AHCI RESEARCH GROUP
Publications
Papers published in international journals,
proceedings of conferences, workshops and books.
OUR RESEARCH
Scientific Publications
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You can expand the Abstract, Links and BibTex record for each paper.
2024
Melillo, Antonio; Rachedi, Sarah; Caggianese, Giuseppe; Gallo, Luigi; Maiorano, Patrizia; Gimigliano, Francesca; Lucidi, Fabio; Pietro, Giuseppe De; Guida, Maurizio; Giordano, Antonio; Chirico, Andrea
In: Games for Health Journal, 2024, ISSN: 2161-783X.
Abstract | Links | BibTeX | Tags: Pain, User study, Virtual Reality
@article{melilloSynchronizationVirtualReality2024,
title = {Synchronization of a Virtual Reality Scenario to Uterine Contractions for Labor Pain Management: Development Study and Randomized Controlled Trial},
author = {Antonio Melillo and Sarah Rachedi and Giuseppe Caggianese and Luigi Gallo and Patrizia Maiorano and Francesca Gimigliano and Fabio Lucidi and Giuseppe De Pietro and Maurizio Guida and Antonio Giordano and Andrea Chirico},
url = {https://www.liebertpub.com/doi/full/10.1089/g4h.2023.0202},
doi = {10.1089/g4h.2023.0202},
issn = {2161-783X},
year = {2024},
date = {2024-06-11},
urldate = {2024-06-11},
journal = {Games for Health Journal},
publisher = {Mary Ann Liebert, Inc., publishers},
abstract = {Background: Labor is described as one of the most painful events women can experience through their lives, and labor pain shows unique features and rhythmic fluctuations.Purpose: The present study aims to evaluate virtual reality (VR) analgesic interventions for active labor with biofeedback-based VR technologies synchronized to uterine activity.Materials and Methods: We developed a VR system modeled on uterine contractions by connecting it to cardiotocographic equipment. We conducted a randomized controlled trial on a sample of 74 cases and 80 controls during active labor.Results: Results of the study showed a significant reduction of pain scores compared with both preintervention scores and to control group scores; a significant reduction of anxiety levels both compared with preintervention assessment and to control group and significant reduction in fear of labor experience compared with controls.Conclusion: VR may be considered as an effective nonpharmacological analgesic technique for the treatment of pain and anxiety and fear of childbirth experience during labor. The developed system could improve personalization of care, modulating the multisensory stimulation tailored to labor progression. Further studies are needed to compare the synchronized VR system to uterine activity and unsynchronized VR interventions.},
keywords = {Pain, User study, Virtual Reality},
pubstate = {published},
tppubtype = {article}
}
Background: Labor is described as one of the most painful events women can experience through their lives, and labor pain shows unique features and rhythmic fluctuations.Purpose: The present study aims to evaluate virtual reality (VR) analgesic interventions for active labor with biofeedback-based VR technologies synchronized to uterine activity.Materials and Methods: We developed a VR system modeled on uterine contractions by connecting it to cardiotocographic equipment. We conducted a randomized controlled trial on a sample of 74 cases and 80 controls during active labor.Results: Results of the study showed a significant reduction of pain scores compared with both preintervention scores and to control group scores; a significant reduction of anxiety levels both compared with preintervention assessment and to control group and significant reduction in fear of labor experience compared with controls.Conclusion: VR may be considered as an effective nonpharmacological analgesic technique for the treatment of pain and anxiety and fear of childbirth experience during labor. The developed system could improve personalization of care, modulating the multisensory stimulation tailored to labor progression. Further studies are needed to compare the synchronized VR system to uterine activity and unsynchronized VR interventions.
Melillo, Antonio; Rachedi, Sarah; Caggianese, Giuseppe; Gallo, Luigi; Maiorano, Patrizia; Gimigliano, Francesca; Lucidi, Fabio; Pietro, Giuseppe De; Guida, Maurizio; Giordano, Antonio; Chirico, Andrea
In: Games for Health Journal, 2024, ISSN: 2161-783X, (Publisher: Mary Ann Liebert, Inc., publishers).
