ObjectiveIn recent years, virtual reality (VR) has been tested as a therapeutic tool in neurorehabilitation research. However, the impact effectiveness of VR technology on for Parkinson’s Disease (PD) patients is still remains controversial unclear. In order to provide a more scientific basis for rehabilitation of PD patients’ modality, we conducted a systematic review of VR rehabilitation training for PD patients and focused on the improvement of gait and balance.MethodsAn comprehensive search was conducted using the following databases: PubMed, Web of Science, Cochrane Library, CINHAL, Embase and CNKI (China National Knowledge Infrastructure).Articles published before 30 December 2018 and of a randomized controlled trial design to study the effects of VR for patients with PD were included. The study data were pooled and a meta-analysis was completed. This systematic review was conducted in accordance with the PRISMA guideline statement and was registered in the PROSPERO database (CRD42018110264).ResultsA total of sixteen articles involving 555 participants with PD were included in our analysis. VR rehabilitation training performed better than conventional or traditional rehabilitation training in three aspects: step and stride length (SMD = 0.72, 95%CI = 0.40,1.04, Z = 4.38, P<0.01), balance function (SMD = 0.22, 95%CI = 0.01,0.42, Z = 2.09, P = 0.037), and mobility(MD = -1.95, 95%CI = -2.81,-1.08, Z = 4.41, P<0.01). There was no effect on the dynamic gait index (SMD = -0.15, 95%CI = -0.50,0.19, Z = 0.86, P = 0.387), and gait speed (SMD = 0.19, 95%CI = -0.03,0.40, Z = 1.71, P = 0.088).As for the secondary outcomes, compared with the control group, VR rehabilitation training demonstrated more significant effects on the improvement of quality of life (SMD = -0.47, 95%CI = -0.73,-0.22, Z = 3.64, P<0.01), level of confidence (SMD = -0.73, 95%CI = -1.43,-0.03, Z = 2.05, P = 0.040), and neuropsychiatric symptoms (SMD = -0.96, 95%CI = -1.27,-0.65, Z = 6.07, P<0.01), while it may have similar effects on global motor function (SMD = -0.50, 95%CI = -1.48,0.48, Z = 0.99, P = 0.32), activities of daily living (SMD = 0.25, 95%CI = -0.14,0.64, Z = 1.24, P = 0.216), and cognitive function (SMD = 0.21, 95%CI = -0.28,0.69, Z = 0.84, P = 0.399).During the included interventions, four patients developed mild dizziness and one patient developed severe dizziness and vomiting.ConclusionsAccording to the results of this study, we found that VR rehabilitation training can not only achieve the same effect as conventional rehabilitation training. Moreover, it has better performance on gait and balance in patients with PD. Taken together, when the effect of traditional rehabilitation training on gait and balance of PD patients is not good enough, we believe that VR rehabilitation training can at least be used as an alternative therapy. More rigorous design of large-sample, multicenter randomized controlled trials are needed to provide a stronger evidence-based basis for verifying its potential advantages.

IntroductionBackward walking (BW) is otherwise known as retrowalking. As opposed to forward walking, BW is a countersequential exercise and is a common method of rehabilitation training and disease-assisted treatment. Studies have shown that BW has a helpful effect on improving lower limb proprioception, gait synergy and improving limb balance. Many studies have concluded that BW can improve the symptoms of patients with knee osteoarthritis (KOA) and can be used for rehabilitation and adjunctive treatment of KOA, but there is a lack of evidence-based medical evidence.This research aims to provide an update to the most recent available evidence on the effect of BW on patients with KOA .Methods and analysesElectronic databases, such as Ovid/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and PubMed, will be searched by us. We will include studies identified from citation until 12 May 2020 and will not be restricted by geographical setting. The search will not be limited to the language of the publication, but the study of human subjects. Randomised controlled trials (RCTs) on the BW training of KOA will be included, with outcome measures including pain, knee function or balance function. The quality of included RCTs will be evaluated according to the Cochrane Collaboration’s risk of bias tool. A meta-analysis or systematic review will be performed to summarise the effects of BW training. We will perform sensitivity analysis on the sample size of RCTs, meta-regression analysis of the follow-up periods, dosages and baselines of outcome measures, and publication bias analysis.Ethics and disseminationEthical approval is not required as this study will not involve confidential personal data. The results of this study will be disseminated through a peer-reviewed journal.PROSPERO registration numberCRD42020185694.

