ТЕХНОЛОГИИ ВИРТУАЛЬНОЙ РЕАЛЬНОСТИ ДЛЯ ВОССТАНОВЛЕНИЯ КОГНИТИВНЫХ ФУНКЦИЙ И КАЧЕСТВА ЖИЗНИ: ПРИМЕНЕНИЕ ДЛЯ КАРДИОЛОГИЧЕСКИХ ПАЦИЕНТОВ С ИШЕМИЕЙ МОЗГА

Основные положения

Представлен обзор публикаций о программах нейро- и кардиореабилитации с использованием технологий виртуальной реальности. Для улучшения качества жизни пациентов с ишемической болезнью сердца наиболее эффективна тренировка с помощью многозадачности и совмещения когнитивной и физической нагрузки с применением интерактивных сценариев. Для снижения тревожности и стресса перспективна экотерапия в виртуальной среде.

В обзоре представлены публикации о программах нейро- и кардиореабилитации с использованием технологий виртуальной реальности, включающих интеграцию мультисенсорных и мультидоменных заданий, а также метаанализ таких исследований. Технологии виртуальной реальности позволяют моделировать интерактивные сценарии для имитации активной деятельности с заданными визуальными, тактильными и кинестетическими ощущениями и их коррекцией в соответствии с потребностями различных пользователей. При разработке программ на основе технологий виртуальной реальности необходимо учитывать степень погружения пользователей в виртуальную среду и симптомы киберболезни. Результаты метаобзоров свидетельствуют о необходимости исследований в данном направлении вследствие большого разнообразия программ реабилитации, используемых показателей когнитивных функций и состояния здоровья у привлеченных к тренировке разнородных популяций здоровых лиц и кардиологических пациентов.

Для нейро- и кардиореабилитации наиболее эффективна тренировка с использованием многозадачности и совмещения когнитивной и физической нагрузок на основе технологий виртуальной реальности. Для снижения тревожности и стресса перспективна экотерапия в виртуальной среде.

1. Разумникова О.М. Закономерности старения мозга и способы активации его компенсаторных ресурсов. Успехи физиол. наук. 2015; 46 (2): 3–16

2. Kang J.M., Kim N., Lee S.Y., Woo S.K., Park G., Yeon B.K., Park J.W., Youn J.H., Ryu S.H., Lee J.Y., Cho S.J. Effect of cognitive training in fully immersive virtual reality on visuospatial function and frontal-occipital functional connectivity in predementia: Randomized controlled trial. J Med Internet Res. 2021; 23(5): e24526. doi: 10.2196/24526

3. Lauenroth A., Ioannidis A. E., Teichmann B. Influence of combined physical and cognitive training on cognition: a systematic review. BMC Geriatr. 2016; 16:141. doi: 10.1186/s12877-016-0315-1

4. Smith S.A. Virtual reality in episodic memory research: A review. Psychon. Bull. Rev. 2019; 26: 1213–1237. doi: 10.3758/s13423-019-01605-w.

5. Bruderer-Hofstetter M., Rausch-Osthoff A.K., Meichtry A., Munzer T., Niedermann K. Effective multicomponent interventions in comparison to active control and no interventions on physical capacity, cognitive function and instrumental activities of daily living in elderly people with and without mild impaired cognition – A systematic review and network meta-analysis. Ageing Res Rev. 2018; 45: 1–14. doi: 10.1016/j.arr.2018.04.002.

6. Chiu H. L., Chu, H., Tsai, J. C., Liu, D., Chen, Y. R., Yang, H. L., Chou K.R. The effect of cognitive-based training for the healthy older people: a meta-analysis of randomized controlled trials. PLoS One. 2017; 12: e0176742. doi: 10.1371/journal.pone.0176742

7. Gómez-Soria I., Cuenca-Zaldívar J.N., Rodriguez-Roca B., Subirón-Valera A.B., Salavera C., Marcén-Román Y., Andrade-Gómez E., Calatayud E. Cognitive effects of a cognitive stimulation programme on trained domains in older adults with subjective memory complaints: Randomised controlled trial. Int J Environ Res Public Health. 2023; 20(4):3636. doi: 10.3390/ijerph20043636.

8. Youn J., Park S., Lee J., Cho S., Kim J., Ryu S. Cognitive improvement in older adults with mild cognitive impairment: evidence from a multi-strategic metamemory training. J Clin Med 2020; 9(2): 362. doi:10.3390/jcm9020362

9. Eggenberger P., Schumacher V., Angst M., Theill N., de Bruin E.D. Does multicomponent physical exercise with simultaneous cognitive training boost cognitive performance in older adults? A 6-month randomized controlled trial with a 1-year follow-up. Clin Interv Aging. 2015; 10: 1335–49. doi: 10.2147/CIA.S87732.