Abstract | Links | BibTeX | Tags: Pain, User study, Virtual Reality
@article{melillo_synchronization_2024,
title = {Synchronization of a Virtual Reality Scenario to Uterine Contractions for Labor Pain Management: Development Study and Randomized Controlled Trial},
author = {Antonio Melillo and Sarah Rachedi and Giuseppe Caggianese and Luigi Gallo and Patrizia Maiorano and Francesca Gimigliano and Fabio Lucidi and Giuseppe De Pietro and Maurizio Guida and Antonio Giordano and Andrea Chirico},
url = {https://www.liebertpub.com/doi/full/10.1089/g4h.2023.0202},
doi = {10.1089/g4h.2023.0202},
issn = {2161-783X},
year = {2024},
date = {2024-06-01},
urldate = {2024-06-19},
journal = {Games for Health Journal},
abstract = {Background: Labor is described as one of the most painful events women can experience through their lives, and labor pain shows unique features and rhythmic fluctuations.Purpose: The present study aims to evaluate virtual reality (VR) analgesic interventions for active labor with biofeedback-based VR technologies synchronized to uterine activity.Materials and Methods: We developed a VR system modeled on uterine contractions by connecting it to cardiotocographic equipment. We conducted a randomized controlled trial on a sample of 74 cases and 80 controls during active labor.Results: Results of the study showed a significant reduction of pain scores compared with both preintervention scores and to control group scores; a significant reduction of anxiety levels both compared with preintervention assessment and to control group and significant reduction in fear of labor experience compared with controls.Conclusion: VR may be considered as an effective nonpharmacological analgesic technique for the treatment of pain and anxiety and fear of childbirth experience during labor. The developed system could improve personalization of care, modulating the multisensory stimulation tailored to labor progression. Further studies are needed to compare the synchronized VR system to uterine activity and unsynchronized VR interventions.},
note = {Publisher: Mary Ann Liebert, Inc., publishers},
keywords = {Pain, User study, Virtual Reality},
pubstate = {published},
tppubtype = {article}
}
Background: Labor is described as one of the most painful events women can experience through their lives, and labor pain shows unique features and rhythmic fluctuations.Purpose: The present study aims to evaluate virtual reality (VR) analgesic interventions for active labor with biofeedback-based VR technologies synchronized to uterine activity.Materials and Methods: We developed a VR system modeled on uterine contractions by connecting it to cardiotocographic equipment. We conducted a randomized controlled trial on a sample of 74 cases and 80 controls during active labor.Results: Results of the study showed a significant reduction of pain scores compared with both preintervention scores and to control group scores; a significant reduction of anxiety levels both compared with preintervention assessment and to control group and significant reduction in fear of labor experience compared with controls.Conclusion: VR may be considered as an effective nonpharmacological analgesic technique for the treatment of pain and anxiety and fear of childbirth experience during labor. The developed system could improve personalization of care, modulating the multisensory stimulation tailored to labor progression. Further studies are needed to compare the synchronized VR system to uterine activity and unsynchronized VR interventions.
2022
Melillo, Antonio; Chirico, Andrea; Pietro, Giuseppe De; Gallo, Luigi; Caggianese, Giuseppe; Barone, Daniela; Laurentiis, Michelino De; Giordano, Antonio
Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature Journal Article
In: Cancers, vol. 14, no. 13, pp. 3163, 2022, ISSN: 2072-6694.
Abstract | Links | BibTeX | Tags: Cancer, Disability, Fatigue, Healthcare, Lymphedema, Pain, Rehabilitation, Robotics, Telemedicine, Virtual Reality
@article{melillo_virtual_2022,
title = {Virtual Reality Rehabilitation Systems for Cancer Survivors: A Narrative Review of the Literature},
author = {Antonio Melillo and Andrea Chirico and Giuseppe De Pietro and Luigi Gallo and Giuseppe Caggianese and Daniela Barone and Michelino De Laurentiis and Antonio Giordano},
url = {https://www.mdpi.com/2072-6694/14/13/3163},
doi = {10.3390/cancers14133163},
issn = {2072-6694},
year = {2022},
date = {2022-06-01},
urldate = {2023-05-10},
journal = {Cancers},
volume = {14},
number = {13},
pages = {3163},
abstract = {Rehabilitation plays a crucial role in cancer care, as the functioning of cancer survivors is frequently compromised by impairments that can result from the disease itself but also from the long-term sequelae of the treatment. Nevertheless, the current literature shows that only a minority of patients receive physical and/or cognitive rehabilitation. This lack of rehabilitative care is a consequence of many factors, one of which includes the transportation issues linked to disability that limit the patient’s access to rehabilitation facilities. The recent COVID-19 pandemic has further shown the benefits of improving telemedicine and home-based rehabilitative interventions to facilitate the delivery of rehabilitation programs when attendance at healthcare facilities is an obstacle. In recent years, researchers have been investigating the benefits of the application of virtual reality to rehabilitation. Virtual reality is shown to improve adherence and training intensity through gamification, allow the replication of real-life scenarios, and stimulate patients in a multimodal manner. In our present work, we offer an overview of the present literature on virtual reality-implemented cancer rehabilitation. The existence of wide margins for technological development allows us to expect further improvements, but more randomized controlled trials are needed to confirm the hypothesis that VRR may improve adherence rates and facilitate telerehabilitation.},
keywords = {Cancer, Disability, Fatigue, Healthcare, Lymphedema, Pain, Rehabilitation, Robotics, Telemedicine, Virtual Reality},
pubstate = {published},
tppubtype = {article}
}
Rehabilitation plays a crucial role in cancer care, as the functioning of cancer survivors is frequently compromised by impairments that can result from the disease itself but also from the long-term sequelae of the treatment. Nevertheless, the current literature shows that only a minority of patients receive physical and/or cognitive rehabilitation. This lack of rehabilitative care is a consequence of many factors, one of which includes the transportation issues linked to disability that limit the patient’s access to rehabilitation facilities. The recent COVID-19 pandemic has further shown the benefits of improving telemedicine and home-based rehabilitative interventions to facilitate the delivery of rehabilitation programs when attendance at healthcare facilities is an obstacle. In recent years, researchers have been investigating the benefits of the application of virtual reality to rehabilitation. Virtual reality is shown to improve adherence and training intensity through gamification, allow the replication of real-life scenarios, and stimulate patients in a multimodal manner. In our present work, we offer an overview of the present literature on virtual reality-implemented cancer rehabilitation. The existence of wide margins for technological development allows us to expect further improvements, but more randomized controlled trials are needed to confirm the hypothesis that VRR may improve adherence rates and facilitate telerehabilitation.
