Virtual Reality Exercise Research Articles

Effect of virtual reality exercises on balance and fall in elderly people with fall risk: a randomized controlled trial

BackgroundDeficient balance and fear of falling in elderly people can lead to disturbed daily activities, falling, and finally reduced quality of life. Therefore, evaluation of low-risk methods that might partially improve balance in this group of people is of utmost importance. The present study aimed to investigate the impact of Virtual Reality (VR) exercises based on Xbox Kinect on balance and fear of falling among elderly people.MethodsThis clinical trial was performed on 60 elderly individuals living in nursing homes divided into two groups of control and Xbox. The participants in the intervention group received VR exercises based on Xbox Kinect in form of two 30–45-min sessions held on a weekly basis for 6 weeks. The individuals in the control group, on the other hand, received routine exercises of the nursing homes. The research tools used in this study included a demographic questionnaire, the Berg Balance Scale (BBS), the Timed Up and Go (TUG) test, and the Falling Efficacy Scale (FES).ResultsThe findings of the current study demonstrated that the scores of BBS and TUG test as the indices of balance among elderly people improved significantly in the Xbox group after the intervention (p < 0.001 for both BBS and TUG test). Moreover, the score of fear of falling diminished significantly in the intervention group compared to the control group (p < 0.001).ConclusionAccording to the results of the present investigation, 6 weeks of VR balance exercises could enhance balance and fear of falling among elderly people living in nursing homes.Trial registrationCode:IRCT20190727044347N1, Date: 17-8-2019.

Combining virtual reality and 3D-printed models to simulate patient-specific dental operative procedures-A study exploring student perceptions.

Students face a number of challenges in translating the skills acquired in pre-clinical simulation environments to the delivery of real patient care. These are particularly emphasised for complex operative procedures such as tooth preparations for indirect restorations. This paper reports student perceptions of a novel approach designed to improving student confidence when undertaking operative procedures on patients for the first time, by providing patient-specific simulation using virtual reality (VR) and 3D-printed models of the student's real clinical case. Students practised on patient-specific models, in the presence of a clinical tutor, firstly using VR simulation then with 3D-printed models in a clinical skills laboratory. The students then carried out the operative procedure on their patients, on the third occasion of practice. After providing the treatment for their patients, students attended a semi-structured interview to discuss their experiences. The qualitative data were analysed using two forms of inductive analysis. Students most frequently cited: the value of the educator, increased confidence and efficiency during the clinical procedure, improved patient confidence and the complementary benefits of the two simulation modalities. Thematic analysis of participants' responses uncovered five key themes: The value of virtual reality dental simulators The value of clinical skills laboratory simulation with 3D-printed models The value of educator engagement The impact on the clinical procedure and the patient The VR and clinical skills laboratory balance CONCLUSION: This paper reports the early findings of an intervention that improves dental student confidence through the use of patient-specific VR exercises and 3D-printed models. These provided an incremental learning experience for an operative clinical procedure, prior to treatment of the live patient. Early results suggest this is a positive experience for the students, providing a valuable contribution to their confidence and preparedness.

The WIRED Trial - Wii Sports™ as a virtual Reality Exercise Experience to improve Depression in healthcare workers during the COVID-19 Pandemic: A Multicenter, Prospective, Randomized, Controlled, Superiority Phase II Trial.

Background: Due to the coronavirus pandemic, the number of hospitalized individuals increased exponentially. The sudden increase in workload, the social isolation, and the fear of COVID-19 contributed to a remarkable increase of depression cases (from 20.9% to 43.2%) among healthcare workers. Although many treatments are available for depression, including pharmacotherapy, exercise, and virtual reality, response varies widely, from complete recovery to non-responders and relapsing cases. In this sense, Wii Sports™ may serve as an alternative to improve response to standard first-line therapy, since it provides an interactive environment, physical activity and incorporates playfulness. Objective: Evaluate the effect of Wii Sports™ in treating mild and moderate cases of major depressive disorder in healthcare professionals who developed depression during the COVID-19 pandemic. Methods: The WIRED trial is a phase II, multicenter, randomized, active-controlled, single-blinded, superiority trial with two parallel groups. The intervention group will be composed of Wii Sports™ in addition to a first-line antidepressant, while the control group will be composed of Wii™ games that do not involve physical activity in addition to a first-line antidepressant. The primary outcome is to detect a group mean difference in the 17-item Hamilton Depression Rating Scale (HAM-D17) at week twelve, while secondary outcomes include participant adherence and comparison of HAM-D17 scores at different time points. Conclusion: To our knowledge, there is no previous literature published that targets the same population, tests the same intervention, and evaluates the same outcomes, highlighting the possible impact of the study on the psychological and psychiatric fields, regardless of its results. Keywords: Coronavirus, COVID-19, depression, Major Depression Disorder, Wii Sports™, virtual reality, exercise.