10. Weng W., Liang J., Xue J., Zhu T., Jiang Y., Wang J., Chen S. The transfer effects of cognitive training on working memory among Chinese older adults with mild cognitive impairment: a randomized controlled trial. Front Aging Neurosci 2019; 11:212. doi: 10.3389/fnagi.2019.00212

11. Bauer A.C.M., Andringa G. The potential of immersive virtual reality for cognitive training in elderly. Gerontology. 2020; 66(6): 614-623. doi: 10.1159/000509830.

12. Huygelier H., Schraepen B., van Ee R., VandenAbeele V., Gillebert C.R. Acceptance of immersive head-mounted virtual reality in older adults. Sci Rep. 2019; 9(1): 4519. doi: 10.1038/s41598-019-41200-6.

13. Riva G., Mantovani F., Capideville C.S., Preziosa A., Morganti F., Villani D., Gaggioli A., Botella C., Alcañiz M. Affective interactions using virtual reality: the link between presence and emotions. Cyberpsychol Behav. 2007; 10(1): 45–56. doi: 10.1089/cpb.2006.9993.

14. Sayma M., Tuijt R., Cooper C., Walters K. Are we there yet? Immersive virtual reality to improve cognitive function in dementia and mild cognitive impairment. Gerontologist. 2020; 60(7): e502-e512. doi: 10.1093/geront/gnz132

15. Tieri G., Morone G., Paolucci S., Iosa, M. Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies. Expert Rev. Med. Devices. 2018. doi: 10.1080/17434440.2018.1425613

16. Brugada-Ramentol V., Bozorgzadeh A., Jalali H. Enhance VR: A multisensory approach to cognitive training and monitoring. Front. Digit. Health. 2022; 4:916052. doi: 10.3389/fdgth.2022.916052

17. García-Betances R.I., Jiménez-Mixco V., Arredondo M.T., Cabrera Umpiérrez M. F. Using virtual reality for cognitive training of the elderly. Am. J. Alzheimers Dis. Other Demen. 2015; 30: 49–54. doi: 10.1177/1533317514545866

18. Keshner E.A., Weiss P.T., Geifman D., Raban D. Tracking the evolution of virtual reality applications to rehabilitation as a field of study. Journal of NeuroEngineering and Rehabilitation. 2019; 16(1):76. doi: 10.1186/s12984-019-0552-6.

19. Kim H., Chey J., Lee S. Effects of multicomponent training of cognitive control on cognitive function and brain activation in older adults. Neurosci Res. 2017; 124:8-15 doi: 10.1016/j.neures.2017.05.004

20. Sokołowska B. Impact of Virtual Reality Cognitive and Motor Exercises on Brain Health. Int J Environ Res Public Health. 2023; 20(5): 4150. doi: 10.3390/ijerph20054150

21. Chan L.P.P., Cheng Y., Ng J.Y.H., Zheng Z., Cheing G.L.Y. A review of virtual reality technology in exercise training for older adults. J Endocrinol Thyroid Res. 2022; 6(4): 555694. doi: 10.19080/JETR.2022.06.555694

22. De Vries A. W., Van DieЁen J. H., Van Den Abeele V., Verschueren S. M. Understanding motivations and player experiences of older adults in virtual reality training. Games for Health Journal. 2018; 7(6): 369–376. doi: 10.1089/g4h.2018.0008

23. Volmer J., Burkert M., Krumm H., Abodahab A., Dinklage P., Feltmann M., Kröger C., Panta P., Schäfer F., Scheidt D., Sellung M., Singerhoff H., Steingrefer C., Schmidt T., Hoffmann J.D., Willemsen D., Reiss N. Enhancing long-term motivation of cardiac patients by applying exergaming in rehabilitation training. Stud Health Technol Inform. 2017; 237:183-187.

24. Bond S., Laddu D.R., Ozemek C., Lavie C.J., Arena R. Exergaming and virtual reality for health: Implications for cardiac rehabilitation. Curr Probl Cardiol. 2021; 46(3): 100472. doi: 10.1016/j.cpcardiol.2019.100472.

25. Campo-Prieto P.; Cancela-Carral J.M.; Rodríguez-Fuentes G. Feasibility and effects of an immersive virtual reality exergame program on physical functions in institutionalized older adults: A randomized clinical trial. Sensors. 2022; 22: 6742. doi.org/10.3390/s22186742

26. Chang E., Kim H.T., Yoo B. Virtual reality sickness: A review of causes and measurements. International Journal of Human–Computer Interaction. 2020; 36(17):1658–82.

