Purpose: This study compared the effects of inpatient-based rehabilitation program of patients with chronic obstructive pulmonary disease (COPD) using non-immersive virtual reality (VR) training with a traditional pulmonary rehabilitation program. The aims of this study were to determine 1) whether rehabilitation featuring both VR as well as exercise training provides benefits over exercise training (ET) alone and 2) whether rehabilitation featuring VR training instead of exercise training provides equivalent benefits. Patients and Methods: The study recruited 106 patients with COPD to a 2-week high-intensity, five times a week intervention. Randomized into three groups, 34 patients participated in a traditional pulmonary rehabilitation program including endurance exercise training (ET), 38 patients participated in traditional pulmonary rehabilitation, including both endurance exercise training and virtual reality training (ET+VR) and 34 patients participated in pulmonary rehabilitation program including virtual reality training but no endurance exercise training (VR). The traditional pulmonary rehabilitation program consisted of fitness exercises, resistance respiratory muscle and relaxation training. Xbox 360^® and Kinect^® Adventures software were used for the VR training of lower and upper body strength, endurance, trunk control and dynamic balance. Comparison of the changes in the Senior Fitness Test was the primary outcome. Analysis was performed using linear mixed-effects models. Results: The comparison between ET and ET+VR groups showed that ET+VR group was superior to ET group in Arm Curl (p< 0.003), Chair stand (p< 0.008), Back scratch (p< 0.002), Chair sit and reach (p< 0.001), Up and go (p< 0.000), 6-min walk test (p< 0.011). Whereas, the comparison between ET and VR groups showed that VR group was superior to ET group in Arm Curl (p< 0.000), Chair stand (p< 0.001), 6-min walk test (p< 0.031). Conclusion: Results suggest that pulmonary rehabilitation program supplemented with VR training is beneficial intervention to improve physical fitness in patients with COPD.

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.

Purpose: The aim of this study was to perform a randomized trial to assess the impact of exercise training in patients with non–small cell lung cancer during chemotherapy on several outcomes in comparison to a control group (CG).Methods: The exercise training group (ETG) consisted of 20 patients and the CG consisted of 10 patients. In the ETG, a 4-wk in-hospital exercise training program was performed in 2-wk cycles interspersed with consecutive rounds of chemotherapy with cytostatic drugs. The exercise training program was individualized and included warm-up, respiratory muscle exercise, training on a cycle ergometer or treadmill, and Nordic walking. CG participants were assessed before and after 6 wk of chemotherapy alone.Results: Comparing pre- and post-intervention values, the ETG demonstrated an increase in 6-min walk distance (486 ± 92 vs 531 ± 103 m,P= .01). In a battery of physical performance tests: Up and Go Test (6.3 ± 1.0 vs 6.0 ± 1.1 sec,P= .01); chair stand (13.3 ± 2.8 vs 14.3 ± 3.4 repetitions,P= .001); and arm curl (18.4 ± 3.1 vs 20.4 ± 3.5 repetitions,P= .001) all improved significantly. Spirometry values also improved: FEV₁% predicted (76 ± 16 vs 84 ± 15,P= .01), FVC % predicted (87 ± 14 vs 95 ± 13,P= .01), and FEV₁/FVC (73 ± 13% vs 76 ± 12%,P= .04). The exercise training was well tolerated, without any adverse events due to exercise. There were no significant improvements in the CG.Conclusions: This study suggests that planned, individualized, and supervised exercise programs in patients with advanced lung cancer during chemotherapy are a practical and beneficial intervention for enhancing mobility and physical fitness.

Aim: The COVID-19 pandemic has forced the education system to undergo changes, which have also affected universities. E-learning became the main form of education, reducing interpersonal contacts, which could affect the mental wellbeing of students. The aim of this study was to investigate the prevalence of depressive symptoms and the level of perceived stress during e-learning among Polish students and to identify the factors for predicting higher levels of depression symptoms.Methods: The study included 753 participants with a mean age of 22.47 (±4.02) years. The Perception of Stress Questionnaire (PSQ) and Beck Depression Inventory (BDI-II) were used to measure the severity of stress and level of depression. Furthermore, our own survey was used to assess the impact of e-learning on various aspects of life. To examine how much stress can explain a statistically significant amount of variance in depression, three-step hierarchical multiple regression was used. In addition, our own questionnaire was used to assess the impact of e-learning on education, social contacts and technical abilities.Results: A total of 58% of the students characterized by an increased level of stress. 56% show symptoms of depression and 18% of the participants had suicidal thoughts. The most significant predictor of depression is high stress levels and factors related to e-learning: isolation from friends and acquaintances, negative impact on level of knowledge, reduced motivation to learn, and worsening grades. This predictors may explain about 66% of the variance of depression.Conclusion: Universities should implement interventions and educational programmes, providing ad hoc assistance in the form of individual or group meetings with a psychologist (also in a remote form) and organizing workshops and webinars on strategies for managing stress.

The implementation of virtual reality (VR) opens up a wide range of possibilities for the development of dexterity, speed and precision of movements. The aim of this study was to investigate whether immersive VR training affected the hand–eye coordination and reaction time in students of the state music school. This study implemented a single-group pre-post study design. This study enrolled 14 individuals, submitted to a 15 min training session of the immersive music game “Beat Saber”, once a day for 5 consecutive days. The plate-tapping test (PTT) and the ruler-drop test (Ditrich’s test) were used to assess the reaction time. Trial-making test (TMT) A and TMT B were used to assess coordination and visual attention. Analysis of the results showed a statistically significant improvement in hand–eye coordination and reaction time of music school students using the TMT-A (p < 0.002), TMT-B (p < 0.001), Ditrich’s test for the non-dominant hand (0.025) and PTT (0.0001) after applying a week-long training period in immersive VR. The results obtained in the present study show that the VR system, along with the immersive music game, has the potential to improve hand–eye coordination and reaction time in young musicians, which may lead to the faster mastering of a musical instrument.