Effect of Virtual Reality Exercises on the Cognitive Status and Dual Motor Task Performance of the Aging Population.

Aging is a global phenomenon affecting numerous developed and developing countries. During this process, the functional state of the body, especially the cognitive state, declines. This research investigated the impact of virtual reality exercises on the cognitive status and dual-task performance in the elderly of Tabriz city, Iran. Forty men with a mean age of 71.5 were selected and assigned to either the experimental (n = 20) or control groups (n = 20). Both groups completed the Mini-Mental State Examination for cognitive status. The pre-test was performed through the Timed Up and Go test (TUG) along with a countdown of numbers. Then, the experimental group practiced virtual driving for six weeks, while the control group received no treatment. After the treatment, both groups completed the post-test. At each stage, the test was performed as a dual motor task as well. Data were analyzed using the paired t-test and the independent sample t-test to show the intra-group and inter-group differences, respectively. The results showed a significant improvement in the cognitive status and dual-task performance of the elderly men after the six-week training period, which was also significant compared to the control group. Virtual reality driving can be used to improve the cognitive status and dual task performance of elderly men.

Enhancement of Anticipatory Postural Adjustments by Virtual Reality in Older Adults with Cognitive and Motor Deficits: A Randomised Trial.

Background: Postural activities involved in balance control integrate the anticipatory postural adjustments (APA) that stabilize balance and posture, facilitating arm movements and walking initiation and allowing an optimal coordination between posture and movement. Several studies reported the significant benefits of virtual reality (VR) exercises in frail older adults to decrease the anxiety of falling and to induce improvements in behavioural and cognitive abilities in rehabilitation processes. The aim of this study was thus to test the efficiency of a VR system on the enhancement of the APA period, compared to the use of a Nintendo Wii system. Methods: Frail older adults (n = 37) were included in this study who were randomized and divided into a VR exercises group (VR group) or a control group using the Nintendo Wii system (CTRL group). Finally, 22 patients were included in the data treatment. APA were studied through muscular activation timings measured with electromyographic activities. The functional reach test, the gait speed, and the time up and go were also evaluated before and after a 3-week training phase. Results and discussion: As the main results, the training phase with VR improved the APA and the functional reach test score along the antero-posterior axis. Together, these results highlight the ability of a VR training phase to induce neuromuscular adaptations during the APA period in frail older adults. Then, it underlines the effective transfer from learning carried out during the VR training movements to control balance abilities in a more daily life context.

An intradialytic non-immersive virtual reality exercise programme: a crossover randomized controlled trial.

Chronic kidney disease is closely related to a high risk of death and disability, poor physical performance and frailty. The main objective of this research was to analyse how intradialytic administration of a non-immersive virtual reality (VR) exercise programme would affect physical function and adherence to exercise in these patients. A total of 56 individuals participated in two 12-week periods in a crossover randomized controlled trial. Each patient underwent a functional capacity evaluation before and after each study period. The functional tests administered included the 4-m gait speed test, Short Physical Performance Battery (SPPB), timed up-and-go (TUG) test, one-legged stance test (OLST) for balance, sit-to-stand 10 (STS-10) and sit-to-stand 60 (STS-60) tests and 6-min walking test (6MWT). Adherence to the exercise programme was also recorded. To assess the effect of VR exercise on the functional test outcomes over time, the patients were analysed using a two-way repeated-measures analysis of variance with time and treatment as the within-participant factors. By the end of the 12 weeks of exercise, compared with the control period, 33 participants showed significant change in physical function as measured through the 4-m gait speed test (0.14 m/s), SPPB (1.2 points), TUG (-1.7 s), OLST (7.1 s), STS-10 (-5.8 s), STS-60 (5 repetitions) and 6MWT (85.2 m), with adherence rates exceeding 70%. There were no changes in the biochemical data or in the medications in the period of the study. An intradialytic non-immersive VR exercise programme improves patient physical function.

