Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review

[EN] Autism Spectrum Disorder (ASD) is a neurodevelopmental disease that is specially characterized by impairments in social communication and social skills. ASD has a high prevalence in children, affecting 1 in 160 subjects. Virtual reality (VR) has emerged as an effective tool for intervention in the health field. Different recent papers have reviewed the VR-based treatments in ASD, but they have an important limitation because they only use clinical databases and do not include important technical indexes such as the Web of Science index or the Scimago Journal & Country Rank. To our knowledge, this is the first contribution that has carried out an evidence-based systematic review including both clinical and technical databases about the effectiveness of VR-based intervention in ASD. The initial search identified a total of 450 records. After the exclusion of the papers that are not studies, duplicated articles, and the screening of the abstract and full text, 31 articles met the PICO (Population, Intervention, Comparison and Outcomes) criteria and were selected for analysis. The studies examined suggest moderate evidence about the effectiveness of VR-based treatments in ASD. VR can add many advantages to the treatment of ASD symptomatology, but it is necessary to develop consistent validations in future studies to state that VR can effectively complement the traditional treatments.Mesa Gresa, P.; Gil Gómez, H.; Lozano Quilis, JA.; Gil-Gómez, J. (2018). Effectiveness of Virtual Reality for Children and Adolescents with Autism Spectrum Disorder: An Evidence-Based Systematic Review. Sensors. 18(8):1-15. https://doi.org/10.3390/s18082486S115188World Health Organizationhttp://www.who.int/en/news-room/fact-sheets/detail/autism-spectrum-disordersColombi, C., & Ghaziuddin, M. (2017). 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The Effect of Balance Training on Postural Control in Patients with Parkinson s Disease Using a Virtual Rehabilitation System

