael E. Traiba, Hajar Perez, Hector R. Montefiore Med Ctr Dept Med Div Gen Internal Med 3300 Kossuth Ave Bronx NY 10467 USA

Background: virtual reality (VR) interventions have demonstrated efficacy for more than a decade for mood and anxiety disorders and emerging evidence suggests they can reduce pain symptoms in both acute and chronic pain. More recently, these interventions have abounded within the commercial and academic sectors, immersing participants within a virtual environment to confer health benefits to users. VR immersion can facilitate the delivery of health interventions by isolating participants from distractors and stressors in a therapeutic environment. While recent studies of VR interventions have exploded, they are not uniform in approach or device type, limiting generalizability. Recent scoping reviews on VR and chronic pain have focused on specific diseases or limited inquiries to specific interventions or study types. Objective: We conducted a scoping review to generate new knowledge about the sum total of VR studies on chronic pain with specific emphasis on the methods and results of each study, including (1) the type of interventions, (2) outcomes chosen, (3) samples studied, and (4) data generated. Methods: A scoping review was performed on the literature on VR and chronic pain to describe themes associated with the literature to date and identify important gaps and unanswered questions to guide future research. CINAHL [EBSCO] (Cumulative Index to Nursing and Allied Health Literature) and PubMed were queried for the terms "virtual reality" and "pain," providing studies of chronic pain adult participants using VR delivered through headset displays. We included English-language manuscripts that had at least one VR intervention arm with adults with chronic pain. For this analysis, we only included VR interventions that were immersive (ie, using headsets). Non-study reports, studies with no specific chronic pain component, those not involving adults, and those using VR as part of a comprehensive rehabilitation program were excluded. A descriptive analytical method was

关键词： virtual reality chronic pain scoping review pain management efficacy anxiety disorders mood health condition health intervention adults aging therapeutic descriptive-analytical method monitoring US PRISMA

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virtual reality Interventions for Older Adults With Mild Cognitive Impairment: Systematic Review and Meta-Analysis of Randomized Controlled Trials

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JOURNAL OF MEDICAL INTERNET RESEARCH 2025年 27卷 e59195页

作者： Yang, Qin Zhang, Liuxin Chang, Fangyuan Yang, Hongyi Chen, Bin Liu, Zhao Shanghai Jiao Tong Univ Sch Design 800 Dongchuan Rd Shanghai 200240 Peoples R China

Background: Alzheimer disease is incurable, but it is possible to intervene and slow down the progression of dementia during periods of mild cognitive impairment (MCI) through virtual reality (VR) technology. Objective: This study aimed to analyze the effects of VR interventions on older adults with MCI. The examined outcomes includecognitiveabilities, mood, quality of life, and physical fitness, including general cognitive function, memory performance, attention and information processing speed, executivefunction, language proficiency, visuospatial abilities, depression, daily mobility of individuals, muscle performance, and gait and balance. Methods: A total of 4 web-based databases (Web of Science, PubMed, Embase, and Ovid) were searched up to December 30, 2023, for randomized controlled trials assessing the self-reported outcomes of VR-based technology on cognition, mood, quality of life, and physical fitness in older adults (aged >= 55 years) with MCI. Two reviewers independently screened the search results and reference lists of the identified papers and related reviews. Data on the intervention components and delivery and behavioral changetechniques used were extracted. A meta-analysis, risk-of-bias sensitivity analysis, and subgroup analysis were performed where appropriateto explore potential moderators. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the quality of evidence. Results: This review analyzed 18 studies involving 722 older adults with MCI. VR was delivered through different immersion levels with VR cognitive training, VR physical training, or VR cognitive-motor dual-task training. VR interventions showed significant improvements in memory (standardized mean difference [SMD] 0.2, 95% CI 0.02-0.38), attention and information processing speed (SMD 0.25, 95% CI 0.06-0.45), and executive function (SMD 0.22, 95% CI 0.02-0.42). VR without therapist involvement improved memory as well as atte

关键词： Alzheimer disease virtual reality VR mild cognitive impairment meta-analysis health care cognitive function memory attention executivefunction older adults

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virtual reality improves pain threshold and recall in healthy adults: A randomized, crossover study

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JOURNAL OF CLINICAL ANESTHESIA 2025年 103卷 111816-111816页

作者： Rodriguez, Samuel T. Jimenez, Ricardo T. Wang, Ellen Y. Zuniga-Hernandez, Michelle Titzler, Janet Jackson, Christian Suen, Man Yee Yamaguchi, Craig Ko, Brian Kong, Jiang-Ti Caruso, Thomas J. Lucile Packard Childrens Hosp Stanford Stanford Chariot Program Palo Alto CA USA Stanford Sch Med Dept Anesthesiol Perioperat & Pain Med Div Pediat Anesthesiol Stanford CA USA Stanford Univ Sch Med Stanford CA USA