Deteriorating Patient Training Using Nonimmersive Virtual Reality: A Descriptive Qualitative Study.

Recent nurse education pedagogical strategies are starting to embrace the use of virtual patient simulations in higher education settings. This study evaluated student, simulation technician, and lecturer perspectives on student performance after virtual training for care of a deteriorating diabetic patient. Second year nursing students learned using a virtual patient simulation, which was a follow-up of a randomized controlled trial that took place during the academic year 2017-2018. Group and individual interviews were conducted comprising the 21 staff and students involved in the virtual reality simulation in four individual lecture sessions. Five themes emerged from this study: engagement, immersion, confidence, knowledge, and challenges. Student participants found that the virtual reality exercise aided their understanding of the complex concepts associated with hypoglycemia, provided immediate feedback about their clinical decisions, could be completed multiple times, and provided more opportunities for safe practice, complimenting their ward and clinical skills experiences. Simulation technicians and lecturing staff also recognized these benefits but identified challenges, including time and cost constraints. We recommend further research into potential benefits and challenges, including likely consequences of increased use of virtual reality technologies for nurse education curriculum design.

A novel virtual reality approach for functional lateralization in healthy adults

Functional lateralization relates to a natural asymmetry in the dominance right or left body side, and is a fundamental principle of the brain. The hemispheres of the brain control the contralateral body side, and show subtle, yet striking, anatomical asymmetries and functional lateralization. Innovative technologies, including Virtual Reality (VR), are entering the areas of experimental research, modeling and simulation related to the study of lateralization, with new perspectives of different applications in modern medical practice. Researchers/clinicians note that there are fewer VR studies with healthy participants, and which are important in evaluating/interpreting clinical outcomes, and testing the usefulness, limitations, and sensitivity of VR. The presented influence of the domination of upper/lower limbs on the performance of VR exercises was studied in healthy right-handed adults. Virtual testing sessions were performed independently with both/ dominant/ non-dominant hands, and the similar VR sessions were conduced on a Wii Balance Board (WBB) with the choice of body side, at different levels of the difficulty. The obtained results are consistent with other studies which show that cognitive-motor training in VR with the WBB platform is a very sensitive and promising tool for recognizing/assessing functional asymmetries of the right-left body side not only in disturbed lateralization, but also in the test training of healthy subjects.

Efeito da realidade virtual no equilíbrio corporal de idosos: Revisão Sistemática

Processo de envelhecimento influencia as capacidades físicas dos idosos, tornando-os mais suscetíveis a quedas e limitações funcionais. Equilíbrio postural prejudicado aumenta o risco de quedas em idosos. Exercício com realidade virtual tem sido amplamente utilizado para o equilíbrio postural de treinamento. Objetivo: deste estudo é investigar o efeito dos exercícios físicos com realidade virtual no equilíbrio corporal de idosos. Metodologia: Para esta revisão sistemática foi utilizado o método PRISMA, selecionou artigos randomizados e controlados publicados até Janeiro de 2021, que utilizavam videogame como recurso para reabilitação de equilíbrio corporal em idosos. A base de dados utilizada foi PubMed. Resultados: Foram encontrados 316 estudos, após as fases de triagem selecionamos 7 estudos para esta revisão sistemática. Os estudos passaram por uma avaliação metodológica pela escala de JADAD. O tamanho de efeito intra-grupos (ESw) variou de pequeno a muito grande (0,23-2,41) para o grupo que utilizou a RV como intervenção, enquanto para o grupo controle o tamanho de efeito variou de trivial a grande (0,00-1,98). No entanto o tamanho de efeito inter-grupos variou de trivial a perfeito (0,00-5,87) mostrando um efeito maior para o uso da RV. Conclusão: Concluímos que o uso da RV para a reabilitação de equilíbrio corporal é benéfico para a população idosa.

