The VESPA Project: Virtual Reality Interventions for Neurocognitive and Developmental Disorders

VESPA is a financed project supported by the Sicilian Regional Research and Development funds, and it is structured by the development, research and validation of Virtual Reality (VR) based application for the diagnosis and treatment of neurocognitive conditions. In particular, this article presents its characteristics, referred to as the first (2013-2015) and second (2021-ongoing) generations of VESPA, with particular reference to literature regarding the VR technology application and development, the VR treatment of neurocognitive conditions and prior versions of this intervention. Through a comprehensive review of the research conducted over the last 5 years, evidence has emerged supporting VESPA’s aim and scopes, highlighting how the application of VR can be considered to add value to typical rehabilitation/therapeutic paths. VESPA project generations are then presented in detail, including specific session/task battery characteristics, 2.5D, 3D and 5D typologies, system usability and architecture and pathological domain-based dynamics and features. The discussion about VESPA will highlight the current advantages along with limitations and future directions

Interventions for Persons with Mild Cognitive Impairment (MCI) An Evidence-Based Practice Project

This Evidence-Based Practice (EBP) project addressed the following question: What occupational therapy and multidisciplinary/interprofessional interventions are most effective for addressing mild cognitive impairment (MCI) to improve occupational performance, functional cognition, participation, well-being, quality of life, and caregiver burden

Effectiveness and Acceptability of e- and m-Health Interventions to Promote Physical Activity and Prevent Falls in Nursing Homes—A Systematic Review

Age-related decreases in physical activity (PA) and a decline in physical functioning lead to increased fall risk. As falls are a major cause of accidental deaths and hospitalization in older adults, PA promotion and fall prevention are important measures, especially in nursing homes (NH). With advances in information and communication technology, e- and m-health solutions have been developed to positively influence various health-related factors. To date, only little research exists on the implementation of these technologies to promote health in NH. Therefore, the objective of this systematic review was to provide an overview of the effectiveness, acceptability, and feasibility of e- and m-health interventions aimed at promoting PA and preventing falls in NH. Additionally, the effectiveness of such interventions regarding the secondary outcomes physical function, cognitive function, neuropsychiatric symptoms, and psychosocial status was examined. A systematic literature search was performed in five databases and studies published until 15 November 2021, were considered for inclusion. All studies that examined the effectiveness and/or the acceptability and feasibility of e- or m-health interventions in promoting PA and preventing falls in NH, without restriction on language or date of publication, were included in the final synthesis. Of the 1,358 records retrieved, 28 studies were included in this systematic review. Twenty-four studies contained digital exergaming as an intervention or as a part of the intervention, the four additional studies on e-health interventions only examined a small number of outcomes. No m-health intervention study was identified. Data synthesis indicates that exergaming may be effective in reducing the number of falls and fall risk in NH residents. Several significant improvements were also reported regarding secondary outcomes albeit not consistent across studies. No conclusion can be drawn about the effects of exergaming and other e-health interventions on PA, as data is scarce. E-health interventions were mostly reported as feasible and well accepted by NH residents. However, these findings may not be applicable to NH residents with advanced physical and/or cognitive impairments, since they were excluded in many studies. Therefore, more research examining other digital solutions besides exergaming to promote PA in this specific population is critical. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD4202128948

Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

Cognitive-motor interventions based on virtual reality and instrumental activities of daily living (iADL): an overview

Non-invasive, non-pharmacological interventions utilizing virtual reality (VR) represent a promising approach to enhancing cognitive function in patients with degenerative cognitive disorders. Traditional “pen and paper” therapies often lack the practical engagement in everyday activities that older individuals encounter in their environment. These activities pose both cognitive and motor challenges, underscoring the necessity of understanding the outcomes of such combined interventions. This review aimed to assess the advantages of VR applications that integrate cognitive-motor tasks, simulating instrumental activities of daily living (iADLs). We systematically searched five databases–Scopus, Web of Science, Springer Link, IEEE Xplore, and PubMed, from their inception until January 31, 2023. Our review revealed that motor movements, coupled with VR-based cognitive-motor interventions, activate specific brain areas and foster improvements in general cognition, executive function, attention, and memory. VR applications that meld cognitive-motor tasks and simulate iADLs can offer significant benefits to older adults. Enhanced cognitive and motor performance can promote increased independence in daily activities, thereby contributing to improved quality of life

Overview and Strategy Analysis of Technology-Based Nonpharmacological Interventions for In-Hospital Delirium Prevention and Reduction:Systematic Scoping Review