Study objective: virtual reality (VR) is an emerging technology increasingly used to ameliorate acute and chronic pain although controlled, quantifiable data are limited. The purpose of this study is to evaluate VR's effect on heat pain threshold (HPT), pressure pain threshold (PPT), immediate pain and anxiety, and recalled pain and anxiety. Design: Prospective, randomized, crossover clinical trial. Setting: The Stanford Chariot Program conducted this study at the Stanford School of Medicine Health System. Patients: Healthy participants meeting inclusion criteria were recruited by solicitation from the Stanford School of Medicine Health System. Interventions: Participants were randomized by hand dominance and condition sequence and underwent standardized pain threshold tests with a thermode or an algometer during VR and control conditions. Measurements: Pain threshold, numeric pain scores, and anxiety scores were immediately recorded. Recalled pain and anxiety scores were recorded 24 h later. Main results: A total of 80 participants were included, 40 who underwent HPT testing and 40 who underwent PPT testing. VR increased pain thresholds for both HPT (P = 0.002) and PPT (P = 0.044). The use of VR resulted in no difference in initial pain scores for HPT (P = 0.432) or PPT (P = 0.24). There was no difference in recalled pain when using VR for HPT (P = 0.851) although there was for PPT (P = 0.003). Initial and recalled anxiety scores for HPT (P = 0.006, P = 0.018, respectively) and PPT (P = 0.014, P = 0.002, respectively) were all reduced when using VR. Conclusions: This study demonstrates that VR increased pain thresholds while modulating initial and recalled experiences with anxiety, which has implications for enhancing patient experiences during medical interventions and long-term health outcomes by optimizing memories during stressful events. Clinical trial registration: NCT05836649, 4/19/23. IRB registration: Stanford IRB #69330.

关键词： virtual reality Pain Anxiety Pain threshold Anesthesia

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virtual reality based executive function training in schools: The impact of adaptivity on executive function and motivation

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COMPUTERS & EDUCATION 2025年 234卷

作者： Hindman, Susan King, Rachel Pereira, Antonina Univ Chichester Dept Psychol & Counselling Chichester England

Executive function (EF) is a skill that is essential in many aspects of daily functioning and as such is a pertinent target for cognitive training protocols. With current findings about EF training being inconsistent, work is now needed to understand the core components that ensure successful training. A key component that is often cited as essential, but which lacks solid empirical justification is training adaptivity, which is thought to improve participant motivation and support engagement. Therefore, the present study aimed to explore the relationship between adaptivity and motivation, in virtual reality (VR) based EF training with primary school-aged children. Sixty participants were allocated to one of three conditions: VR adaptive training, VR non-adaptive training, and a passive control group. Training in VR conditions consisted of 12 15-min sessions, delivered over 4 weeks and was delivered using the cognitive training game Koji's Quest, developed by Neuroreality. All participants completed EF tests at pre- and post-time points. Participants in the VR conditions also completed motivation measures after the training. Results suggest that the adaptive training might influence the switching response over time, but further analyses did not confirm significant differences, possibly due to the small sample size and the high scores variability. Although no differences were observed on the quantitate measures of motivation, qualitative feedback did indicate that perhaps motivation may have been a contributing factor. Results provide initial evidence that short term VR cognitive training may be effective in improving cognitive flexibility in primary aged children, however due to the small sample size and high variability, results are tentative, and further research is necessary. Findings are discussed in terms of the implications for educational application.

关键词： Executive function Adaptivity virtual reality Cognitive flexibility Motivation

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virtual reality effects on balance and mobility in people with Parkinson's disease: A systematic review with meta-analysis

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ANNALS OF PHYSICAL AND REHABILITATION MEDICINE 2025年第6期68卷 101967-101967页

作者： Lheureux, Alexis Lejeune, Thierry Simons, Alexane Gillis, Aurore Everard, Gauthier Catholic Univ Louvain NeuroMuscoloSkeletal Lab Inst Rech Expt & Clin B-1200 Woluwe St Lambert Belgium Ctr Hosp Univ UCL Namur Site Mont Godinne B-5530 Yvoir Belgium Clin Univ St Luc Phys & Rehabil Med B-1200 Brussels Belgium Univ Laval Ctr Interdisciplinaire Rech Readaptat & Integrat S Quebec City PQ G1M 2S8 Canada Laval Univ Fac Med Dept Rehabil Quebec City PQ G1V 0A6 Canada