Effects of Wii Virtual Reality Exercise Program on the Balance Function of Elderlies Living Alone with High Fall Risk

Effects of Wii Virtual Reality Exercise Program on the Balance Function of Elderlies Living Alone with High Fall Risk

Task-Oriented and Imitation-Oriented Movements in Virtual Reality Exercise Performance and Design.

This study investigated the influence of game features and practice type on human kinematic and muscular performance in a virtual reality exercise (VRE). Participants demonstrated changes in shoulder flexion angle and muscle activation under different virtual scenarios. Conventional VRE studies often compared the outcomes between an experimental group that underwent exercise in VR and a real-world exercise control group, whereas comparisons between VRE programs are lacking. Besides, the attributes of VREs received little attention. Thirteen able-bodied participants performed upper extremity exercise movements in immersive VR using a head-mounted display. Participants performed task-oriented and imitation-oriented movements with different game features. Shoulder muscle activity (the deltoid, supraspinatus, and infraspinatus) and shoulder motion were collected. Practice type (task-oriented, imitation-oriented) significantly influenced the flexion angle of the shoulder complex (F(1,11) = 9.53, p = .01), and the muscle activity of the supraspinatus (F(1,9) = 12.61, p = .006) and the infraspinatus (F(1,9) = 12.71, p = .006). Game features did not have a statistically significant effect on shoulder flexion angle or shoulder muscles' activations. Compared to imitation-oriented practice, task-oriented practice elicited more intensive shoulder movements and muscular efforts but also induced greater movement variations. Substantial differences across game features levels should be further investigated to have significant effects. This research may help guide the design of future VREs. For strength training or rehabilitation where intensive practice is required, task-oriented practice should be considered; for movement learning where movement consistency is required, imitation oriented practice should be adopted.

Α Virtual Reality App for Physical and Cognitive Training of Older People With Mild Cognitive Impairment: Mixed Methods Feasibility Study.

BackgroundTherapeutic virtual reality (VR) has emerged as an effective treatment modality for cognitive and physical training in people with mild cognitive impairment (MCI). However, to replace existing nonpharmaceutical treatment training protocols, VR platforms need significant improvement if they are to appeal to older people with symptoms of cognitive decline and meet their specific needs.ObjectiveThis study aims to design and test the acceptability, usability, and tolerability of an immersive VR platform that allows older people with MCI symptoms to simultaneously practice physical and cognitive skills on a dual task.MethodsOn the basis of interviews with 20 older people with MCI symptoms (15 females; mean age 76.25, SD 5.03 years) and inputs from their health care providers (formative study VR1), an interdisciplinary group of experts developed a VR system called VRADA (VR Exercise App for Dementia and Alzheimer’s Patients). Using an identical training protocol, the VRADA system was first tested with a group of 30 university students (16 females; mean age 20.86, SD 1.17 years) and then with 27 older people (19 females; mean age 73.22, SD 9.26 years) who had been diagnosed with MCI (feasibility studies VR2a and VR2b). Those in the latter group attended two Hellenic Association Day Care Centers for Alzheimer’s Disease and Related Disorders. Participants in both groups were asked to perform a dual task training protocol that combined physical and cognitive exercises in two different training conditions. In condition A, participants performed a cycling task in a lab environment while being asked by the researcher to perform oral math calculations (single-digit additions and subtractions). In condition B, participants performed a cycling task in the virtual environment while performing calculations that appeared within the VR app. Participants in both groups were assessed in the same way; this included questionnaires and semistructured interviews immediately after the experiment to capture perceptions of acceptability, usability, and tolerability, and to determine which of the two training conditions each participant preferred.ResultsParticipants in both groups showed a significant preference for the VR condition (students: mean 0.66, SD 0.41, t29=8.74, P<.001; patients with MCI: mean 0.72, SD 0.51, t26=7.36, P<.001), as well as high acceptance scores for intended future use, attitude toward VR training, and enjoyment. System usability scale scores (82.66 for the students and 77.96 for the older group) were well above the acceptability threshold (75/100). The perceived adverse effects were minimal, indicating a satisfactory tolerability.ConclusionsThe findings suggest that VRADA is an acceptable, usable, and tolerable system for physical and cognitive training of older people with MCI and university students. Randomized controlled trial studies are needed to assess the efficacy of VRADA as a tool to promote physical and cognitive health in patients with MCI.

