Search Results (62)

Background/Objectives: Orbital reconstruction remains one of the most demanding procedures in maxillofacial surgery. It requires not only precise anatomical knowledge but also poses multiple intraoperative challenges. Limited surgical visibility—especially in transconjunctival or transcaruncular approaches—demands exceptional precision from the surgeon. At the same time, the complex anatomical structure of the orbit, its rich vascularization and innervation, and the risk of severe postoperative complications—such as diplopia, sensory deficits, impaired ocular mobility, or in the most serious cases, post-traumatic blindness due to nerve injury or orbital compartment syndrome—necessitate the highest level of surgical accuracy. In this context, patient-specific implants (PSIs), commonly fabricated from zirconium oxide or ultra-high-density polyethylene, have become invaluable. Within CAD-based reconstructive planning, especially for orbital implants, critical factors include the implant’s anatomical fit, passive stabilization on intact bony structures, and non-interference with orbital soft tissues. Above all, precise replication of the orbital dimensions is essential for optimal clinical outcomes. This study compares the morphological accuracy of orbital structures based on anthropometric measurements from 3D models generated from fan-beam computed tomography (FBCT) and cone-beam computed tomography (CBCT). Methods: A cohort group of 500 Caucasian patients aged 8 to 88 years was analyzed. 3D models of the orbits were generated from FBCT and CBCT scans. Anthropometric measurements were taken to evaluate the morphological accuracy of the orbital structures. The assessed parameters included orbital depth, orbital width, the distance from the infraorbital rim to the infraorbital foramen, the distance between the piriform aperture and the infraorbital foramen, and the distance from the zygomatico-orbital foramen to the infraorbital rim. Results: Statistically significant differences were observed between virtual models derived from FBCT and those based on CBCT in several key parameters. Discrepancies were particularly evident in measurements of orbital depth, orbital width, the distance from the infraorbital rim to the infraorbital foramen, the distance between the piriform aperture and the infraorbital foramen, and the distance from the zygomatico-orbital foramen to the infraorbital rim. Conclusions: The statistically significant discrepancies in selected orbital dimensions—particularly in regions of so-called thin bone—demonstrate that FBCT remains the gold standard in the planning and design of CAD/CAM patient-specific orbital implants. Despite its advantages, including greater accessibility and lower radiation dose, CBCT shows limited reliability in the context of orbital and infraorbital reconstruction planning. Full article

Background: Current methods of postural control assessments and interventions to improve postural stability and thereby prevent falls often fail to incorporate the hazardous perturbation situations that frequently accompany falls. Virtual environments can safely incorporate these hazards. The purpose of the study was to identify if virtual slip and trip perturbations can be used as an exposure paradigm in place of real slip and trip perturbations to improve postural control. Methods: Fifteen healthy young adults were included in this study. Two paradigms, real gait exposure (real) and virtual environment gait exposure (virtual), consisting of real and virtual slip and trip trials, were performed by each participant in a counterbalanced order to avoid order effects. At baseline and following real and virtual paradigms, the modified clinical test for sensory integration and balance (mCTSIB), limits of stability (LOS), and single-leg stance (SLS) using BTracks balance plate were administered. Separate one-way (baseline vs. Real vs. Virtual) repeated measures analysis of variance were conducted on response variables. Results: In the posterior left quadrant of the LOS, significant differences were found after the real paradigm compared to baseline (p = 0.04). For the anterior left quadrant and total LOS, significant differences post real paradigm (p = 0.002 and p < 0.001) and virtual paradigm (p = 0.007 and p < 0.001) compared to baseline were observed. For the SLS, the left-leg significant differences were observed post real paradigm (p = 0.019) and virtual paradigm (p = 0.009) compared to BL in path length, while significant main effects were found for mean sway velocity for the left leg only (p = 0.004). For the right leg, significant differences were only observed after the virtual paradigm (p = 0.01) compared to BL. Conclusions: Both virtual and real paradigms were identified to improve postural control. The virtual paradigm led to increased postural control in the right-leg SLS condition, while the real paradigm did not, without any adverse effects. Findings suggest virtual reality perturbation exposure acutely improves postural control ability compared to baseline among healthy young adults. Full article