[EN] Objectives: Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our pur-pose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. Methods: Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. Results: There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. Conclusions: Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control in all positions. We think that the main factor influencing these results is that patients use more of their available cognitive processing to improve their postural control. The ABAR system allows us to make this assumption because the system requires the continuous attention of patients, promoting cognitive processing.This contribution was partially funded by the Gobierno de Aragon, Departamento de Industria e Innovacion, y Fondo Social Europeo "Construyendo Europa desde Aragon" and by the Programa Ibercaja-CAI de Estancias de Investigacion.Albiol-Perez, S.; Gil-Gómez, J.; Muñoz-Tomás, M.; Gil Gómez, H.; Vial Escolano, R.; Lozano Quilis, JA. (2017). 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M., & Mashat, A. S. (2014). Virtual Rehabilitation for Multiple Sclerosis Using a Kinect-Based System: Randomized Controlled Trial. JMIR Serious Games, 2(2), e12. doi:10.2196/games.2933Badarny, S., Aharon-Peretz, J., Susel, Z., Habib, G., & Baram, Y. (2014). Virtual Reality Feedback Cues for Improvement of Gait in Patients with Parkinson’s Disease. Tremor and Other Hyperkinetic Movements, 4(0), 225. doi:10.5334/tohm.192Ehgoetz Martens, K. A., Ellard, C. G., & Almeida, Q. J. (2014). Does manipulating the speed of visual flow in virtual reality change distance estimation while walking in Parkinson’s disease? Experimental Brain Research, 233(3), 787-795. doi:10.1007/s00221-014-4154-zAlbiol-Perez, S., Gil-Gomez, J.-A., Llorens, R., Alcaniz, M., & Font, C. C. (2014). The Role of Virtual Motor Rehabilitation: A Quantitative Analysis Between Acute and Chronic Patients With Acquired Brain Injury. IEEE Journal of Biomedical and Health Informatics, 18(1), 391-398. doi:10.1109/jbhi.2013.2272101Forcano-García, M., Muñoz-Tomás, M. T., Manzano-Fernández, P., Solsona-Hernández, S., Mashat, M. A., Gil-Gómez, J. A., & Albiol-Pérez, S. (2015). A Novel Virtual Motor Rehabilitation System for Guillain-Barré Syndrome. Methods of Information in Medicine, 54(02), 127-134. doi:10.3414/me14-02-0002Gil-Gómez, J.-A., Lloréns, R., Alcañiz, M., & Colomer, C. (2011). Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. Journal of NeuroEngineering and Rehabilitation, 8(1), 30. doi:10.1186/1743-0003-8-30Muñoz Tomás, M. T., Gil Gómez, J. A., Gil Gómez, H., Lozano Quillis, J. A., Albiol-Pérez, S., & Forcano García, M. (2013). Suitability of virtual rehabilitation for elderly: A study of a virtual rehabilitation system using the SEQ. European Geriatric Medicine, 4, S109. doi:10.1016/j.eurger.2013.07.358Pompeu, J. E., Mendes, F. A. dos S., Silva, K. G. da, Lobo, A. M., Oliveira, T. de P., Zomignani, A. P., & Piemonte, M. E. P. (2012). Effect of Nintendo Wii™-based motor and cognitive training on activities of daily living in patients with Parkinson’s disease: A randomised clinical trial. Physiotherapy, 98(3), 196-204. doi:10.1016/j.physio.2012.06.004Pompeu, J. E., Arduini, L. A., Botelho, A. R., Fonseca, M. B. F., Pompeu, S. M. A. A., Torriani-Pasin, C., & Deutsch, J. E. (2014). Feasibility, safety and outcomes of playing Kinect Adventures!™ for people with Parkinson’s disease: a pilot study. Physiotherapy, 100(2), 162-168. doi:10.1016/j.physio.2013.10.003Summa, S., Basteris, A., Betti, E., & Sanguineti, V. (2013). A feasibility study on using kinect™ for the rehabilitation in persons with Parkinson’s disease. Gait & Posture, 37, S15. doi:10.1016/j.gaitpost.2012.12.040Herz, N. B., Mehta, S. H., Sethi, K. D., Jackson, P., Hall, P., & Morgan, J. C. (2013). Nintendo Wii rehabilitation («Wii-hab») provides benefits in Parkinson’s disease. Parkinsonism & Related Disorders, 19(11), 1039-1042. doi:10.1016/j.parkreldis.2013.07.014Holmes, J. D., Jenkins, M. E., Johnson, A. M., Hunt, M. A., & Clark, R. A. (2012). Validity of the Nintendo Wii® balance board for the assessment of standing balance in Parkinson’s disease. Clinical Rehabilitation, 27(4), 361-366. doi:10.1177/0269215512458684Mhatre, P. V., Vilares, I., Stibb, S. M., Albert, M. V., Pickering, L., Marciniak, C. M., … Toledo, S. (2013). Wii Fit Balance Board Playing Improves Balance and Gait in Parkinson Disease. PM&R, 5(9), 769-777. doi:10.1016/j.pmrj.2013.05.019Plotnik, M., Roggen, D., Giladi, N., Hausdorff, J. M., Tröster, G., & Bächlin, M. (2010). A Wearable System to Assist Walking of Parkinson´s Disease Patients. Methods of Information in Medicine, 49(01), 88-95. doi:10.3414/me09-02-0003Rigas, G., Tzallas, A. T., Tsipouras, M. G., Bougia, P., Tripoliti, E. E., Baga, D., … Konitsiotis, S. (2012). Assessment of Tremor Activity in the Parkinson’s Disease Using a Set of Wearable Sensors. IEEE Transactions on Information Technology in Biomedicine, 16(3), 478-487. doi:10.1109/titb.2011.2182616Duval, C. (2006). Rest and postural tremors in patients with Parkinson’s disease. Brain Research Bulletin, 70(1), 44-48. doi:10.1016/j.brainresbull.2005.11.010The World Medical Association Ethics Unit. Declaration of Helsinki. Available from: http://www.wma.net/en/30publications/10policies/b3/Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). «Mini-mental state». Journal of Psychiatric Research, 12(3), 189-198. doi:10.1016/0022-3956(75)90026-6Collin, C., Wade, D. T., Davies, S., & Horne, V. (1988). The Barthel ADL Index: A reliability study. International Disability Studies, 10(2), 61-63. doi:10.3109/09638288809164103Lawton, M. P. (1975). The Philadelphia Geriatric Center Morale Scale: A Revision. Journal of Gerontology, 30(1), 85-89. doi:10.1093/geronj/30.1.85Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373-383. doi:10.1016/0021-9681(87)90171-8Gil-Gómez JA, Manzano-Hernández P, Albiol-Pérez S, Aula-Valero C, Gil-Gómez H, Lozano-Quilis JA. SEQ: suitability evaluation questionnaire for virtual rehabilitation systems. Application in a virtual rehabilitation system for balance rehabilitation. Proceedings of the 7th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth ’13); 2013. p. 335-338Kizony R, Katz N, Rand D, Weiss PL. A Short Feedback Questionnaire (SFQ) to enhance client-centered participation in virtual environments. 11th Annual Cyber Therapy Conference: Virtual Healing: Designing Reality, Gatineau, Canada; 2006Shapiro SS, Wilk MB. An analysis of variance test for normality (complete samples). Biometrika; 1965; 52(3-4): 591-611Horak, F. B. (2006). Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age and Ageing, 35(suppl_2), ii7-ii11. doi:10.1093/ageing/afl077Kim, S. D., Allen, N. E., Canning, C. G., & Fung, V. S. C. (2012). Postural Instability in Patients with Parkinson’s Disease. CNS Drugs, 27(2), 97-112. doi:10.1007/s40263-012-0012-3Robbins, T. W., & Cools, R. (2014). Cognitive deficits in Parkinson’s disease: A cognitive neuroscience perspective. Movement Disorders, 29(5), 597-607. doi:10.1002/mds.25853De Rijk, M. C., Tzourio, C., Breteler, M. M., Dartigues, J. F., Amaducci, L., Lopez-Pousa, S., … Rocca, W. A. (1997). Prevalence of parkinsonism and Parkinson’s disease in Europe: the EUROPARKINSON Collaborative Study. European Community Concerted Action on the Epidemiology of Parkinson’s disease. 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Hacia un Mercado Único Digital: Caso práctico del Proyecto europeo: Promoting the AS4 between PEPPOL Access Points around EU

