-
JMIR MHealth and UHealth Dec 2020Duchenne muscular dystrophy is a serious and progressive disease affecting one in 3500-6000 live male births. The use of new virtual reality technologies has... (Review)
Review
BACKGROUND
Duchenne muscular dystrophy is a serious and progressive disease affecting one in 3500-6000 live male births. The use of new virtual reality technologies has revolutionized the world of youth rehabilitation.
OBJECTIVE
We performed a systematic review to study the effectiveness of the use of virtual reality systems applied in the rehabilitation of the upper limbs of individuals with Duchenne muscular dystrophy.
METHODS
Between June 2018 and September 2019, we carried out a series of searches in 5 scientific databases: (1) PubMed, (2) Web of Science, (3) Scopus, (4) The Cochrane Library, and (5) MEDLINE via EBSCO. Two evaluators independently conducted the searches following the PRISMA recommendations for systematic reviews for articles. Two independent evaluators collated the results. Article quality was determined using the PEDro scale.
RESULTS
A total of 7 clinical trials were included in the final review. These studies used new technologies as tools for physiotherapeutic rehabilitation of the upper limbs of patients with Duchenne muscular dystrophy. Collectively, the studies showed improvement in functionality, quality of life, and motivation with the use of virtual reality technologies in the rehabilitation of upper limbs of individuals with Duchenne muscular dystrophy.
CONCLUSIONS
The treatment of neuromuscular diseases has changed in recent years, from palliative symptom management to preventive methods for capacity building. The use of virtual reality is beginning to be necessary in the treatment of progressive diseases involving movement difficulties, as it provides freedom and facilitates the improvement of results in capacity training. Given that new technologies are increasingly accessible, rehabilitation and physiotherapy programs can use these technologies more frequently, and virtual reality environments can be used to improve task performance, which is essential for people with disabilities. Ultimately, virtual reality can be a great tool for physiotherapy and can be used for Duchenne muscular dystrophy rehabilitation programs to improve patient performance during training.
TRIAL REGISTRATION
PROSPERO International Prospective Register of Systematic Reviews CRD42018102548; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=102548.
Topics: Adolescent; Humans; Male; Motivation; Muscular Dystrophy, Duchenne; Quality of Life; Upper Extremity; Virtual Reality
PubMed: 33289679
DOI: 10.2196/21576 -
International Journal of Qualitative... Dec 2021: In light of the increasing prevalence of overweight and obesity, understanding the experiences, strategies and challenges encountered when trying to achieve...
: In light of the increasing prevalence of overweight and obesity, understanding the experiences, strategies and challenges encountered when trying to achieve substantial, sustainable weight loss is an important area to investigate. We systematically evaluated qualitative studies focusing on the accounts of individuals who have achieved sustained weight loss to create a comprehensive picture of the experience of sustainable weight loss. : Included studies were peer-reviewed studies that qualitatively assessed the views and experiences of adults who previously had or currently have overweight or obesity who successfully lost weight and who subsequently maintained or regained weight. The evidence was systematically synthesized, which enabled the formulation of clear themes and recommendations. : The 15 chosen studies included the accounts of 294 individuals. We found that continuous monitoring and goal setting, driven by sustained motivation and encouraging experiences, while resisting ever present challenges and enduring discouraging experience encapsulates the experience of sustained, substantial weight loss. : This review aims to provide a comprehensive understanding of the experiences, strategies and challenges encountered when trying to achieve substantial, sustained weight loss. Additional research taking into account findings from this review and others of its kind will enhance the formulation of treatment protocols.
Topics: Goals; Humans; Motivation; Obesity; Overweight; Qualitative Research; Weight Loss; Weight Reduction Programs
PubMed: 33455563
DOI: 10.1080/17482631.2020.1862481 -
BioMed Research International 2019Spinal cord injury (SCI) is often associated with long-term impairments related to functional limitations in the sensorimotor system. The use of virtual reality (VR)...
BACKGROUND
Spinal cord injury (SCI) is often associated with long-term impairments related to functional limitations in the sensorimotor system. The use of virtual reality (VR) technology may lead to increased motivation and engagement, besides allowing a wide range of possible tasks/exercises to be implemented in rehabilitation programs. The present review aims to investigate the possible benefits and efficacy of VR-based rehabilitation in individuals with SCI.
