Luisa Cacciante

Bio: Luisa Cacciante is an academic researcher. The author has contributed to research in topics: Medicine & Physical therapy. The author has an hindex of 2, co-authored 6 publications receiving 22 citations.

Use of virtual reality-based training in different fields of rehabilitation: A systematic review and meta-analysis.

Abstract: Objectives To analyse the effectiveness of virtual reality-based interventions within several fields of rehabilitation, and to investigate whether the outcomes of virtual reality-based interventions, in terms of upper or lower limb function, gait and balance, differ with respect to the virtual reality system used. Methods A search of PubMed database resulted in an initial total of 481 records. Of these, 27 articles were included in the study. A final total of 20 articles, with neurological, orthoapedic, geriatric or paediatric patients, published between 2012 and 2019, were included in the study. Two independent reviewers selected potentially relevant articles based on the inclusion criteria for full-text reading. They extracted data, and evaluated the methodological quality of each study. Results Seventeen studies were included in the meta¬ -analysis. Eight studies analysed upper limb function, with no significant evidence that specialized VR is superior to conventional treatment. Regarding FuglMeyer scale results, the effect of specialized virtual reality therapy was found to be significantly better than conventional treatment. No significant differences between specialized VR and conventional treatment were observed in effects on hand dexterity and gait. There was a significant difference in effects on balance in favour of specialized virtual reality as compared to conventional treatment. Gaming virtual reality was significantly better than conventional treatment for upper limb function, but not for hand dexterity, gait and balance. Conclusion Use of specialized virtual reality and gaming virtual reality can be advantageous for treatment of the upper extremity, but not for hand dexterity and gait in all pathologies considered. Specialized virtual reality can improve balance in neurological patients.

The Impact of Isolation Due to COVID-19 on Physical Activity Levels in Adult Students

Abstract: The lockdown with a prohibition of free mobility introduced in many countries has affected restrictions in physical activity (PA). The purpose of the study was to compare PA during restrictions and the “unfreezing” stage. The study group consisted of 89 healthy adult students. To assess the level of PA, a long version of the International Physical Activity Questionnaire (IPAQ) was used. The first evaluation was carried out in the period from 16 to 20 April 2020 at the time of the lockdown and the second in the period from 11 to 14 May 2020 during the so-called “unfreezing”. The average total PA rate during the first measurement was 8640 metabolic equivalent (MET)-min/week and in the second, 10,560 MET-min/week. The analysis of total energy expenditure showed a statistically significant difference (p < 0.029). The establishment of “unfreezing” laws for sport and recreation and the reduction of restrictions have significantly contributed to an increase in the overall level of PA. Based on our outcomes, we recommend students follow the scientific guidelines for undertaking PA (i.e., WHO) during the pandemic in order to maintain an appropriate pro-healthy dose of exercise.

Cognitive telerehabilitation in neurological patients: systematic review and meta-analysis.

Abstract: Telerehabilitation (TR) seems to be an encouraging solution for the delivery of cognitive treatments in patients with neurological disorders. This study was aimed to analyze and synthesize the evidence on the efficacy of cognitive TR interventions in patients with neurological diseases, compared with conventional face-to-face rehabilitation. From a total of 4485 records, 9 studies met the inclusion criteria for qualitative analysis. At the end of the process, 7 studies remained for quantitative analysis. By comparing TR with face-to-face treatments for cognitive impairments, we assessed improvements in global cognitive domain (Mini Mental State Exam) (MD = -0.86; 95% CI -2.43, 0.72, I2 = 0%), in learning and memory domains (SMD = 0.26, 95% CI -0.22, 0.74, I2 = 24%), in verbal fluency (SMD = 0.08, 95% CI -0.47, 0.62, I2 = 0%), and in executive functions (i.e., problem-solving, central processing speed and working memory) (SMD = 0.38, 95% CI 0.06, 0.71, I2 = 0%). In all the included studies, improvement in the performance of the TR groups was comparable to that achieved through face-to-face intervention. Significant differences between those two modalities of providing treatments were observed for working memory and total executive function comparison, in favor of TR. The results of this study can sustain the efficacy of TR and its application for the treatment of neurological patients, especially when treated for executive function impairments.