Melillo, Antonio; Maiorano, Patrizia; Rachedi, Sarah; Caggianese, Giuseppe; Gragnano, Elisabetta; Gallo, Luigi; Pietro, Giuseppe De; Guida, Maurizio; Giordano, Antonio; Chirico, Andrea
In: Critical Reviews in Eukaryotic Gene Expression, vol. 32, no. 2, pp. 61–89, 2022, ISSN: 1045-4403.
Abstract | Links | BibTeX | Tags: Analgesia, Childbirth, Healthcare, Labor, Pain, Virtual Reality
@article{melillo_labor_2022,
title = {Labor Analgesia: A Systematic Review and Meta-Analysis of Non-Pharmacological Complementary and Alternative Approaches to Pain during First Stage of Labor},
author = {Antonio Melillo and Patrizia Maiorano and Sarah Rachedi and Giuseppe Caggianese and Elisabetta Gragnano and Luigi Gallo and Giuseppe De Pietro and Maurizio Guida and Antonio Giordano and Andrea Chirico},
url = {http://www.dl.begellhouse.com/journals/6dbf508d3b17c437,4a955da472dd8ffd,6da0908c373137cf.html},
doi = {10.1615/CritRevEukaryotGeneExpr.2021039986},
issn = {1045-4403},
year = {2022},
date = {2022-01-01},
urldate = {2023-05-10},
journal = {Critical Reviews in Eukaryotic Gene Expression},
volume = {32},
number = {2},
pages = {61–89},
abstract = {The aim of the study was to conduct a meta-analysis to evaluate the efficacy of non-invasive and non-pharmacological techniques on labor first-stage pain intensity. Literature databases were searched from inception to May 2021, and research was expanded through the screening of previous systematic reviews. Inclusion criteria were: (1) population: women in first stage of labor; (2) intervention: non-pharmacological, non-invasive, or minimally invasive intrapartum analgesic techniques alternative and/or complementary to pharmacological analgesia; (3) comparison: routine intrapartum care or placebos; (4) outcomes: subjective pain intensity; and (5) study design: randomized controlled trial. Risk of bias of included studies was investigated, data analysis was performed using R version 3.5.1. Effect size was calculated as difference between the control and experimental groups at posttreatment in terms of mean pain score. A total of 63 studies were included, for a total of 6146 patients (3468 in the experimental groups and 2678 in the control groups). Techniques included were massage (n = 11), birth balls (n = 5) mind-body interventions (n = 8), heat application (n = 12), music therapy (n = 9), dance therapy (n = 2), acupressure (n = 16), and transcutaneous electrical nerve stimulation (TENS) (n = 8). The present review found significant evidence in support of the use of complementary and alternative medicine for labor analgesia, and different methods showed different impact. However, more high-quality trials are needed.},
keywords = {Analgesia, Childbirth, Healthcare, Labor, Pain, Virtual Reality},
pubstate = {published},
tppubtype = {article}
}
The aim of the study was to conduct a meta-analysis to evaluate the efficacy of non-invasive and non-pharmacological techniques on labor first-stage pain intensity. Literature databases were searched from inception to May 2021, and research was expanded through the screening of previous systematic reviews. Inclusion criteria were: (1) population: women in first stage of labor; (2) intervention: non-pharmacological, non-invasive, or minimally invasive intrapartum analgesic techniques alternative and/or complementary to pharmacological analgesia; (3) comparison: routine intrapartum care or placebos; (4) outcomes: subjective pain intensity; and (5) study design: randomized controlled trial. Risk of bias of included studies was investigated, data analysis was performed using R version 3.5.1. Effect size was calculated as difference between the control and experimental groups at posttreatment in terms of mean pain score. A total of 63 studies were included, for a total of 6146 patients (3468 in the experimental groups and 2678 in the control groups). Techniques included were massage (n = 11), birth balls (n = 5) mind-body interventions (n = 8), heat application (n = 12), music therapy (n = 9), dance therapy (n = 2), acupressure (n = 16), and transcutaneous electrical nerve stimulation (TENS) (n = 8). The present review found significant evidence in support of the use of complementary and alternative medicine for labor analgesia, and different methods showed different impact. However, more high-quality trials are needed.