27. Coyle H., Traynor V., Solowij N. Computerized and virtual reality cognitive training for individuals at high risk of cognitive decline: systematic review of the literature. Am. J. Geriatr. Psychiatry. 2015; 23: 335–359. doi: 10.1016/j.jagp.2014.04.009

28. Baragash R.S., Aldowah H., Ghazal S. Virtual and augmented reality applications to improve older adults' quality of life: A systematic mapping review and future directions. Digit Health. 2022; 8: 20552076221132099. doi: 10.1177/20552076221132099.

29. Plechatá A., Nekováˇrová T., Fajnerová I. What is the future for immersive virtual reality in memory rehabilitation? A systematic review. NeuroRehabilitation 2021; 48: 389–412. doi: 10.3233/NRE-201534.

30. Despoti A., Karatzanos E., Patsaki I., Tzoumi D., Roussou G., Leventakis N., Papathanasiou A., Nanas S., Dimitriadi N. Immersive virtual reality in cognitive rehabilitation: A systematic Review. Health & Research Journal. 2022; 8(3) 225–241. doi:10.12681/healthresj.2887272-178.

31. Penn I.W., Chuang E., Chuang T.Y., Yang C.Y. Effects of virtual-reality-augmented cardiopulmonary rehabilitation programs for patients with cardiovascular diseases: A systemic review. Neuropsychiatry. 2018; doi: 10.4172/NEUROPSYCHIATRY.1000499

32. García-Bravo S., Cuesta-Gómez A., Campuzano-Ruiz R., López-Navas M.J., Domínguez-Paniagua J., Araújo-Narváez A., Barreñada-Copete E., García-Bravo C., Flórez-García M.T., Botas-Rodríguez J., Cano-de-la-Cuerda R. Virtual reality and video games in cardiac rehabilitation programs. A systematic review. Disabil Rehabil. 2021; 43(4): 448-457. doi: 10.1080/09638288.2019.1631892

33. Chen Y., Cao L., Xu Y., Zhu M., Guan B., Ming W.K. Effectiveness of virtual reality in cardiac rehabilitation: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud. 2022; 133:104323. doi: 10.1016/j.ijnurstu.2022.104323

34. Chuang T.Y., Sung W.H., Lin C.Y. Application of a virtual reality-enhanced exercise protocol in patients after coronary bypass. Arch Phys Med Rehabil. 2005; 86(10): 1929-32. doi: 10.1016/j.apmr.2005.05.003.

35. Cacau Lde A., Oliveira G.U., Maynard L.G., Araújo Filho A.A., Silva W.M.Jr., Cerqueria Neto M.L., Antoniolli A.R., Santana-Filho V.J. The use of the virtual reality as intervention tool in the postoperative of cardiac surgery. Rev Bras Cir Cardiovasc. 2013; 28(2): 281-9. doi: 10.5935/1678-9741.20130039.

36. Тарасова И.В., Трубникова О.А., Разумникова О.М. Пластичность функциональных систем мозга как компенсаторный ресурс при нормальном и патологическом старении, ассоциированном с атеросклерозом. Атеросклероз. 2020; 16(1):59-67. doi: 10.15372/ATER20200108

37. Pressler S.J., Jung M., Haedtke C. Interventions transformed through technology to improve cognitive function in heart failure. J Cardiovasc Nurs. 2019; 34(6): 430-432. doi: 10.1097/JCN.0000000000000609

38. Тарасова И.В., Разумникова О.М., Трубникова О.А., Мезенцев Ю.А., Куприянова Д.С., Барбараш О.Л. Нейрофизиологические корреляты послеоперационных когнитивных расстройств. Журнал неврологии и психиатрии им. С.С. Корсакова. 2021;121(2):18–23. doi:10.17116/jnevro202112102118

39. Jung M., Apostolova L.G., Moser D.K., Gradus-Pizlo I., Gao S., Rogers J.L., Pressler S.J. Virtual reality cognitive intervention for heart failure: CORE study protocol. Alzheimers Dement (NY). 2022; 8(1):e12230. doi: 10.1002/trc2.12230.

40. Pressler S.J. Cognitive functioning and chronic heart failure: a review of the literature (2002-July 2007). J Cardiovasc Nurs. 2008; 23(3): 239–249. doi: 10.1097/01.JCN.0000305096.09710.ec.