Background/Objectives: Neurological disorders often result in a broad spectrum of disabilities that impact mobility, communication, cognition, and sensory processing, leading to significant limitations in independence and quality of life. Assistive technologies (ATs) offer tools to compensate for these impairments, support daily living, and improve quality of life. The World Health Organization encourages the adoption and diffusion of effective assistive technology (AT). This narrative review aims to explore the integration, benefits, and challenges of assistive technologies in individuals with neurological disabilities, focusing on their role across mobility, communication, cognitive, and sensory domains. Methods: A narrative approach was adopted by reviewing relevant studies published between 2014 and 2024. Literature was sourced from PubMed and Scopus using specific keyword combinations related to assistive technology and neurological disorders. Results: Findings highlight the potential of ATs, ranging from traditional aids to intelligent systems like brain–computer interfaces and AI-driven devices, to enhance autonomy, communication, and quality of life. However, significant barriers remain, including usability issues, training requirements, accessibility disparities, limited user involvement in design, and a low diffusion of a health technology assessment approach. Conclusions: Future directions emphasize the need for multidimensional, user-centered solutions that integrate personalization through machine learning and artificial intelligence to ensure long-term adoption and efficacy. For instance, combining brain–computer interfaces (BCIs) with virtual reality (VR) using machine learning algorithms could help monitor cognitive load in real time. Similarly, ATs driven by artificial intelligence technology could be useful to dynamically respond to users’ physiological and behavioral data to optimize support in daily tasks. Full article

Virtual reality (VR) technologies have gained increasing attention in the field of physical rehabilitation due to their potential to enhance patient engagement and provide adaptive, feedback-rich environments. In this study, we report on the development and preliminary evaluation of a VR-based rehabilitation application aimed at improving upper extremity function, including muscle strength, endurance, and joint mobility. The application delivers a structured set of interactive exercises designed to support recovery through engaging, gamified tasks with real-time performance feedback and scalable difficulty levels. A pilot usability study was conducted with a cohort of target users to assess the system’s practicality, therapeutic relevance, and user satisfaction. Qualitative data were collected to evaluate usability, effectiveness, and areas for further improvement. Preliminary results suggest that the VR application is usable, accessible, and well-received by users, with high levels of engagement reported throughout the intervention. Participants also provided constructive feedback, emphasizing the potential benefits of incorporating enhanced sensory feedback mechanisms to improve immersion and therapeutic impact. These initial findings support the viability of VR-based rehabilitation tools and provide a foundation for future clinical studies aimed at validating their efficacy in diverse patient populations. Full article

Background: Bilateral movement training (BMT) and interlimb coupling have emerged as promising neurophysiologically-based rehabilitation approaches for stroke survivors. However, the underlying mechanisms and optimal implementation strategies remain incompletely understood. This systematic review explored the neurophysiological principles underlying BMT and interlimb coupling interventions that led to positive clinical post-stroke rehabilitation outcomes, focusing on identifying the most effective bilateral and interlimb movement strategies. Methods: A 10-year literature search (2014–2024) following PRISMA guidelines was conducted across PubMed, Cochrane, and Google Scholar databases using keywords including stroke rehabilitation, bilateral movement training, cross-education, interlimb coupling, and interlimb transfer. Studies were included if they involved human subjects, clinical trials, stroke survivors, and described bilateral training protocols. Data extraction focused on neurophysiological mechanisms, intervention characteristics, and clinical outcomes. Quality assessment was performed using validated methodological appraisal tools, including the Newcastle-Ottawa Scale and Cochrane RoB 2.0. Results: Of 199 initially identified studies, 28 met inclusion criteria for detailed analysis. BMT demonstrated effectiveness in enhancing motor recovery by engaging neurophysiological mechanisms, including central pattern generators, interhemispheric coupling, and cortical disinhibition. High-intensity BMT provided significant gains for individuals with moderate to severe impairments, while low-intensity training benefited early recovery stages. Interventions incorporating task-specific exercises, robotic assistance, sensory enhancement, and virtual reality showed particular promise for addressing motor recovery complexities. However, significant research gaps were identified, including limited understanding of individualized responses to BMT, insufficient research on combined upper and lower limb training, and minimal integration of advanced technologies. Conclusions: BMT and interlimb coupling play critical roles in post-stroke rehabilitation by facilitating neural plasticity and interlimb coordination. Integrating robotic assistance, sensory enhancement, and virtual reality with BMT offers a robust framework for maximizing rehabilitation outcomes. Future research should prioritize longitudinal studies, personalized rehabilitation approaches, technology integration, and stratified interventions tailored to individual needs to optimize neuroplasticity and enhance quality of life for stroke survivors. Full article