Background Specific virtual reality (VR) systems designed for rehabilitation and non-specific VR systems intended for entertainment are used in Parkinson's disease (PD) rehabilitation, but their effects are unclear. The extent to which these systems integrate neurorehabilitation principles for PD rehabilitation is unknown. Previous meta-analyses exist but data are lacking on the impact of VR on mobility. Objectives Primary aim: to perform a systematic review with meta-analysis comparing the effects of VR and conventional therapy (CT) on balance and mobility in people with PD. Secondary aim: to perform subgroup analyses on VR type, disease severity, and treatment duration. Methods Randomized controlled trials comparing VR and CT effects on balance and mobility in adults with PD were selected from Pubmed and EMBASE until September 2024. Data were synthesized qualitatively and quantitatively using a standardized mean difference (SMD) with random-effects model. Subgroup analyses (VR type, disease severity, and treatment duration) and analysis of fulfilled neurorehabilitation principles were conducted. Risk of bias was assessed (PEDro checklist and Cochrane RoB-2). Results Twenty-eight studies (12 countries) were included: 1151 participants, mean Hoehn & Yahr stage between 1.4 and 3.4, mean (SD) treatment duration 18.8 (11.5) hours in the qualitative analysis and 23 in the quantitative analysis. Overall risk of bias was high (10 studies), some concerns (13 studies), or low (5 studies). VR was more effective than CT for balance (630 participants;11 studies;SMD 0.42;95% CI, 0.19-0.65;P < 0.001) and as effective as CT for mobility (591 participants;10 studies;SMD 0.18;95% CI, -0.03 to 0.40;P = 0.09). Balance and mobility outcomes did not differ between specific and non-specific VR. Subgroup analyses found no significant differences. Conclusions VR improved balance in people with PD more than CT (low-certainty evidence). VR improved mobility similarly to CT (moderate-certain

关键词： Parkinson's disease virtual reality Exergaming Rehabilitation Physiotherapy modalities virtual reality exposure therapy

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virtual reality cue exposure as an add-on to smoking cessation group therapy: a randomized controlled trial

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ADDICTION SCIENCE & CLINICAL PRACTICE 2025年第1期20卷 1-12页

作者： Kroczek, A. M. Schroeder, B. Rosenbaum, D. Muehleck, A. Diemer, J. Muehlberger, A. Ehlis, A. C. Batra, A. Univ Hosp Tubingen Tubingen Ctr Mental Hlth TuCMH Dept Psychiat & Psychotherapy Tubingen Germany Univ Regensburg Dept Psychol Clin Psychol & Psychotherapy Regensburg Germany Univ Hosp Tubingen Tubingen Ctr Mental Hlth TuCMH Dept Psychiat & Psychotherapy Sect Addict Res & Med Tubingen Germany Kbo Inn Salzach Hosp Wasserburg Germany Ludwig Maximilians Univ Munchen Dept Psychol Munich Germany German Ctr Mental Hlth DZPG Partner Site Tubingen Tubingen Germany

BackgroundCue exposure (CE) is used for relapse prevention as part of smoking cessation therapy to reduce the automatized response to smoking-related cues. Using CET in virtual reality (VR) is an approach to increase its efficacy by creating cost-efficient high-risk situations. The efficacy of VR-based CETs was compared to that of an unspecific relaxation intervention as an add-on to an established cognitive-behaviorally oriented smoking cessation group therapy (G-CBT).MethodsN = 246 abstinence-motivated smokers were included in a two-armed randomized controlled trial (G-CBT with VR-CET vs. G-CBT with progressive muscle relaxation/PMR) with 1-, 3-, and 6-month follow-ups (measurements in 2018-2020). All smokers joined a well-established G-CBT smoking cessation program with six sessions with four additional sessions of either VR-based smoking cue exposure therapy (VR-CET) or four sessions of group-based PMR. The primary outcome was abstinence after 6 months according to the Russell Standard;secondary outcomes included changes in the number of smoked cigarettes, craving (assessed by the Questionnaire of Smoking Urges/QSU), and self-efficacy (assessed by the Smoking Abstinence Self-Efficacy Scale/SES) over *** outcome: Six months after G-CBT, 24% of the participants were abstinent, and there was no significant difference between the PMR (n = 34/124) and VR-CET (n = 24/122) groups (odds ratio PMR/VR = 0.64). Secondary measures: SES increased, and QSU and the number of smoked cigarettes decreased over time. Baseline craving ratings predicted abstinence only in the VR-CET *** randomized controlled trial did not show increased abstinence rates related to smoking cue exposure in virtual reality. Secondary measures demonstrated significant reductions in craving and cigarette consumption as well as increases in self-efficacy over time, regardless of the intervention. However, high baseline craving was negatively related to abstinence in the VR

关键词： Smokers Smoking cessation Cue reactivity Cue exposure Craving virtual reality

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virtual reality cricothyrotomy - a tool in medical emergency education throughout various disciplines

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BMC MEDICAL EDUCATION 2025年第1期25卷 1-10页