41. Gamito P., Oliveira J., Alves C., Santos N., Coelho C., Brito R. Virtual reality-based cognitive stimulation to improve cognitive functioning in community elderly: A controlled study. Cyberpsychol Behav Soc Netw. 2020; 23(3):150-156. doi: 10.1089/cyber.2019.0271.

42. Gamito P., Oliveira J., Morais D., Coelho C., Santos N., Alves C., Galamba A., Soeiro M., Yerra M., French H., Talmers L., Gomes T., Brito R. Cognitive stimulation of elderly individuals with instrumental virtual reality-based activities of daily life: pre-post treatment study. Cyberpsychol Behav Soc Netw 2019; 22(1):69-75. doi: 10.1089/cyber.2017.0679

43. Huang K-T. Exergaming executive functions: An immersive virtual reality-based cognitive training for adults aged 50 and older. Cyberpsychol Behav Soc Netw. 2020 Mar;23(3):143-149. doi: 10.1089/cyber.2019.0269.

44. Трубникова О.А., Тарасова И.В., Артамонова А.И., Сырова И.Д., Барбараш О.Л. Возраст как фактор риска когнитивных нарушений у пациентов, перенесших коронарное шунтирование. Журнал неврологии и психиатрии им. С.С. Корсакова. 2011; 111(8):46‑49.

45. Optale G., Urgesi C., Busato V., Marin S., Piron L., Priftis K., Gamberini L., Capodieci S., Bordin A. Controlling memory impairment in elderly adults using virtual reality memory training: a randomized controlled pilot study. Neurorehabil Neural Repair. 2010; 24(4): 348-357. doi: 10.1177/1545968309353328

46. Sakhare A.R., Yang V., Stradford J., Tsang I., Ravichandran R., Pa J. Cycling and spatial navigation in an enriched, immersive 3D virtual park environment: A feasibility study in younger and older adults. Frontiers in Aging Neuroscience. 2019; 11:218. doi: 10.3389/fnagi.2019.00218.

47. Howett D., Castegnaro A., Krzywicka K., Hagman J., Marchment D., Henson R., Rio M., King J.A., Burgess N., Chan D. Differentiation of mild cognitive impairment using an entorhinal cortex-based test of virtual reality navigation. Brain. 2019; 142(6):1751-1766. doi: 10.1093/brain/awz116

48. Zając-Lamparska L., Wiłkość-Dębczyńska M., Wojciechowski A., Podhorecka M., Polak-Szabela A., Warchoł Ł., Kędziora-Kornatowska K., Araszkiewicz A., Izdebski P. Effects of virtual reality-based cognitive training in older adults living without and with mild dementia: a pretest-posttest design pilot study. BMC Res Notes. 2019; 12(1):776. doi: 10.1186/s13104-019-4810-2.

49. Borgnis F., Baglio F., Pedroli E., Rossetto F., Uccellatore L., Oliveira J.A.G., Riva G., Cipresso P. Available virtual reality-based tools for executive functions: A systematic review. Front Psychol. 2022; 13:833136. doi: 10.3389/fpsyg.2022.833136.

50. Manera V., Petit P. D., Derreumaux A., Orvieto I., Romagnoli M., Lyttle G., David R., Robert P. “Kitchen and cooking”, a serious game for mild cognitive impairment and alzheimer’s disease: A pilot study. Front. Aging Neurosci. 2015; 7: 24. doi: 10.3389/fnagi.2015.00024

51. Corriveau Lecavalier N., Ouellet É., Boller B., Belleville S. Use of immersive virtual reality to assess episodic memory: A validation study in older adults. Neuropsychol. Rehabil. 2020; 30: 462–480. doi: 10.1080/09602011.2018.1477684.

52. Ouellet É., Boller B., Corriveau-Lecavalier N., Cloutier S., Belleville S. The virtual shop: A new immersive virtual reality environment and scenario for the assessment of everyday memory. J. Neurosci. Methods. 2018; 303: 126–135. doi: 10.1016/j.jneumeth.2018.03.010.