The food industry faces growing challenges due to evolving consumer demands, requiring digital technologies to enhance sensory analysis. Innovations such as eye tracking, FaceReader, virtual reality (VR), augmented reality (AR), and artificial intelligence (AI) are transforming consumer behavior research by providing deeper insights into sensory experiences. For instance, FaceReader captures emotional responses to food by analyzing facial expressions, offering valuable data on consumer preferences for taste, texture, and aroma. Together, these technologies provide a comprehensive understanding of the sensory experience, aiding product development and branding. Electronic nose, tongue, and eye technologies also replicate human sensory capabilities, enabling objective and efficient assessment of aroma, taste, and color. The electronic nose (E-nose) detects volatile compounds for aroma evaluation, while the electronic tongue (E-tongue) evaluates taste through electrochemical sensors, ensuring accuracy and consistency in sensory analysis. The electronic eye (E-eye) analyzes food color, supporting quality control processes. These advancements offer rapid, non-invasive, reproducible assessments, benefiting research and industrial applications. By improving the precision and efficiency of sensory analysis, digital tools help enhance product quality and consumer satisfaction in the competitive food industry. This review explores the latest digital methods shaping food sensory research and innovation. Full article

Introduction: In line with previous research conducted during chemotherapy to explore whether virtual reality (VR) can support patients’ emotional regulation, this study examines the relevance of adding olfactory reinforcement to VR sessions during breast cancer treatment. Methods: An experimental protocol assessed the impact of VR sensoriality in 50 patients over three chemotherapy sessions. Each patient experienced a 10-min immersion in a natural environment under three randomized conditions: Contemplative VR, Participatory VR, Participatory VR with olfactory reinforcement. The sense of presence measured immersion, while anxiety, depression, and emotional state were evaluated using a within-subject design to compare the effects of each VR modality. Results: A reduction in anxiety and depression was observed in patients regardless of the type of VR immersion experienced. The interactive and multimodal nature of VR may support patients in their emotional regulation. Conclusions: This study provides preliminary evidence for the usefulness of olfactory enhancement in VR during chemotherapy sessions in breast cancer patients. The multimodal potential of VR contributes to the reduction of anxiety and depression by inducing a positive emotional experience in a soothing natural environment. The reported results highlight the value of sensorimotor VR, which also stimulates the sense of smell, in improving supportive care. Full article

