Feasibility and safety of an immersive virtual reality-based vestibular rehabilitation programme in people with multiple sclerosis experiencing vestibular impairment: a protocol for a pilot randomised controlled trial

Introduction: Vestibular system damage in patients with multiple sclerosis (MS) may have a central and/or peripheral origin. Subsequent vestibular impairments may contribute to dizziness, balance disorders and fatigue in this population. Vestibular rehabilitation targeting vestibular impairments may improve these symptoms. Furthermore, as a successful tool in neurological rehabilitation, immersive virtual reality (VRi) could also be implemented within a vestibular rehabilitation intervention. Methods and analysis: This protocol describes a parallel-arm, pilot randomised controlled trial, with blinded assessments, in 30 patients with MS with vestibular impairment (Dizziness Handicap Inventory ≥16). The experimental group will receive a VRi vestibular rehabilitation intervention based on the conventional Cawthorne-Cooksey protocol; the control group will perform the conventional protocol. The duration of the intervention in both groups will be 7 weeks (20 sessions, 3 sessions/week). The primary outcomes are the feasibility and safety of the vestibular VRi intervention in patients with MS. Secondary outcome measures are dizziness symptoms, balance performance, fatigue and quality of life. Quantitative assessment will be carried out at baseline (T0), immediately after intervention (T1), and after a follow-up period of 3 and 6 months (T2 and T3). Additionally, in order to further examine the feasibility of the intervention, a qualitative assessment will be performed at T1. Ethics and dissemination: The study was approved by the Andalusian Review Board and Ethics Committee, Virgen Macarena-Virgen del Rocio Hospitals (ID 2148-N-19, 25 March 2020). Informed consent will be collected from participants who wish to participate in the research. The results of this research will be disseminated by publication in peer-reviewed scientific journals

ARCH 14 - International Conference on Research on Health Care Architecture - November 19-21, 2014, Espoo, Finland - Conference Proceedings

Healthcare Architecture has grown rapidly in recent years. However, there are still many questions remaining. The commission, therefore, is to share the existing research knowledge and latest results and to carry out research projects focusing more specifically on the health care situation in a variety of contexts. The ARCH14 conference was the third conference in the series of ARCH conferences on Research on Health Care Architecture initiated by Chalmers University. It was realized in collaboration with the Nordic Research Network for Healthcare Architecture .It was a joint event between Aalto University, Finnish Institute of Occupational Health (FIOH) and National Institute of Health and Welfare (THL International).The conference gathered together more than 70 researchers and practitioners from across disciplines and countries to discuss the current themes

The effects of person-centred active rehabilitation on symptoms of suspected Chronic Traumatic Encephalopathy: A mixed methods single case design

Background: For almost a century, cases of former contact sport athletes who have developed cognitive impairments, changes in mood/behaviour, or motor dysfunction have been reported within scientific journals and major news outlets. In 2015, Chronic Traumatic Encephalopathy (CTE) was established as a unique neurodegenerative pathology linked to the repeated exposure to mild traumatic brain injury. Due to the observed long-term effects, multiple generations of former athletes are at-risk of developing symptoms of CTE. With no pathology-led intervention yet established, these athletes remain vulnerable and unsupported. Aim: The aims of the thesis included (1) to establish the potential for active rehabilitation as an intervention strategy for the management of symptoms associated with suspected CTE, and (2) to equally consider evidence-based medicine (EBM) and person-centred care (PCC) when designing and evaluating a programme for the management of suspected CTE. Methods: An umbrella review was carried out to examine the effect that active rehabilitation had on symptoms of tauopathies. Six mixed-method n-of-1 studies were carried out to assess the effect that a person-centred active rehabilitation programme had on symptoms of suspected CTE. Results: The umbrella provided preliminary evidence to support the use of active rehabilitation in the management of tauopathies, with specific implications for the management of suspected CTE. A key observation was the positive effect of active rehabilitation on motor and cognitive symptoms in tauopathies. The mixed methods single case series provided preliminary evidence of a positive effect on some symptoms of suspected CTE. A positive effect was primarily seen in cognitive functioning, with mood and behavioural symptoms (e.g., anxiety, depression, loneliness, irritability, and insomnia) largely reporting a mix of positive and inconclusive effects. Conclusions: For the first time, this thesis has offered preliminary evidence which suggests active rehabilitation may offer some benefit to individuals with symptoms of suspected CTE. This is supported by the findings of a one-year observational study which demonstrated positive effects across a range of symptoms utilising a person-centred rehabilitation approach. Further, this thesis has illustrated the benefit of PCC in clinical research and practice

Neurorehabilitation in dementia on the move : Influences of physical activity on cognition, mood, and the rest-activity rhythm

Scherder, E.J.A. [Promotor]Swaab, D.F. [Promotor

Designing for self-transcendent experiences in virtual reality

This thesis contributes to Psychology and Human-Computer Interaction (HCI) research with a focus on the design of immersive experiences that support self-transcendence. Self-transcendence is defined as a decrease in a sense of self and a increase in unity with the world. It can change what individuals know and value, their perspective on the world and life, evolving them as a grown person. Consequently, self-transcendence is gaining attention in Psychology, Philosophy, and Neuroscience. But, we are still far from understanding the complex phenomenological and neurocognitive aspects of self-transcendence, as well as its implications for individual growth and psychological well-being. In reviewing the methods for studying self-transcendence, we found differing conceptual models determine different ways for understanding and studying self-transcendence. Understanding self-transcendence is made especially challenging because of its ineffable qualities and extraordinary conditions in which it takes place. For that reason, researchers have began to look at technological solutions for both eliciting self-transcendence to better study it under controlled and replicable conditions as well as giving people greater access to the experience. We reviewed immersive, interactive technologies that aim to support positive experiences such as self-transcendence and extracted a set of design considerations that were prevalent across experiences. We then explored two different focuses of self-transcendence: awe and lucid dreaming. First, we took an existing VR experience designed specifically to support the self-transcendent experience of awe and looked at how the mindset and physical setting surrounding that VR experience might better support the experience of and accommodation of awe. Second, we delved deep into lucid dreaming to better understand the aspects that could help inform the design of an immersive experience that supports self-transcendence. We put those design ideas into practice by developing a neurofeedback system that aims to support lucid dreaming practices in an immersive experience. Through these review papers and design explorations, we contribute to the understanding of how one might design and evaluate immersive technological experiences that support varieties of self-transcendence. We hope to inspire more work in this area that holds promise in better understanding human nature and living our best lives

The Phenomenology of Husbands Caring for Wives with Dementia

The lived experience of husbands caring for wives with dementia was investigated in order to develop a better understanding of their caregiver burden. The conceptual background for the study originated in the work of philosophical phenomenologists Edmund Husserl and Edith Stein with particular attention to their theories of inter-subjectivity and empathy. Amadeo Giorgis Descriptive Phenomenological Method in Psychology was used for study design and analysis. Results suggest an enduring connectedness of the couples and their bonds throughout the shifting of roles and emotions as the dementia progresses. Implications for nursing include the need to employ interventions respectful of the persistence of affective awareness in those with the dementia even towards end-stage and the resulting importance of situational assessment of decisional capacity

Older people and their carers' perspectives of causes and risk factors to hospital readmissions

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