53. Zygouris S., Segkouli S., Triantafyllidis A., Giakoumis D., Tsolaki M., Votis K., Tzovaras D. Usability of the virtual supermarket test for older adults with and without cognitive impairment. J Alzheimers Dis Rep. 2022; 6(1): 229-234. doi: 10.3233/ADR-210064

54. Zygouris S., Iliadou P., Lazarou E., Giakoumis D., Votis K., Alexiadis A., Triantafyllidis A., Segkouli S., Tzovaras D., Tsiatsos T., Papagianopoulos S., Tsolaki M. Detection of Mild Cognitive Impairment in an at-risk group of older adults: Can a novel self-administered serious game-based screening test improve diagnostic accuracy? J Alzheimers Dis. 2020; 78(1): 405-412. doi: 10.3233/JAD-200880

55. Iliadou P., Paliokas I., Zygouris S., Lazarou E., Votis K., Tzovaras D., Tsolaki M. A comparison of traditional and serious game-based digital markers of cognition in older adults with mild cognitive impairment and healthy controls. J Alzheimers Dis. 2021; 79(4):1747-1759. doi: 10.3233/JAD-201300.

56. Voinescu A., Petrini K., Fraser D. S., Lazarovicz R. A., Papav I., Fodor L. A., David D. The effectiveness of a virtual reality attention task to predict depression and anxiety in comparison with current clinical measures. Virtual Reality. 2021; 1–22. doi: 10.1007/s10055-021-00520-7

57. Summers J.K., Vivian D.N. Ecotherapy - A forgotten ecosystem service: A review. Front Psychol. 2018; 9:1389. doi: 10.3389/fpsyg.2018.01389

58. Appel L., Appel E., Bogler O., Wiseman M., Cohen L., Ein N., Abrams H.B., Campos J.L. Older adults with cognitive and/or physical impairments can benefit from immersive virtual reality experiences: A feasibility study. Front. Med. 2020; 6:329. doi: 10.3389/fmed.2019.00329

59. Mrakic-Sposta S., Di Santo S.G., Franchini F., Arlati S., Zangiacomi A., Greci L., Moretti S., Jesuthasan N., Marzorati M., Rizzo G., Sacco M., Vezzoli A. Effects of combined physical and cognitive virtual reality-based training on cognitive impairment and oxidative network in MCI Patients: A Pilot Study. Front Aging Neurosci. 2018; 10: 282. doi: 10.3389/fnagi.2018.00282.

60. Cacciata M., Stromberg A., Lee J.A., Sorkin D., Lombardo D., Clancy S., Nyamathi A., Evangelista L.S. Effect of exergaming on health-related quality of life in older adults: A systematic review. Int J Nurs Stud. 2019; 93:30-40. doi: 10.1016/j.ijnurstu.2019.01.010.

61. Ruivo J.A. Exergames and cardiac rehabilitation: a review. J Cardiopulm Rehabil Prev. 2014; 34(1): 2-20. doi: 10.1097/HCR.0000000000000037.

62. Klompstra L., Jaarsma T., Mårtensson J., Strömberg A. Exergaming Through the eyes of patients with heart failure: A qualitative content analysis study. Games Health J. 2017; 6(3):152-158. doi: 10.1089/g4h.2016.0087

63. Blasco-Peris C., Fuertes-Kenneally L., Vetrovsky T., Sarabia J.M., Climent-Paya V., Manresa-Rocamora A. Effects of exergaming in patients with cardiovascular disease compared to conventional cardiac rehabilitation: A systematic review and meta-analysis. Int J Environ Res Public Health. 2022; 19(6): 3492. doi: 10.3390/ijerph19063492.

64. Vieira Á., Melo C., Machado J., Gabriel J. Virtual reality exercise on a home-based phase III cardiac rehabilitation program, effect on executive function, quality of life and depression, anxiety and stress: a randomized controlled trial. Disabil Rehabil Assist Technol. 2018; 13(2): 112-123. doi: 10.1080/17483107.2017.1297858

65. Anguera J.A., Boccanfuso J., Rintoul J.L., Al-Hashimi O., Faraji F., Janowich J., Kong E., Larraburo Y., Rolle C., Johnston E., Gazzaley A. Video game training enhances cognitive control in older adults. Nature. 2013; 501(7465): 97-101 doi: 10.1038/nature12486.

66. Liao Y., Chen I., Lin Y., Chen Y., Hsu W. Effects of virtual reality-based physical and cognitive training on executive function and dual-task gait performance in older adults with mild cognitive impairment: A randomized control trial. Frontiers in Aging Neuroscience. 2019; 11:162. doi: 10.3389/fnagi.2019.00162

67. Разумникова О.М., Тарасова И.В., Трубникова О.А., Барбараш О.Л. Изменения в структуре когнитивных функций и тревожности у кардиохирургических пациентов в зависимости от выраженности стенозов сонных артерий. Комплексные проблемы сердечно-сосудистых заболеваний. 2022; 11(1):36-48. doi:10.17802/2306-1278-2022-11-1-36-48