METHODS
An electronically systematic search was performed in multiple databases (PubMed, BVS, Web of Science, Cochrane Central, and Scielo) up to May 2019. MESH terms and keywords were combined in a search strategy. Two reviewers independently selected the studies in accordance with eligibility criteria. The PEDro scale was used to score the methodological quality and risk of bias of the selected studies.
RESULTS
Twenty-five studies (including 482 participants, 47.6 ± 9.5 years, 73% male) were selected and discussed. Overall, the studies used VR devices in different rehabilitation protocols to improve motor function, driving skills, balance, aerobic function, and pain level, as well as psychological and motivational aspects. A large amount of heterogeneity was observed as to the study design, VR protocols, and outcome measures used. Only seven studies (28%) had an excellent/good quality of evidence. However, substantial evidence for significant positive effects associated with VR therapy was found in most of the studies (88%), with no adverse events (88%) being reported.
CONCLUSION
Although the current evidence is limited, the findings suggest that VR-based rehabilitation in subjects with SCI may lead to positive effects on aerobic function, balance, pain level, and motor function recovery besides improving psychological/motivational aspects. Further high-quality studies are needed to provide a guideline to clinical practice and to draw robust conclusions about the potential benefits of VR therapy for SCI patients. Protocol details are registered on PROSPERO (registration number: CRD42016052629).
Topics: Adult; Female; Humans; Male; Middle Aged; Spinal Cord Injuries; Telerehabilitation; Treatment Outcome; Virtual Reality
PubMed: 31828120
DOI: 10.1155/2019/7106951 -
Inquiry : a Journal of Medical Care... 2023Nursing leadership is critical in facilitating and improving nurse performance, which is essential for providing quality care and ensuring patient safety. The aim of...
Nursing leadership is critical in facilitating and improving nurse performance, which is essential for providing quality care and ensuring patient safety. The aim of this study is to explore the relationship between nursing leadership and nurse performance by understanding the leadership behaviors and factors that motivate nurses to perform well. To study the factors that nurses believe motivate them to perform better, a systematic review was undertaken, correlating these factors to leadership behaviors/styles. The PRISMA guidelines were followed to identify relevant articles. After applying the selection criteria, 11 articles were included in the final analysis. Overall, 51 elements that influence nurses' motivation to perform better were found and categorized into 6 categories, including autonomy, competencies, relatedness, individual nursing characteristics, relationships and support, and leadership styles/practices. It has been discovered that both direct and indirect nursing leadership behaviors affect nurses' performance. A better understanding of the factors that motivate nurses to perform well and facilitating them in the work environment through leadership behaviors/styles can improve nurses' performance. There is a need to increase research on nurse leadership and nurses' performance in the current innovative and technologically integrated work environment to identify new factors of influence.
Topics: Humans; Nursing Staff; Leadership; Motivation; Quality of Health Care; Job Satisfaction
PubMed: 37269099
DOI: 10.1177/00469580231178528 -
The Cochrane Database of Systematic... Nov 2019Low back pain is costly and disabling. Prognostic factor evidence can help healthcare providers and patients understand likely prognosis, inform the development of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Low back pain is costly and disabling. Prognostic factor evidence can help healthcare providers and patients understand likely prognosis, inform the development of prediction models to identify subgroups, and may inform new treatment strategies. Recent studies have suggested that people who have poor expectations for recovery experience more back pain disability, but study results have differed.
OBJECTIVES
To synthesise evidence on the association between recovery expectations and disability outcomes in adults with low back pain, and explore sources of heterogeneity.
SEARCH METHODS
The search strategy included broad and focused electronic searches of MEDLINE, Embase, CINAHL, and PsycINFO to 12 March 2019, reference list searches of relevant reviews and included studies, and citation searches of relevant expectation measurement tools.
SELECTION CRITERIA
We included low back pain prognosis studies from any setting assessing general, self-efficacy, and treatment expectations (measured dichotomously and continuously on a 0 - 10 scale), and their association with work participation, clinically important recovery, functional limitations, or pain intensity outcomes at short (3 months), medium (6 months), long (12 months), and very long (> 16 months) follow-up.
