Many contemporary systems for neurorehabilitation utilize 3D virtual environments (VEs) that allow for training patients' hand or arm movements. In the current paper we comparatively test the ...effectiveness of two characteristics of VEs in rehabilitation training when utilizing a 3D haptic interaction device: Stereo Visualization (monoscopic vs stereoscopic image presentation) and Graphic Environment (2.5D vs 3D).
An experimental study was conducted using a factorial within-subjects design. Patients (10 MS, 8 CVA) completed three tasks, each including a specific arm-movement along one of three directional axes (left-right, up-down and forward-backward).
The use of stereoscopy within a virtual training environment for neurorehabilitation of CVA and MS patients is most beneficial when the task itself requires movement in depth. Further, the 2.5D environment yields the highest efficiency and accuracy in terms of patients' movements. These findings were, however, dependent on participants' stereoscopic ability.
Despite the performance benefits of stereoscopy, our findings illustrate the non-triviality of choices of using stereoscopy, and the type of graphic environment implemented. These choices should be made with the task and target group, and even the individual patient in mind.
Cardiac telerehabilitation has been introduced as an adjunct or alternative to conventional center-based cardiac rehabilitation to increase its long-term effectiveness. However, before large-scale ...implementation and reimbursement in current health care systems is possible, well-designed studies on the effectiveness of this new additional treatment strategy are needed.
The aim of this trial was to assess the medium-term effectiveness of an Internet-based, comprehensive, and patient-tailored telerehabilitation program with short message service (SMS) texting support for cardiac patients.
This multicenter randomized controlled trial consisted of 140 cardiac rehabilitation patients randomized (1:1) to a 24-week telerehabilitation program in combination with conventional cardiac rehabilitation (intervention group; n=70) or to conventional cardiac rehabilitation alone (control group; n=70). In the telerehabilitation program, initiated 6 weeks after the start of ambulatory rehabilitation, patients were stimulated to increase physical activity levels. Based on registered activity data, they received semiautomatic telecoaching via email and SMS text message encouraging them to gradually achieve predefined exercise training goals. Patient-specific dietary and/or smoking cessation advice was also provided as part of the telecoaching. The primary endpoint was peak aerobic capacity (VO2 peak). Secondary endpoints included accelerometer-recorded daily step counts, self-assessed physical activities by International Physical Activity Questionnaire (IPAQ), and health-related quality of life (HRQL) assessed by the HeartQol questionnaire at baseline and at 6 and 24 weeks.
Mean VO2 peak increased significantly in intervention group patients (n=69) from baseline (mean 22.46, SD 0.78 mL/min*kg) to 24 weeks (mean 24.46, SD 1.00 mL/min*kg, P<.01) versus control group patients (n=70), who did not change significantly (baseline: mean 22.72, SD 0.74 mL/min*kg; 24 weeks: mean 22.15, SD 0.77 mL/min*kg, P=.09). Between-group analysis of aerobic capacity confirmed a significant difference between the intervention group and control group in favor of the intervention group (P<.001). At 24 weeks, self-reported physical activity improved more in the intervention group compared to the control group (P=.01) as did the global HRQL score (P=.01).
This study showed that an additional 6-month patient-specific, comprehensive telerehabilitation program can lead to a bigger improvement in both physical fitness (VO2 peak) and associated HRQL compared to center-based cardiac rehabilitation alone. These results are supportive in view of possible future implementation in standard cardiac care.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
This paper describes the development and implementation of GAPc, a gamification project in chemistry. GAPc is an online active student-centered remedial teaching tool allowing prospective and ...enrolled students to electronically assess their knowledge of basic and advanced chemistry concepts via different game levels of expertise. This provides them with ways to correct potential shortcomings in view of academic education. A large number of exercises with different degrees of difficulty, links to additional sources of information, automated feedback, and the integrated grading center are key features of GAPc. Notwithstanding that GAPc is conceived as a distance learning and self-learning tool, it works equally well in a classroom setting. Indeed, GAPc was initially meant as a trajectory for precollege students to remediate their acquainted knowledge of chemistry by easy remote access. Today, on the Hasselt University Campus, GAPc is used in the chemistry summer school for senior high school students, and in chemistry courses for freshmen and sophomores enrolled in curricula with a major chemistry component.