作者： Burkhardt, Valentin Vallette, Marianne Speck, Iva Flayyih, Omar Huber, Christine Widder, Angela Wunderlich, Robert Everad, Friederike Offergeld, Christian Albrecht, Tobias Univ Freiburg Fac Med Med Ctr Dept Otorhinolaryngol Head & Neck Surg Killianstr 5 D-79106 Freiburg Germany Univ Freiburg Fac Med Med Ctr Dept Nucl Med Hugstetterstr 55 D-79106 Freiburg Germany Univ Freiburg Fac Med Med Ctr Deans Off Human Med Breisacher Str 153 D-79110 Freiburg Germany Univ Hosp Tubingen Dept Anesthesiol & Intens Care Med Tubingen Germany Univ Hosp Tubingen Dept Otorhinolaryngol Head & Neck Surg Tubingen Germany TIME Tubingen Inst Med Educ Med Fac Tubingen Tubingen Germany

ObjectivesA cricothyrotomy represents an emergency procedure that may be considered a last option for securing the airway. While fortunately rare, it is important to note that such invasive procedures must be mastered if they are to be used. Therefore, regular training is essential to gain routine. The aim of the present study was to investigate whether professional groups with different levels of experience with the procedure succeed in learning the procedure with a virtual reality *** and methodsIn a multicenter approach, 146 employees with four different professional backgrounds-otorhinolaryngologists, anesthesiologists, emergency physicians and certified nurses-were included in the study. The participants were required to complete a virtual reality (VR) cricothyrotomy scenario in three consecutive runs, and the time required and errors in the procedure were recorded. The training experience was subsequently evaluated subjectively using a *** study included 146 participants with an average age of 33 years and an average of 5 years of professional experience. The majority of participants (74%) reported an improvement in the speed of the procedure and in the procedural steps (87%). These subjective improvements were confirmed objectively by the time required for completion of the procedure and the points achieved. Gaming experience had a significant effect on both the score (p = 0.023) and procedure time (p = 0.039), whereas age and medical specialization did not. Real-life experience with cricothyrotomy had no significant effect on performance in *** reality provides an effective method for training healthcare professionals in cricothyrotomy, regardless of their specialty or prior experience. The participants showed significant improvements in both the speed and accuracy of the procedure after training, regardless of their prior experience or medical background. Further research is necessary to assess the benefit

关键词： Cricothyrotomy Gamification Education virtual reality VR Emergency medicine

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virtual reality simulation training for childbirth: A cluster randomized crossover study

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INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS 2025年第0期 2025 Mar 29页

作者： Gosavi, Arundhati Kanneganti, Abhiram Khoo, Eng Tat Singh, Kuldip Shen, Liang Rauff, Mary Liu, Chang Choolani, Mahesh Natl Univ Hlth Syst Natl Univ Ctr Women & Children NUWoC Dept Obstet & Gynaecol Singapore Singapore Natl Univ Singapore Yong Loo Lin Sch Med Dept Obstet & Gynaecol Singapore Singapore Natl Univ Singapore Immers Real Lab Singapore Singapore Natl Univ Singapore Coll Design & Engn Engn Design & Innovat Ctr Singapore Singapore Natl Univ Singapore Yong Loo Lin Sch Med Biostat Unit Singapore Singapore

Objective: To compare knowledge acquisition and domain-specific feedback between virtual reality (VR) and mannequin-based simulation for teaching medical students normal vaginal delivery (NVD). Methods: We conducted a cluster randomized crossover study comparing a novel in-house-developed NVD VR simulator utilizing an Oculus (R) Quest 2 HMD with the PROMPT Flex (R) mannequin. We randomly assigned medical student clinical groups to either VR or mannequin simulation. Participants took an 11-item knowledge quiz before and after their first simulation before crossing over to the alternate simulation. Participants took a six-domain, 14-item feedback questionnaire evaluating both simulations. The primary outcome was percentage improvement in knowledge scores, while the secondary outcome was adjusted mean difference in mean feedback scores between each simulation. Results: Twenty clinical groups comprising 111 medical students participated. There was no difference in either arm for baseline characteristics and pre-simulation knowledge scores. Medical students undergoing VR simulation had significantly higher overall post-simulation mean percentage correct scores (79.0% vs. 54.0%;P < 0.001). The mannequin simulator had significantly higher feedback scores (61.0 vs. 58.3;adjusted mean difference 2.45 [95% confidence interval 0.95-3.95];P = 0.002) and in five of six domains. A total of 40.5% of respondents preferred the mannequin simulation, 4.5% preferred the VR simulation, and 42.5% preferred a mixture of the two. Conclusions: Our novel VR NVD simulator was superior to traditional mannequin simulation in content delivery. As more respondents preferred a mixed approach over any single method, VR simulation could complement legacy mannequin simulation methods by serving as a primer or a distance-learning tool and help increase skill birth attendant training.

关键词： distance learning medical students normal vaginal delivery simulation virtual reality

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