Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

Mantovani, Elisa; Zucchella, Chiara; Bottiroli, Sara; Federico, Angela; Giugno, Rosalba; Sandrini, Giorgio; Chiamulera, Cristiano; Tamburin, Stefano

doi:10.3389/fneur.2020.00926

Cited by 118 publications

(111 citation statements)

References 76 publications

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“…Remote communication technologies are increasingly regarded as potential effective options to support health care interventions, including neurorehabilitation and cognitive rehabilitation. Among them, telemedicine, virtual reality, augmented reality, and serious games could be in the forefront of these efforts ( 20 ). Growing evidence supports active video games and low-cost virtual reality as viable therapeutic interventions for children with physical disabilities.…”

Section: Discussionmentioning

confidence: 99%

Education, Training, and Practices of Neurorehabilitation in India During the COVID-19 Pandemic

et al. 2021

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Background: Corona virus disease (COVID-19) was declared a pandemic by the World Health Organization in March 2020. This has affected service delivery among all medical disciplines in India including neurorehabilitation services.Aims and Objectives: The aims and objectives of the study were to assess the effect of COVID-19 pandemic on neurorehabilitation services across India.Methodology: A prospective nationwide survey study was undertaken by the Indian Federation of Neurorehabilitation during the pandemic. A questionnaire was prepared using Google forms software consisting of four sections: demography, neurorehabilitation practice before COVID-19 pandemic, neurorehabilitation practice during COVID-19 pandemic, and continuing medical education during COVID-19 pandemic.Results: Responses (872) were received from neurorehabilitation professionals across the country out of which 2.2% professionals did not give consent for participating in the survey. Participants (36.6%) were practicing traditional or independent referral basis rehabilitation, while 63.4% participants were practicing multidisciplinary rehabilitation. On an average, respective units were conducting 500–750 therapy sessions per month. Majority of the rehabilitation units in India lacked a physiatrist, rehabilitation nurse, music therapist, cognitive therapist, and urologist. Approximately 80% of the rehabilitation units have the basic rehabilitation modalities and advance technology was present in only 20% of the rehabilitation units. During COVID-19 pandemic, 19.5% centers were providing elective services, 50.3% emergency services, 15.6% new outpatient services, and 22.7% were providing follow-up outpatient services. Centers (51.5%) were providing telerehabilitation services for neurological conditions during the times of COVID-19 pandemic. Professionals (61.1%) providing telerehabilitation were working from home. Among the patients who needed neurorehabilitation, 28% were doing their exercises independently, 31% were supervised by caregivers, 17% were supervised by therapists, and 24% were not receiving any therapy. Participants (95.5%) wanted to receive more training in the field of neurorehabilitation. The participants utilized webinars (71%), online courses (22%), case discussion forums (19%), panel discussions (13%), and literature search (8%) during COVID-19 pandemic to continue education.Conclusion: The study reflects the situation of neurorehabilitation service delivery in India during the pandemic as the respondents were from all parts of the country and included most components of the neurorehabilitation team. Neurorehabilitation services were severely affected across India during the COVID-19 pandemic. Tele-neurorehabilitation has emerged as a new service delivery model during the pandemic. Online means of education has emerged as the primary source of continuing medical education during the pandemic.

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Section: Discussionmentioning

confidence: 99%

Education, Training, and Practices of Neurorehabilitation in India During the COVID-19 Pandemic

et al. 2021

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“…To this end, we recommend considerations of Mantovani et al ( 152 ) who recently collected and reviewed relevant evidence-based recommendations on the efficacy of cognitive rehabilitation, based on a comprehensive evaluation of 491 papers presenting the latest evidence-based practice for neurorehabiliation of traumatic brain injury (TBI) patients whose pathobiology bears many similarities to that presented in this review in the context of COVID-19 and systemic involvement ( 147 , 152 , 153 ).…”

Section: Covid Neurological Manifestations and Implications For Neurmentioning

confidence: 99%

“…Mantovani et al as well offer a road map and a comprehensive perspective on the role of tele-neurorehabilitation and virtual rehabilitation to gain adequate cognitive stimulation in the era of physical distancing and lockdowns related to COVID-19 pandemic, reminding us of the potential opportunities globally ( 152 ). For further details, see Mantovani et al and the 29 recommendations on evidence-based cognitive rehabilitation in the context of stroke and TBI nominated by the Cognitive Rehabilitation Task Force (CRTF), which suggests that a more comprehensive biological understanding of the various systems affected by TBI should lead to more collaborative translational research utilizing artificial intelligence and novel technology to find better individually designed precision solutions (e.g., video-consults, tablet-based measurements, and use of wearable devices).…”