Background and Objectives: Virtual reality (VR)-based interventions provide immersive and interactive environments that can enhance motor learning and deliver real-time feedback, offering potential advantages over conventional therapies. This systematic review evaluated the impact of non-immersive and immersive VR exergaming interventions versus conventional therapy on balance in Parkinson’s disease (PD) through a detailed analysis of randomized controlled trials (RCTs). Materials and Methods: A comprehensive search was conducted across the PubMed, Lilacs, IBECS, CENTRAL, Web of Science (WOS), EBSCOHost, and SciELO databases. Article selection and duplicate removal were managed using Rayyan QCRI. The quality of the evidence was assessed using the GRADE system. Results: From an initial screening of 100 studies, 58 underwent title and abstract screening. After full-text evaluation, 11 RCTs met the inclusion criteria, involving 518 participants with PD (average age: 67.3 years; 67.95% men). The balance outcomes were primarily measured using the Berg balance scale (BBS), employed in most studies (n = 9). The pooled analysis demonstrated a significant improvement in the balance scores for the experimental groups compared to the controls, with a standardized mean difference (SMD) of 0.58 [95% CI: 0.07, 1.09, p = 0.03]. However, the heterogeneity was substantial (I² = 77%). The analysis of the six-minute walking test (6 MWT), as another outcome of four articles, revealed a mean difference of 32.99 m [95% CI: −8.02, 74.00], but the effect was not statistically significant (p = 0.11). The heterogeneity for this outcome was moderate (I² = 41%), indicating some variability across studies. Alternative tools, such as the Tinetti Performance-Oriented Mobility Assessment (POMA) scale, the UPDRS III, and the sensory organization test (SOT), were also evaluated where possible. Conclusions: VR-based interventions offer promise for improving balance in Parkinson’s disease, enhancing rehabilitation engagement. Their integration into clinical practice could complement conventional therapy. However, further research is needed to optimize protocols, standardize parameters, and maximize their impact on mobility, independence, and quality of life. Full article

Background/Objectives: Pediatric cerebral palsy (CP) is a neurological disorder that affects motor skills, posture, and muscle coordination, impacting children’s daily functioning and quality of life. Treatment approaches in occupational therapy aim to enhance motor function and functional independence through a variety of rehabilitative techniques. Recently, new technologies—such as virtual reality, robotics, and assistive devices—have emerged as promising tools in occupational therapy to complement traditional interventions and potentially enhance motor and sensory outcomes in children with CP. This systematic review aims to analyze the effectiveness of these innovative technological interventions in the rehabilitation of children with CP. Methods: A systematic review was conducted and different scales were used to assess the risk of bias and methodological quality. The degree of evidence and level of recommendation were established according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The review adhered to PRISMA guidelines, with a comprehensive literature search performed across multiple databases, including Cochrane, Web of Science, and PubMed. This systematic review has been registered in the PROSPERO database with the registration number CRD42025630162. Results: The reviewed studies indicate that technologies such as functional electrical stimulation, robotic assistance, and adaptive devices have shown improvements in mobility, motor control, posture, strength, and autonomy in children with CP. Similarly, virtual environments support the correction of facial dysfunctions and enhance social interaction through video games and social networks. While these tools hold significant potential for rehabilitation, further adjustments are needed to achieve more consistent results. Conclusions: Emerging technologies appear to be effective tools in occupational therapy for pediatric CP, with positive impacts on motor skills and functional capabilities. Nevertheless, further studies with larger sample sizes and rigorous methodological designs are necessary to confirm these findings and establish more robust evidence on their long-term efficacy. Full article

Background/Objectives: Modern therapeutic strategies incorporating virtual reality (VR) have emerged as potential treatments for generalized anxiety disorder (GAD), a prevalent and debilitating condition that is challenging to cure. This study aimed to evaluate the efficacy of VR combined with relaxation techniques in patients with GAD by comparing VR-based relaxation with standard mental imagery (MI) relaxation. Methods: Fifty-eight patients with GAD participated in a randomized comparative trial. Specific virtual environments were created using an inexpensive game engine/level editor (GLE). Psychometric scales and physiological instruments were employed to assess the effects of relaxation therapy on anxiety, depression, quality of life, presence within virtual environments and cybersickness. Results: Both the VR and MI groups demonstrated statistically significant improvements in anxiety, worry and mental quality of life scores. However, no significant differences were observed between the two groups in pre–post comparisons of psychometric scores. The VR group exhibited a noticeably higher protocol completion rate and a significant increase in heart rate variability during the therapy. The level of presence in the VR group was satisfactory and significantly correlated with physiological improvements and anxiety reduction, while cybersickness remained low. Participants’ preferences for specific virtual environments for relaxation are also discussed. Conclusions: These findings suggest that teaching and practicing relaxation in VR holds therapeutic potential for the treatment of GAD. Further research leveraging advanced VR sensory equipment and artificial intelligence agents is warranted to enhance therapeutic outcomes and explore additional applications. Full article