DATA COLLECTION AND ANALYSIS
We extracted study characteristics and all reported estimates of unadjusted and adjusted associations between expectations and related outcomes. Two review authors independently assessed risks of bias using the Quality in Prognosis Studies (QUIPS) tool. We conducted narrative syntheses and meta-analyses when appropriate unadjusted or adjusted estimates were available. Two review authors independently graded and reported the overall quality of evidence.
MAIN RESULTS
We screened 4635 unique citations to include 60 studies (30,530 participants). Thirty-five studies were conducted in Europe, 21 in North America, and four in Australia. Study populations were mostly chronic (37%), from healthcare (62%) or occupational settings (26%). General expectation was the most common type of recovery expectation measured (70%); 16 studies measured more than one type of expectation. Usable data for syntheses were available for 52 studies (87% of studies; 28,885 participants). We found moderate-quality evidence that positive recovery expectations are strongly associated with better work participation (narrative synthesis: 21 studies; meta-analysis: 12 studies, 4777 participants: odds ratio (OR) 2.43, 95% confidence interval (CI) 1.64 to 3.62), and low-quality evidence for clinically important recovery outcomes (narrative synthesis: 12 studies; meta-analysis: 5 studies, 1820 participants: OR 1.89, 95% CI 1.49 to 2.41), both at follow-up times closest to 12 months, using adjusted data. The association of recovery expectations with other outcomes of interest, including functional limitations (narrative synthesis: 10 studies; meta-analysis: 3 studies, 1435 participants: OR 1.40, 95% CI 0.85 to 2.31) and pain intensity (narrative synthesis: 9 studies; meta-analysis: 3 studies, 1555 participants: OR 1.15, 95% CI 1.08 to 1.23) outcomes at follow-up times closest to 12 months using adjusted data, is less certain, achieving very low- and low-quality evidence, respectively. No studies reported statistically significant or clinically important negative associations between recovery expectations and any low back pain outcome.
AUTHORS' CONCLUSIONS
We found that individual recovery expectations are probably strongly associated with future work participation (moderate-quality evidence) and may be associated with clinically important recovery outcomes (low-quality evidence). The association of recovery expectations with other outcomes of interest is less certain. Our findings suggest that recovery expectations should be considered in future studies, to improve prognosis and management of low back pain.
Topics: Adult; Chronic Pain; Humans; Low Back Pain; Motivation; Pain Measurement; Prognosis; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 31765487
DOI: 10.1002/14651858.CD011284.pub2 -
Journal of Behavioral Addictions Sep 2022The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
The present systematic review and meta-analysis aimed to synthesize the available literature on the relationship between gaming motivations and gaming disorder symptoms. Specifically, to (1) explore what gaming motivation questionnaires and classifications are used in studies on gaming disorder symptoms and (2) investigate the relationship between motivational factors and symptoms of gaming disorder.
METHOD
An electronic database search was conducted via EBSCO (MEDLINE and PsycINFO) and the Web of Science Core Collection. All studies using validated measurements on gaming disorder symptoms and gaming motivations and available correlation coefficients of the relationship between gaming disorder and gaming motivations were included. The meta-analyses were conducted using a random-effects model.
RESULTS
In total, 49 studies (k = 58 independent sub-samples), including 51,440 participants, out of which 46 studies (k = 55 sub-samples, n = 49,192 participants) provided data for the meta-analysis. The synthesis identified fourteen different gaming motivation instruments, seven unique motivation models, and 26 motivational factors. The meta-analysis showed statistically significant associations between gaming disorder symptoms and 23 out of 26 motivational factors, with the majority of the pooled mean effect sizes ranging from small to moderate. Moreover, large heterogeneity was observed, and the calculated prediction intervals indicated substantial variation in effects across populations and settings. Motivations related to emotional escape were robustly associated with gaming disorder symptoms.
DISCUSSION AND CONCLUSIONS
The present meta-analysis reinforces the importance of motivational factors in understanding problematic gaming behavior. The analysis showed significant heterogeneity in most outcomes, warranting further investigation.