Management Challenges in Chronic Obstructive Pulmonary Disease in the COVID-19 Pandemic: Telehealth and Virtual Reality.

Abstract: For the treatment of chronic obstructive pulmonary disease (COPD), early diagnosis and unconditionally correct management at the initial stage of the disease are very important when the symptoms are not yet too worrying. In this way, the progress of the disease can be slowed down, as can the occurrence of late, life-threatening symptoms. Pulmonary rehabilitation is an essential component of the management of COPD. The selection of appropriate exercises, which are determined during the classification of patients into a suitable improvement program, is of key importance in the process of rehabilitation. The coronavirus disease 2019 (COVID-19) pandemic has resulted in major limitations to public health care. Health systems were largely unprepared for an outbreak of this magnitude. Searching for new, attractive technologies that help patients with chronic diseases seems to be justified. This may be driven by telehealth platforms, likewise with the use of virtual reality (VR). Analysis of the available literature indicates promising effectiveness, high patient acceptance, and high motivations to undertake physical activity with the use of such a solution. Thus, the management of patients with COPD during the COVID-19 pandemic should include options for remote delivery of pulmonary rehabilitation, including home-based, telerehabilitation, and computer-based virtual programs.

Effects of Digitalisation on Higher Education in a Sustainable Development Framework—Online Learning Challenges during the COVID-19 Pandemic

Abstract: Throughout the planet, the medical challenges posed by the pandemic caused by the SARS-Cov-2/COVID-19 coronavirus have overlapped, inter alia, with the necessity to continue the academic process on every level. Romania was no exception. With the new vaccines against COVID-19, the hope of resuming face-to-face activity, considered as ‘normal’ before 2020, has emerged. In these circumstances, not at all far-fetched, certain questions have arisen, such as: should and must the online university education be completely removed? Should this form of education be continued? If so, to what extent? We have used econometric methods related to ARDL (auto regressive distributed lag models) such as pooled mean group (PMG) and mean group (MG) and used different tests for unit roots for the stationarity check of the series implied. The results show the positive effect of digitalisation on tertiary education and also the positive impact of the latter on sustainable development, as a base for future stimulation in public policies. The present study also aims to harness the university experience of these times, from some of the main Romanian university centres; the method used was a quantitative and qualitative research based on a questionnaire, which was answered by a number of 258 university teachers and 1569 students from prestigious public and private universities. The results of this analysis allowed us to conclude that most of the participants in the university educational process have adapted to the online activity, and the latter ‘saved’ the academic years 2019–2020 and, respectively, 2020–2021. The present study is useful for tertiary education institution and policymakers in terms of formulating strategies and policy recommendations to support teachers and students during any future pandemics.

Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses.

Abstract: Neurological disorders are a leading cause of death and disability worldwide. Can virtual reality (VR) based intervention, a novel technology-driven change of paradigm in rehabilitation, reduce impairments, activity limitations, and participation restrictions? This question is directly addressed here for the first time using an umbrella review that assessed the effectiveness and quality of evidence of VR interventions in the physical and cognitive rehabilitation of patients with stroke, traumatic brain injury and cerebral palsy, identified factors that can enhance rehabilitation outcomes and addressed safety concerns. Forty-one meta-analyses were included. The data synthesis found mostly low- or very low-quality evidence that supports the effectiveness of VR interventions. Only a limited number of comparisons were rated as having moderate and high quality of evidence, but overall, results highlight potential benefits of VR for improving the ambulation function of children with cerebral palsy, mobility, balance, upper limb function, and body structure/function and activity of people with stroke, and upper limb function of people with acquired brain injury. Customization of VR systems is one important factor linked with improved outcomes. Most studies do not address safety concerns, as only nine reviews reported adverse effects. The results provide critical recommendations for the design and implementation of future VR programs, trials and systematic reviews, including the need for high quality randomized controlled trials to test principles and mechanisms, in primary studies and in meta-analyses, in order to formulate evidence-based guidelines for designing VR-based rehabilitation interventions.