[ES] La Unión Europea está eliminando las barreras transfronterizas en las transacciones comerciales dentro del territorio europeo, fomentando así la economía digital. La estrategia del Mercado Único Digital busca que los ciudadanos europeos puedan acceder libremente a bienes y servicios en línea. En esta comunicación se presentará la estrategia del Mercado Único Digital y se analizará como caso de estudio el proyecto ‘Promoting the AS4EU between PEPPOL Access points around EU-AS4EU’ financiado por la Comisión Europea dentro de su programa CEF Telecom.Los autores agradecen a la Comisión Europea la financión al Proyecto “Promoting the AS4 between PEPPOL Access Points around EU (AS4EU)’’ (Ref.: INEA/CEF/ICT/A2017/1527217 Action number: 2017-EU-IA-0104) dentro del programa “Connecting Europe Facility (CEF).Gil Gómez, H.; Stratu Strelet, D.; Lozano Quilis, JA.; Guerola Navarro, V. (2020). Hacia un Mercado Único Digital: Caso práctico del Proyecto europeo: Promoting the AS4 between PEPPOL Access Points around EU. Editorial Universitat Politècnica de València. 951-959. https://doi.org/10.4995/INN2019.2019.10945OCS95195

USEQ: A Short Questionnaire for Satisfaction Evaluation of Virtual Rehabilitation Systems