Background: Serious games (SGs) are primarily aimed at promoting learning, skills training, and rehabilitation. Artificial intelligence, immersive technologies, the metaverse, and neurotechnologies promise the next revolution in gaming. Meta-skills are considered the “must-have” skills for thriving in the era of rapid change, complexity, and innovation. Μeta-skills can be defined as a set of higher-order skills that incorporate metacognitive, meta-emotional, and meta-motivational attributes, enabling one to be mindful, self-motivated, self-regulated, and flexible in different circumstances. Skillfulness, and more specifically meta-skills development, is recognized as a predictor of optimal performance along with mental and emotional wellness. Nevertheless, there is still limited knowledge about the effectiveness of integrating cutting-edge technologies in serious games, especially in the field of meta-skills training. Objectives: The current systematic review aims to collect and synthesize evidence concerning the effectiveness of advanced technologies in serious gaming for promoting meta-skills development. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was employed to identify experimental studies conducted in the last 10 years. Four different databases were employed: Web of Science, PubMed, Scopus, and Google Scholar. Results: Forty-nine studies were selected. Promising outcomes were identified in AI-based SGs (i.e., gamified chatbots) as they provided realistic, adaptive, personalized, and interactive environments using natural language processing, player modeling, reinforcement learning, GPT-based models, data analytics, and assessment. Immersive technologies, including the metaverse, virtual reality, augmented reality, and mixed reality, provided realistic simulations, interactive environments, and sensory engagement, making training experiences more impactful. Non-invasive neurotechnologies were found to encourage players’ training by monitoring brain activity and adapting gameplay to players’ mental states. Healthy participants (n = 29 studies) as well as participants diagnosed with anxiety, neurodevelopmental disorders, and cognitive impairments exhibited improvements in a wide range of meta-skills, including self-regulation, cognitive control, attention regulation, meta-memory skills, flexibility, self-reflection, and self-evaluation. Players were more self-motivated with an increased feeling of self-confidence and self-efficacy. They had a more accurate self-perception. At the emotional level, improvements were observed in emotional regulation, empathy, and stress management skills. At the social level, social awareness was enhanced since they could more easily solve conflicts, communicate, and work in teams. Systematic training led to improvements in higher-order thinking skills, including critical thinking, problem-solving skills, reasoning, decision-making ability, and abstract thinking. Discussion: Special focus is given to the potential benefits, possible risks, and ethical concerns; future directions and implications are also discussed. The results of the current review may have implications for the design and implementation of innovative serious games for promoting skillfulness among populations with different training needs. Full article

Background: Children with special needs often need tailored approaches to oral healthcare to address their unique needs effectively. It is essential to analyze the effectiveness of non-pharmacological management in reducing dental anxiety among special needs children during dental treatment. Methods: Five electronic databases, PubMed, Scopus, Web of Science, Embase, and Google Scholar, were searched from 2007 to August 2024 for randomized control trials and observational studies comparing the effectiveness of non-pharmacological techniques in reducing dental anxiety during invasive and noninvasive dental treatment. The primary outcomes of the studied intervention were reduced dental anxiety and improved behavior during dental treatment. The conceptual map was created to understand the need for assessment and behavior management for special needs children (SN). Results: Nineteen articles qualified for the final analysis from 250 screened articles. Included studies evaluated the effect of strategies applied clinically, such as audio–visual distraction, sensory-adapted environment, and virtual reality. The included studies measured the trivial to large effect of measured interventions and supported non-pharmacological interventions in clinical settings. Conclusions: Most basic non-pharmacological interventions showed a trivial to large reduction in dental anxiety among SN patients. The conceptual map developed in this study supports the need for non-pharmacological interventions as they are cost-effective and create a positive environment in dental clinics. However, more studies need to focus on non-pharmacological behavior interventions in SN children to support the findings of this scoping review. Full article