•Game design elements that improve player enjoyment in games are presented in the article as a result of the systematic review.•A well-rounded understanding of game design elements and their ...relationships is paramount to design enjoyable games.•Literature reports on instruments to assess individual game design elements, and determine their respective influence on player enjoyment.•The use of standardised instruments is highly recommended to facilitate analysis and comparison between studies.•GWAP study for linguistics shows that the GDE adds interaction to linguistic tasks, preventing them from becoming monotonous.
Designing serious games that engage lots of players is still a challenge, especially for domains that introduce complex, specialised, and tedious tasks that are difficult to represent in a game in terms of entertainment. Therefore, researchers have investigated ways to motivate players, including enjoyment. Enjoyment is tied to emotional experience and is associated with positive player reactions throughout a gameplay session. However, an inventory with concrete elements (including descriptions and empirical proofs) producing that experience is missing. While researchers have investigated enjoyment and its relationship with game design elements (GDE), the efforts remain dispersed and isolated across different areas. Besides, there is no guideline describing this relationship that assists designers in their creation process. Therefore, this paper presents a systematic literature review to provide a detailed understanding of GDE, player enjoyment, and instruments for evaluation. Additionally, an analysis of two successful cases of Games With a Purpose (GWAP, a subset of serious games) for linguistics is presented to highlight the impact of the GDE and providing relationships with the GDE mentioned in this literature review. We found 33 GDE, from which 28 positively affect player enjoyment, and they can be used as building blocks to design enjoyable GWAP (or other serious games). Further, we create a list of instruments that provide an ample understanding of the constructs of player enjoyment, namely enjoyment, immersion, flow, positive affect, and presence. The listed instruments can give researchers higher confidence as they will allow replication and comparison of studies. These two components are critical in the process of design and evaluation of games. Furthermore, the GWAP analysis shows that effectively the GDE are used in GWAP to enhance interaction and player enjoyment. Finally, conclusions and practical suggestions for future work are given.
Physiotherapists often treat patients with (elevated risk for) cardiovascular disease (CVD), and should thus be able to provide evidence-based exercise advice to these patients. This study, ...therefore, aims to examine whether exercise prescriptions by physiotherapists to patients with CVD are in accordance with European recommendations.
This prospective observational survey included forty-seven Belgian physiotherapists. The participants agreed to prescribe exercise intensity, frequency, session duration, program duration, and exercise type (endurance or strength training) for the same three patient cases. Exercise prescriptions were compared between physiotherapists and relations with their characteristics were studied. The agreement between physiotherapists' exercise prescriptions and those from European recommendations ('agreement score': based on a maximal score of 60/per case) was assessed. A wide inter-clinician variability was noticed for all exercise modalities, leading to a large variance for total peak-effort training minutes (from 461 up to 9000 over the three cases). The exercise frequency was prescribed fully out of range of the recommendations and the prescription of additional exercise modes was generally flawed. Exercise intensity and program duration were prescribed partially correct. The addition of strength exercises and session duration was prescribed correctly. This led to physiotherapist agreement scores of 25.3 ± 9.6, 23.2 ± 9.9, and 27.1 ± 10.6 (all out of 60), for cases one, two, and three, respectively. A greater agreement score was found in younger colleagues and those holding a Ph.D.
Exercise prescriptions for CVD patients vary widely among physiotherapists and often disagree with European recommendations.
ClinicalTrials.gov NCT05449652.
In Europe alone, on a yearly basis, millions of people need an appropriate exercise prescription to prevent the occurrence or progression of cardiovascular disease (CVD). A general exercise ...recommendation can be provided to these individuals (at least 150 min of moderate-intensity endurance exercise, spread over 3-5 days/week, complemented by dynamic moderate-intensity resistance exercise 2 days/week). However, recent evidence shows that this one size does not fit all and that individual adjustments should be made according to the patient's underlying disease(s), risk profile, and individual needs, to maximize the clinical benefits of exercise. In this paper, we (i) argue that this general exercise prescription simply provided to all patients with CVD, or elevated risk for CVD, is insufficient for optimal CVD prevention, and (ii) show that clinicians and healthcare professionals perform heterogeneously when asked to adjust exercise characteristics (e.g. intensity, volume, and type) according to the patient's condition, thereby leading to suboptimal CVD risk factor control. Since exercise training is a class 1A intervention in the primary and secondary prevention of CVD, the awareness of the need to improve exercise prescription has to be raised among clinicians and healthcare professionals if optimized prevention of CVD is ambitioned.
Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to ...optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient.
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