REGISTRATION DETAIL
PROSPERO (CRD42020220050).
Topics: Humans; Video Games; Behavior, Addictive; Motivation; Disruptive, Impulse Control, and Conduct Disorders; Surveys and Questionnaires
PubMed: 36094861
DOI: 10.1556/2006.2022.00053 -
Advances in Nutrition (Bethesda, Md.) Sep 2023Ghrelin is an orexigenic hormone primarily released by the stomach and has 2 isoforms: acylated ghrelin (AG) and de-acylated ghrelin (DAG), that appear to have different... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ghrelin is an orexigenic hormone primarily released by the stomach and has 2 isoforms: acylated ghrelin (AG) and de-acylated ghrelin (DAG), that appear to have different functions in humans.
OBJECTIVES
To perform a systematic review and meta-analysis of the association between plasma concentrations of total ghrelin (TG), AG, and DAG and perceptions of hunger in healthy adults.
METHODS
The following criteria were used for inclusion: 1) sample contained adults ≥18 y of age, 2) body mass index [BMI kg/m] was ≥18.5, 3) ghrelin was sampled through blood, 4) subjective hunger was measured on a validated scale, 5) study reported a Pearson product correlation of ghrelin or had relevant figure(s) for data extraction, 6) participants were healthy with no overt disease, 7) protocols contained no physical activity or weight loss medication that suppressed appetite, 8) interventions were conducted without environmental manipulations. Moderators assessed were age, BMI, percentage of body fat (%BF), macronutrient content of test meals, energy intake (kcals), sex, and ghrelin isoform (AG, DAG, or TG).
RESULTS
The analysis included 47 studies (110 trials, n = 1799, age: 31.4 ± 12.0 y, BMI: 26.0 ± 4.75 kg/m) and measured AG (n = 47 trials), DAG (n = 12 trials), and TG (n = 51 trials). The overall model indicated that ghrelin concentrations and perceptions of hunger were moderately correlated (r = 0.43, P < 0.001), and ghrelin isoform significantly moderated this relationship (AG: r = 0.60, P < 0.001; TG: r = 0.215, P = 0.01; DAG: r = 0.53, P = 0.695). Other significant moderators included age (b = -0.02, P = 0.01), BMI (b = -0.03, P = 0.05), %BF (b = -0.03, P = 0.05), energy intake (b = 0.0003, P = 0.04), and percentage of carbohydrates of test meals (b = 0.008, P = 0.05).
CONCLUSIONS
Ghrelin is associated with perceptions of hunger in humans, and this relationship is strengthened when AG is isolated; thus, AG may have a large impact on hunger signals in various populations. Future research should attempt to understand the role of DAG in hunger sensations.
Topics: Adult; Humans; Young Adult; Child, Preschool; Hunger; Ghrelin; Energy Intake; Body Mass Index; Perception; Appetite
PubMed: 37536563
DOI: 10.1016/j.advnut.2023.07.011 -
Pharmacological Reviews Jan 2022A widely held dogma in the preclinical addiction field is that females are more vulnerable than males to drug craving and relapse. Here, we first review clinical studies... (Review)
Review
A widely held dogma in the preclinical addiction field is that females are more vulnerable than males to drug craving and relapse. Here, we first review clinical studies on sex differences in psychostimulant and opioid craving and relapse. Next, we review preclinical studies on sex differences in psychostimulant and opioid reinstatement of drug seeking after extinction of drug self-administration, and incubation of drug craving (time-dependent increase in drug seeking during abstinence). We also discuss ovarian hormones' role in relapse and craving in humans and animal models and speculate on brain mechanisms underlying their role in cocaine craving and relapse in rodent models. Finally, we discuss imaging studies on brain responses to cocaine cues and stress in men and women.The results of the clinical studies reviewed do not appear to support the notion that women are more vulnerable to psychostimulant and opioid craving and relapse. However, this conclusion is tentative because most of the studies reviewed were correlational, not sufficiently powered, and not a priori designed to detect sex differences. Additionally, imaging studies suggest sex differences in brain responses to cocaine cues and stress. The results of the preclinical studies reviewed provide evidence for sex differences in stress-induced reinstatement and incubation of cocaine craving but not cue- or cocaine-induced reinstatement of cocaine seeking. These sex differences are modulated in part by ovarian hormones. In contrast, the available data do not support the notion of sex differences in craving and relapse/reinstatement for methamphetamine or opioids in rodent models. SIGNIFICANCE STATEMENT: This systematic review summarizes clinical and preclinical studies on sex differences in psychostimulant and opioid craving and relapse. Results of the clinical studies reviewed do not appear to support the notion that women are more vulnerable to psychostimulant and opioid craving and relapse. Results of preclinical studies reviewed provide evidence for sex differences in reinstatement and incubation of cocaine seeking but not for reinstatement or incubation of methamphetamine or opioid seeking.