In this narrative historical review, we take a closer look at the role of tactile/haptic stimulation in enhancing people’s immersion (and sense of presence) in a variety of entertainment experiences, including virtual reality (VR). An important distinction is highlighted between those situations in which digital tactile stimulation and/or haptic feedback are delivered to those (i.e., users/audience members) who passively experience the stimulation and those cases, including VR, where the user actively controls some aspects of the tactile stimulation/haptic feedback that they happen to be experiencing. A further distinction is drawn between visual and/or auditory VR, where some form of tactile/haptic stimulation is added, and what might be classed as genuinely haptic VR, where the active user/player experiences tactile/haptic stimulation that is effortlessly interpreted in terms of the objects and actions in the virtual world. We review the experimental evidence that has assessed the impact of adding a tactile/haptic element to entertainment experiences, including those in VR. Finally, we highlight some of the key challenges to the growth of haptic VR in the context of multisensory entertainment experiences: these include those of a technical, financial, psychological (namely, the fact that tactile/haptic stimulation often needs to be interpreted and can reduce the sense of immersion in many situations), psycho-physiological (such as sensory overload or fatigue), physiological (e.g., relating to the large surface area of the skin that can potentially be stimulated), and creative/artistic nature. Full article

Donor site morbidity remains a significant concern in free flap microsurgery, with implications that extend beyond immediate postoperative outcomes to affect patients’ long-term quality of life. This review explores the multi-faceted impact of donor site morbidity on physical, psychological, social, and occupational well-being, synthesizing findings from the existing literature. Particular attention is given to the functional limitations, sensory deficits, aesthetic outcomes, and chronic pain associated with commonly utilized free flaps. Advancements in surgical techniques, including nerve-sparing and muscle-sparing methods, as well as innovations, like perforator flaps, have demonstrated the potential to mitigate these morbidities. Furthermore, the integration of regenerative medicine strategies, such as stem cell therapy and fat grafting, and technological innovations, including virtual reality rehabilitation and biofeedback devices, has shown promise in enhancing recovery and minimizing long-term complications. Despite these advances, challenges persist in standardizing QoL assessments and optimizing donor site management. This review emphasizes the need for a holistic, patient-centered approach in reconstructive microsurgery, advocating for further research to refine current strategies, improve long-term outcomes, and develop robust tools for QoL evaluation. By addressing these gaps, reconstructive surgeons can better align surgical objectives with the comprehensive well-being of their patients. Full article

Building information modeling (BIM) is increasingly used during the conceptual design phase, which focuses on simulations such as energy usage analysis and comfort levels, like temperature and lighting conditions, to enhance user experience and well-being, which are key factors for meeting Sustainable Development Goal 3. This study employs a systematic literature review and an e-Delphi survey to explore how a pre-occupancy evaluation integrated within BIM frameworks addresses affective responses and suggests ways to improve design decisions that align with the UN’s sustainable development goals. The study identified a research gap in how BIM evaluations are conducted during the conceptual design stage, including crucial sensory aspects for human well-being. The research suggests incorporating evidence-based design instruments like body sensor networks (BSN) and immersive virtual reality and methods like neurophenomenology to enhance the assessment of user interactions in the design process. Prioritizing the human-centered design approach right from the start can facilitate the integration of innovative workflows into architecture, engineering, and construction practices. Overcoming resistance to these workflows and methodologies is essential for advancing BIM’s role in fostering spatial environments that support health, well-being, and positive affective experiences. Full article