[EN] New emerging technologies have proven their efficacy in aiding people in their rehabilitation. The tests that are usually used to evaluate usability (in general) or user satisfaction (in particular) of this technology are not specifically focused on virtual rehabilitation and patients. The objective of this contribution is to present and evaluate the USEQ (User Satisfaction Evaluation Questionnaire). The USEQ is a questionnaire that is designed to properly evaluate the satisfaction of the user (which constitutes part of usability) in virtual rehabilitation systems. Forty patients with balance disorders completed the USEQ after their first session with ABAR (Active Balance Rehabilitation), which is a virtual rehabilitation system that is designed for the rehabilitation of balance disorders. Internal consistency analysis and exploratory factor analysis were carried out to identify the factor structure of the USEQ. The six items of USEQ were significantly associated with each other, and the Cronbach alpha coefficient for the questionnaire was 0.716. In an analysis of the principal components, a one-factor solution was considered to be appropriate. The findings of the study suggest that the USEQ is a reliable questionnaire with adequate internal consistency. With regard to patient perception, the patients found the USEQ to be an easy-to-understand questionnaire with a convenient number of questions.Gil-Gómez, J.; Manzano-Hernández, P.; Albiol-Perez, S.; Aula-Valero, C.; Gil Gómez, H.; Lozano Quilis, JA. (2017). USEQ: A Short Questionnaire for Satisfaction Evaluation of Virtual Rehabilitation Systems. Sensors. 17(7):1-12. https://doi.org/10.3390/s17071589S112177BEVAN, N. (2001). International standards for HCI and usability. International Journal of Human-Computer Studies, 55(4), 533-552. doi:10.1006/ijhc.2001.0483Abran, A., Khelifi, A., Suryn, W., & Seffah, A. (2003). Software Quality Journal, 11(4), 325-338. doi:10.1023/a:1025869312943Ergonomic Requirements for Office Work with Visual Display Terminals (VDTs) Part 11: Guidance on Usabilityhttp://www.iso.org/iso/catalogue_detail.htm?csnumber=16883Holden, M. K. (2005). Virtual Environments for Motor Rehabilitation: Review. CyberPsychology & Behavior, 8(3), 187-211. doi:10.1089/cpb.2005.8.187Sveistrup, H. (2004). Journal of NeuroEngineering and Rehabilitation, 1(1), 10. doi:10.1186/1743-0003-1-10Lange, B., Koenig, S., Chang, C.-Y., McConnell, E., Suma, E., Bolas, M., & Rizzo, A. (2012). Designing informed game-based rehabilitation tasks leveraging advances in virtual reality. Disability and Rehabilitation, 34(22), 1863-1870. doi:10.3109/09638288.2012.670029Lewis, G. N., & Rosie, J. A. (2012). Virtual reality games for movement rehabilitation in neurological conditions: how do we meet the needs and expectations of the users? Disability and Rehabilitation, 34(22), 1880-1886. doi:10.3109/09638288.2012.670036Singh, D. K. A., Mohd Nordin, N. A., Aziz, N. A. A., Lim, B. K., & Soh, L. C. (2013). Effects of substituting a portion of standard physiotherapy time with virtual reality games among community-dwelling stroke survivors. BMC Neurology, 13(1). doi:10.1186/1471-2377-13-199Green, D., & Wilson, P. H. (2011). Use of virtual reality in rehabilitation of movement in children with hemiplegia − A multiple case study evaluation. Disability and Rehabilitation, 34(7), 593-604. doi:10.3109/09638288.2011.613520Meldrum, D., Herdman, S., Moloney, R., Murray, D., Duffy, D., Malone, K., … McConn-Walsh, R. (2012). Effectiveness of conventional versus virtual reality based vestibular rehabilitation in the treatment of dizziness, gait and balance impairment in adults with unilateral peripheral vestibular loss: a randomised controlled trial. BMC Ear, Nose and Throat Disorders, 12(1). doi:10.1186/1472-6815-12-3Gil-Gómez, J.-A., Lloréns, R., Alcañiz, M., & Colomer, C. (2011). Effectiveness of a Wii balance board-based system (eBaViR) for balance rehabilitation: a pilot randomized clinical trial in patients with acquired brain injury. Journal of NeuroEngineering and Rehabilitation, 8(1), 30. doi:10.1186/1743-0003-8-30Albiol-Perez, S., Gil-Gomez, J.-A., Llorens, R., Alcaniz, M., & Font, C. C. (2014). The Role of Virtual Motor Rehabilitation: A Quantitative Analysis Between Acute and Chronic Patients With Acquired Brain Injury. IEEE Journal of Biomedical and Health Informatics, 18(1), 391-398. doi:10.1109/jbhi.2013.2272101Jokela, T., Koivumaa, J., Pirkola, J., Salminen, P., & Kantola, N. (2005). Methods for quantitative usability requirements: a case study on the development of the user interface of a mobile phone. Personal and Ubiquitous Computing, 10(6), 345-355. doi:10.1007/s00779-005-0050-7Vermeulen, J., Neyens, J., Spreeuwenberg, van Rossum, E., Sipers, Habets, … de Witte. (2013). User-centered development and testing of a monitoring system that provides feedback regarding physical functioning to elderly people. Patient Preference and Adherence, 843. doi:10.2147/ppa.s45897Duffy, S. A., Fowler, K. E., Flanagan, P. S., Ronis, D. L., Ewing, L. A., & Waltje, A. H. (2013). The Development of the Tobacco Tactics Website. JMIR Research Protocols, 