The Effect of Virtual Reality Exercises on Pain, Functionality, Cardiopulmonary Capacity, and Quality of Life in Fibromyalgia Syndrome: A Randomized Controlled Study.

Objective: To investigate the effect of motion-controlled videogames on pain, functionality, cardiopulmonary capacity, and quality of life in women with fibromyalgia. Materials and Methods: Forty women with fibromyalgia were randomized into virtual reality group (VRG) and conventional training group (CTG). The CTG performed aerobic exercise (cycling, 3 days per week, 20 minutes per day) and conventional exercises (muscle strengthening, balance, and flexibility, 3 days per week, 15 minutes per day) for 4 weeks. The VRG performed virtual reality exercise (volleyball, Microsoft Xbox Kinect®, 3 days per week, 15 minutes per day) together with cycling exercise for 4 weeks. After the exercise program, both groups received the same home exercise program for 4 weeks. All patients were evaluated at baseline, fourth, and eighth weeks. Primary outcome measure was Fibromyalgia Impact Questionnaire. Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale, Fatigue Severity Scale (FSS), Symptom Severity Scale, EuroQol-Five Dimensions İndex Scale/Visual Analogue Scale (EQ-5D-index/VAS) and Six Minute Walk Test (6MWT) were used as secondary outcome measures. Results: Thirty-four patients (17 VRG, 17 CTG) were evaluated at the eighth week. After 4 weeks, all outcome measures improved significantly in both groups (P < 0.05). However, there was no statistically significant difference in all outcome measures between fourth and eighth weeks. Group and time interactions for 6MWT (P = 0.043), FSS (P = 0.026), EQ-5D-İndex Scale (P = 0.014), and EQ-5D-VAS (P = 0.049) were significant only for the VRG. In addition, median individual's satisfaction was significantly higher in the VRG (P < 0.001). Conclusion: Virtual reality exercises along with aerobic exercise increase cardiopulmonary capacity and quality of life in fibromyalgia syndrome. In addition, they increase patient satisfaction and may improve patient compliance to exercise.

Effects of Visual Flow Alterations on Psychophysiological Responses to Virtual Reality Exercise.

Virtual reality (VR) technology combined with exercise, called VR exercise, is believed to have beneficial effects on mood; but VR factors contributing to improved mood remain ambiguous. The purpose of this study was to examine the effect of visual flow speed on psychophysiological responses (i.e., physiological responses, ratings of perceived exertion or RPE, and mood) to immersive VR exercise in a simulated natural environment. Eighteen male participants (Mage =23.1, SD = 1.9 years) cycled an ergometer at 80 watts for 5 minutes on three separate occasions while watching a first-person VR movie through VR goggles at three different speeds of visual flow, corresponding to 7.5 km.h-1, 15 km.h-1, and 22.5 km.h-1. The order of the three speeds was randomized in a counterbalanced design. We measured heart rate, oxygen uptake, minute ventilation, respiratory rate, and cadence during the exercise, and we recorded ratings of perceived exertion (RPE) and mood immediately after the exercise. We evaluated mood states with the Two-Dimensional Mood Scale. One-way repeated measures analysis of variance or the Friedman test revealed no significant effects on any physiological variables, RPE or cadence as a result of altered visual flow speed during VR exercise (p > .05). However, speed of visual flow significantly influenced participant ratings of Vitality (p = 0.01) and Pleasure (p = 0.02), with the faster speed resulting in a more positive mood state. As these findings showed that VR exercise with faster visual flow induced positive mood states, we recommend faster visual flow to induce better mood states in VR exercise.

