Background Sleep disorders are a major public health issue. Nearly 1 in 2 people experience sleep disturbances during their lifetime, with a potential harmful impact on well-being and physical and mental health. Objective The aim of this study was to better understand the clinical applications of wearable-based sleep monitoring; therefore, we conducted a review of the literature, including feasibility studies and clinical trials on this topic. Methods We searched PubMed, PsycINFO, ScienceDirect, the Cochrane Library, Scopus, and the Web of Science through June 2019. We created the list of keywords based on 2 domains: wearables and sleep. The primary selection criterion was the reporting of clinical trials using wearable devices for sleep recording in adults. Results The initial search identified 645 articles; 19 articles meeting the inclusion criteria were included in the final analysis. In all, 4 categories of the selected articles appeared. Of the 19 studies in this review, 58 % (11/19) were comparison studies with the gold standard, 21% (4/19) were feasibility studies, 15% (3/19) were population comparison studies, and 5% (1/19) assessed the impact of sleep disorders in the clinic. The samples were heterogeneous in size, ranging from 1 to 15,839 patients. Our review shows that mobile-health (mHealth) wearable–based sleep monitoring is feasible. However, we identified some major limitations to the reliability of wearable-based monitoring methods compared with polysomnography. Conclusions This review showed that wearables provide acceptable sleep monitoring but with poor reliability. However, wearable mHealth devices appear to be promising tools for ecological monitoring.
Specific sleep disturbances such as reduced slow-wave sleep (SWS) and decreased serotonergic (5-HT) activity have been observed in depressive disorders. Ritanserin, a specific 5-HT2 receptor antagonist, has been shown to increase SWS in healthy subjects. This study explored the effects of a single dose or ritanserin (5 mg) on sleep electroencephalography in 18 major depressed patients and in 10 control subjects. Ritanserin affected SWS differently in the two groups. Although stage 3 increased significantly in the groups, in contrast to controls, there was no significant effect of ritanserin on stage 4 in depressed patients. In the depressed group, irritability and DSM-III-R melancholic type predicted 40% or the variance of stage 4 increment after ritanserin, as assessed by stepwise multiple regression. These results are in agreement with a potential 5-HT disturbance, particularly at the 5-HT2 receptor level, in some clinical forms of depression.
Navigating consists of coordinating egocentric and allocentric spatial frames of reference. Virtual environments have afforded researchers in the spatial community with tools to investigate the learning of space. The issue of the transfer between virtual and real situations is not trivial. A central question is the role of frames of reference in mediating spatial knowledge transfer to external surroundings, as is the effect of different sensory modalities accessed in simulated and real worlds. This challenges the capacity of blind people to use virtual reality to explore a scene without graphics. The present experiment involves a haptic and auditory maritime virtual environment. In triangulation tasks, we measure systematic errors and preliminary results show an ability to learn configurational knowledge and to navigate through it without vision. Subjects appeared to take advantage of getting lost in an egocentric "haptic" view in the virtual environment to improve performances in the real environment.
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Nowadays, thanks to the accessibility of GPS, sighted people widely use electronic charts to navigate through different kinds of environments. In the maritime domain, it has considerably improved the precision of course control. In this domain, blind sailors can not make a compass bearing, however they are able to interact with multimodal electronic charts. Indeed, we conceived SeaTouch, a haptic (tactilekinesthetic) and auditory virtual environment that allows users to perform virtual maritime navigation without vision. In this study we attempt to assess if heading or northing "haptic" views during virtual navigation training influences non-visual spatial knowledge. After simulating a navigation session in each condition, a blind sailor truly navigated on the sea and estimated seamark bearings. We used the triangulation technique to compare the efficiency of northing and heading virtual training. The results are congruent with current knowledge about spatial frames of reference and suggest that getting lost in heading mode forces the blind sailor to coordinate his current "view" with a more global and stable representation.
Adherence to exercise programs for chronic low back pain (CLBP) is a major issue. The R-COOL feasibility study evaluated humanoid robot supervision of exercise for CLBP. Aims are as follows: (1) compare stretching sessions between the robot and a physiotherapist (control), (2) compare clinical outcomes between groups, and (3) evaluate participant perceptions of usability and satisfaction and therapist acceptability of the robot system. Prospective, randomized, controlled, single-blind, 2-centre study comparing a 3-week (3 hours/day, 5 days/week) physical activity program. Stretching sessions (30 minutes/day) were supervised by a physiotherapist (control) or the robot. Primary outcome: daily physical activity time (adherence). Secondary outcomes: lumbar pain, disability and fear and beliefs, participant perception of usability (system usability scale) and satisfaction, and physiotherapist acceptability (technology acceptance model). Clinical outcomes were compared between groups with a Student t -test and perceptions with a Wilcoxon test. Data from 27 participants were analysed ( n = 15 control and n = 12 robot group). Daily physical activity time did not differ between groups, but adherence declined (number of movements performed with the robot decreased from 82% in the first week to 72% in the second and 47% in the third). None of the clinical outcomes differed between groups. The median system usability scale score was lower in the robot group: 58 (IQR 11.8) points vs. 87 (IQR 9.4) in the control group at 3 weeks ( p < 0.001 ). Median physiotherapist rating of the technology acceptance model was <3 points, suggesting a negative opinion of the robot. In conclusion, adherence to robot exercise reduced over time; however, lumbar pain, disability, or fear and beliefs did not differ between groups. The results of the participant questionnaires showed that they were willing to use such a system, although several technical issues suggested the KERAAL system could be improved to provide fully autonomous supervision of physical activity sessions.
Exploring geographic maps on touchscreens is a difficult task in the absence of vision as those devices miss tactile cues. Prior research has therefore introduced non-visual interaction techniques designed to allow visually impaired people to explore spatial configurations on tactile devices. In this paper, we present a study in which six blind and six blindfolded sighted participants evaluated three of those interaction techniques compared to a screen reader condition. We observed that techniques providing guidance result in a higher user satisfaction and more efficient exploration. Adding a grid-like structure improved the estimation of distances. None of the interaction techniques improved the reconstruction of the spatial configurations. The results of this study allow improving the design of non-visual interaction techniques that support a better exploration and memorization of maps in the absence of vision.
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