Joint attention deficit is one of the core disorders in children with autism, which seriously affects the development of multiple basic skills such as language and communication. Virtual reality scene intervention has great potential in improving joint attention skills in children with autism due to its good interactivity and immersion. This article reviewed the application of virtual reality based social and nonsocial scenarios in training joint attention skills for children with autism in recent years, summarized the problems and challenges of this intervention method, and proposed a new joint paradigm for social scenario assessment and nonsocial scenario training. Finally, it looked forward to the future development and application prospects of virtual reality technology in joint attention skill training for children with autism.
Objective To explore the application effect of virtual reality simulation technology (VRST) combined with problem-based learning (PBL) mode in knee arthroscopy teaching in sports medicine department. Methods A total of 76 trainees in sports medicine at Sichuan Provincial Orthopedic Hospital from June 2021 to June 2022 were retrospectively selected. According to the different teaching modes, they were divided into the research group and the control group with 38 trainees in each group. The traditional teaching mode was implemented in the control group, while VRST and PBL mode were implemented in the research group. The objective assessment results and teaching effect feedback of the two groups were compared. Results There was no statistical difference between the two groups in the average theoretical score of the trainees (91.35±1.05 vs. 90.94±1.12, P>0.05). The scores of the three manipulating parts of the research group (9.03±0.24, 9.12±0.31, and 9.24±0.27, respectively) were higher than those of the control group (8.76±0.36, 8.44±0.57, and 8.35±0.51, respectively), moreover, trainees in the research group had higher scores for study enthusiasm, teaching satisfaction, three-dimensional space sense, and virtual reality conversion degree (9.12±0.16, 9.67±0.11, 9.34±0.22, and 9.56±0.18, respectively) than those of the control group (8.89±0.27, 9.16±0.34, 8.67±0.37, and 8.42±0.23, respectively), and the differences were all statistically significant (P<0.05). Conclusion VRST combined with PBL mode could improve trainees’ ability to operate arthroscopy significantly, and stimulate trainees’ subjective learning ability to improve teaching effect.
Objective To investigate the effect of virtual reality (VR) sham feeding on gastrointestinal function in elderly patients with hip fracture. Methods Elderly patients with hip fracture admitted to Trauma Center, West China Hospital, Sichuan University between June and December 2024 who met the case selection criteria were selected. Patients who were willing to complete the postoperative VR operation were assigned to the experimental group (VR group), and the other patients were assigned to the control group by 1∶1 manual interval matching according to sex, age (±5 years), and body mass index (±2 kg/m2). The control group received fasting and nutrition management strategy during perioperative period of accelerated rehabilitation. In the VR group, VR sham feeding intervention was performed on the basis of the control group. The time of first postoperative exhaust and defecation, postoperative gastrointestinal symptoms, postoperative nutrition (hemoglobin, serum albumin) and inflammatory indicators (white blood cell count, erythrocyte sedimentation rate, C-reactive protein, interleukin-6), postoperative appetite and postoperative complications (bleeding, fever, delirium, aspiration, vertigo) were compared between the two groups. Results A total of 70 patients were enrolled, with 35 in each group. There were statistically significant differences (P<0.05) between the VR group and the control group in the time of postoperative first exhaust [(9.17±4.81) vs. (13.66±5.97) h], time of postoperative first defecation [(49.00±28.61) vs. (66.83±29.93) h], degree of abdominal distension 3 d after surgery (grade 0/1/2: 26/7/2 vs. 16/12/7 cases), appetite score 1 d after surgery (62.86±12.85 vs. 54.71±11.50), appetite score 3 d after surgery (76.29±9.95 vs. 62.43±8.86), albumin level 3 d after surgery [(33.18±3.41) vs. (31.40±3.07) g/L], and hospitalization days [(7.97±1.38) vs. (9.06±2.43) d], while there was no statistically significant difference in other indicators (P>0.05). Conclusions The incidence of postoperative gastrointestinal dysfunction is high in elderly patients with hip fracture. VR sham feeding can promote the early recovery of gastrointestinal function, alleviate postoperative abdominal distension, significantly improve postoperative appetite, and increase albumin level after surgery.
Post-stroke cognitive dysfunction is a common complication of stroke, and active rehabilitation therapy can effectively promote the recovery of patients. As a new treatment method, telecognitive rehabilitation is used in rehabilitation treatment of cognitive disorders. Its main technologies include computer-assisted cognitive rehabilitation, virtual reality technology, and artificial intelligence technology. It can use the Internet platform to provide homogeneous treatment, make patients more convenient for cognitive rehabilitation treatment, help to ensure the continuity of rehabilitation treatment, and save medical costs. This article describes the definition of cognitive telerehabilitation, the development and application of cognitive telerehabilitation technology, and summarizes the existing problems. The purpose is to provide a reference for the clinical application of cognitive telerehabilitation in China and future research directions.