Virtual Reality Interventions for Needle-Related Procedural Pain, Fear and Anxiety-A Systematic Review and Meta-Analysis.

Abstract: Needle-related procedures are often a source of pain, anxiety and fear in young patients. This systematic review aimed to investigate the effectiveness of virtual reality (VR) on reducing pain, fear and anxiety in pediatric patients undergoing needle-related procedures. Pain, anxiety, fear, changes in blood pressure and heart rate as well as satisfaction were evaluated as outcomes during needle-related procedures in VR compared with standard care conditions. A meta-analysis was performed, taking into account online databases. Two authors independently conducted literature searches in December 2020. The last search was conducted in March 2021 from a total of 106 records, 7 met our inclusion criteria. One study was excluded from the meta-analysis due to insufficient data. VR was applied as a distractor during venous access. Statistically significant benefits of using VR were shown in children's pain scores, where VR significantly decreased symptoms (n = 3204 patients, MD = -2.85; 95% CI -3.57, -2.14, for the Wong-Baker Faces Pain Rating Scale and n = 2240 patients, MD = -0.19; 95% CI -0.58, 0.20, for the Faces Pain Scale-Revised). The analysis of fear, anxiety and satisfaction scores revealed no significant differences between the conditions, as the studies were too heterogeneous to be pooled. Distraction using virtual reality may be an effective intervention for reducing pain in children undergoing needle-related medical procedures. However, further research in the implementation of VR as a distractor for children and adolescents is required, due to the limited research into this field.

Framing twitter public sentiment on Nigerian government COVID-19 palliatives distribution using machine learning

Abstract: Sustainable development plays a vital role in information and communication technology. In times of pandemics such as COVID-19, vulnerable people need help to survive. This help includes the distribution of relief packages and materials by the government with the primary objective of lessening the economic and psychological effects on the citizens affected by disasters such as the COVID-19 pandemic. However, there has not been an efficient way to monitor public funds’ accountability and transparency, especially in developing countries such as Nigeria. The understanding of public emotions by the government on distributed palliatives is important as it would indicate the reach and impact of the distribution exercise. Although several studies on English emotion classification have been conducted, these studies are not portable to a wider inclusive Nigerian case. This is because Informal Nigerian English (Pidgin), which Nigerians widely speak, has quite a different vocabulary from Standard English, thus limiting the applicability of the emotion classification of Standard English machine learning models. An Informal Nigerian English (Pidgin English) emotions dataset is constructed, pre-processed, and annotated. The dataset is then used to classify five emotion classes (anger, sadness, joy, fear, and disgust) on the COVID-19 palliatives and relief aid distribution in Nigeria using standard machine learning (ML) algorithms. Six ML algorithms are used in this study, and a comparative analysis of their performance is conducted. The algorithms are Multinomial Naive Bayes (MNB), Support Vector Machine (SVM), Random Forest (RF), Logistics Regression (LR), K-Nearest Neighbor (KNN), and Decision Tree (DT). The conducted experiments reveal that Support Vector Machine outperforms the remaining classifiers with the highest accuracy of 88%. The “disgust” emotion class surpassed other emotion classes, i.e., sadness, joy, fear, and anger, with the highest number of counts from the classification conducted on the constructed dataset. Additionally, the conducted correlation analysis shows a significant relationship between the emotion classes of “Joy” and “Fear”, which implies that the public is excited about the palliatives’ distribution but afraid of inequality and transparency in the distribution process due to reasons such as corruption. Conclusively, the results from this experiment clearly show that the public emotions on COVID-19 support and relief aid packages’ distribution in Nigeria were not satisfactory, considering that the negative emotions from the public outnumbered the public happiness.