Topics: Analgesics, Opioid; Animals; Cocaine; Cocaine-Related Disorders; Craving; Extinction, Psychological; Female; Humans; Male; Recurrence; Self Administration; Sex Characteristics
PubMed: 34987089
DOI: 10.1124/pharmrev.121.000367 -
JMIR Mental Health Feb 2022There has been a surge in interest in examining internet gaming disorder (IGD) and its associations with gaming motivation. Three broad components of gaming motivation... (Review)
Review
BACKGROUND
There has been a surge in interest in examining internet gaming disorder (IGD) and its associations with gaming motivation. Three broad components of gaming motivation have been proposed: achievement, immersion, and social. Achievement-oriented players are motivated by gaining in-game rewards, immersion-oriented players are motivated by the experience of immersion in the virtual world, and social-oriented players are motivated by the need to socialize with other players through gaming.
OBJECTIVE
This study aimed to (1) quantitatively synthesize the growing body of literature to systematically examine the discrepancies in the magnitude of associations between various components of gaming motivation and IGD and (2) examine the moderating role of cultural dimension on the association between escapism gaming motivation and IGD.
METHODS
We conducted a systematic search of multiple databases between 2002 and 2020. Studies were included if they (1) included quantitative data, (2) used measures assessing both gaming motivation and IGD, and (3) contained sufficient information for effect size calculation.
RESULTS
The findings revealed IGD to have a stronger association with achievement motivation (r=0.32) than with immersion (r=0.22) or social motivation (r=0.20), but the strongest such association was found to be with escapism motivation (r=0.40), a subcomponent of immersion motivation. Our cross-cultural comparison further showed a stronger association between escapism motivation and IGD in studies conducted in individualistic (vs collectivistic) regions.
CONCLUSIONS
This meta-analysis highlights the importance of acknowledging the discrepancies among different components of gaming motivation with respect to their role in the development of IGD, as well as the potential cultural variations in the strength of such associations.
PubMed: 35175204
DOI: 10.2196/23700 -
International Journal of Environmental... Feb 2023Motivated behaviours are thought to lead to enhanced performances. In the neurorehabilitation field, motivation has been demonstrated to be a link between cognition and... (Review)
Review
Motivated behaviours are thought to lead to enhanced performances. In the neurorehabilitation field, motivation has been demonstrated to be a link between cognition and motor performance, therefore playing an important role upon rehabilitation outcome determining factors. While motivation-enhancing interventions have been frequently investigated, a common and reliable motivation assessment strategy has not been established yet. This review aims to systematically explore and provide a comparison among the existing motivation assessment tools concerning stroke rehabilitation. For this purpose, a literature search (PubMed and Google Scholar) was performed, using the following Medical Subject Headings terms: "assessment" OR "scale" AND "motivation" AND "stroke" AND "rehabilitation". In all, 31 randomized clinical trials and 15 clinical trials were examined. The existing assessment tools can be grouped into two categories: the first mirroring the trade-off between patients and rehabilitation, the latter reflecting the link between patients and interventions. Furthermore, we presented assessment tools which reflect participation level or apathy, as an indirect index of motivation. In conclusion, we are left to put forth a possible common motivation assessment strategy, which might provide valuable incentive to investigate in future research.
Topics: Humans; Stroke Rehabilitation; Motivation; Stroke; Neurological Rehabilitation; Cognition
PubMed: 36901206
DOI: 10.3390/ijerph20054187