2(2), e22. doi:10.2196/resprot.2445Mathew, D., McKibbon, K. A., Lokker, C., & Colquhoun, H. (2014). Engaging With a Wiki Related to Knowledge Translation: A Survey of WhatisKT Wiki Users. Journal of Medical Internet Research, 16(1), e21. doi:10.2196/jmir.3001Mattos, L. S., Deshpande, N., Barresi, G., Guastini, L., & Peretti, G. (2014). A novel computerized surgeon-machine interface for robot-assisted laser phonomicrosurgery. The Laryngoscope, 124(8), 1887-1894. doi:10.1002/lary.24566Meldrum, D., Glennon, A., Herdman, S., Murray, D., & McConn-Walsh, R. (2011). Virtual reality rehabilitation of balance: assessment of the usability of the Nintendo Wii®Fit Plus. Disability and Rehabilitation: Assistive Technology, 7(3), 205-210. doi:10.3109/17483107.2011.616922Kalawsky, R. S. (1999). VRUSE—a computerised diagnostic tool: for usability evaluation of virtual/synthetic environment systems. Applied Ergonomics, 30(1), 11-25. doi:10.1016/s0003-6870(98)00047-7Cameirao, M. S., Bermudez i Badia, S., Duarte Oller, E., & Verschure, P. F. (2010). Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation. Journal of NeuroEngineering and Rehabilitation, 7(1), 48. doi:10.1186/1743-0003-7-48Regenbrecht, H., Hoermann, S., McGregor, G., Dixon, B., Franz, E., Ott, C., … Hoermann, J. (2012). Visual manipulations for motor rehabilitation. Computers & Graphics, 36(7), 819-834. doi:10.1016/j.cag.2012.04.012Shin, J.-H., Ryu, H., & Jang, S. (2014). A task-specific interactive game-based virtual reality rehabilitation system for patients with stroke: a usability test and two clinical experiments. Journal of NeuroEngineering and Rehabilitation, 11(1), 32. doi:10.1186/1743-0003-11-32Kizony, R., Katz, N., & (Tamar) Weiss, P. L. (2003). Adapting an immersive virtual reality system for rehabilitation. The Journal of Visualization and Computer Animation, 14(5), 261-268. doi:10.1002/vis.323Witmer, B. G., & Singer, M. J. (1998). Measuring Presence in Virtual Environments: A Presence Questionnaire. Presence: Teleoperators and Virtual Environments, 7(3), 225-240. doi:10.1162/105474698565686Kizony, R., Raz, L., Katz, N., Weingarden, H., & Weiss, P. L. T. (2005). Video-capture virtual reality system for patients with paraplegic spinal cord injury. The Journal of Rehabilitation Research and Development, 42(5), 595. doi:10.1682/jrrd.2005.01.0023Muñoz Tomás, M. T., Gil Gómez, J. A., Gil Gómez, H., Lozano Quillis, J. A., Albiol-Pérez, S., & Forcano García, M. (2013). Suitability of virtual rehabilitation for elderly: A study of a virtual rehabilitation system using the SEQ. European Geriatric Medicine, 4, S109. doi:10.1016/j.eurger.2013.07.358Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). «Mini-mental state». Journal of Psychiatric Research, 12(3), 189-198. doi:10.1016/0022-3956(75)90026-6Forcano García, M., Albiol-Perez, S., Aula Valero, M. C., Gil Gómez, J. A., Solsona Hernández, S., & Manzano Hernández, P. (2013). Balance virtual rehabilitation in the elderly: The use of the «ABAR» system. European Geriatric Medicine, 4, S109. doi:10.1016/j.eurger.2013.07.356Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16(3), 297-334. doi:10.1007/bf02310555Babikian, T., & Asarnow, R. (2009). Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature. Neuropsychology, 23(3), 283-296. doi:10.1037/a0015268Streiner, D. L. (2003). Starting at the Beginning: An Introduction to Coefficient Alpha and Internal Consistency. Journal of Personality Assessment, 80(1), 99-103. doi:10.1207/s15327752jpa8001_18Fackrell, K., Fearnley, C., Hoare, D. J., & Sereda, M. (2015). Hyperacusis Questionnaire as a Tool for Measuring Hypersensitivity to Sound in a Tinnitus Research Population. BioMed Research International, 2015, 1-12. doi:10.1155/2015/29042

SEQ: Suitability Evaluation Questionnaire for Virtual Rehabilitation systems. Application in a Virtual Rehabilitation system for Balance Rehabilitation. 2013 Presented at: SEQ: Suitability Evaluation Questionnaire for Virtual Rehabilitation systems. Appli

Abstract-Usability, acceptance and security of use are key factors in the validation of Virtual Rehabilitation system. Current literature offers different questionnaires for this purpose, but many of them do not consider some important issues and other are inadequate for patients. In this paper, we present SEQ (Suitability Evaluation Questionnaire) a novel questionnaire designed specifically for Virtual Rehabilitation systems. SEQ is based on a questionnaire with proven efficacy (SFQ) but with new questions that cover fundamental items not covered by SFQ. SEQ is an easy to understand questionnaire, with an affordable number of questions (14), which is being currently validated. This contribution presents also the study that is being carried out, and the preliminary results obtained from patients who have already completed the study (N=13). These initial results show an acceptable internal consistency of SEQ. As a secondary result, this contribution also indicates initial suitability evaluation of a Virtual Rehabilitation system designed for balance recovery

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

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