Technological Features of Immersive Virtual Reality Systems for Upper Limb Stroke Rehabilitation: A Systematic Review.

Stroke is the second most common cause of death worldwide, and it greatly impacts the quality of life for survivors by causing impairments in their upper limbs. Due to the difficulties in accessing rehabilitation services, immersive virtual reality (IVR) is an interesting approach to improve the availability of rehabilitation services. This systematic review evaluates the technological characteristics of IVR systems used in the rehabilitation of upper limb stroke patients. Twenty-five publications were included. Various technical aspects such as game engines, programming languages, headsets, platforms, game genres, and technical evaluation were extracted from these papers. Unity 3D and C# are the primary tools for creating IVR apps, while the Oculus Quest (Meta Platforms Technologies, Menlo Park, CA, USA) is the most often used headset. The majority of systems are created specifically for rehabilitation purposes rather than being readily available for purchase (i.e., commercial games). The analysis also highlights key areas for future research, such as game assessment, the combination of hardware and software, and the potential integration incorporation of biofeedback sensors. The study highlights the significance of technological progress in improving the effectiveness and user-friendliness of IVR. It calls for additional research to fully exploit IVR's potential in enhancing stroke rehabilitation results.

Effectiveness of Respiratory Muscle Training on Respiratory Muscle Strength, Pulmonary Function, and Respiratory Complications in Stroke Survivors: A Systematic Review of Randomized Controlled Trials.

Background: Stroke is the most common leading cause of mortality and related morbidities worldwide. After stroke, the motor function of extremities and spinal muscles is significantly impairment, but not only this, it also has attributable factors leading to respiratory dysfunction. Nevertheless, to the extent of the authors' knowledge, there is a dearth of conclusive studies which examined the effectiveness of RMT on muscle strength, pulmonary function, and respiratory complications of individuals after stroke. Objective: The purpose of this systematic review was to evaluate the effectiveness of respiratory muscle training on respiratory muscle strength, pulmonary function, and respiratory complications in patients after stroke. Methods: An electronic database search of HINARI, PEDro, PubMed, Cochrane Library and Google scholar was used to identify randomized controlled trials that evaluated the effectiveness of respiratory muscle training in patients with stroke. Articles published from 2010 to 2019 were included. The quality of the articles was assessed using PEDro scale. Articles with abstract only, PEDro scores less than 5, published in non-English language, not freely available articles, and quasi experimental studies were excluded from this study. Results: The literature search yielded a total of 7 articles (6 randomized controlled trials with 1 pilot randomized controlled trial) which met inclusion criteria despite their heterogeneity. The methodological quality of all studies ranged from 6 to 8 in Pedro score. Most of the articles reported a significant increase in respiratory muscle strength, respiratory muscle function, and reduced risk of complications with a p value <0.05. Conclusion: Respiratory muscle training could potentially improve muscle strength and pulmonary functions of subjects after stroke. Thus, it may reduce stroke-related respiratory complications in subjects after stroke. However, further study is warranted with high quality RCTs and pooled synthesis of results.

Phytoremediation Potential of Macrophytes of Urban Waterbodies in Central India.

BACKGROUND: India's rapidly increasing population and growing urbanization pose a great challenge for wastewater treatment efforts, leading to increased pollution of surrounding waterbodies. OBJECTIVES: A field sampling-based study was conducted to analyze water quality, heavy metals and bioconcentration and bioaccumulation in the roots and shoots of naturally growing vegetation in an urban lake, Laxmi Taal. The lake receives domestic sewage from Jhansi city in Central India. METHODS: Temperature, pH, electrical conductivity, turbidity, and water-soluble ions were measured with appropriate instruments. Plant accumulation of metals was measured with the bioconcentration factor (BCF), the ratio of metal concentration in the root to wastewater. The translocation factor (TF) was estimated as the ratio of metal concentration in the shoot to the root. RESULTS: Water quality and heavy metal concentrations were found to be within the prescribed limit as per Indian standards IS-2296 "D". In the present study, BCF was assessed to be >1 and the plants Typha angustifolia and Echhornia crassipus were determined to be accumulator plants. The TF study revealed that translocation of all the metals studied were significant, except for manganese (Mn), where concentration was found to be below detection limit. CONCLUSIONS: The present study validated that Typha angustifolia and Echhornia crassipus could be used for bioremediation purposes in cases of urban waterbodies receiving varying amounts of domestic wastewaters which have relatively limited concentrations of toxic metals. COMPETING INTERESTS: The authors declare no competing financial interests.