BACKGROUND: Delirium prevention is crucial, especially in critically ill patients. Nonpharmacological multicomponent interventions for preventing delirium are increasingly recommended and technology-based interventions have been developed to support them. Despite the increasing number and diversity in technology-based interventions, there has been no systematic effort to create an overview of these interventions for in-hospital delirium prevention and reduction. OBJECTIVE: This systematic scoping review was carried out to answer the following questions: (1) what are the technologies currently used in nonpharmacological technology-based interventions for preventing and reducing delirium? and (2) what are the strategies underlying these currently used technologies? METHODS: A systematic search was conducted in Scopus and Embase between 2015 and 2020. A selection was made in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were eligible if they contained any type of technology-based interventions and assessed delirium-/risk factor–related outcome measures in a hospital setting. Data extraction and quality assessment were performed using a predesigned data form. RESULTS: A total of 31 studies were included and analyzed focusing on the types of technology and the strategies used in the interventions. Our review revealed 8 different technology types and 14 strategies that were categorized into the following 7 pathways: (1) restore circadian rhythm, (2) activate the body, (3) activate the mind, (4) induce relaxation, (5) provide a sense of security, (6) provide a sense of control, and (7) provide a sense of being connected. For all technology types, significant positive effects were found on either or both direct and indirect delirium outcomes. Several similarities were found across effective interventions: using a multicomponent approach or including components comforting the psychological needs of patients (eg, familiarity, distraction, soothing elements). CONCLUSIONS: Technology-based interventions have a high potential when multidimensional needs of patients (eg, physical, cognitive, emotional) are incorporated. The 7 pathways pinpoint starting points for building more effective technology-based interventions. Opportunities were discussed for transforming the intensive care unit into a healing environment as a powerful tool to prevent delirium. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42020175874; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=17587

A framework for AI-driven neurorehabilitation training: the profiling challenge

Cognitive decline is a common sign that a person is ageing. However, abnormal cases can lead to dementia, affecting daily living activities and independent functioning. It is a leading cause of disability and death. Its prevention is a global health priority. One way to address cognitive decline is to undergo cognitive rehabilitation. Cognitive rehabilitation aims to restore or mitigate the symptoms of a cognitive disability, increasing the quality of life for the patient. However, cognitive rehabilitation is stuck to clinical environments and logistics, leading to a suboptimal set of expansive tools that is hard to accommodate every patient’s needs. The BRaNT project aims to create a tool that mitigates this problem. The NeuroAIreh@b is a rehabilitation tool developed within a framework that combines neuropsychological assessments, neurorehabilitation procedures, artificial intelligence and game design, composing a tool that is easy to set up in a clinical environment and accessible to adapt to every patient’s needs. Among all the challenges within NeuroAlreh@b, one focuses on representing a cognitive profile through the aggregation of multiple neuropsychological assessments. To test this possibility, we will need data from patients currently unavailable. In the first part of this master’s project, study the possibility of aggregating neuropsychological assessments for the case of Alzheimer’s disease using the Alzheimer’s Disease Neuroimaging Initiative database. This database contains a vast collection of images and neuropsychological assessments that will serve as a baseline for the NeuroAlreh@b when the time comes. In the second part of this project, we set up a computational system to run all the artificial intelligence models and simulations required for the BRaNT project. The system allocates a database and a webserver to serve all the required pages for the project.O declínio cognitivo é um sinal comum de que uma pessoa está a envelhecer. No entanto, casos anormais podem levar à demência, afetando as atividades diárias e funcionamento independente. Demência é uma das principais causas de incapacidade e morte. Fazendo da sua prevenção uma prioridade para a saúde global. Uma forma de lidar com o declínio cognitivo é submeter-se à reabilitação cognitiva. A reabilitação cognitiva visa restaurar ou mitigar os sintomas de uma deficiência cognitiva, aumentando a qualidade de vida do paciente. No entanto, a reabilitação cognitiva está presa a ambientes clínicos e logística, levando a um conjunto sub-ideal de ferramentas com custos elevados e complicadas de acomodar as necessidades de cada paciente. O projeto BRaNT visa criar uma ferramenta que atenue este problema. O NeuroAIreh@b é uma ferramenta de reabilitação desenvolvida num quadro que combina avaliações neuropsicológicas, reabilitação, inteligência artificial e design de jogos, compondo uma ferramenta fácil de adaptar a um ambiente clínico e acessível para se adaptar às necessidades de cada paciente. Entre todos os desafios dentro de NeuroAlreh@b, foca-se em representar um perfil cognitivo através da agregação de múltiplas avaliações neuropsicológicas. Para testar esta possibilidade, precisaremos de dados de pacientes, que atualmente não temos. Na primeira parte do projeto deste mestrado, vamos testar a possibilidade de agregar avaliações neuropsicológicas para o caso da doença de Alzheimer utilizando a base de dados da Iniciativa de Neuroimagem da Doença de Alzheimer. Esta base de dados contém uma vasta coleção de imagens e avaliações neuropsicológicas que servirão de base para o NeuroAlreh@b quando chegar a hora. Na segunda parte deste projeto, vamos criar um sistema informático para executar todos os modelos e simulações de inteligência artificial necessários para o projeto BRaNT. O sistema também irá alocar uma base de dados e um webserver para servir todas as páginas necessárias para o projeto