Objective To study the application of virtual reality bronchoscopy stimulation in novice trainees. Methods Four novice bronchoscopists entered the training programby using a VR bronchoscopy in the clinical skill center. After the program, the dexterity, speed, and accuracy of all the four doctors were tested using the virtual simulation models. Results were compared to four skilled physicians as control group who had performed at least 50 bronchoscopies. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired twosample t tests were used. Results All of the four trainees finished the training program. The novices significantly improved their dexterity, speed and accuracy. The percentage of observed segments increased from ( 74. 0 ±5. 1) % to ( 89. 3 ±4. 0) % . The number of contacts with the bronchial wall decreased from 87. 5 ±13. 2 to 30. 5 ±9. 3, and total time spent shortened from ( 700. 8 ±56. 6) s to ( 607. 0 ±17. 8) s. There were no statistically significant differences between novice accuracy ( the percentage of observed segments) after training and skilled physician accuracy [ ( 89. 3 ±4. 0) % vs ( 91. 3 ±3. 0) % , P = 0. 456] . Conclusion Practice using a virtual bronchoscopy simulator help novice trainees to attain a level of skill at performing diagnostic bronchoscopy, and it might play an important role in the training of chest physicians.
ObjectiveTo investigate the effects of transcranial direct current stimulation (tDCS) combined with virtual reality (VR) on upper limb dysfunction of stroke patients.MethodsPatients with stroke who were hospitalized in the Department of Rehabilitation Medicine, the Third Affiliated Hospital of Sun Yat-Sen University from July 2018 to January 2020 were selected. The patients were divided into tDCS group, VR group and combined treatment group by random number table method. All three groups received conventional rehabilitation treatment. Based on this, tDCS group received 2.0 mA tDCS treatment, VR group received 20 min VR treatment, and combined treatment group received the same tDCS and VR treatment. Before and 4 weeks after treatment, the Fugl-Meyer assessment-upper limb (FMA-UL), Wolf motor function test (WMFT) and modified barthel index (MBI) were used to evaluate the upper limb motor function and activities of daily life (ADL) of the three groups.ResultsA total of 45 patients were included, 15 in each group. No adverse reactions or fall off occurred during the treatment. Before treatment, there were no significant difference in FMA-UL, WMFT-Times, WMFT functional ability scores (WMFT-FAS), and MBI between the three groups (P>0.05). After 4 weeks of treatment, the FMA-UL, WMFT-Times, WMFT-FAS, and MBI scores of the three groups were significantly improved compared with those before treatment (P<0.05); the MBI score of the combination treatment group was significantly better than the tDCS group and VR group, and the FMA-UL was significantly better than the tDCS group, and the differences were statistically significant (P<0.05). Also, there were no significant differences in the improvement of FMA-UL, WMFT-Times, WMFT-FAS, and MBI scores between the tDCS group and the VR group (P>0.05); the differences of FMA-UL, WMFT-Times, WMFT-FAS, and MBI scores before and after treatment in the combined treatment group, which were significantly better than those in tDCS group and VR group (P<0.05). ConclusiontDCS combined with virtual reality can significantly improve the upper limb motor function and ADL ability of stroke patients, and the effect is superior to tDCS or VR treatment solely.
Objective To explore the feasibility of virtual reality (VR) technology combined with reduction plasty of the femoral head in the treatment of coxa plana and evaluate its effectiveness. Methods Three patients with coxa plana were selected as the research objects between October 2018 and October 2020, all of them were male, aged 15-24 years. Preoperative surgical planning was performed using VR technology; 256 rows of CT data of hip joint were imported into software to generate three-dimensional (3D) imaging, simulate the surgical process, and determine the matching relationship between the femoral head and acetabulum. According to the preoperative planning, reduction plasty of the femoral head under surgical dislocation, relative lengthening of the femoral neck, and periacetabular osteotomy were performed. The reduction of osteotomy size of femoral head and rotation angle of acetabulum were confirmed by C-arm fluoroscopy. The healing of the osteotomy were assessed by radiological examination after operation. The Harris score of hip function and visual analogue scale (VAS) score were recorded before and after operation. The femoral head roundness index, center-edge (CE) angle, and femoral head coverage were measured by X-ray films. ResultsThree operations were completed successfully, and the operation time was 460, 450, and 435 minutes, and the intraoperative blood loss was 733, 716, and 829 mL, respectively. All patients were infused with 3 U suspension oligoleucocyte and 300 mL frozen virus inactivated plasma after operation. No postoperative complication occurred, such as infection and deep vein thrombosis. Three patients were followed up 25, 30, and 15 months, respectively. CT showed good healing of the osteotomy at 3 months after operation. The VAS score and Harris score at 12 months after operation and at last follow-up, as well as the femoral head rounding index, hip CE angle, and femoral head coverage at 12 months after operation significantly improved when compared with those before operation; the hip function was evaluated by the Harris score at 12 months after operation, and all three patients were good. ConclusionVR technology combined with reduction plasty of the femoral head can achieve satisfactory short-term effectiveness in the treatment of coxa plana.