Rapid Prototyping of Virtual Reality Cognitive Exercises in a Tele-Rehabilitation Context

In recent years, the need to contain healthcare costs due to the growing public debt of many countries, combined with the need to reduce costly travel by patients unable to move autonomously, have captured the attention of public administrators towards tele-rehabilitation. This trend has been consolidated overwhelmingly following the Covid-19 pandemic, which has made it precarious, difficult and even dangerous for patients to access hospital facilities. We present an approach based on the rapid prototyping of virtual reality, cognitive tele-rehabilitation exercises, which reinforce the group of exercises available in the Nu!reha platform. Patients who experienced injury or pathology need to practice continuous training in order to recover functional abilities, and the therapist needs to monitor the outcomes of such practices. The group of new exercises based on the rapid prototyping approach, become crucial especially in this pandemic period. The Virtual Reality exercises are designed on Unity 3D to empower the therapist to set up personalized exercises in an easy way, enabling the patient to receive personalized stimuli, which are essential for a positive outcome in the practice. Furthermore, the reaction speed of the system is of fundamental importance, as the temporal evolution of the scene must proceed parallel to the patient’s movements, to ensure an effective and efficient therapeutic response. So, we optimized the virtual reality application in order to make the loading phase and the startup phase as fast as possible and we have tested the results obtained with many devices: in particular computers and smartphones with different operating systems and hardware. The implemented method powers up the Nu!Reha system®, a collection of tele-rehabilitation services that helps patients to recover cognitive and functional capabilities.

Cross-Sectional Study Using Virtual Reality to Measure Cognition.

Dual-task research is limited in its transferability to authentic contexts because laboratory conditions do not replicate real-world physical activity and decision-making scenarios. Creating valid, reliable methodologies to assess physiological and behavioral responses under varying physical and cognitive demands using virtual reality (VR) environment addresses this limitation. This study determined the feasibility of using VR to investigate the effects of dual-tasking on healthy young adults' cognitive performance. Three dual-tasking conditions (i.e., standing, preferred-paced walking, and fast-paced walking, each with blocked congruent and incongruent tasks) were developed. Using a within-subjects, randomized design, thirty-two young adults (17 female, mean age = 21.03 ± 2.86) were randomly assigned to a starting condition but experienced all three conditions. Physiological responses of heart rate (HR) and accelerometry data measured energy expenditure as the physical demand. Behavioral responses of reaction time and error rate quantified cognitive performance. Results indicated that (a) each condition verified independent physiological and behavioral responses; (b) reaction time and error rate during preferred walking or fast-paced walking dual-tasking conditions was significantly lower than standing condition; and surprisingly, (c) congruent tasks showed lower reaction time than the incongruent tasks. These findings suggest that it is feasible to use VR to assess the effects of dual-task conditions. Specifically, walking can optimize the motor-cognitive dual-task performance, compared to standing. These findings may be attributed to the dose-response effects of exercise intensity. Future studies should incorporate advanced technology such as the VR exercise.

The Effect of Virtual Reality Exercise Program on Sitting Balance Ability of Spinal Cord Injury Patients.

(1) Background: Virtual reality (VR) is a useful device for rehabilitation therapy. The purpose of this study was to examine the effect of virtual reality exercise program on sitting balance with spinal cord injury; (2) Methods: 20 subjects who selected on the basis of the screening criteria were divided into the experimental group (n = 10) who underwent the virtual reality exercise program and rehabilitation therapy and the control group (n = 10) who underwent a regular sitting balance training program and a regular rehabilitation therapy. Each intervention consisted of a 30-min session a day, three times a week, for eight weeks. In order to measure functions of the sitting balance, FSA (force sensitive application) and LOS (limit of stability) were used before and after the treatment intervention; (3) Results: We found significant differences for the FSA, LOS between pre-test and post-test in the 2 groups; (4) Conclusions: The findings of this study suggest that virtual reality exercise program can be applied as a useful approach for spinal cord injury patients.