2018
Indovina, Paola; Barone, Daniela; Gallo, Luigi; Chirico, Andrea; Pietro, Giuseppe De; Giordano, Antonio
Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review Journal Article
In: The Clinical Journal of Pain, vol. 34, no. 9, 2018, ISSN: 0749-8047.
Abstract | BibTeX | Tags: Chemotherapy, Healthcare, Pain, Virtual Reality
@article{indovinaVirtualRealityDistraction2018,
title = {Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review},
author = { Paola Indovina and Daniela Barone and Luigi Gallo and Andrea Chirico and Giuseppe De Pietro and Antonio Giordano},
issn = {0749-8047},
year = {2018},
date = {2018-01-01},
journal = {The Clinical Journal of Pain},
volume = {34},
number = {9},
abstract = {Objectives: This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. Methods: A broad literature search was performed using as main terms ``virtual reality,'' ``distraction,'' and ``pain.'' No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. Results: VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care, and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Discussion: Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.},
keywords = {Chemotherapy, Healthcare, Pain, Virtual Reality},
pubstate = {published},
tppubtype = {article}
}
Objectives: This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. Methods: A broad literature search was performed using as main terms ``virtual reality,'' ``distraction,'' and ``pain.'' No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. Results: VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care, and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Discussion: Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.
Indovina, Paola; Barone, Daniela; Gallo, Luigi; Chirico, Andrea; Pietro, Giuseppe De; Giordano, Antonio
Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review Journal Article
In: The Clinical Journal of Pain, vol. 34, no. 9, 2018, ISSN: 0749-8047.
Abstract | Links | BibTeX | Tags: Chemotherapy, Healthcare, Pain, Virtual Reality
@article{indovina_virtual_2018,
title = {Virtual Reality as a Distraction Intervention to Relieve Pain and Distress During Medical Procedures: A Comprehensive Literature Review},
author = {Paola Indovina and Daniela Barone and Luigi Gallo and Andrea Chirico and Giuseppe De Pietro and Antonio Giordano},
url = {https://journals.lww.com/clinicalpain/Fulltext/2018/09000/Virtual_Reality_as_a_Distraction_Intervention_to.9.aspx},
issn = {0749-8047},
year = {2018},
date = {2018-01-01},
journal = {The Clinical Journal of Pain},
volume = {34},
number = {9},
abstract = {Objectives: This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. Methods: A broad literature search was performed using as main terms “virtual reality,” “distraction,” and “pain.” No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. Results: VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care, and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Discussion: Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.},
keywords = {Chemotherapy, Healthcare, Pain, Virtual Reality},
pubstate = {published},
tppubtype = {article}
}
Objectives: This review aims to provide a framework for evaluating the utility of virtual reality (VR) as a distraction intervention to alleviate pain and distress during medical procedures. We first describe the theoretical bases underlying the VR analgesic and anxiolytic effects and define the main factors contributing to its efficacy, which largely emerged from studies on healthy volunteers. Then, we provide a comprehensive overview of the clinical trials using VR distraction during different medical procedures, such as burn injury treatments, chemotherapy, surgery, dental treatment, and other diagnostic and therapeutic procedures. Methods: A broad literature search was performed using as main terms “virtual reality,” “distraction,” and “pain.” No date limit was applied and all the retrieved studies on immersive VR distraction during medical procedures were selected. Results: VR has proven to be effective in reducing procedural pain, as almost invariably observed even in patients subjected to extremely painful procedures, such as patients with burn injuries undergoing wound care, and physical therapy. Moreover, VR seemed to decrease cancer-related symptoms in different settings, including during chemotherapy. Only mild and infrequent side effects were observed. Discussion: Despite these promising results, future long-term randomized controlled trials with larger sample sizes and evaluating not only self-report measures but also physiological variables are needed. Further studies are also required both to establish predictive factors to select patients who can benefit from VR distraction and to design hardware/software systems tailored to the specific needs of different patients and able to provide the greatest distraction at the lowest cost.