ObjectiveTo research the value of virtual reality (VR) technology in the preoperative planning of transtrochanteric curved varus osteotomy for avascular necrosis of the femoral head (ANFH) in adults.MethodsBetween June 2018 and November 2018, 7 patients (11 hips) with ANFH, who were treated with transtrochanteric curved varus osteotomy, were enrolled in the study. There were 4 males (7 hips) and 3 females (4 hips) with an average age of 31.9 years (range, 14-46 years). Among them, 3 patients were unilateral ANFH and 4 patients were bilateral ANFH. There was 1 patient (1 hip) of traumatic ANFH, 2 patients (4 hips) of alcohol-induced ANFH, 2 patients (3 hips) of hormonal ANFH, and 2 patients (3 hips) of idiopathic ANFH. All hips were Association Research Circulation Osseous (ARCO) stage Ⅲ. There were 5 hips for Japanese Investigation Committee (JIC) type C1 and 6 hips for type C2. There were 5 hips for China-Japan Friendship Hospital (CJFH) type L1,1 for type L2, and 5 for type L3. The disease duration ranged from 5 to 12 months (mean, 8 months). Preoperative Harris score was 53.91±7.66. The neck-shaft angle ranged from 128 to 143° (mean, 133.9°). VR technology was adopted for the preoperative planning. CT data were imported into the software to construct the morphology of necrotic area, and the transrtrochanteric varus osteotomy was simulated. The varus angle was designed according to the integrity rate of femoral head. The planned varus angle was 6 to 16° (mean, 9.7°). The transtrochanteric curved varus osteotomy was performed according to the preoperative planning, and the varus angle and loading area were confirmed under fluoroscopy. If the planned varus angle was too small, it would continue to increase under the fluoroscopy until a satisfactory varus angle. Postoperative changes of the neck-shaft angle were calculated and compared with the preoperative planned varus angle (error). The hip function was assessed by using the Harris score.ResultsAll incisions healed by first intention. All patients were followed up 6-11 months with an average of 8 months. The X-ray film at 2 days after operation showed that the neck-shaft angle was 112-135° (mean, 123.4°). The difference of the neck-shaft angle between pre- and post-operation was 6-16° (mean, 11.0°). Among them, the difference of the neck-shaft angle was consistent with planned varus angle in 5 hips, while the error of the remaining 6 hips was 1-4°. There was 1 patient (1 hip) of osteotomy nonunion at 4 months after operation, 1 patient (1 hip) of proximal femur fracture at 2 months after operation. The rest 5 patients (9 hips) obtained union at the osteotomy. At last follow-up, the Harris score was 82.18±16.35, showing significant difference when compared with preoperative score (t=–5.195, P=0.000).ConclusionVR technology is a brand-new preoperative planning method for transtrochanteric curved varus osteotomy in treating ANFH.
ObjectiveTo evaluate the application value of virtual reality (VR) technology in the surgical treatment of coronary artery fistula (CAF) and abnormal origin of coronary artery (AOOCA).MethodsFrom January 2014 to June 2018, with the assistance of virtual reality technology, 4 patients with CAF and 4 patients with AOOCA in the Department of Cardiac Surgery of our hospital underwent treatment method deciding and operation details planning. In the CAF patients, there was 1 male and 3 females and they were 8 years, 16 years, 62 years, and 65 years, respectively. In the AOOCA patients, there was 1 male and 3 females at age of 4-month, 2 years, 14 years, and 29 years, respectively.ResultsThe virtual heart models in all 8 patients were well matched with the real heart. The spatial structure information of CAF/AOOCA and surroundings can be intuitively and fully shown by virtual reality technology in all patients. All of the 4 CAF patients repaired coronary artery incision, including 2 patients with autologous pericardium patch and 2 patients with direct suture. Of the 4 AOOCA patients, 3 underwent coronary directly transplantation but 1 underwent Takeuchi surgery. And 2 had mitral valve plasty at the same time. All the operations were completed successfully, with good recovery and no serious complications. Among the 4 CAF patients, 3 had no residual fistula, and 1 had minor residual fistula. Coronary arteries were all unobstructed in 4 patients of AOOCA; moderate and severe mitral regurgitation in 2 patients were significantly reduced after surgery.ConclusionVR allows doctors to understand the spatial structure information of CAF/AOOCA and surroundings before the operation, and assists them to make accurate treatment decisions and develop detailed surgical plans before the operation, ensuring its safety. Its clinical application value is significant.
Electronic skin has shown great application potential in many fields such as healthcare monitoring and human-machine interaction due to their excellent sensing performance, mechanical properties and biocompatibility. This paper starts from the materials selection and structures design of electronic skin, and summarizes their different applications in the field of healthcare equipment, especially current development status of wearable sensors with different functions, as well as the application of electronic skin in virtual reality. The challenges of electronic skin in the field of wearable devices and healthcare, as well as our corresponding strategies, are discussed to provide a reference for further advancing the research of electronic skin.