Background Exercise is significant for the elderly to improve their poor health outcomes. It can delay weakness, enhance the quality of muscle and body balance, and prevent adverse events. But the factors that hinder or promote exercise among frail nursing home residents are unclear. Few studies have investigated the exercise-related experiences and coping strategies of the frail elderly, and it is necessary to understand the overall situation among the elderly further. Therefore, this study aims to obtain information about the impact of exercise-related barriers and facilitators on the daily life of frail older adults and how they cope with this condition. Methods/Design: Qualitative research design uses a phenomenological framework. Older adults participating in the study will be invited to describe their life experiences with exercise-related barriers and facilitators, the impact on their daily lives, and the strategies they use to cope with the condition. This study will use purposeful sampling to ensure that the sample provides informative cases representative of frail older adults with exercise-related barriers and facilitators. Face-to-face, personal and semi-structured interviews will be conducted in nursing homes in Sichuan, China. A trained qualitative person will conduct interviews. Transcripts will be analyzed using NVivo10 qualitative software, and themes will be synthesized to highlight the critical issues raised by the frail elderly about the exercise process. Discussion Understanding the awareness of frail older adults on exercise management care will help improve the existing health services in this area. This research data will be used in future research to develop a validated survey, which can be used by medical staff working in nursing homes to understand and strengthen the health service provision of the frail elderly.

BACKGROUND The rapid development of health information technology has an increasingly significant impact on nursing work. The development of informatization also puts forward higher requirements for nurses under standardized training (NUST). Informatics knowledge and skills are essential if clinicians are to master the large volume of information generated in healthcare today. Nurses with competent nursing informatics competencies (NIC) will be able to better adapt to the needs of work and the development of the times. OBJECTIVE This study aimed to explore, analyze, and discuss the current situation of NIC of NUST in China, and analyze the influencing factors, to provide references for improving the NIC of NUST. METHODS We conducted a cross-sectional survey of standard training nurses' NIC in a tertiary hospital in Sichuan Province, China, with convenience sampling. The study consists of two parts included socio-demographic characteristics and NIC, a self-designed general information questionnaire, and a Self-Assessment Nursing Informatics Competency Scale-SF28 were used as survey tools. An online survey collected the data, and the scores of nurses' NIC were analyzed, and the factors were determined by linear regression statistical analysis. RESULTS Overall 191 target population responded to the questionnaire, including 22 males (11.52%) and 169 females (88.48%), the age range was 21 to 28 years, the average age was 24.64 (SD 1.43). 53 persons without computer level certificate (27.75%), 138 persons with computer level certificate (72.25%), the total score of Self-Assessment Nursing Informatics Competency Scale was 68.65 (SD 10.47), the scores of each dimension were role of clinical information 10.12 (SD 2.17), basic computer knowledge and skills 26.64 (SD 4.96), application ability of computer skills 7.16 (SD 1.82), wireless equipment skills 8.02 (SD 2.04), nursing information attitude 16.73 (SD 3.25). In the analysis of influencing factors of NIC, “whether learned professional knowledge through the internet” is the influencing factor of NIC (P< .05). CONCLUSIONS The clinical nursing informatics (NC) of nurses was at a medium level, mainly influenced by “whether learned professional knowledge through the internet.” In the future regulation process, it is necessary to strengthen further the capacity training of information to improve their clinical information decision-making ability and better serve patients.

IntroductionAs the population continuous to age and family sizes decrease, residing in nursing homes has emerged as a crucial option for older adults’ care. Ensuring a dignified life for older adults in nursing homes is critical for enhancing their overall quality of life. The primary objective of this study is to synthesise the evidence of qualitative research on the feelings and experiences of dignity among older adults living in nursing homes. This will enable a better understanding of the factors influencing the perception of dignity and its preservation, ultimately assisting older adults in achieving a more comfortable and fulfilling experience in nursing homes.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses will guide this meta-synthesis. We conducted an initial search on 1 June 2022, for studies published between the inception of each database and 2022, using the population exposure-outcome nomenclature. We searched the Embase, Web of Science, CINAHL, Cochrane Library and PubMed databases for relevant studies. For data synthesis, we will employ the Ritchie and Spencer framework, and the Supporting the Use of Research Evidence Framework will be used for data analysis. To minimise the risk of bias, we will critically appraise the selected studies using the Qualitative Assessment and Review Instrument.Ethics and disseminationThis review does not involve human participants and, therefore, does not necessitate ethical approval. We plan to disseminate the protocol and findings through relevant channels, including publication in pertinent journals, presentations at conferences and symposia, and engagement with local and international health stakeholders.PROSPERO registration numberCRD42022343983.ConclusionThis study aims to offer comprehensive evidence to guide nursing staff in providing dignity-focused interventions for older adult residents in nursing homes.