The Effect of 8 Weeks Virtual Reality Training on Static and Dynamic Balance and Performance in Male Athletes With Functional Ankle Instabilit

Purpose: The purpose of this study is to investigate the effect of 8 weeks virtual reality training on static and dynamic balance and performance of in male athletes with functional ankle instability Methods: or this research, 30 volleyball, basketball, football and handball players ranged from 18 to 25 years were selected purposefully from Tehran province league male athletes based on inclusion and Exclusion criteria. Then Subjects were randomly divided into two groups included 15 subjects of virtual reality exercises and control group. After a 5 minute warm-up program, the static and dynamic balance and performance were measured by stork test, y balance test and side jump and triple jump test respectively. Then, training group completed an 8-week (24 sessions) exercise program. Finally, after completing the training protocol, a similar post-test with pre-test was done. To test and analyze datum, also analysis, paired t-test and ANCOVA statistical method was used. Results: Paired t-test and analysis of covariance showed that there was a significant difference in all variables in the post-test compared to the pre-test and also between the two groups (05.0&gt;p).The balance of subjects and their performance in the experimental group was improved Conclusion: The 8 weeks of virtual reality training significantly improve balance and performance of male with functional ankle instability; therefore coaches and athletes can use this exercises to improve balance and performance in athletes with functional ankle instability.

Effect of Taping and Virtual Reality Combined Exercise on Static and Dynamic Balance With Functional Ankle Instability

Background: Ankle sprain is one of the most common musculoskeletal injuries in the sports population or during usual daily life activities. The sprain can cause functional ankle instability (FAI), and it is very important to treat FAI. However, the optimum intervention method for FAI has yet to be determined. Objects: This study investigated the impact that virtual reality (VR) training program on balance with ankle kinesio taping for FAI. Methods: Twenty-two people were selected for the study and randomly divided into the experimental (n = 11) and the control group (n = 11). The experimental group had attached kinesio taping on the ankle and then implemented a virtual reality exercise program for 30 minutes a day. Nintendo Wii Fit Plus was used for the VR intervention three times a week for four weeks. The control group performed only two measurements without intervention. Results: There were no statistically significant differences in overall, anterior-posterior (AP), medial-lateral (ML) index of the static balance, and significant differences in overall, AP, ML index of the dynamic balance when taping and VR exercise were applied at the same time (p < 0.05). There were no significant differences in overall and ML index of static and dynamic balance compared with before and after assessment between the experimental and the control group, and found differences in AP index of static and dynamic balance (p < 0.05). Conclusion: Kinesio taping may not influence the balance of FAI as great as people expected. VR approach does not affect the static balance of FAI, but it influences dynamic balance in overall, AP, ML index. The authors suggest that VR-based exercises can be used as an additional concept in clinicians for FAI or as part of a home program because the exercises still have limitations.

Medical education in times of COVID-19: German students' expectations - A cross-sectional study.

Since the COVID-19 pandemic has affected the education of medical students, medical faculties have faced the challenge of adapting instruction to digital platforms. Although medical students are willing to support pandemic response efforts, how the crisis will affect their medical training remains uncertain. Thus, in this study, we investigated the teaching- and learning-related stressors and expectations of medical students in Germany during the COVID-19 pandemic. A cross-sectional survey was distributed online to undergraduate medical students at medical faculties in Germany. Students answered questions about COVID-19 and teaching (on a 7-point Likert scale from 0 ("not at all") to 6 ("completely")) and completed mental well-being measurements, including the State-Trait Anxiety Inventory (STAI), the Generalised Anxiety Disorder scale (GAD-7) and the Perceived Health Questionnaire (PHQ-9). Descriptive data analysis, a t-test and Pearson correlations were performed to process the data. Medical students felt well-informed about COVID-19 in general (M = 5.64, SD = 1.28) and in the medical context (M = 5.14, SD = 1.34) but significantly less informed about the pandemic in the academic context, M = 2.47, SD = 1.49, t(371) = 31.98, p < .001. Their distress levels were high (STAI: M = 45.12, SD = 4.73) and significantly correlated with the academic context (rp = .164, p < .01) but not their private lives. Concerning how they were taught, they most often expected online lectures (91.7%) and live broadcasts (67.2%) and less often expected innovative digital teaching strategies, including serious games (17.3%) and virtual-reality exercises (16.7%). Medical students seem to be aware of the COVID-19 pandemic and its consequences for academic and healthcare contexts. They also seem to think that their teachers will enhance their digital competencies during the pandemic. Therefore, faculties of medicine need to rapidly and adequately digitalise their approaches to teaching.