Section: Covid Neurological Manifestations and Implications For Neurmentioning

confidence: 99%

COVID-19 Pathophysiology Predicts That Ischemic Stroke Occurrence Is an Expectation, Not an Exception—A Systematic Review

2021

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Clinical reports of neurological manifestations associated with severe coronavirus disease 2019 (COVID-19), such as acute ischemic stroke (AIS), encephalopathy, seizures, headaches, acute necrotizing encephalitis, cerebral microbleeds, posterior reversible leukoencephalopathy syndrome, hemophagocytic lymphohistiocytosis, peripheral neuropathy, cranial nerve palsies, transverse myelitis, and demyelinating disorders, are increasing rapidly. However, there are comparatively few studies investigating the potential impact of immunological responses secondary to hypoxia, oxidative stress, and excessive platelet-induced aggregation on the brain. This scoping review has focused on the pathophysiological mechanisms associated with peripheral and consequential neural (central) inflammation leading to COVID-19-related ischemic strokes. It also highlights the common biological processes shared between AIS and COVID-19 infection and the importance of the recognition that severe respiratory dysfunction and neurological impairments associated with COVID and chronic inflammation [post-COVID-19 neurological syndrome (PCNS)] may significantly impact recovery and ability to benefit from neurorehabilitation. This study provides a comprehensive review of the pathobiology of COVID-19 and ischemic stroke. It also affirms that the immunological contribution to the pathophysiology of COVID-19 is predictive of the neurological sequelae particularly ischemic stroke, which makes it the expectation rather than the exception. This work is of fundamental significance to the neurorehabilitation community given the increasing number of COVID-related ischemic strokes, the current limited knowledge regarding the risk of reinfection, and recent reports of a PCNS. It further highlights the need for global collaboration and research into new pathobiology-based neurorehabilitation treatment strategies and more integrated evidence-based care.

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“…Thus, by using an AT-implemented strategy such as VR interventions, patients with neurodegenerative diseases may be enabled to communicate his/her needs, feelings, and thoughts to their relatives or medical staff during the hospitalization or isolation period. Accordingly, it may be fostered with positive outcomes on his/her health conditions, with a meaningful reduction of the anxiety and/or depression levels, and with beneficial effects in terms of quality of life ( 106 , 107 ). Therefore, the caregivers, families, and health care systems may find a significant burden reduction ( 108 , 109 ).…”

Section: New Communication Technologies: Virtual Reality As a Communimentioning

confidence: 99%

Virtual Reality as a Technological-Aided Solution to Support Communication in Persons With Neurodegenerative Diseases and Acquired Brain Injury During COVID-19 Pandemic

Stasolla

Matamala-Gomez

Bernini³

et al. 2021

Front. Public Health

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The COVID-19 poses an ongoing threat to lives around the world and challenges the existing public health and medical service delivery. The lockdown or quarantine measures adopted to prevent the spread of COVID-19 has caused the interruption in ongoing care and access to medical care including to patients with existing neurological conditions. Besides the passivity, isolation, and withdrawal, patients with neurodegenerative diseases experience difficulties in communication due to a limited access to leisure opportunities and interaction with friends and relatives. The communication difficulties may exacerbate the burden on the caregivers. Therefore, assistive-technologies may be a useful strategy in mitigating challenges associated with remote communication. The current paper presents an overview of the use of assistive technologies using virtual reality and virtual body ownership in providing communication opportunities to isolated patients, during COVID-19, with neurological diseases and moderate-to-severe communication difficulties. We postulate that the assistive technologies-based intervention may improve social interactions in patients with neurodegenerative diseases and acquired brain injury-thereby reducing isolation and improving their quality of life and mental well-being.

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Telemedicine and Virtual Reality for Cognitive Rehabilitation: A Roadmap for the COVID-19 Pandemic

Cited by 118 publications

References 76 publications

Education, Training, and Practices of Neurorehabilitation in India During the COVID-19 Pandemic

Education, Training, and Practices of Neurorehabilitation in India During the COVID-19 Pandemic

COVID-19 Pathophysiology Predicts That Ischemic Stroke Occurrence Is an Expectation, Not an Exception—A Systematic Review

Virtual Reality as a Technological-Aided Solution to Support Communication in Persons With Neurodegenerative Diseases and Acquired Brain Injury During COVID-19 Pandemic

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